Shock - CRASH! Medical Review Series

[@walichowdhury370]

These videos are gold! Thank you so much for doing this for medical students like me. I tried all sources of videos and your videos are by far the clearest and easiest to follow. Thank you.

[@iliaskorniakov6099]

Thank you for your very comprehensive and clear videos, they are true marvels for international medical graduates. Just one brief note - I think you meant G, not Fr when you were taking about IV lines (diameter of 16F equals to 5 mm).

[@abelhaileyesus4824]

First I really want to thank u for this videos. They have made my surgery attachment much less cumbersome. But with due respect, I think u may need to correct on a few things 1. The BP does indeed drop during inspiration and increases during expiration. And pulsus paradoxus is a misnomer. It is just an exaggerated drop in the BP during inspiration (nothing paradoxical about it). 2. The decreased qRs on ECG in cardiac tamponade is due to the column of blood in the pericardial cavity impeding the flow of current rather than due to the decreased pumping by the heart

[@mayTK]

Thank you for these videos. I think around 11:10 , u meant resistance and radius relation. Poiseuille's law. Resistance is inversely relate to fourth power of radius.

[@theasiandoc]

Thank you so much for your time in making these awesome vids!! Quick question though, in needle decompression, does the needle have a one-way valve? Is that how it allows the air inside the pleural space to escape without letting air in?

[@rustyfo1]

I think it's just because the intra-thoracic air pressure is higher than the atmospheric room-air pressure, in the case of Tension Pneumo. The needle doesn't fix the pneumothorax. Just the tension part.

[@redache467]

rustyfo1 exactly, the needle just relieves the positive pressure (in comparison to atmosphere) in the thorax. In tension pneumothorax you DONT want to fix the lung, you want to relieve the pressure on the heart and veins. Then later on u can fix the pneumothorax wt chest tube.

[@DrDinooshDeLivera]

Thank you !

[@bomhayhay]

very essential and clear explanation..thank you..

[@shahriarahmedsujoyAMC]

Really superb video

[@danielfamayoutubable]

Around 11:10 I think it's radius to the 4th power, rather than diameter, but that's just being picky.

[@pwbmd]

Mpigadebe - Yes it should be r^4

[@mayTK]

and that is resistance and radius relation. not rate of flow.

[@theasiandoc]

Another question. Why is the skin cold and clammy in septic shock, and red and sweaty (warm?) in anaphylaxis when both processes are secondary to vasodilation?

[@cosmicworld4362]

Septic shock has two stages - initially warm then cold

[@MarinaKufa]

Great EDU

[@shaemckenzie8792]

Systemic blood pressure drops on inspiration but not >10mmHg.

[@eelivia]

Hi again, Dr. Bolin. Another quick question. In the cardio section, you mentioned that the best first diagnostic test to do in the case of cardiac tamponade is echocardiogram. Is ultrasound faster for trauma patients in general, hence better?

[@pwbmd]

Livvy Liv - An echocardiogram is performed via ultrasound. So they are essentially the same thing.

[@eelivia]

Paul Bolin Welp. Now I feel silly. Thanks for your answer! :)

[@SG-Photography]

Thanks Paul...what if you got someone in hypovolemic shock and you can't get a a proper forearm venous access ? Please tell me what would be the next step ? Should we go Jaguar , arterial , intra osseus ? I d appreciate if you can address that...thanks

[@rustyfo1]

Go for the cubital fossae vein. If that fails you're gonna need an anaesthesiologist to place a central venous catheter (usually jugular or sub-clavian afaik). Intra-osseus I guess could be a last resort. Arterial line is for when you need frequently repeated ABGs in the ICU. Source: I'm a medical student.