August 2021

Deep Dive: Airway, Breathing, and Defibrillation

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No me gusta!

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Ian L., Dr -

Does hair on the chest matter?

Ian L., Dr -

There was a theory that pads don’t stick well enough and the shock is not as well delivered so the hair over the defibrillator pads ought be quickly cropped or shaven .
Certainly done with an ECG and those ECG monitors .

tom f. -

thank you Jessie and Mel!

excellent .
a few thoughts..
double sequential defib... was "all the rage" these last 2-3 years (?) , but you know there are some docs who have stopped doing it.
I think Scott Weingart is one, or was.
Corey Slovic I think said in one pod you can try it, but just dont tell Zoll thats how you burnt out their 10-20,000 defibrillator when you send it back to the shop.

I would still try it I think, depending on the situation.
as well as lopressor (easier to get quickly for us than esmolol). I'd use (for refractory Vfib) less epi, more beta blocker; also I often ask the timer to give me a 20 second heads up before the next pulse check: I ask the defib nurse to charge the biphasic to 200, and this way at the pulse check we can shock instantly if called for. also have US ready in case its a PEA.

lastly, I think it's Avilla that has a cool blog on US guided stellate ganglion blockade for refractory Vfib.

thank you both so very much!!

tom fiero, merced, ca.

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