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Amal M. - January 9, 2016 4:13 PM
Just to be clear about ECMO, it is still just a temporizing measure just like everything else, and is not a definitive therapy in post-MI cardiogenic shock. I hope that the key points that people got from the discussion were (1) there is no definitive therapy or protocol for these patients in the ED, (2) anyone who tells you that there IS a simple ED recipe for treatment that is well-researched and validated is fooling you...including the people that write ACLS, textbooks, board reviews, or plaintiff "experts", and (3) your goal is to do whatever you can do to keep these patients alive until they get upstairs to the cath lab or OR.
richard m. - January 30, 2016 10:20 AM
Excellent discussion. Thank you for that. Would anyone in the EMRAP world consider THAM for a rapid fix of the acidosis that can be seen in cardiogenic shock? I realize this isn't an FDA approved use of THAM. But...if the acidosis in cardiogenic shock is a contributing factor of the dysrythmias that can case cardiac arrest, especially during the time of RSI, could THAM theoretically be used as another temporizing measure to lessen this risk?