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LIN Sessions - THAM

Curtis Geier , PharmD and Michelle Lin, MD
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14:50
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Nurses Edition Commentary

Mizuho Spangler, DO
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00:59

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EMRAP 2016 January Summary 874 KB - PDF

In the critically ill, severely acidotic patient, consider THAM.

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Alex K. -

In this section you note that you have to make sure the patient is ventilated in order to use bicarb, and you correctly mention separately you have to hyperventilate a patient. But, in the context of an arrest, it's important to remember that restrained respirations (8-10min) are indicated to minimize reductions in venous return/preload. These will not work well with attempts at using sodium bicarbonate (for this purpose). Though obviously the data are scarce, I think that if we follow the logic and physiology of THAM, it makes more sense for the intra-arrest patient.

Ben S., Dr -

Is anyone using THAM pre-RSI for the metabolic acidosis patient? Seems like on a simple level it could provide us an extra margin of safety

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Cracking The Chest Full episode audio for MD edition 254:13 min - 354 MB - M4AEMRAP 2016 January Aussie Edition Australian 27:57 min - 38 MB - MP3EMRAP 2016 January Canadian Edition Canadian 15:02 min - 21 MB - MP3EMRAP 2016 Janiver Résumé en Francais Français 63:14 min - 87 MB - MP3EMRAP 2016 Enero Resumen Español Español 83:06 min - 114 MB - MP3EMRAP 2016 January Board Review Answers 120 KB - PDFEMRAP 2016 January Board Review Questions 422 KB - PDFEMRAP 2016 January MP3 314 MB - ZIPEMRAP 2016 January Summary 874 KB - PDF

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