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Welcome to this week's "Last Week Now"...and this is a disclaimer...if you don't like Dr. Anand Swaminathan stop reading here, because there is a lot of Swami in this newsletter. For everyone else, we are talking about the return of #CritBits, PEEP, plateau pressures, a better way to resuscitate your patients, using the bougie, and our April's Grand Rounds announcement.   

 

So are you ready for some good 'ol fashion med ed review? Let's check out Last Week, NOW!

CritBits was a series that I introduced a few years ago and people enjoyed the squeaky pen on paper approach to education. For now good reason, I stopped making these videos. I recently uploaded an old #CritBits, and wouldn't you know it, the darn thing went viral. If you don't know these are super-short videos where I break down complex topics into small, bite sized concepts that are easy to understand.

Thanks to your support and kind words, I'm going back and adding captions and making the audio better and re-releasing this series. You've also inspired me to make some new #CritBits which I'll be releasing very soon. 

Check the first video that started it all on auto-PEEP; check it out here.

 

Do You Know How To Place a Subclavian Central Line Using Ultrasound? 

Subclavian central lines are great compared to other sites of insertion; less infection, less clots, and easier to manage and maintain. The problem is that traditionally they require a landmark technique for placement increasing the risk for patient centered complications such as pneumothorax and vascular injury. Ultrasound can be used for subclavian line placement, the problem is that many people don't know how to do this. 

This educational video talks about how to perform this procedure using ultrasound and why it is a superior technique. I strongly advise that you practice this technique in a simulation lab and with supervision. I know many ICUs that prefer this site as their preferred site of insertion. Watch the video here and drop a comment in the comments section....and please like and subscribe to the channel.

Do you perform a cognitive pause when you are resuscitating your patients? Don't worry if you're not sure what a cognitive pause is. This is a concept that Anand Swaminathan spoke about at ResusX:ReVolved. A cognitive pause is the part of the resuscitation where you stop and ask the question "could there be something else wrong with my patient?" other than the primary diagnosis that you were considering. This is a fascinating lecture and highlights the importance of not getting anchored into a diagnosis while resuscitate your critically ill patients. 

This episode is available in both audio and video format so head over and check out this episode now!

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We are very excited to announce that our April Grand Rounds speaker is none other than Dr. Anand Swaminathan. Swami is a speaker who needs very little introduction and he will be presenting on aortic dissection. Grand Rounds are FREE for everyone to attend, but you have to be signed up here to join. Please register now so you reserve your spot for this amazing event!

In this podcast episode, Salim Rezaie discusses the bougie trial and whether it increases first pass success for endotracheal intubation in critically ill patients compared to an endotracheal tube with stylet. The study compared bougie versus stylet and found no statistical difference between the two groups. The primary outcome was successful first attempt intubation, and the secondary outcome was severe hypoxemia. Salim discusses the strengths and limitations of the study and emphasizes the importance of practice when using the bougie.

This episode is a must-listen for anyone who acutely manages patients in shock. The ResusNation Podcast is FREE for All-Access Members.

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