The Patient Protection and Affordable Care Act, also known as the Affordable Care Act or ObamaCare, is the biggest change in health care policy since Medicare in 1965. Despite its importance, very few understand it. This is not surprising given its complexity. Popular news outlets and politicians (on both sides) capitalize on our ignorance by exaggerating, distorting or misrepresenting pieces of it. As health care providers and citizens, love it or hate it, we have a duty to understand it.
Hats off to Dr. Supurna Dutta. Her grand rounds on the PPACA served as inspiration for portions of these videos.
In the first video we’ll look at the anatomy of the neck. It is important to know what structures are contained within so you know what may be damaged.
Once you know what is potentially damaged, how do you work it up?
Introduction to DKA and HHS
Treatment of DKA and HHS
AG = Na – Cl – HCO3
Corrected Na = Na + 1.6 (Gluc-100 / 100)
Corrected K = K – 0.6 (7.4-pH)*10
Serum Osmolarity = 2 (Na + K) + Gluc/18 + BUN/2.8
Total Body Water Deficit = 0.6 (Wt Kg) (1 – 140/Na)
Monitoring and Access (or IV O2 Monitor)
This is a 12 minute review of the treatment of status epilepticus in the Emergency Department.
One note: there you don’t give Valium IM during status. I don’t know why I wrote that, but it’s wrong. Ignore it.
Here’s a link to the PDF I made during the video.
Here are the 2010 ACLS Guidelines for Cardiac Arrest. This catch-all category encompasses anything without a pulse, but what had previously been separated out into the separate rhythms of ventricular fibrillation, pulseless ventricular tachycardia, asystole and pulseless electrical activity. I love the fact that they simplified this into one algorithm – and they stress:
- early, deep and uninterrupted chest compressions, and
- early defibrillation (when indicated – VF/VT)
The first video covers the algorithm and drugs
The second video goes into more details about these drugs
The third video looks at PEA and asystole
iResus app (Free) based on the UK resuscitation council guidelines
Written summary of videos (by AJ Kadhim-Saleh)
Here’s an introduction to ACLS 2010, an important skill you should pick up not only for your ER rotation, but for all your rotations! Let me know if you have any questions. I’ll be putting up more vids as I make ’em.
Again, leave me feedback in the comments.
The first part of ACLS is A and B… yes, the order has changed to CAB for adults suffering from likely cardiac causes, but I’m old fashioned, so let’s cover A & B first…
So let’s talk about capnography and intubations, etc. The use of capnography is a big change in the new 2010 guidelines. Looks like we got some new equipment to buy.