Two New York Docs in the Resus Room with Reuben Strayer & Scott Weingart [Link is to the video on YouTube]*.
* The reason to watch the video on YouTube is because you can follow the video with the usually excellent auto-transcript.
In the video the two doctors discuss several topics:
- Sympathetic Crashing Acute Pulmonary Edema (SCAPE) – Pulmonary edema due to a sky high blood pressure.
- 2:30 – 8:15
- During this time, the doctors discuss the importance of non-invasive positive pressure ventilation with a ventilator that you, the physician, have immediately available in the department and you, the physician, can immediately set it up by yourself.
- If you don’t have a ventilator available, Dr. Weingart gives us a way to do a work-around using a peep valve and bag-valve-mask. Dr. Weingart states that if you don’t use Dr. Weingart’s his work-around the peep valve by itself won’t do anything to provide continuous positive airway pressure.
- Put the patient on nasal cannula and crank it up to 15.
- Then put the bag-valve-mask with Peep valve set at the pressure you want.
- And hold the mask on the patient with a good two hand mask seal.
- Next you are going to want to start high dose nitroglycerin, Dr. Streyer gives one milligram of nitroglycerin IV push over several seconds and Dr. Streyer says there is literature to support a two milligram IV nitro push. Or if you’re worried about a medication error in drawing up your IV nitro push you can go ahead and just hand a bag of IV nitroglycerin premix and just run it in real fast – details in the transcript.
- See and review EMCrit Podcast 1 – Sympathetic Crashing Acute Pulmonary Edema (SCAPE)
April 25, 2009 by Dr. Scott Weingart
- 2:30 – 8:15
- Use of Push Dose Pressors and IV Infusion Pressors
- 9:11 – 15:00
- Review the transcript for details.
- 9:11 – 15:00
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