Alix Barnes
@AlixB8
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Former @OhioStateIMRes & NW PallCare | Current @PittCardiology Fellow 🫀 | Future @PittCCM Fellow | ♥️ Cards CCM, PalliCards, and Med Ed
Joined September 2024
Learning dual sequential defibrillation from one of my fav CCC mentors @RickyHansra !.⚡️ Make sure the pads are not touching.⚡️Have one person touch both buttons to have best chance for synchronized timing— < 75ms with dual shock resulted in the high rates of ROSC. #CCCES25
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RT @KatieVanchiere: @CardioNerds Crew having fun and learning tons at #CCCES25!! 🤩❤️🔥⚡️. @UMN_CCCEdSummit
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Getting some experience with automated CPR devices. Thanks @zoll_cms and Stryker!!. #CCCES25 @UMN_CCCEdSummit @CardioNerds
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Next up: Impella Management.🚨Suction Alarms? .Think LV preload versus improper positioning.✔️ Check position with echo.✔️ If position okay, can decrease P level or give volume. Also consider RV fxn as etiology of reduced LV preload!. #CCCES25 @UMN_CCCEdSummit @CardioNerds
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Cardiac Arrest Pearl for Refractory VF.⚡️ For patients with a core body temp < 32C, defibrillations and antiarrhythmics are less successful.⚡️Support end organ perfusion with ECMO, rewarm and repeat defibrillation and antiarrhythmic admin as the patients core temp increases.
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RT @KatieVanchiere: For our final session of #CCCES25 day 1… (drum roll please 🥁🥁). ECMO Master @jason_bartos teaches on one of the critica….
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One approach: .1. Establish the baseline Vt or Pplat. Also note the BP and SpO2.2. Increase the PEEP by 2-4.3. Wait 2 mins.4. Reassess Vt/Pplat, BP and SpO2.- If Vt improved or Pplat rose < PEEP = Recruitment!.- If Vt unchanged = No recruitment .- If Vt lower = Overdistension.
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Goal of PEEP titration is unclear— optimal compliance is most often used, but optimal oxygenation, lowest transpulmonary pressure, and optimized regional V:Q matching.
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What about lung recruitment?.The ability to recruit lung tissue is highly variable! It is important to assess your patient to determine who is responding to higher PEEP and who is not. #CCCES25 @UMN_CCCEdSummit @CardioNerds @KatieVanchiere.
nejm.org
In the acute respiratory distress syndrome (ARDS), positive end-expiratory pressure (PEEP) may decrease ventilator-induced lung injury by keeping lung regions open that otherwise would be collapsed...
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Lunch + Vent Basics with Dr Dezfulian to kick off our afternoon!. #CCCES25 @CardioNerds @UMN_CCCEdSummit @KatieVanchiere
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RT @KatieVanchiere: Considerations.🫁 Need airway first!.⚠️ Esophageal injury has not been reported in this context .👍🏼 Proficiency? Only ~3….
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How can we better document a neuro exam? The FOUR Score = Full Outline of UnResponsiveness.Looks at Arousal, Motor Response, and Brainstem Reflex with a score of 0-4 for each . #CCCES25 @UMN_CCCEdSummit @CardioNerds.
pmc.ncbi.nlm.nih.gov
OBJECTIVE: To evaluate the validity of the FOUR (Full Outline of UnResponsiveness) score (ranging from 0 to 16), a new coma scale consisting of 4 components (eye response, motor response, brainstem...
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Excited to dive into the post arrest brain with some of my UPMC PCAS favorites Pat & Cecelia!. #CCCES25 @UMN_CCCEdSummit @CardioNerds
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TEE in Cardiac Arrest?.⭐️ Assist with diagnosis.⭐️ Can be used to look for cardiac activity and identify “pseudoPEA”.⭐️ Locate to find the area of maximal compression (AMC).⭐️ Distinguish fine VF from PEA. #CCCES25 @CardioNerds @UMN_CCCEdSummit @KatieVanchiere.
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Excited to kick off the @UMN_CCCEdSummit with some hands on skills! Knot tying here we go!. @CardioNerds @KatieVanchiere
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