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Still thinking about today’s amazing @UWEmerMed VIP Grand Rounds featuring #EMCCM legend, Dr. Susan Wilcox! It is no surprise she has had teaching awards named after her after listening to her talk on how to recognize and effectively treat pulmonary HTN and RV failure in the ED.
Key points:
1) Look beyond the EF on the echo report!
RVSP/PASP, RV enlargement, & TR are signs of pulm HTN
2) Pts w/ pulm HTN require thoughtful consideration of their vol status w/ close hemodynamic monitoring - conscious sedations in ED are high-risk
better served in the OR
1) Look beyond the EF on the echo report!
RVSP/PASP, RV enlargement, & TR are signs of pulm HTN 2) Pts w/ pulm HTN require thoughtful consideration of their vol status w/ close hemodynamic monitoring - conscious sedations in ED are high-risk
better served in the OR
3) Treat hypoxia w/ HFNC! Avoid intubation if at all possible
4) Norepi = pressor of choice. Vasopressin = close 2nd. Avoid phenylephrine
5) POCUS for unexplained shock or dyspnea can dramatically alter management - always note RV size
6) Chronic RV failure is
preload-dependent
4) Norepi = pressor of choice. Vasopressin = close 2nd. Avoid phenylephrine
5) POCUS for unexplained shock or dyspnea can dramatically alter management - always note RV size
6) Chronic RV failure is
preload-dependent
