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A not-so-comprehensive guide to assessing the right ventricle

Quick word: Demonstrating a normal sized RV does not rule out PE. With that said, if you have a hypotensive patient in whom you are concerned about massive PE, demonstrating the patient has a normal sized RV can lead you to consider alternate dangerous diagnoses. RV size The ratio of RV:LV chamber size should beRead more

BIPAP in SCAPE: (a few of) the hemodynamic effects of positive pressure ventilation

This pearl will be a brief rundown of the hemodynamic effects of BIPAP on the patient with sympathetic crashing pulmonary edema. This is an apical four chamber view with a dilated right ventricle – stretched vertically to the point of being almost unrecognizable – superimposed on the screen of a ventilator. Yes. BIPAP works forRead more

A Strange Pearl

As the title implies, this is a strange pearl. Imagine the following: You are in a can’t intubate/can’t ventilate scenario. The patient’s neck is large, and the landmarks are poor.  You cut through a depth of redundant tissue to get to the cricothyroid membrane, make your incision, insert your finger, and place a bougie. TheRead more