Resus Tonight - Critical Care and Emergency Nursing – Details, episodes & analysis

We welcome back Nicole Cook, APRN and CNS to talk all about sepsis... and Nicole shares a personal story about sepsis we won't soon forget.

Allan and Rob continue the conversation with Nicole Cook about neurotrauma. If you haven't listened to episode 26, part one of this conversation, then we suggest you go back to do so.  However, we wouldn't recommend listening to us anyway. 

Nicole's paper on Co2 - https://www.injuryjournal.com/article/S0020-1383(21)00624-0/fulltext

We are pleased to have the trailblazer Tammy Lowe and THE Korbin Haycock on the show to share their amazing Nurse Point of Care Ultrasound program, one of the only programs in the world (to our knowledge - please correct us if we're wrong... we'd love to learn more!).

Their Nurse Point of Care Ultrasound program was published in the Annals of Emergency Medicine in 2017. The link to the paper is HERE.

Tammy is a boss level Registered Nurse and the Clinical Administrator for Critical Care at a large hospital in California. Find Tammy on Twitter HERE @TammyLowe357

Korbin is an emergency physician and the definition of a resuscitationist. Find him on Twitter HERE @KHaycock2

Allan and Rob have the privilege of having a chat with Alin Gragossian about the days before her illness, heart transplant, and return to her work as an emergency medicine resident.

Follow Alin!
Website - https://www.achangeofhe.art/
Twitter: @ag_em33
Instagram: @a_change_of_heart_blog

Do ED ICUs save lives? Probably.

The paper in question is by Gunnerson et al and can be found here.

Scott Weingart's work on ED ICUs can be found here. 

Allan and Rob talk about learning in the clinical environment.

Main topics - 

• The relationship matters
• Intentionality in clinical conversations
• What's the yield on your clinical questions?

Some interesting papers - 

1. Eva, Kevin & Regehr, Glenn. (2008). “I'll never play professional football” and other fallacies of self-assessment. The Journal of continuing education in the health professions. 28. 14-9. 10.1002/chp.150. 
2. Eva, Kevin & Regehr Glenn. (2007). Knowing when to look it up: a new conception of self-assessment ability. Academic Medicine : Journal of the Association of American Medical Colleges. 2007 Oct;82(10 Suppl):S81-4. DOI: 10.1097/acm.0b013e31813e6755
3. Debriefing with Good Judgment: Combining Rigorous Feedback with Genuine Inquiry
   Rudolph, Jenny W. et al. Anesthesiology Clinics, Volume 25, Issue 2, 361 - 376

The show page is found here.

Nyssa from The Q Word Podcast is on the show to talk about the one thing we should be practicing the most: Resuscitation Langauge, coined Resuscitese.

References

• https://www.jpeds.com/article/S0022-3476(14)00878-6/fulltext
• https://emcrit.org/wp-content/uploads/2016/06/Improving-Verbal-Communication-in-Critical-Care.pdf
• https://emcrit.org/emcrit/learning-speak-resuscitese/
• https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201412-552PS   (particularly the sections titled “Ask the Other Clinicians Present for Input,” “Stop Resuscitation Efforts” and “Explain What Has Happened to the Family.” 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278143/

Allan and Rob's final ResusX Series Podcast where they talk about the Zero Point Survey and its place in the resus room with our friends EM Centered (emcentered.com) and Salim Rezaie (rebelem.com). 

Zero Point Survey further reading-

• Cliff Ried's Paper - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166036/
• EMCRIT's post with Cliff Ried - https://emcrit.org/emcrit/emcrit-wee-zero-point-survey-video-by-cliff-reid/
• St. Emlyn's blog post - https://www.stemlynsblog.org/jc-the-zero-point-survey-optimising-resuscitation-teams-in-the-ed-st-emlyns/

We had the opportunity to present The Nurse Led Code and facilitate a Code Choreography workshop to the attendees at ResusX. Needless to say, it was a humbling to learn alongside the curious, bad ass physicians that attended.

We even had the chance to talk to Scott Weingart about The Nurse Led Code which was pretty cool, given that his podcast was the first place we heard of it.


References

The fun piece of The Nurse Led Code is that it hasn’t had direct, published data. So, if you’re a nurse looking for a research project, I recommend you look at this setup!

Click here for our references.

Allan and Rob have the privilege of sitting down with Salim Rezaie of RebelEM to talk about cervical spine collars and backboard in the ED.  RebelEM has has already extensively covered the evidence on collars and backboards. You can find their blog posts and links below.

1. Spinal immobilization in trauma patients
2. Cervical spine evaluation and clearance in the intoxicated patient
3. Stiell et al. (2018) - A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses
4. Skeptics Guide to Emergency Medicine - Ep 232 - An overview and literature evaluation of cervical spine collars and an appraisal of the above paper
5. Dr. Ken Milne and Alison Armstrong filmed a news clip on the 2018 Stiell et al. paper for us at NENA 2019.