EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.
70: REBOA REDUX – Management of Hemorrhagic Shock in Non-Trauma Patients – with Bellezzo & Zaf Qasim
January 1, 2021: The year following COVID19 Global Pandemic brings us a new horizon - lets appreciate what has happened, learn from our mistakes and begin to look forward.
In this episode Joe Bellezzo talks with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) expert Dr. Zaf Qasim about NON-TRAUMA applications of aortic compression for control of non-compressible non-trauma torso hemorrhage.
Dr. Qasim is a world expert in REBOA and has been on the podcast:
edecmo.org/35 - REBOA revisited
edecmo.org/49 - the ACEP-ACS joint statement controversy
edecmo.org/59 - Partial REBOA
REBOA in Hemorrhagic Shock from NON-Trauma Mechanisms:
This episode is highlighted by a remarkable case, managed by Emergency Physician Dr. Garrett Sterling, of a 77 year old patient who suffered non-traumatic hemorrhagic shock from an Iliac artery pseudo-aneurysm that had fistulized to the urinary tract. The patient was bleeding to death from a fistula between the common iliac artery and the ureter. You have to listen to Dr. Sterling describe this case. The patient was resuscitated with REBOA and her pathology was fixed by an Iliac Artery stent placed in Interventional Radiology. We discuss this case which highlights the benefit of REBOA as a bridge to definitive hemorrhage control.
Amazing patient who had an Iliac pseudo-aneurysm causing hemorrhagic shock through the urinary tract, resuscitated using REBOA.
Joe and Zaf talk about:
* brief history of managing hemorrhagic shock with aortic occlusion
* 'Knee REBOA'
* Resuscitative thoracotomy
* REBOA in trauma
* REBOA in non-trauma hemorrhagic shock
69: 2020 Synopsis
2020 was a crazy year. This month Zack goes through the biggest ECMO lessons learned in 2020. This is a short concise run through of ECPR, ECMO for COVID, Imaging, and Aortic Dissection. It's a reminder of how organization is so critical to the outcome of your ECMO program. He also reminds us how improvement in these systems of care can lead to survival rates even the believers in ECMO thought were unattainable.
68: ARREST – The First Randomized ECPR Trial Ever
The ARREST Trial is published! Demetris Yannopoulos, Jason Bartos and their army of rockstars have done it! This is the first randomized ECPR trial and it showed tremendous benefit of ECPR compared to traditional therapies. Zack explores this paper and their concurrent publication of process with Demetris. Their two Lancet papers are below
In the news, Jenelle Badulak and her crew at UW saved a hypothermic mountaineer in Seattle. Story here.
Demetris Yannopoulos and Jason Bartos
67: Da DO2: Fundamental ECMO Physiology with Sage Whitmore
Have you ever wondered about how initiating ECMO changes the cardiovascular physiology? Have you wondered what metrics you should be looking at when resuscitating a patient that has a beating heart and a ECMO flow? Dr. Sage Whitmore, an ED Intensivist from Nashville with ECMO training from UMichigan, leads us through the basic to the tough questions of ECMO physiology.online pharmacy
66: Crash VV ECMO
Have you ever wondered how you would crash someone onto VV ECMO? Have you ever wondered where is the best place to put the cannulas? Have stayed up late at night wondering which patients in your department could benefit from VV rather than VA ECMO? Then this is the episode for you!! After a few recent cases of crash VV ECMO in our hospital, we have decided to focus on the subject. Zack gets critical care physician and ECMO director Dr. David Willms to answer from a very practical standpoint the who, what, where of crash VVECMO.
Great images from Penn - Femoral Jugular approach
Femoral Femoral Approach
Aortic Dissection recent paper and Editorial
65: ECPR Journal Club: Dual Sequential Defibrillation, CT after ECMO, and much, much more
This month we tackle a number of topics. Garrett Sterling is back again with Zack to talk about cutting edge resuscitation, ECMO, and the interplay between the two. Dual sequential defibrillation, CT after ECMO initiation, should you perform bystander CPR in the era of Covid, some US ECMO data, and an awesome 3D modeling for ECPR training models. All in one 30 minute podcast!
Reverse CPR - better systolic BPs
Brown J., Rogers J., Soar J. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review. Resuscitation. 2001;50:233–238. [PubMed] [Google Scholar]
Mazer S.P., Weisfeldt M., Bai D. Reverse CPR: a pilot study of CPR in the prone position. Resuscitation. 2003;57:279–285. [PubMed] [Google Scholar] DOI: a title="Protected by Outlook: https://doi.org/10.1016/s0300-9572(03)00037-6. Click or tap to follow the link." href="https://eur04.safelinks.
Customer ReviewsSee All
Very informative perspective
I’m glad I came across the podcast, out of sheer curiosity, on the topic of ECMO.
As a perfusionist for nearly eight years, I really appreciate the podcast hosts perspective on this crucial care modality. I try to be a lifetime learner and I am open to learning something new.
Keep these podcasts going; which with the ever evolving discipline of medicine, there will always be something new to discuss.
Also, is there a way to get the first half of the earlier podcasts? Seems like Itunes is only post episode 28 and up; I don’t mind if the earlier ones may be outdated information. Some thought processes and strategies may be timeless.
These guys truly know their stuff!
What a great podcast full of detailed and thoughtful information.
Presented so that even students could understand and follow