THANK YOU SO MUCH FOR THIS AMAZING CONTENT!!!! I AM A "COMEBACK" THERAPIST THAT HAS BEEN OUT OF THE FIELD FOR 5 YEARS. YOUR CHANNEL HAS ACTIVATED MY RESPIRATORY MUSCLES!!!!!!!! THANK YOU SO MUCH
Totally enjoyed this vid in the car on my way to my side hustle on the first day of winter break.. in January I start my last semester and graduate in May. I am going to keep you in the rotation and will probably shoot you some questions. So grateful for people like you who want to build strong therapists. I aspire to be like you one day and pay it forward. Thanks again.
some brief points in sepsis ↓SVR→ large tank→ ↓ venous return → ↓cop so, treat with fluid and vasopressor (↓ tank size) - we vetilate septic patient to protect lung and improve oxygenation not to compensate for metabolic acidosis ( sometimes we need Permissive hypercapnia during mechanical ventilation) . you need to improve the tissue perfusion and treat the cause to treat metabolic acidosis. -recently the thiamine deficiency lead to lactate production so, the lactate not only produced by hypoperfusion ( look for marik protocol in sepsis)
Thanks for contributing. I really like the way you referenced the vasodilation and SVR to a large tank, etc. Never heard it put like that before, and it makes perfect sense. And absolutely, sometimes permissive hypercapnia is preferred, but that is typically in the 40% of sepsis patients that also develop ARDS. Thanks for watching and commenting! I really appreciate the input.
Would you be able to do a video on preventing hospital acquired pneumonia or ventilator acquired pneumonia? I have all trike patients that seem to get pneumonia a lot!
Hi, really enjoyed your video your explanation is clear and precise. I have an osce coming up in my last year of nursing was wondering if you have a video on respiratory effects of anaphylaxis shock? Thanks Julie
Hi, Julie. I do not currently have a lesson over that topic, but will see what I can do to get one produced. Thanks for watching and best wishes in your final semester.
thank you for your videos really helpfull but there is important mistakes here... Cardiac output in septic shock is increased not decreased (VD decreases SVR > decrease after load so increase COP .. and increase venous return so increase cardiac output ) second thing is type of hypoxia here is cytotoxic hypoxia due to mitochondria enzymes malfunction so utilization of oxygen is impaired not from decrease oxygen tension in blood .. thats why Po2 of venous blood is increased in septic shock
Depends on stage. Marked VD will increase capacitance and reduce preload, but this will be at war with the sympathetic -mediated increases in heart rate and contractility. In the end the heart can only out-put what is in-put, so the heart is working harder for diminishing returns, which is a recipe for pump failure.
Usually when a patient is in metabolic acidosis, the body compensates by removing CO2. These patients are usually tachypneic. So, when your CO2 is 27 and the patient is breathing 45 times per minutes on the vent, what do we do?
Is this a real life or a hypothetical scenario? I ask because I can better answer this question with more information, such as mode and tidal volume when the patient was breathing 45 bpm. Thanks for watching and asking this question. Looking forward to answering it for you and the FRT community.
@@RespiratoryCoach I saw this too, vent settings: AC/VC RR 20 total Rate 24 Vt 500 Peep 5 FIO 35% ABG 7.31 37.5 CO2, 133 PAO2, 19 Bicarb, BE -7 what would you do?
Great subject matter, especially when a lot of RTs don’t see the significance of sepsis in what we do. Bravo. Subscribed!
What an awesome lecture and great explanation. You have helped me so much. Thank you for your help as always
Your very welcome, Suzy. Thank you for watching and always asking questions.
THANK YOU SO MUCH FOR THIS AMAZING CONTENT!!!! I AM A "COMEBACK" THERAPIST THAT HAS BEEN OUT OF THE FIELD FOR 5 YEARS. YOUR CHANNEL HAS ACTIVATED MY RESPIRATORY MUSCLES!!!!!!!! THANK YOU SO MUCH
Totally enjoyed this vid in the car on my way to my side hustle on the first day of winter break.. in January I start my last semester and graduate in May. I am going to keep you in the rotation and will probably shoot you some questions. So grateful for people like you who want to build strong therapists. I aspire to be like you one day and pay it forward. Thanks again.
Hey, Randa. Thanks for the kind comment. And love the side hustle work. Keep it up! You're destined for whatever you're working towards. Go be great!
love these, thanks for the clear explainations
some brief points in sepsis
↓SVR→ large tank→ ↓ venous return → ↓cop so, treat with fluid and vasopressor (↓ tank size)
- we vetilate septic patient to protect lung and improve oxygenation not to compensate for metabolic acidosis ( sometimes we need Permissive hypercapnia during mechanical ventilation) . you need to improve the tissue perfusion and treat the cause to treat metabolic acidosis.
-recently the thiamine deficiency lead to lactate production so, the lactate not only produced by hypoperfusion ( look for marik protocol in sepsis)
Thanks for contributing. I really like the way you referenced the vasodilation and SVR to a large tank, etc. Never heard it put like that before, and it makes perfect sense. And absolutely, sometimes permissive hypercapnia is preferred, but that is typically in the 40% of sepsis patients that also develop ARDS. Thanks for watching and commenting! I really appreciate the input.
Also a video on good and thorough documentation would be very beneficial please!
Good stuff!
Very informative
Hi May! Thanks for watching and commenting!
This is awesome! thank you
You're very welcome!
Starting with this video for refresher during summer break. I only have nearly 100 more to watch!🥴
NICE! I hope they help keep you sharp during your summer break.
Would you be able to do a video on preventing hospital acquired pneumonia or ventilator acquired pneumonia? I have all trike patients that seem to get pneumonia a lot!
Thank you
You r great man god bless you keep it up man love ur vedios
Great. Thx
You're welcome. Thanks for watching and leaving the kind comment.
Hi, really enjoyed your video your explanation is clear and precise. I have an osce coming up in my last year of nursing was wondering if you have a video on respiratory effects of anaphylaxis shock? Thanks Julie
Hi, Julie. I do not currently have a lesson over that topic, but will see what I can do to get one produced. Thanks for watching and best wishes in your final semester.
Please Don't ever stop making RT videos
HEARD! Thanks for the kind support, Tonya!
Hi coach😊 can u pls make a video about lung recruitment manuevers and PEEP titration😊 Thanks
Hi Barry! Absolutely, got you on the list!
thank you for your videos really helpfull but there is important mistakes here...
Cardiac output in septic shock is increased not decreased (VD decreases SVR > decrease after load so increase COP .. and increase venous return so increase cardiac output )
second thing is type of hypoxia here is cytotoxic hypoxia due to mitochondria enzymes malfunction so utilization of oxygen is impaired not from decrease oxygen tension in blood .. thats why Po2 of venous blood is increased in septic shock
Thank you for those clarifications and for watching!
Depends on stage. Marked VD will increase capacitance and reduce preload, but this will be at war with the sympathetic -mediated increases in heart rate and contractility. In the end the heart can only out-put what is in-put, so the heart is working harder for diminishing returns, which is a recipe for pump failure.
What about septic shock? Since cardiac out put goes up but vasodilation increases? What’s the process to treat that
Usually when a patient is in metabolic acidosis, the body compensates by removing CO2. These patients are usually tachypneic. So, when your CO2 is 27 and the patient is breathing 45 times per minutes on the vent, what do we do?
Is this a real life or a hypothetical scenario? I ask because I can better answer this question with more information, such as mode and tidal volume when the patient was breathing 45 bpm. Thanks for watching and asking this question. Looking forward to answering it for you and the FRT community.
@@RespiratoryCoach I saw this too, vent settings:
AC/VC RR 20 total Rate 24 Vt 500 Peep 5 FIO 35%
ABG
7.31 37.5 CO2, 133 PAO2, 19 Bicarb, BE -7
what would you do?
Got you on the list, Marcial. Thanks for commenting with this question and for watching!
Here you go, Herb. czcams.com/video/17ODoubEGJs/video.html
Here you go, Marcial. czcams.com/video/17ODoubEGJs/video.html I apologize if I mispronounced your name.