Welcome and "Housekeeping" (07:15)
Robin Gilbert asks about participant disciplines, shares her professional background, and covers lecture and scheduling details.
ABC Basics (07:02)
Gilbert discusses the importance of airway, breathing and circulation, and trusting your intuition. The heart, brain and lungs are interconnected. If a patient deteriorates, check for hypoxia, hypoglycemia, hypovolemia, and arrhythmias; fluid imbalance and medications can cause abnormal labs.
Overcrowded emergency departments result in under triaged acuities. Gilbert provides triage examples using outdated emergent, urgent and non-urgent classifications. Learn about the "across the room" assessment.
Emergency Severity Index (13:31)
Gilbert explains the current triage system. Vital function stability and potential life, limb, or organ threats determine acuity. ABCD decision points include immediate lifesaving interventions, high-risk situations, patients requiring resources, and vital signs.
Special Populations (10:08)
The CIAMPEDS mnemonic for pediatrics includes chief complaint, immunizations and isolation, allergies, medications, past medical history, events, diet and diapers, and symptoms. Gilbert discusses assessing neonates, infants, and children. Geriatric patients often have vague complaints and multiple medications. Psychiatric patients require safety measures.
Triage Scenarios (00:0-2805)
Gilbert provides examples of patients requiring immediate lifesaving interventions, in high-risk situations, and requiring multiple resources. Gilbert discusses her home triage policy for her children.
Neurological Emergencies Overview (07:50)
Gilbert reviews epidural, subdural, diffuse axonal and TBI head injuries, including Second-impact syndrome.
Brain Physiology (15:04)
Gilbert explains normal mean arterial pressure, cerebral perfusion pressure, and intracranial pressure. ICP assessments include consciousness level, pupils, and respiratory and cardiac monitoring. Hear the importance of the mean arterial pressure and widened pulse pressure in head injured patients.
ICP Head Injury Management (05:03)
Gilbert discusses patient positioning, the ICP monitoring device, controlling hyperventilation, temperature and blood pressure, analgesics, sedatives, neuromuscular blockades, removing brain fluid, and monitoring for DVTs.
Healthcare professionals should ask patients about onset, duration, intensity, recent injury, visual changes, seizure activity, recent infection, and hypertension history. Gilbert covers migraine types, symptoms and medications and tension headaches.
Secondary Headaches (14:13)
Learn about symptoms, diagnostic methods, and treatment for temporal arteritis, meningitis, and cerebral aneurysms. Gilbert distinguishes a cerebral aneurysm from an arteriovenous malformation and discusses surgical clipping and embolectomy options.
Learn about ischemic and hemorrhagic stroke causes, symptoms, risk factors, protocols, treatments, and common disabilities.
Neurological Emergency Scenarios (07:36)
Gilbert provides examples of patients suffering subarachnoid bleeds with vasospasm, temporal arteritis, and delirium.
Delirium and Autonomic Dysreflexia (17:18)
Learn about delirium screening, including the CAM tool, and hear potential underlying causes. Autonomic dysreflexia is common among spinal injured patients and causes hypertension; hear symptoms and complications. Gilbert provides an example of a subarachnoid hemorrhage patient.
Cardiac Emergencies Overview (07:42)
Gilbert will discuss acute coronary syndromes, including STEMIs, non-STEMIs, and unstable angina. She covers how to identify ischemia on an EKG and discusses its pathophysiology, risk factors and symptoms.
STEMIs, NSTEMIs and Unstable Angina (27:25)
Gilbert discusses lab work and EKG readings for STEMIs and NSTEMIS, and distinguishes chronic stable from unstable angina. These acute coronary syndromes present similarly; Gilbert covers treatment protocols, including oxygen, pain management, anti-coagulants, fibrinolytic therapy, and catheterization lab procedures.
Other Chest Pain Patients (04:43)
Gilbert discusses diagnosis and treatment protocols for cocaine-induced MIs and broken heart syndrome.
Axis Deviation (06:55)
Gilbert provides an overview of identifying axis deviation on an EKG, using leads 1 and 2. Hear left axis deviation and STEMI patient case studies.
Heart Failure (28:53)
Learn about heart failure causes, complications, treatment, and cardiac rehabilitation requirements. Gilbert distinguishes left ventricular systolic from left ventricular diastolic heart failure and discusses anti-coagulants, life vests, LVADs, and cardiac resynchronization therapy. Hear a heart failure patient scenario.
Respiratory Emergencies: Acute Respiratory Failure (08:39)
Hear a respiratory distress patient scenario. Gilbert discusses ventilation/perfusion (V/Q) mismatching. Learn about acute respiratory failure signs, diagnostic measures, management options and complications.
Pulmonary Embolism (10:34)
Gilbert describes stable, unstable, and submassive pulmonary embolism scenarios. Learn about risk factors, signs, diagnostic measures, and management options.
Chronic Obstructive Pulmonary Disease and Acute Asthma (17:58)
Gilbert differentiates emphysema from chronic bronchitis and discusses GOLD stages. Learn about signs, management options, spirometry measuring the FEV1/FVC ratio, and complications. Hear a brief discussion of asthma signs and treatment options.
Acute Lung Injury vs. Acute Respiratory Distress Syndrome (14:41)
Gilbert talks about ALI and ARDS classifications, including the Berlin Definition for ARDS and PaO2/FiO2 ratio. Learn about signs, risk factors, diagnostic measures, complications, and supportive management measures. Hear a DVT patient scenario. Gilbert leads participants in a personality exercise.
Renal System and Acute Renal Failure (07:24)
Gilbert briefly discusses kidney disease indications and lab values, including GFR stages, mean arterial pressure, hourly urine output, and fluid volume status. Urine output is linked to cardiac output. Learn about complications and management options.
Endocrine Emergencies: Diabetes Mellitus (23:12)
Gilbert describes the role of insulin in glucose regulation and explains types I and II diabetes. Learn about diabetic ketoacidosis and HHS risk factors, diagnostic measures, clinical signs, lab values, complications, and insulin agents. Hear a sample DKA protocol.
Hyperglycemia and Hypoglycemia (07:18)
Gilbert provides scenarios for diabetic ketoacidosis and hypoglycemic diabetic patients.
Diabetes Insipidus and SIADH (07:05)
Learn about risk factors, treatment, and complications for anti-diuretic hormone deficiency and for the syndrome of inappropriate antidiuretic hormone secretion. Hear a diabetes insipidus patient scenario.
Fluid and Electrolyte Emergencies: Sepsis (13:59)
Gilbert discusses new criteria for SIRS, sepsis, severe sepsis, septic shock, and multi-system organ dysfunction. Symptoms indicating sepsis risk include mental status changes, respiratory rate, and hypotension. Learn about the QSOFA score and DIC complications; hear a sepsis patient scenario.
Gilbert explains the shock process. Learn about hemorrhagic shock risk factors and management, including restoring intravascular volume, controlled hypotension and massive transfusion protocols. Non-hemorrhagic shock types include obstructive, cardiogenic, and distributive; hear treatment options.
GI Bleeds and Abdominal Aneurysms (06:08)
Learn about risk factors, signs, diagnostic measures and treatment options for gastrointestinal bleeding. Gilbert discusses abdominal aneurysm signs, management options, and rupture outcomes.
Compartment Syndrome (11:34)
GIlbert explains how edema can cause tissue ischemia. Hear signs, complications, and management options for extremity and abdominal compartment syndromes. Hear a case scenario for a trauma patient at risk for liver, spleen, and femoral bleeding.
Arterial Blood Gases (05:38)
Gilbert explains how to interpret pH and PCO2 values for respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.
Patient Case Studies (18:22)
Hear scenarios for non-STEMI, sepsis, Wolff-Parkinson-White Syndrome, HHS, acute renal failure, abdominal aneurysm, acute pancreatitis, diabetic ketoacidosis, renal disease, hyperkalemic, and hypotensive patients.
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