Hemodynamics Puns

Happy Halloween! Interested in a very spooky subject - hemodynamics! I want to understand hemodynamics (like heart failure, shock, critical care) really well. What resources and textbooks do you recommend?

Are there any exact parameters?

Got a question wrong because I didn't think that the patient was exactly unstable.

Stab wound to the abdomen. Patient is alert and communicative, in severe pain (obviously), Temp 100F, HR 130, BP 110/70. Granted he's tachy with a mild fever (not 100.4) and his BP is low but not that low. Like what if his BP was 119/79, is that still hypotensive? The only thing that sticks out to me as Hemodynamically unstable is his HR. Patient is coherent, not confused or anything. I hope I don't kill anyone in the future over this.

We're getting a 3 hour training class to prepare us, but the cardiology head wants this by next month. 15 beds of our 30 bed unit will be ICU stepdown. Our ratios would be going down, we're currently 1:5, but they said they'll try to make it so we're all 1:3, with two being stepdown and one being a regular level acuity.

We already can't staff our unit, I've been picking up $500 incentive pay plus overtime to work weekends recently. Our day shift has great nurses, but all of our experienced night shift nurses left recently and it's all new grads and burnt out veterans.

I made the complaint yesterday that I came in and 3/4 of my patients had infiltrated IVs from night shift. So what's going to happen when we're causing extravasation through an infiltrated IV? I've never worked critical care, do these patients usually get a central line in ICU?

I trust myself and welcome some change, especially if it means our floor is likely to get psych holds and gen. med patients, but I don't trust many of my coworkers with higher acuity when they already can't properly care for the patient population we have. Especially since we're a teaching hospital and our cardiology team is full of new grad residents as well.

(NYSE:CYBN)

Cybin has announced that the FDA has authorized an Investigational New Drug application to proceed with the company’s sponsored feasibility study using Kernel’s Flow technology to measure ketamine’s psychedelic effect on cerebral cortex hemodynamics.

This study requires patients to wear headgear equipped with sensors to record brain activity. Leveraging Kernel’s quantitative neuroimaging technology may lead to new frontiers in psychedelic therapeutics by enabling the acquisition of longitudinal brain activity before, during and after a psychedelic experience.

"We hope this feasibility study can bridge the gap of real-time quantitative data collection during psychedelic treatments to further understand the correlation of effects from these powerful molecules. The ability to access real-time brain activity data during a psychedelic experience has tremendous potential for the development of future psychedelic therapeutics," stated Doug Drysdale, Chief Executive Officer of Cybin.

Source: https://ca.finance.yahoo.com/news/cybin-announces-fda-investigational-drug-113000951.html

This is not financial advice.

Hi,

I've watched various cardiac surgeries on YouTube (valve replacements, ventricular repairs) and I always wondered how surgeons prevented patients from bleeding to death.

It would seem to me (a layman) that any incision to the heart would cause massive blood loss in short order. I am aware that the heart lung machine is used to divert blood away from the heart.

Do all cardiac procedures use some form of bypass either off-pump or heart lung machine?

Is blood suctioned from the heart before cardiac procedures begin?

I tend to struggle quite a lot with any question that involves SVR, pressures, or anything hemodynamic related and then ask us which ones increase/decrease depending on the situation. The toughest part for me is that I understand the concepts of these relatively well but when they give us a unique scenario (i.e. describe PVR in a pulmonary embolism) I don't know how to reason through it. I was wondering if anyone here had success with these questions and if you have any tips on where I can study these more and how to approach the type of questions.