Do You Know About The Cognitive Pause in Resuscitation?

https://www.youtube.com/watch?v=Xq3KnW-MO1o

A doctor discusses the importance of an organized approach to treating patients who don't respond to vasopressors.

00:00 Organized approach to treating patients not responding to vasopressors

03:11 In emergency medicine, instead of just reaching for a second vasopressor, we should have a cognitive pause and think about what else could be going on.

06:12 Hypothyroidism can cause refractory sepsis or hypotension

08:58 Consider anaphylaxis and adrenal insufficiency in refractory shock

11:31 Diagnosing and treating hypocalcemia and cult bleeding in hypotensive patients

14:25 Identifying causes of shock

17:11 Ultrasound can help diagnose various conditions

19:30 Take a cognitive pause to consider underlying causes of refractory hypotension.

Detailed Summary for Do You Know About The Cognitive Pause in Resuscitation? by Merlin

00:00 Organized approach to treating patients not responding to vasopressors

Reaching for a second vasopressor is a cognitive trap
Focus on understanding why the patient is not responding to intervention

03:11 In emergency medicine, instead of just reaching for a second vasopressor, we should have a cognitive pause and think about what else could be going on.

Patients with acidosis may not respond well to vasopressors, and identifying the underlying cause and reversing it is key.
Isotonic bicarb can be used as a resuscitation solution for patients with low bicarb levels, and dialysis or cvvhd can also be considered for acidosis.