Podcasts about massive transfusion protocol

Join us for an eye-opening discussion with  Dr. Megan Rosenstein, and Isabel Pierre-Louis BSN RNC-OB as they shed light on the national health crisis of maternal mortality rates in the United States and the health disparities that exist for black and brown women across our country. This has been a topic that we have wanted to highlight for a long time so we are grateful to our guests for coming on the show and giving us an understanding of what is happening, why the numbers are going up, the heart-breaking disparities for black and brown mothers, and the innovative and equitable solutions that are being implemented at ATLANTIC HEALTH OVERLOOK HOSPITAL and across the country.  Although this is a difficult topic to discuss, the good news is that the more awareness we can bring to the issues, the more we can all work towards a long term solve for this.  About our GuestsDr. Megan Rosenstein is the Associate Chief Medical Officer and Director of Obstetric Anesthesia at Atlantic Health System's Overlook Medical Center in Summit New Jersey.   Dr. Rosenstein came to Overlook from New York Presbyterian Weill Cornell Medical Center, where she completed her training in Anesthesiology with a focus on the care of high risk perinatal patients.  In her time at Overlook, Dr. Rosenstein has actively participated in Atlantic Health's system-wide Maternal Collaborative, Overlook's Perinatal Safety and Quality Committee and spearheaded projects such as the Massive Transfusion Protocol, Opioid Reduction Task Force, protocoled response to Amniotic Fluid Embolism, and Enhanced Recovery after Cesarean Birth.  Dr. Rosenstein is the New Jersey state representative for the Society for Obstetric Anesthesia and Perinatology, which recognized Overlook as one of the first designated centers of excellence in Obstetric Anesthesia care.  Dr. Rosenstein is a wife and mother to three sons and enjoys weekends on the sidelines and enjoying time with her family.  She is an avid supporter of equitable access to women's healthcare in New Jersey and beyond.  Isabel Pierre-Louis, BSN, RNC-OB, is a career-long advocate of equitable, accessible, high-quality healthcare for all. In her specialty of obstetrical nursing, Isabel is attuned to the needs of women and birthing people, including the unique experiences of those chronically exposed to healthcare inequities, like the BIPOC communities. ABOUT R. Seelaus & Co., Inc. Annie Seelaus is CEO of R. Seelaus & Co., Inc. The firm is a certified women's business enterprise ("WBE") and has grown into a full-service financial firm that is mission-driven in its commitment to creating more opportunities for women in financial services. R. Seelaus & Co., Inc., and its subsidiaries offer investment advisory, asset management, capital markets, brokerage, fixed income and equity trading, institutional sales, leveraged finance, and insurance services. The R. Seelaus & Co., LLC subsidiary is a broker-dealer registered with the SEC and a member of FINRA, and the subsidiary Seelaus Asset Management, LLC, is an SEC Registered Investment Advisor ("RIA"). With various fixed-income trading desks and more than seventy professionals, both entities serve individuals, families, public and private companies, non-profit organizations, and institutional investors. The firm has offices in New Jersey, Connecticut, Florida, Illinois, North Carolina, and Massachusetts. For more information about R. Seelaus & Co., and its subsidiaries visit www.rseelaus.com

Massive transfusion can be a highly stressful event in the ICU. The following episode covers the basics of carrying out massive transfusion protocol.    For further reading: https://emcrit.org/ibcc/mtp/  

On this weeks episode I sat down with Clinical Nurse Consultant Daniel Van Vorst to discuss the MTP (massive transfusion protocol). Daniel is an esteemed emergency nurse with over 12 years of experience in a large  tertiary hospital.  Within the podcast Dan spoke about the role of MTP, indications , challenges, and the benefits of having a blood coordinator role  during major resuscitations. Dan also unpacks an amazing case, and talks about the benefits of administering blood early and how the MTP can save lives. Dan also opens up and lets us know what motivates him and what keeps him fresh after working in a high stress environment .    SHOW NOTES    Presentation of the MTP- click link to follow  MTP policy - click this link to read a policy on the MTP Daniel QI project on the MTP- click this link to view  

MTP exists to allow large volume blood product resuscitation while avoiding the lethal triad of coagulopathy, acidosis and hypothermia. In this episode we talk about when and how to initiate MTP, its components (blood products, cryo, adjuncts) and monitoring (blood gases, coags, TEG and ROTEM)

In this episode we cover the crucial approach to what drives hemorrhagic shock: lots of bleeding. Come take a listen for the nuances around an organized approach to 1:1:1 and may we be as bold to say... 1:1:1:1 (fibrinogen, YAY). All things hypocalcemia, hypothermia, acidosis and what lines to use. 

Using Simulation-Based Education to Improve Team Communication During a Massive Transfusion Protocol by AORNJournal

I've known Tiffany for quite a long time now and she truly is like a sister to me.  I was so excited to have her on the show, but I've never once worked with her.  Despite this, she is such a wonderful person that if I ever was to be sick, injured, or my family needed care I would be so fortunate if she was the nurse.  She has been caring for people her entire life, even when not her responsibility.  I hope you feel as inspired as I am after listening to her.   As we discussed here is a wonderful Florence Nightingale quote:   The most important practical lesson that can be given to nurses is to teach them what to observe, how to observe, what symptoms indicate improvement, what the reverse, which are of importance, which are of none, which are the evidence of neglect, and of what kind of neglect.   Thank you Tiffany!       Registered Nurses* Registered nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members.   2017 Median Pay: $70,000 per year ($33/hour)   Educational Degree: Initially Associate's Degree or Bachelor's Degree   Number of US jobs in 2016: 2,955,200   10 Year Job Outlook: 15% growth, much faster then avg.   *Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, on the Internet at https://www.bls.gov/ooh/healthcare/registered-nurses.htm (visited November 16, 2018).   Terms Covered in Episode American Nurses Association   Palliative Medicine - An interdisciplinary approach to specialized medical and nursing care for people with life-limiting illnesses. It focuses on providing relief from the symptoms, pain, physical stress, and mental stress at any stage of illness.   Geriatrics Medicine - A specialty that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults.   Pediatrics Medicine - A branch of medicine that involves the medical care of infants, children, and adolescents.   NP (Nurse Practitioner) - A nurse practitioner is trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose illness and disease, prescribe medication and formulate treatment plans. They may work in a solo practice independently or they may work within part of a hospital system.  They graduate from a Master's or Doctorate level medical program.   Travel RN - Nurse who travels for limited contracts working in all variety of places and roles.  On average 8 to 13 week contracts.   Autonomy - Being able to work independently.   CNA (Certified Nursing Assistant) - Takes care of patients under the supervision of Licensed Practicing Nurses and Registered Nurses in a facility.   Personal Home Care - Providing medical care in a home setting.  Either in a group facility, as a visitor to an individual home, or as a live in caregiver providing 24/7 support.   Pharmacy Tech - A health care provider who performs pharmacy-related functions working under the direct supervision of a licensed pharmacist.   Corpsman - An enlisted member of a military medical unit.   Prerequisites - Classes required to set an educational foundation prior to enrolling in more focal studies.   Bachelor's Degree - On average four to five year University Program to pursue a degree in a specific field.   LPN (Licensed Practicing Nurse, aka Licensed Vocational Nurse) - Provides nursing centered patient care as part of a medical team.  Requires less years of education with less responsibilities on average compared to a Registered Nurse.   ASN/ADN - Associate’s Degree in Nursing   BSN - Bachelor of Science in Nursing, More schooling then Associate's.   ER Techs - Staff who in all aspects of patient care under the supervision of the Practitioners and Nursing staff.  Many have a paramedic/firefighting background.   Antimicrobial - An agent that kills microorganisms or stops their growth.   Oncology - Oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer.   ICU (Intensive Care Unit, Critical Care Unit, or Intensive Therapy/Treatment Unit) - Part of the hospital with the sickest patients requiring the most intervention from both staff and equipment.  May consist of intubated, sedated, and ventilated patients.   CCU (Cardiac Care Unit) - Part of the hospital that focuses on postoperative cardiac surgical patients and those who have suffered from cardiac events or other variety of cardiac related disease processes.   ER (Emergency Room, Emergency Department, Emergency Ward, Accident & Emergency Dept) - Department that must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention that arrive unplanned by walk-in, private vehicle, or ambulance.   CABG (Coronary Artery Bypass Graft Surgery) - "Bypass" surgery is a surgical procedure to restore normal blood flow to an obstructed coronary artery.   MI (Miocardial Infarction) - "Heart Attack" refers to a blocked coronary artery that has caused, or is moments away from causing, irreversible cardiac (heart) tissue damage.   Epinephrine - Endogenous hormone that is given to patient's to treat a number of conditions including anaphylaxis, cardiac resuscitation, and bleeding.  Inhaled epinephrine is used to help treat symptoms of croup.  Is used in the ICU and cardiac unit to help maintain a high enough blood pressure.   Dobutamine - Inotrope class of cardiac medication used in the treatment of adults with weakened cardiac function due to poor effort of cardiac contractions (pumping of the heart) that may result from cardiac disease or cardiac surgery.  Helps the heart to beat stronger and more efficiently.   Dopamine - Medication used as a stimulant for low blood pressure, cardiac arrest, or slow heart rate.   Vasopressors - Class of Antihypotensive medications that are used to raise blood pressure by contracting blood vessels.   Insulin - Hormone naturally produced by the body to help process carbohydrates that is given via injection to diabetics who are unable to either produce, or are no longer as sensitive to, their insulin.   Massive Transfusion Protocol - Protocol that a hospital system has when need of large quantities of blood and blood products are needed to be transfused for a patient with significant blood loss that may still be ongoing.   Florence Nightingale - Founder of Modern Nursing   Certified Breastfeeding Specialist - Specialized healthcare provider who work with mom and their baby to assist in feeding and help those experiencing breastfeeding problems, such as latching issues, painful nursing, or low milk production.   Prenatal Care - Care being provided to those pregnant or planning to become pregnant.   Acute Care - The opposite of long term care.  Providing care for expected temporary illness or injury.   Foley Catheter - A tube that is inserted through the urethra to the bladder to empty urine.  May be left in place and a bag attached to it.   Skills Lab - Focused area to learn new medical techniques or further practice known skills.   Colostomy - A surgical procedure that brings one end of the large intestine out through an opening (stoma) made in the abdominal wall. Poop and liquid moving through the intestine empties via the stoma into a bag attached to the abdomen.   Oregon State Board of Nursing   Latching - The application and placement of the child's mouth to the nipple/breast to form an appropriate connection for feeding.   Colostrum - The nutrient rich first form of milk produced immediately following delivery of the newborn and contains antibodies to protect the newborn against disease.   Breast Pumping - Using a machine to mild the breasts for milk to be used at a later date or if there is issues with the infant latching on to the nipple for adequate feedings.   Torticollis - A rare, and often temporary, condition in which the neck muscles contract, causing the head to twist to one side.   Teddy Bear Constipation - Your teddy bear is "overstuffed."   Each and every episode of Maybe Medical is for educational purposes only, not to be taken as medical advice.  The opinions of those involved are of their own and not representative of their employer.

This week we discuss some pearls from the 14th All NYC EM Conference. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_145_0_Final_Cut.m4a Download Leave a Comment Tags: Documentation, Major Trauma, Massive Transfusion Protocol Show Notes All NYC EM Conference Read More Core EM: Episode 77.0 – Give TXA Now! Read More

This week we discuss some pearls from the 14th All NYC EM Conference. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_145_0_Final_Cut.m4a Download Leave a Comment Tags: Documentation, Major Trauma, Massive Transfusion Protocol Show Notes All NYC EM Conference Read More Core EM: Episode 77.0 – Give TXA Now! Read More

This week the podcast features a talk Jenny Beck-Esmay gave at the 11th All NYC EM Conference entitled "Give TXA Now!" https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_77_0_Final_Cut.m4a Download One Comment Tags: All NYC EM, CRASH-2, Massive Transfusion Protocol, MATTERS, Trauma, TXA Show Notes Take Home Points Giving TXA provides a significant mortality benefit to the any trauma patient requiring massive transfusion with an NNT = 7 for mortality TXA must be given early. Give within 1 hour of injury if possible but the benefit remains up to 3 hours out TXA administration: 1 gram as a bolus followed by 1 gram over the next 8 hours Show Notes Intensive Care Network: Karim Brohi on TXA in Trauma EMCrit: Podcast 67 – Tranexamic Acid (TXA) Core EM: CRASH-2 Tranexamic Acid in Major Trauma References CRASH-2 trial collaborators. Effects of tanexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a ransomised placebo-controlled trial.

This week the podcast features a talk Jenny Beck-Esmay gave at the 11th All NYC EM Conference entitled "Give TXA Now!" https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_77_0_Final_Cut.m4a Download One Comment Tags: All NYC EM, CRASH-2, Massive Transfusion Protocol, MATTERS, Trauma, TXA Show Notes Take Home Points Giving TXA provides a significant mortality benefit to the any trauma patient requiring massive transfusion with an NNT = 7 for mortality TXA must be given early. Give within 1 hour of injury if possible but the benefit remains up to 3 hours out TXA administration: 1 gram as a bolus followed by 1 gram over the next 8 hours Show Notes Intensive Care Network: Karim Brohi on TXA in Trauma EMCrit: Podcast 67 – Tranexamic Acid (TXA) Core EM: CRASH-2 Tranexamic Acid in Major Trauma References CRASH-2 trial collaborators. Effects of tanexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a ransomised placebo-controlled trial. Lancet 2010; 376: 23-32.

Author Paul Huiras discusses with Pamela Hsieh, Assistant Editor for AJHP, how tranexamic acid was added to a traumatic injury massive transfusion protocol. The article under discussion appears in the June 15, 2015, issue of AJHP. AJHP is the official journal of the American Society of Health-System Pharmacists. www.ajhpvoices.org