Friday January 5, 2007

Scenario; You intubated a patient during cardiac arrest but Easy cap (CO2 detector) failed to change color. Should you re-intubate the patient?


Answer: NO

During cardiac arrest, cardiac output is dependent on CPR and exhaled CO2 level is insufficient to produce color change despite endotracheal tube is in right position. In cardiac arrest, CO2 detector is not a reliable mean of confirming tracheal intubation.

Thursday January 4, 2007
Lasix after pRBC transfusion

It is a common practice to give IV Lasix after pRBC transfusion but there is no real scientific basis for it. As a common sense RBCs cannot come out of pulmonary capillaries. They only cause viscous load (increasing viscosity of intravascular fluid) and giving lasix actually can increase viscous load further and make it worse !!