I'm daily following and watching the videos from the past 2month my thinking and approach to AA clinical case has changed thank you to the team AETCM continue to guide thank you for ur efforts
Just a constructive feedback- if the teachers are more friendly,rather than strict in talk,any student/resident can clear his/ her doubts, and will be more confident not only in expressing opinion but also confident in his evaluating/ diagnosing / treating diseases..and A big thankyou for this videos and knowledge, it's a great boon for all doctors to learn from you all..Thank you so much😇
This happens when a teacher is so much knowledgeable that we are afraid of his knowledge But clearing doubt should be principal motto..... Also we, as students should always keep in mind that we are learning yet...... Then things become little bit easy that doesn't means that we should be unaware of common things
Namaskar AETCM team from Nepal, your videos are always very very helpful. Could you please make 1 minute series about," Why polycythemia in COPD patients".
As a newly hired cruise ship doctor and general practitioner eagerly awaiting deployment on board, I find your videos incredibly valuable and watch them daily. Your content has been instrumental in preparing me for this exciting new role. I would greatly appreciate it if you could create more videos on dislocation reduction techniques. Thank you for all that you do!
Shouldn't the first line drugs used in ADHF with hypotension be inotorpes like Dobutamine or milrinone? vasopressors (like noreadrenaline which is less of an inotrope and more a vasoconstrictor) are used if the patient is still hypotensive after the first line drugs as it primarily induce peripheral vasoconstriction which could lead to increased afterload and reduced cardiac output. Also remember that while the patient could be hypotensive he could still have high systemic vascular resistence due to already increased production of catecholamines and vasopressors, and renin-angiotensin--aldosterone response to the acute decompensated heart failure, so noreadrenaline could only worsen cardiac output. Perhaps in India the guidelines are different.
@@Little-v2x I reviewed Uptodate for hypotension due to heart failure (low cardiac output) and it recommends dobutamine before noreadrenaline, circulation journal (from american heart association) also recommends dobutamine first, same thing for Harrison, Rosen's emergency textbook recommends one or both in managing cardiogenic shock, it all depends on how the patient responds, even those who recommended dobutamine first weren't against noreadrenaline as first agent, sources agree that mortality is not decreased in one agent more than the other. The pressure values that you provided 80/60 in a known heart failure condition indicates (probably) hypotension from cardiac dysfunction because of the low difference between systolic and diastolic pressures (acceptable diastolic pressure but heart does not pump so systolic pressure is reduced) and therefore dobutamine seems suitable here (increase cardiac output and also decrease a little bit peripheral vasoconstriction to lower afterload for a better cardiac output). At the end it depends on patient's condition, his response to the first agent used, and doctor's expertise.
I'm daily following and watching the videos from the past 2month my thinking and approach to AA clinical case has changed thank you to the team AETCM continue to guide thank you for ur efforts
Excellent show. My only concern about Residents answering, why they are not confident about their opinion and always scared of their teacher.
Just a constructive feedback- if the teachers are more friendly,rather than strict in talk,any student/resident can clear his/ her doubts, and will be more confident not only in expressing opinion but also confident in his evaluating/ diagnosing / treating diseases..and A big thankyou for this videos and knowledge, it's a great boon for all doctors to learn from you all..Thank you so much😇
This happens when a teacher is so much knowledgeable that we are afraid of his knowledge
But clearing doubt should be principal motto.....
Also we, as students should always keep in mind that we are learning yet......
Then things become little bit easy that doesn't means that we should be unaware of common things
Well he is grilling them so they should be afraid. Haha.
Sir, Sometimes the voice is not so clear, plzz try to solve it 🙏
Namaskar AETCM team from Nepal, your videos are always very very helpful. Could you please make 1 minute series about," Why polycythemia in COPD patients".
In the beginning did he mean that pt should have been given 4L O2 to help with dyspnea?
As a newly hired cruise ship doctor and general practitioner eagerly awaiting deployment on board, I find your videos incredibly valuable and watch them daily. Your content has been instrumental in preparing me for this exciting new role. I would greatly appreciate it if you could create more videos on dislocation reduction techniques. Thank you for all that you do!
Sir could you please do a video on nasal prongs, mask, etc.. with its indications
Shouldn't the first line drugs used in ADHF with hypotension be inotorpes like Dobutamine or milrinone? vasopressors (like noreadrenaline which is less of an inotrope and more a vasoconstrictor) are used if the patient is still hypotensive after the first line drugs as it primarily induce peripheral vasoconstriction which could lead to increased afterload and reduced cardiac output.
Also remember that while the patient could be hypotensive he could still have high systemic vascular resistence due to already increased production of catecholamines and vasopressors, and renin-angiotensin--aldosterone response to the acute decompensated heart failure, so noreadrenaline could only worsen cardiac output.
Perhaps in India the guidelines are different.
Pls read about dobutamine
As u said in our college They started dobutamine as first choice rather than Non adrenaline 🤷♀️ BP was 80/60mmhg
@@Little-v2x I reviewed Uptodate for hypotension due to heart failure (low cardiac output) and it recommends dobutamine before noreadrenaline, circulation journal (from american heart association) also recommends dobutamine first, same thing for Harrison, Rosen's emergency textbook recommends one or both in managing cardiogenic shock, it all depends on how the patient responds, even those who recommended dobutamine first weren't against noreadrenaline as first agent, sources agree that mortality is not decreased in one agent more than the other.
The pressure values that you provided 80/60 in a known heart failure condition indicates (probably) hypotension from cardiac dysfunction because of the low difference between systolic and diastolic pressures (acceptable diastolic pressure but heart does not pump so systolic pressure is reduced) and therefore dobutamine seems suitable here (increase cardiac output and also decrease a little bit peripheral vasoconstriction to lower afterload for a better cardiac output).
At the end it depends on patient's condition, his response to the first agent used, and doctor's expertise.
Dobutamine is contraindicated if SBP
Greatly discused
What about digoxin in CHF case
With nasal prong 2 lt can deliver 28 percent.How two litre is equal to room air????If spo2 above 94 means po2 is around 80_100.Thats good
Your content discussion awesome,,, the best channel
Thank you, im your distant student, getting lot of benefit from your lecture series 🙏🙏
Very informative discussions, yes I also think sometime voice problems specially when discussing drugs.
Excellent discussion and very informative.
Aminophylline action was nicely explained.
I m watching from beginning 😊this channel is very good
TOday 's question asked during discussion super
Thankyou Sir and the entire ER team 👍😊🥰
Thank you so much sir ❤🙏
Ya sir the voice is too low😢
Very nice sir
No voice at 8,30 min
Thank you sir
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