Your videos are fantastic. I can't believe that I am just discovering them as I start my final term of nursing school. Currently preparing for ACLS and your videos have helped me so much. You explain concepts so clearly. You truly have a talent for teaching. Thank you!
Thank you so much for the kind words Lindsay! Wish you would have found the channel sooner, but glad you have found it and hopefully some good info here to carry with you moving forward. Lots of videos here at this point!
WOW! That is so amazing to hear. Super stoked and huge congratulations to you. You should be very proud as that is a huge accomplishment, and I'm happy to have been able to help in any way. Way to go!!
You helped me through Nursing school, a year later I’m still listening to you! ACLS today and I start in Neuro ICU/CCU next week. Your videos are a life saver! Thanks for all you do!
Thank you so much Christina! Congrats on the new ICU position. Really glad I’ve been of help for you! Appreciate you taking the time to drop a comment! 😊
Thank you for all your heart work in making these videos. I had a placement in ICU last year and watching your videos helped me so much in making the most of my placement, and I was even complimented on my knowledge thanks to your videos! I am now an RN starting in cardiology and mixed surgical this year and hope to transition into ICU next year. Much love from Australia and hope you are staying safe and well!
Wow what a great story Sarah! I'm humbled to hear this and truly happy to be able to help in any way I can. Wishing you the best in your new nursing journey and if you stay driven I have no doubt you will end up where you want to be. Thank you and much appreciation all the way to Australia! :)
Hey!! Thanks for putting all these videos out here on YT!! I'm an ER nurse and it helps so much being able to brush up and remember all the little intricacies of CC management. Thank you!!
Revisiting this again for my renewal tomorrow. Eddie, thank you for all you do! I recommend your channel all the time to nurses I work with, as well as to our new grad and nursing externs.
Hi! i just discovered your channel a few days ago..I was looking for videos about icu nursing management for patient in mechenical ventilator in preparation for my virtual interview..Just want to Thank you for you effort in doing videos about Icu management it helps a lot of people in medical field..you are a great educator.
Ahhh yup, certainly missed that. I guess 6,12,12 is just too trained in my brain! Glad you liked the video and thanks for taking the time to leave a comment Craig.
Could you explain to me why under the “wide QRS yes” it says if regular and monomorphic then consider adenosine? Is the “regular” talking about the QRS? Thank you!!
Hey can you plz talk more on indications for amio? Guidelines have it in the algorithms but in any video I watch it seems it’s not widely used. Thanks!
If a patient is stable and in a Monomorphic Wide complex tachycardia, can we skip adenosine and go straight to Amiodarone 150mg over 10min? I’m not understanding why adenosine would be considered. Adenosine only slows conduction through the AV node.
Hi any explanation on issue about adenosine …why is it there and should it be given before amiodorone or can we skip adenosine and give Amiodorone first???
Hi, I loved your video, and it was super helpful with the tachycardias. I was just wondering when you talked about the stable tachycardias from 5:11 - 6:00, you mentioned polymorphic tachycardia (Torsades), but polymorphic tachycardia would never be stable and would always be pulseless, right? Just wasn't sure why it was mentioned along with the stable tachycardias, but maybe I misunderstood something. Thank you! 👍🙂
ROSC - the patient now has BP of 60/38. A fib with a heart rate of 128 bpm. Intubated and unresponsive. Would you synchronize cardiovert or administer dopamine?
I wouldn't be considering dopamine as thats only going to increase rate and irritation here, probably making things worse. A lot to consider here before deciding. Cardioverting is certainly a possibility if the afib is acute and we think the BP is driven by our rate and lack of atrial kick. But post ROSC afib is not uncommon (although associated with higher mortality). That being said, the hypotension (which is pretty profound here) needs to be address quickly, but could also be the result of many other things going on, so its a complex picture that needs to be looked at with the particular patient. Maybe fluids, maybe pressors (ideally neo with the mild RVR) as some other options to consider too. Perhaps meds to rate control too, although again, with that pressure, options are limited in the moment. Sorry it's not a clear and dry, do this. :| Also depending how soon after this is, we may just want to control the pressure better first and see if the rate comes down after some time and/or if they convert themselves if new.
Are there any other ecg? legit question cause when u said if the person has wide QRS, then we wanna get a 12 lead ecg. So initially the person was already on another ecg? feel like its a dumb question :( Thank you for the answer in advanced.
Not a dumb question. So if the patient is on a bedside monitor (3 or 5 lead, or even pads on the defibrillator) then we are assessing the rhythm and if needed get the more involved 12-lead for more detail analysis.
@@ICUAdvantage wow! thank you for your answer :) im so happy it’s giving me light. i never have the experience after graduating and i really enjoy watching your videos. i might have more questions along the way and im forever grateful to you for sharing your knowledge. this is such a generous act. :)
Great question! So Vtach is a tachycardia with impulse generating from the ventricle. WCT, the easiest way to think about it would be a tachyarrhythmia, such as SVT, but with a bundle branch block. It can get more complex there, but its originating from higher up the chain, but some aberrancy is leading to the wide complex and not that it is originating in the ventricle like with vtach.
Thanks for your videos. You mentioned atropine is contraindicated with brady from a MI and TCP would be preferred. It seems that since the heart is contracting from the TCP the myocardium would also use O2. Is O2 consumption less when using TCP, and if yes, is there any evidence of that? Just curious. Thanks
Great question. I believe there is, but I'll have to try and search around and see if I can find that. I think its less over activation with TCP vs atropine.
Hi How do you create these kind of videos? Can you suggest the websites were you download these free stock images of medical or human organs or medical devices ?
I use Adobe Photoshop screen cast to an iPad and write with an Apple Pencil, then screen record with Quicktime. As for images, just search around. There are plenty of resources free and paid.
Great question. So it can vary, depending on what and why, as well as you may need to increase joules if no effect. But generally start at around 50J and can go all the way up if needed.
Hello.. thank you so much for this video, I have a question, I just had a patient with cardiac arrest that had the svt rythm and after pushing 6mg adenosine, the rythm was converted but after a while it slowed down gradually till complete asystole, despite our chest compression and epinephrine injection.. what should I do to prevent this situation? I mean the bradycardia.. thank you
Appreciate your videos very much...Question: V-tach with pulse is being referred in the tach algorithm as a tach with wide QRS complex? The treatment is antiarhythmic with anticipation of fast deterioration?...Thank You!
You got it! I should have clarified that better, but yup, 100% v-tach with a pulse is one of the wide-complex tachycardias mentioned :) As for treatment, yes anti-arrhythmic. While this isn't mentioned in the ACLS algorithm, cardio version may be the fix that cardiology looks to use if the anti-arrhythmic is ineffective. While some people can persist in a stable v-tach, more often than not, if left unchecked they can quickly decline.
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You don't just help the ICU. You help us paramedics so much
Your videos are fantastic. I can't believe that I am just discovering them as I start my final term of nursing school. Currently preparing for ACLS and your videos have helped me so much. You explain concepts so clearly. You truly have a talent for teaching. Thank you!
Thank you so much for the kind words Lindsay! Wish you would have found the channel sooner, but glad you have found it and hopefully some good info here to carry with you moving forward. Lots of videos here at this point!
Your channel helped me passed the CCRN.
That’s wonderful!! Congratulations 🎉🎊🍾🎈
WOW! That is so amazing to hear. Super stoked and huge congratulations to you. You should be very proud as that is a huge accomplishment, and I'm happy to have been able to help in any way. Way to go!!
I wish I knew about it when I was studying for my exam
Same! Helped me passed an interview as well!
This was extremely helpful for my last semester in nursing school. Thank you!
LOVE your content! I’m getting ready to start my nursing residency in the ER, and I watch your videos frequently to review. You’re awesome! TYSM 😊
You helped me through Nursing school, a year later I’m still listening to you! ACLS today and I start in Neuro ICU/CCU next week. Your videos are a life saver! Thanks for all you do!
Thank you so much Christina! Congrats on the new ICU position. Really glad I’ve been of help for you! Appreciate you taking the time to drop a comment! 😊
Thank you for all your heart work in making these videos. I had a placement in ICU last year and watching your videos helped me so much in making the most of my placement, and I was even complimented on my knowledge thanks to your videos! I am now an RN starting in cardiology and mixed surgical this year and hope to transition into ICU next year.
Much love from Australia and hope you are staying safe and well!
Wow what a great story Sarah! I'm humbled to hear this and truly happy to be able to help in any way I can. Wishing you the best in your new nursing journey and if you stay driven I have no doubt you will end up where you want to be. Thank you and much appreciation all the way to Australia! :)
This has been such a great resource for my ACLS class!! Thank you for breaking it down so thoughtfully.
Yay! Happy to hear this Maria! You are very welcome.
Currently studying for my acls exam tomorrow. Your videos have helped me a lot. Thank you!
Thanknyou! I learned form an ER doctor to run the WKG strip on slower speed to check for a P wave to differentiate between a sinusvtachnor SVT.
we love how you break it down
Thats so awesome to hear! I try my best to make it understandable so glad to hear its well received.
Preparing for my ACLS class right now and your videos are so helpful- thank you for putting them together and sharing!!!
Absolutely my pleasure and happy to be able to help!
Hey!! Thanks for putting all these videos out here on YT!! I'm an ER nurse and it helps so much being able to brush up and remember all the little intricacies of CC management. Thank you!!
This is so great to hear Becky and happy to have been able to help in some way!
Revisiting this again for my renewal tomorrow. Eddie, thank you for all you do! I recommend your channel all the time to nurses I work with, as well as to our new grad and nursing externs.
I’m in Paramedic and your videos that are relevant to my field, which is at least half of them, have helped me out extremely! Thank you!
Very cool. Glad to be able to help out and thanks for taking the time to pop in the comments Ryan!
Aye, I'm a paramedic in making and watching these videos for clinicals that began last week
Thanks for your video lessons. I passed my acls and bls today. Great review. Thank you!
i have been searching acls videos that is easy to understand and i found your content. thank you and i did subscribe to your channel.
Thank you! This helped me review for my ACLS renewal
Awesome!
As always, your approach and delivery of the information is so concise.👍🎯💯
As a paramedic student u made it super easy for me
This channel is one of the best. Im getting ready for my upcoming acls this month. Thanks
Thank you! Glad you like it and best of luck on ACLS!
I will be taking my ACLS tomorrow and I am reviewing using your posts. Thanks alot
Best of luck!!
It is helpful for exams and it is not boring at al and your videos are of short duration which is also very strong point
Thank you for breaking this down! This helped me SO much for my ACLS class!
Yay! So happy to hear this and happy to be able to help!
Wow thank you so much this has been so helpful through my ICU placement
This is very helpful on my coming ALS course. Informative and simplified 👍👍👍
Awesome. Best of luck on ALS!
Thank u so much.. it helps me a lot for my ACLS renewal this month.
All the best
Taking ACLS tomorrow and appreciate your easy overview of all your ACLS Modules. Nice job!
Happy to be able to help! Hope your ACLS went well!
@@ICUAdvantage I got 100% on the written exam and aced the mock scenarios!!! Thanks again for your great teaching!!
@@dawnschubert8418 daaaang!! 🔥 way to go!
Thank you for all of your awsome lessons..
Glad you like them!
I love your videos for quick pre exam revision!
Shine Bright like diamond❤❤❤thank you
Hi! i just discovered your channel a few days ago..I was looking for videos about icu nursing management for patient in mechenical ventilator in preparation for my virtual interview..Just want to Thank you for you effort in doing videos about Icu management it helps a lot of people in medical field..you are a great educator.
Wow this is so great to hear. Wishing you all the best for your interview. You'll have to check back in and let me know how you did.
@@ICUAdvantage i got the job.😁
@@darwajaalpad7896 Amazing to hear!! Congrats and thanks for the follow up.
@@ICUAdvantage Thank you!!
Thank you for this great presentation.
Glad you enjoyed it!
Such a nice explanation bro ..thank you
Appreciate that!
Your videos are the best. Thank
you so much!
Thank you so much Ali!
God bless you bro. You are the man.
Appreciate that!
Sir u have d best explanation
Great efforts Sir ❤
So excellent that you soo much 🙏🙏🙏
I use these videos for coders and tagged your channel on mine. Another nice one Eddie
Awesome to hear! Again, glad to hear you enjoyed this one as well! :)
Thanks for your videos!! Good to have a overview to refresh now & then!!👍
Happy to be able to help.
Thank you for this valuable educational video
Glad you liked it Burdette! Happy to help.
New guide lines recommend adenosine 6mg 12mg only. Thanks this is great information
Ahhh yup, certainly missed that. I guess 6,12,12 is just too trained in my brain! Glad you liked the video and thanks for taking the time to leave a comment Craig.
@@ICUAdvantage you are welcome
In wide complex QRS monomorphic and try adenosine, at this point you refer to SVT abberant?
Thoroughly enjoyed
Could you explain to me why under the “wide QRS yes” it says if regular and monomorphic then consider adenosine? Is the “regular” talking about the QRS? Thank you!!
Hey can you plz talk more on indications for amio? Guidelines have it in the algorithms but in any video I watch it seems it’s not widely used. Thanks!
Wait, when do you do cardioversion vs giving adenosine?
Thanks have a recert this morning 😂
Thank you so much
so much learnt in 8mins
Thank you so much.Well explained
Thank you!
If a patient is stable and in a Monomorphic Wide complex tachycardia, can we skip adenosine and go straight to Amiodarone 150mg over 10min? I’m not understanding why adenosine would be considered. Adenosine only slows conduction through the AV node.
Hi any explanation on issue about adenosine …why is it there and should it be given before amiodorone or can we skip adenosine and give Amiodorone first???
we want to slow the rhythm quickly and with adenosine its quick! amid is last resort because it does prolong QT
So informative, much appreciated.
Thank you Rose! Happy to help!
This is great. Would you share a little about your nursing background
Excellent
Thank you so much 😀
Thank you for your videos
very clear. thank you
Thank you!!
Youre welcome!
Thank u very much the video is very understanding
Great, as usual
Really precious informations you have helped us with
Appreciating all the wonderful work you have done..
Thank you
Thank you so much for that!
Hi, I loved your video, and it was super helpful with the tachycardias. I was just wondering when you talked about the stable tachycardias from 5:11 - 6:00, you mentioned polymorphic tachycardia (Torsades), but polymorphic tachycardia would never be stable and would always be pulseless, right? Just wasn't sure why it was mentioned along with the stable tachycardias, but maybe I misunderstood something. Thank you! 👍🙂
Usually is unstable or pulseless, but have seen it stable for short periods before.
@@ICUAdvantage That's interesting! Thank you!
Great video Eddie
Thank you so much Justin!
Please I haven't heard you talk about ventricular fibrillation isn't it a type of tachyarrhythmia?
Thank you sir.
Most welcome
U R gifted
great video
ROSC - the patient now has BP of 60/38. A fib with a heart rate of 128 bpm. Intubated and unresponsive. Would you synchronize cardiovert or administer dopamine?
I wouldn't be considering dopamine as thats only going to increase rate and irritation here, probably making things worse. A lot to consider here before deciding. Cardioverting is certainly a possibility if the afib is acute and we think the BP is driven by our rate and lack of atrial kick. But post ROSC afib is not uncommon (although associated with higher mortality). That being said, the hypotension (which is pretty profound here) needs to be address quickly, but could also be the result of many other things going on, so its a complex picture that needs to be looked at with the particular patient. Maybe fluids, maybe pressors (ideally neo with the mild RVR) as some other options to consider too. Perhaps meds to rate control too, although again, with that pressure, options are limited in the moment. Sorry it's not a clear and dry, do this. :| Also depending how soon after this is, we may just want to control the pressure better first and see if the rate comes down after some time and/or if they convert themselves if new.
Thanks 🙏❤️
You're welcome 😊
Thank you
You're welcome
Love this
Awesome!
Just want to say thank you, helps so much. :)
Fantastic! Happy to be able to help Andrew!
Last semester of RN school. CRNA school next!
Thanks !
It is so ironic how increased HR actually means decreased perfusion. I honestly find that fascinating.
Can epinephrine 1mg combined with Amiodarone used when the patient is having pulse ss vT
Yeah, although just start with the epi and give it every 3-5 and then give the amio when you reach that point in the algorithm
Nice this vlogs clear
Very good
Thank you!
Great way to teach
Thank you!
What does it really mean when you say UNSTABLE? What does i need to observe??? Pls acknowledge.
signs of shock like BP systolic less than 90mm, altered mental status, etc
Great video!
Thank you Michelle!
What's your favorite medications for sedation? And what's the dose?
Sedation for what purpose? It certainly depends...
Thanks.🌺
You're welcome!
Nicely explained. You make it sound easy. Yet, I know it’s not.
Is adenosine given instead of synced cardioversion or with/after in case of SVT?
The patient with stable SVT, give adenosine, in an unstable SVT, synchronize cardioversion.
@@mymilliondreams1860👍🏼 Thanks
dreams got it!
Are there any other ecg? legit question cause when u said if the person has wide QRS, then we wanna get a 12 lead ecg. So initially the person was already on another ecg? feel like its a dumb question :( Thank you for the answer in advanced.
Not a dumb question. So if the patient is on a bedside monitor (3 or 5 lead, or even pads on the defibrillator) then we are assessing the rhythm and if needed get the more involved 12-lead for more detail analysis.
@@ICUAdvantage wow! thank you for your answer :) im so happy it’s giving me light. i never have the experience after graduating and i really enjoy watching your videos. i might have more questions along the way and im forever grateful to you for sharing your knowledge. this is such a generous act. :)
thanks
You're welcome!
😊 great
whats the difference between wide complex tachycardia and monomorphic vtachycardia?
Great question! So Vtach is a tachycardia with impulse generating from the ventricle. WCT, the easiest way to think about it would be a tachyarrhythmia, such as SVT, but with a bundle branch block. It can get more complex there, but its originating from higher up the chain, but some aberrancy is leading to the wide complex and not that it is originating in the ventricle like with vtach.
Thanks for your videos. You mentioned atropine is contraindicated with brady from a MI and TCP would be preferred. It seems that since the heart is contracting from the TCP the myocardium would also use O2. Is O2 consumption less when using TCP, and if yes, is there any evidence of that? Just curious. Thanks
Great question. I believe there is, but I'll have to try and search around and see if I can find that. I think its less over activation with TCP vs atropine.
Are you sure about giving another dose of 12mg adenosine on top of the previous 12 mg given?
Yes. Agree. AHA 2020 recommends IV Adenosine 6mg &12mg.
Yup apparently I missed that update! Just 1 dose now. All these years of 6-12-12 in my head to retrain! haha
Hi
How do you create these kind of videos?
Can you suggest the websites were you download these free stock images of medical or human organs or medical devices ?
I use Adobe Photoshop screen cast to an iPad and write with an Apple Pencil, then screen record with Quicktime.
As for images, just search around. There are plenty of resources free and paid.
Awesome
If you do cardiovert, how many j’s?
Great question. So it can vary, depending on what and why, as well as you may need to increase joules if no effect. But generally start at around 50J and can go all the way up if needed.
Hello.. thank you so much for this video, I have a question, I just had a patient with cardiac arrest that had the svt rythm and after pushing 6mg adenosine, the rythm was converted but after a while it slowed down gradually till complete asystole, despite our chest compression and epinephrine injection.. what should I do to prevent this situation? I mean the bradycardia.. thank you
Transient Asystole is one of the side effect of adenosine
Appreciate your videos very much...Question: V-tach with pulse is being referred in the tach algorithm as a tach with wide QRS complex? The treatment is antiarhythmic with anticipation of fast deterioration?...Thank You!
You got it! I should have clarified that better, but yup, 100% v-tach with a pulse is one of the wide-complex tachycardias mentioned :)
As for treatment, yes anti-arrhythmic. While this isn't mentioned in the ACLS algorithm, cardio version may be the fix that cardiology looks to use if the anti-arrhythmic is ineffective. While some people can persist in a stable v-tach, more often than not, if left unchecked they can quickly decline.
Do you get copyright strike for your videos if you use screenshots from Google website , images , ?
Theres some freedom to use stuff under the fair use statutes.
❤️❤️❤️🙏
Thank you!