Massive GI Bleed 👇🏼

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This lecture on Massive GI Bleeds is from Dr. Jenn Repanshek (@jennrepanshek) from ResusEM5. She discusses the impact intubation can have on a patient's hemodynamics, especially those in shock. The switch from negative to positive pressure ventilation during intubation can significantly alter venous return and preload, affecting the patient's condition. • Key Takeaway: • Always resuscitate before you intubate! Be vigilant about who is at increased risk of decompensation and cardiac arrest. • -Predicting Decompensation Risk: The Shock Index (SI) is a critical tool. It's calculated as heart rate divided by systolic blood pressure. A pre-RSI (Rapid Sequence Intubation) SI of ≥0.9 is a red flag, closely linked to cardiac arrest risks. • -Research Highlights: A 2013 study in Resuscitation by Heffner et al. revealed significant findings. Analyzing 410 patients undergoing endotracheal intubation, the study noted a higher incidence of cardiac arrest in patients with pre-intubation hypotension and those with a high pre-RSI shock index. • -Utilize the pre-RSI shock index to identify patients at risk of cardiac arrest post-intubation. Awareness and preparedness can save lives! • #CriticalCare #Emergencymedicine #Shock #Resuscitation #GIBleed

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