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UF Health University of Florida
Department of Anesthesiology College of Medicine
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Clinical Overview

Hemodynamics

Shock
Vasopressors
Arrhythmias
Cardiac Arrest
EKGs

Hemodynamics in the ICU

*Please take the quiz below the lectures to receive credit.

Objectives

  1. Basic monitoring routinely performed in the ICU
  2. Advanced hemodynamic monitoring techniques and their utility

Articles

Lectures

Hemodynamics the Introduction

Hemodynamics I

Hemodynamics II

Hemodynamics III

Quiz

Name(Required)
1. True or False: due to the site from which it is obtained, the SvO2 is usually higher than ScVO2(Required)
2. Of the methods/measurements used in assessing hemodynamics, all of the following are non-invasive except:(Required)
3. Limitations of pulse oximetry include all of the following except:(Required)
4. The most sensitive leads used to monitor for cardiac infarction by telemetry are:(Required)
5. An arterial line should be zeroed at the level of the:(Required)
6. All of the following are true concerning a dampened arterial wave form except:(Required)
7. Absolute contraindications of PA catheter placement include all of the following except(Required)
8. All of the following are true of mixed venous oxygen saturation (SvO2) except:(Required)
9. All of the following are true concerning measuring the CVP except:(Required)
10. When using arterial waveform analysis (FloTrac/Vigileo) to calculate cardiac output, all of the following conditions may render its reading inaccurate except(Required)

Shock Overview

*Please take the quiz below the video to receive credit.

Objectives

  1. Define the different types of shock and pathophysiology associated with each
  2. Describe methods of shock assessment and differentiation
  3. Understand and describe appropriate management strategies for shock

Articles

Lecture

Quiz

Name(Required)
1. Septic Shock is a type of what general form of shock?(Required)
2. What type of shock is associated with bradycardia?(Required)
3. What product is produced by tissue cells in the presence of hypoxia?(Required)
4. What is the name of the ultrasound protocol designed to differentiate between cardiogenic and non-cardiogenic causes of shock in peri-arrest scenarios?(Required)
5. All of the following are methods used to assess volume status except:(Required)
6. Pulse pressure variation (PPV) is used to assess:(Required)
7. Limitations to using arterial wave form analysis to measure SVV or PPV include all of the following except:(Required)
8. What value demonstrates better predictability of hypovolemia when compared to PCWP?(Required)
9. When using ultrasound to assess a patient's volume status, a caval index greater than _______ indicates fluid responsiveness.(Required)
10. True or False: Oliguria as defined by less than 0.3cc/kg for 3hrs is not a specific indicator of hypovolemia.(Required)

Vasopressors in the OR

*Please take the quiz below the video to receive credit.

Objectives

  1. Understand and describe commonly used vasopressors
  2. Understand and describe commonly used vasodilators
  3. Identify and discuss indications and differences among commonly used drugs

Articles

Lectures

Quiz

"*" indicates required fields

Name*
1. True or false, Alpha 2 adrenergic agonists act by increasing arterial tone.*
2. True or false, Beta 1 adrenergic agonists increase contractility and heart rate.*
3. Which of the following receptors does epinephrine NOT act upon?*
4. Which of the following medications acts solely on the alpha receptor and has no beta effects?*
5. In which of the following situations should norepinephrine be your first vasoactive drug of choice.*
6. You are working in the TICU and are taking care of a 25yo M with a history of a MVC three days prior. His injuries include right femoral neck fracture as well as TBI. He has an EVD and codman wire in place. You are called to the bedside by his nurse because his CPPs are below goal. His EVD was just transduced and his ICP was 8. His MAP is 55, his HR is 105, temp 37.9, recent TTE appears euvolemic with normal contractility, and most recent blood work reveals a Hct of 27 and lactate of 1.2. What medication would be the most appropriate choice to raise the patients’s MAP and CPP.*
7. True or False, Dopamine acts primarily on the Beta 1 receptors at low doses, and primarily at the alpha 1 receptors at higher doses?*
8. Dobutamine acts on the following receptors?*
9. What is the mechanism of action of Milrinone?*
10. True or False, Milrinone increases contractility without direct effect on blood pressure.*
11. Nitroglycerin should be used with caution in neuro patients with high ICPs due to what reason?*
12. Which of the following antihypertensives has the shortest half life, making it an easily titratable drip?*
13. Why should calcium channel blockers and beta blockers be used with caution in conjunction with each other?*

Cardiac Arrest & Resuscitation

*Please take the quiz below the video to receive credit.

Objectives

  1. Describe and define the pathophysiology of a cardiovascular arrest.
  2. Formulate the correct management of patient’s experiencing a cardiovascular arrest.
  3. Determine whether appropriate post-resuscitative measures have occurred in a  resuscitated cardiovascular arrest patient.

Articles

Lecture

Quiz

Name(Required)
1. True or False: A cardiac arrest is defined as the abrupt loss of heart function in a person who may or may not have diagnosed heart disease.(Required)
2. The LAD feeds which of the following muscle areas?(Required)
3. After which rhythm would one initiate lidocaine immediately after ROSC?(Required)
4. For which rhythm would the provider initiate Amiodarone?(Required)
5. Which is not a reversible cause of PEA arrest?(Required)
6. What is the ACLS IV dose of Epinephrine?(Required)
7. Which is not a complication of utilizing Hypothermia post-cardiac arrest?(Required)
8. Which of the following rhythms is a shockable rhythm?(Required)
9. How frequently should you rotate the compressor while doing CPR?(Required)
10. Which of the following is not in the ACLS adult cardiac arrest algorithm?(Required)

EKGs in the Critically Ill

*Please take the quiz below the video to receive credit.

Objectives

  1. Identify and describe life threatening rhythms found on EKG
  2. Discuss non-specific but common EKG findings associated with acute cardio-pulmonary conditions

Articles

Lecture

Quiz

*Use the images in this document to answer the questions below.

Name(Required)
1. 61 y/o male with palpitations and lightheadedness exhibits the above on EKG. Identify the rhythm in image 1.(Required)
2. 33-year-old obese man with sharp chest pain and dyspnea exhibits the following on EKG (see image 2 in pdf) The rhythm is highly suggestive of which of the following:(Required)
3. 43-year-old man, with severe palpitations exhibits the following on EKG (see image 3). Identify the rhythm.(Required)
4. 45-year-old man with severe left chest pressure, nausea, and diaphoresis exhibits the following on EKG (see image 4). The rhythm is highly suggestive of which of the following?(Required)
5. 85-year-old woman presents after a syncopal episode, still reports lightheadedness and exhibits the following on EKG (see image 5). The rhythm is highly suggestive of which of the following?(Required)
6. 66-year-old man with severe lightheadedness and diaphoresis exhibits the following on EKG (see image 6). Identify the rhythm.(Required)
7. 62-year-old man with renal failure complains of progressive dyspnea and orthopnea after missing his last two hemodialysis sessions exhibits the following on EKG (see image 7). Identify the rhythm.(Required)
8. 36-year-old woman has had intermittent episodes of palpation and lightheadedness exhibits the following on EKG (see image 8). Identify the rhythm.(Required)
9. 23-year-old woman with sudden abdominal pain and vaginal bleeding exhibits the following on EKG (see image 9). Identify the rhythm.(Required)
10. 32-year-old M with pleuritic chest pain and dyspnea exhibits the following on EKG (see image 10). The rhythm is highly suggestive of which of the following?(Required)