Paul Wischmeyer MD
@Paul_Wischmeyer • 36,758 subscribers
#Nutrition #ICU #Exercise Physician-Researcher, Professor at DukeMedSchool, Passionate About Patient Recovery!, #Dancer, #ICU & #IBD Survivor, #Ostomy, Dad
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🙋♂️ INCREDIBLE ICU MOBILITY in intubated patient on ventilator & CRRT 👉This should be the standard of care in all ICU’s and hospitals worldwide 🌎 ❓Does your ICU walk and mobilize intubated patients? H/T Early physiotherapy ICU #ICUrehab #FOAMcc #PhysicalTherapy #MedEd #MedTwitter
Paul Wischmeyer MD743,932 Aufrufe • vor 2 Jahren
🙋♂️ AMAZING intubated ICU patient playing volleyball 👉NOTICE only 1 physical therapist needed 🎯 Early mobility should be standard of care in all ICU’s 🌎 Sedation can allow pts to be awake w/o pain-see WesElyMD A-F bundle! ❓Does your ICU walk intubated patients? H/T Early physiotherapy ICU #ICUrehab #FOAMcc #PhysicalTherapy #MedEd #MedTwitter
Paul Wischmeyer MD522,579 Aufrufe • vor 2 Jahren
21-year-old with sudden cardiac arrest!! Would you know what to do? Notice the quick initiation of CPR and application of the gym AED which saved her life. Perfect example of why training the public in CPR/ AED use is so important. She has a rare heart condition called Bland White Garland Syndrome where the left coronary artery originates from the pulmonary trunk. Some other causes of sudden cardiac arrest in the young: Commotio Cordis, Brugada Syndrome, Hypertrophic Cardiomyopathy, Long QT Syndrome, WPW. Remember CPR basics for Adults: - 2 hands center of the chest, lower half of breast bone - At least 2 inches compression depth - 30:2 compression to breath radio - Stop each breath when you see the chest rise - 100 to 120 compression rate per minute (no medical training or do not feel comfortable giving breaths - just do compressions) - No delay in compressions over 10 secs. Better outcomes if no delay. Follow the courageous woman in this video at @emilysheartbeat Credit to @wildernessdoctor and Medical Motivation #cardiacarrest #cpr #MedEd #FOAMcc #MedTwitter #MedX
Paul Wischmeyer MD102,418 Aufrufe • vor 1 Jahr
🙋♂️This video shows a modified Valsalva maneuver being used in the emergency treatment of stable SVT 🫀(supraventricular tachycardia)! Learn more👇 This awesome ER team was able to temporarily convert a stable paroxysmal SVT back into sinus rhythm! This is a beautiful example of how manipulating nervous system & leveraging physiology can be used as a simple, cost-free treatment. So, how does it work: The modified Valsalva can be divided into 3 phases: * Phase 1: Increasing intrathoracic pressure: At beginning of video, you’ll see patient perform a standardized ‘strain’ (blowing into a 10mL syringe) for about ~15 seconds while sitting up or in a semirecumbent position. Bearing down like this contracts thoracic & abdominal muscles & causes a drop in blood flow back to the heart (decreased preload) & brain. This drop stimulates baroreceptor reflex & compensates by triggering the sympathetic nervous system (stress response) in an attempt to raise BP, cardiac output & peripheral vascular resistance. * Phase 2: Dropping intrathoracic pressure: After the ~15 second strain, just prior to being laid flat (or simultaneously), patient will stop blowing into syringe, this causes pressure in thorax to suddenly decrease, subsequently increasing blood flow back to heart & increasing preload-> leading to opposite of phase 1: a compensatory increase in parasympathetic (vagal) activity aimed at decreasing heart rate + increasing relaxation response. * Phase 3: Laying flat & raising legs to 45 degrees: This postural modification causes more blood flow back to heart, leading to increase in stroke volume & cardiac output. Causing further vagal - parasympathetic - stimulation, which compensates for these changes by telling body to decrease the heart rate (SA node) -> this can convert patient back into sinus rhythm! Credit: Brazil Med Team Credit:@medspired #nutrition #nutrição #nutricion #dietitian #nurse #nursingstudent #medicine #mbbs #science #biology #medstudent #health #nutrologia #meded #valsalva #svt #cardiology
Paul Wischmeyer MD99,724 Aufrufe • vor 1 Jahr
Wrong shock ⚡️ How many mistakes were made here?❓Tell me what you find wrong with this. 🙋♂️ I’ll start: ✅ Basic CPR training step 1 — It’s vital to carefully assess patient for responsiveness and normal breathing before initiating CPR. 😨 Seems like common sense, but performing CPR & ACLS on someone with a pulse or who doesn’t need it potentially cause harm to individual. It leads to physical injuries, psychological distress, wasted time, and potential legal consequences. 🔎 Specifically, CPR and defibrillation, while lifesaving, come with risks. During CPR, common risks include rib and sternal fractures due to the force of chest compressions, particularly in older adults. These fractures can lead to lung injuries, such as pneumothorax (collapsed lung), or internal organ damage, including to the liver and spleen, potentially causing internal bleeding. Incorrectly performed compressions may also reduce blood flow to vital organs. Defibrillation, used to restore normal heart rhythms, can cause burns to the skin from electrode pads or paddles. Misuse of the defibrillator, such as shocking a patient without a shockable rhythm, can further harm the heart. There’s also a risk of accidental shock to rescuers or bystanders if proper safety precautions aren’t followed. Both procedures, while vital, must be executed carefully to minimize these risks. ❗️Don’t fight the victim! 🙋♂️Always follow ACLS Guidelines and be sure to take a good CPR class! Thanks to Medical Motivation for this amazing video and they are a must follow! Please DM for credit or removal. For educational purposes only and no copyright issue intended. #cpr #acls #FOAMcc #cardiacarrest #icu #criticalcare #icunurse #anesthesia #anesthesiology #nurse #medicine #mbbs #medstudent #health #meded #sccm #sccmsome
Paul Wischmeyer MD90,482 Aufrufe • vor 1 Jahr
Heart Transplant Update- Please leave a ❤️ to support this amazing child! This little one is battling for life- but showing incredible strength & resilience. Please pray for her. Great example of post-ICU mobility- wish all ICU & surgery patients were helped to move this way.
Paul Wischmeyer MD18,045 Aufrufe • vor 4 Monaten
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🙋♂️ INCREDIBLE ICU MOBILITY in intubated patient on ventilator 👉This should be the standard of care in all ICU’s and hospitals worldwide 🌎 ❓Does your ICU walk and mobilize intubated patients? H/T Heidi Engel, PT, DPT #ICUrehab #FOAMcc #PhysicalTherapy #MedEd #MedTwitter @DukeAnesRes Duke Anesthesiology Fellows WesElyMD
Paul Wischmeyer MD27,293 Aufrufe • vor 1 Jahr
Why Bedrest 🛌 is SO BAD for you when you’re sick! 💪We know if you lay a healthy 21 year old in bed for 28 days they will lose significant muscle mass and not be able to walk. NASA did these experiments with Astronauts. 👉 If you are older / elderly and healthy you lose 5 X more muscle (10% of your muscle mass) if you lay in bed for just 10 days. 👉If you are older / elderly and sick on hospital you lose 5 X more muscle mass (10%) in just 3 days! 👉This muscle loss leads to significant disability after hospital or ICU stay that can last for months to years! And can lead to significant complications or even death. ☠️ Beds are evil… they cause life threatening complications in hospitalized patients including blood clots, pulmonary embolism, and pneumonia all of which can lead to death 💀! 👨🏫Subscribe free on my YouTube channel at @paul_wischmeyerMD to see my full lectures #muscle #musclemass #nutrition #nutrición #nutrição #bedrest #rehabilitation #foamcc #physicaltherapy #physicaltherapist #physiotherapy #physiotherapist #getoutofbed #strength #rehabilitacion #icurehab #rehabscience #musculação #musculos #health #espen2024 Stuart Phillips (he/him) Neil Floch MD Simon Hill MSc, BSc Syed Shahrul Naz Professor Katarzyna Kotfis, MD, PhD, EDAIC
Paul Wischmeyer MD33,071 Aufrufe • vor 1 Jahr
🙋♂️ AMAZING intubated ICU patient playing volleyball 👉NOTICE only 1 physical therapist needed 🎯 Early mobility should be standard of care in all ICU’s 🌎 Sedation can allow pts to be awake w/o pain-see WesElyMD A-F bundle! ❓Does your ICU walk intubated patients? H/T Early physiotherapy ICU #ICUrehab #FOAMcc #PhysicalTherapy #MedEd #MedTwitter Kate Tantam (She/her) Heidi Engel, PT, DPT Justyna Swol MD • ECMOdaily Paul Young
Paul Wischmeyer MD28,469 Aufrufe • vor 2 Jahren
❓Do you check gastric residual volumes (GRVs) 🔎 Hear if you should & other #ICUNutrition “myths-busted” on my Critical Care Time podcast with Nick Mark MD & Cyrus Askin, MD, FACP Check out Critical Care Time for links to podcast & video! #FOAMcc #Dietitian
Paul Wischmeyer MD15,254 Aufrufe • vor 2 Jahren
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