Donor management with simulation

Donor mgt with Human Simulator ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Once upon a time…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical picture and hx ,[object Object],[object Object],[object Object],[object Object],[object Object]

Physical findings ,[object Object],[object Object],[object Object],[object Object],[object Object]

Initial OPO Lab Highlights Lactate 5 Urine Na+ 4 U/A spec grav <1.005 Urine osmo 84 SaO2 96% HCO3 11 PCO2 24 PaO2 89 pH 7.02 Troponin -I 0.02 INR 1 ALT 179 AST 212 T protein 2.7 Albumin 1.7 Mag 2 Ca++ 7.2 CO2 11 Glucose 150 Creat 2.1 BUN 30 Cl 152 K+ 2.1 Na 187

The choice is yours; Initial mgt ,[object Object],[object Object],[object Object],[object Object],15

Standard donor care you’ll also initiate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Once you get those initial interventions running follow them with: ,[object Object],[object Object],[object Object],[object Object],15

Next set of labs Lactate 4 Urine Na+ 39 U/A spec grav 1.01 Urine osmo 280 SaO2 96% HCO3 15 PCO2 24 PaO2 156 pH 7.18 Troponin -I 0.02 INR 1.2 ALT 179 AST 212 T protein 2.7 Albumin 1.7 Mag 2 Ca++ 7.2 CO2 14 Glucose 150 Creat 1.9 BUN 30 Cl 142 K+ 3.5 Na 178

What do we still need to do to donate organs? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hemodynamics ,[object Object],[object Object],[object Object],[object Object]

Vasoactive choices (current doses: Levo 40 mcg/min & Neo 160 mcg/min) ,[object Object],[object Object],[object Object],[object Object]

Vent mgt…your choice… ,[object Object],[object Object],[object Object],[object Object]

What we MEAN by airway pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

In contrast, to raise mean airway pressure using PEEP alone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Inversion Pressure Flow Volume

Other benefits of APRV & PCV- IR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ABG 1 hr after vent changes ( 7 hrs after initial interventions) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Thank you!! ,[object Object],[object Object],[object Object],[object Object]

Donor management with simulation

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