Current Concepts in Adult Critical Care-Case Presentation and Audience Participation

Video Transcription

And actually, the answer to this question comes straight out of Dr. Dangaich's chapter, and it's 145 mLs. And obviously, unstable patients shouldn't be moving  around too much, and a bedside transcranial Doppler would be the perfect test for this situation.  So back to our patient. Now, unfortunately, despite not rapidly improving, despite successful thrombectomy, the family starts to begin asking questions  regarding the patient's prognosis. After discussion, the family believes that if the patient is able to talk and interact with family, then he would want aggressive medical care.  So here's question one. Which of the following would be the next best step for the team? Use available scales. I'm not gonna read all these. I'll let you guys read them,  but a little bit on the longer side, so I'll give you some extra time here.  And just as a reminder, refresh your page if it doesn't show up.  A few more seconds.  The results are interesting.  Okay, we'll keep going. So the team gets him through peak brain swelling.  His mental status begins to improve and he's eventually able to interact with the providers and his family. However, the team continues to be unsure  about how he will do his extubation.  So true or false, this is an appropriate time to rediscuss plan of care with family.  And I guess this one's an easy one here.  Got 100% correct answers, awesome. Great, so the team discusses that if the patient fails extubation, they would need to proceed with tracheostomy.  And in the past, the patient had clearly expressed to family that he would not want to be dependent on machines. But fortunately, the team believes that once he gets a tracheostomy,  they'll be able to wean him off the ventilator pretty quickly and transition over to trach collar.  So last question.  Don't know what's going on here. Can you reset? Thank you. All right, last question here. Can we go forward and back real quick?  And I'll let you guys answer this one as well.  You'll be proud to know our audience is getting 100% right on this one. Yeah, close, very close. It's been pretty good.  All right.

Video Summary

The video discusses a patient who had a successful thrombectomy but did not rapidly improve. The family is involved in decision-making regarding the patient's prognosis. The medical team considers the patient's wishes for aggressive care, especially regarding extubation and potential tracheostomy. The team aims to wean the patient off the ventilator quickly post-tracheostomy. Multiple questions are posed to the audience throughout the video, prompting discussions about next steps and involving family in care decisions. The audience consistently responds correctly to the questions, indicating a good understanding of the presented case study.

Keywords

thrombectomy

patient prognosis

family involvement

ventilator weaning

care decisions

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.