Cases/

Someone cranked the gate overnight

V-AVintermediate00:00Score 100
V-AV-ECMOintermediate6 min

Someone cranked the gate overnight

Handover

V-AV for Harlequin, balanced on both limbs last night with a flow probe on each return. Overnight someone cranked the venous-return gate nearly shut. Qven 0.3 L, Qart 4.2 L. Right-hand sat is sliding and the venous limb looks dark and sluggish. A nearly occluded limb is a clot factory.

Uncorrected hypoxemia, shock, or a dead circuit progresses to pre-arrest, then a code.

Goals

  • · Qven ≥ 1.0 L
  • · Upper SpO₂ ≥ 86%
  • · Qart still ≥ 1.8 L