Dr. Roth begins this lesson with a reflection of bygone years, saying, “The world is no longer the way where you could just say, ‘If I only knew what the cardiac output was, it would tell me something.'”
He’s right, and it’s precisely the reason why hemodynamic ultrasound technology is so vitally important for older, sicker patients with multiple co-morbidities.
Learn more when you watch this 2:45 video featuring ImaCor founder, Dr. Scott Roth.
“It’s like the 80/20 rule, the Pareto principle, the 80/20 rule, okay?
In order to get into the ICU in this day and age, we don’t have 50-year olds with pneumonia going to ICU. We don’t have a 60-year old who had a stent, and heart attack go to the ICU, for the most part.
The people that we have who come to this higher acute care situation are, by definition, these high risk, complex patients.
This is the driver for what’s going on inside the health care system and inside ICUs.
The reason that it isn’t good enough to just let your doctors run around and use whatever they have available, knew how to do this 20 years ago.
It might have worked 20 years ago where on a trauma service, you had a 20-year old, gunshot wound, and guy is bleeding out on the floor. That’s a volume problem, hello, right? That’s not that difficult to figure out.
And it’s the reason physicians are running around using their old methods, it doesn’t really matter, okay? Who cares what they’re doing? Because, I didn’t need a FlowTrack to figure that out, the guys bleeding on the floor. It’s a single-issue problem.
It’s hypovolemia, give volume.
What happens when you become older, sicker, with multiple comorbidities and complex procedures, with all sorts of different things going on? That’s a multi-system problem.
There is some volume issue that you have to deal with. There’s some cardiac function issue, the heart muscle, the myocardia function, and there’s some distributive issue and these things will occur simultaneously.
You can’t figure this out or manage it with any one parameter.
So, this is like the difference between seeing the world the way it is versus seeing the world the way you wish that it were.
The world is no longer the way that it used to be where you could just say, ‘If I only knew what the cardiac output was it would tell me something.’
If the world was simple that might help you, but in the land of the mixed picture it really won’t help you. And so what you need is to have the ability to manage multiple levers simultaneously.”