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John Wilmas

John Wilmas

Physician and EMS Medical Director at Mercy Hospital St. Louis; Chief Physician Advisor and Medical Director at Air Methods Corp., co-host of the Air Methods Prehospital EDucation (AMPED) Podcast.

Sep 16, 2026

7:34
Can one of you kind of refresh our audience as to what that means in regards to the patient's heart and why then a balloon pump is indicated for that?
7:42
So ejection fraction simply means how much of the blood is coming out of the heart or is being ejected from the heart with every beat.
7:50
I think most people, well, most non-medical people think that when the heart beats, 100% of the blood comes out of it and it gets pumped forward.
7:57
And that's not the case at all.
7:59
For a normal heart, you know, 65, 70% or so of the blood will get ejected.
8:04
That is, gets pumped to the body.
8:06
And a severe heart failure, I mean, which is what this patient has.

15 MINS LATER

23:25
For context, a regular systolic blood pressure is around 120 millimeters of mercury.
7:14
And Dr. Wilmes, do you want to explain an ER mentality when you have that 88% on room air, who's somebody who's short of tachycardic, who's 33 years old, what your typical workup is?
7:25
Young guy, hypoxic, you know, kind of start developing a differential for that.
7:30
I was kind of joking about PE, but you hear hypoxemia, young person, tachycardic.
7:34
I mean, that's a PE, you know, that's a PE brewing until proving otherwise.
7:39
But this young guy has a, you know, autoimmune disorder.
7:43
So you have to kind of worry about things associated with that.
7:46
Certainly still infection is going to be high on the list, right? So does he have a pneumonia? Does he have a viral pneumonitis? Those sorts of things.
10:02
So tell us what you're worried about and what you're always going to be watching for, especially with the 33-year-old gentleman with pneumonia, labs really getting funky, a complete whiteout of his right lung.

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