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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

Date: December 6th , 2018 Reference: Perkins et al. Date: December 6th , 2018 Reference: Perkins et al. A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation. JAMA 2009, Hagihara et al. JAMA 2012 and Cournoyer et al. He is unsuccessfully shocked.

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EM@3AM: Brugada Syndrome

EMDocs

Patients with Brugada syndrome should have a prompt cardiology consultation for consideration of implantable defibrillator placement due to the high risk of sudden cardiac death. Rosh Review Website Link References Antzelevitch C, Brugada P, Borggrefe M, et al. Priori SG, Napolitano C, Gasparini M, et al. 2012 May;9(5):752-9.

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What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

We examined the effect of ibutilide, a class III antiarrhythmic agent, on the energy requirement for atrial defibrillation and assessed the value of this agent in facilitating cardioversion in patients with atrial fibrillation that is resistant to conventional transthoracic cardioversion.

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Cardiac Care Show – Episode 1: Mechanical CPR

ECG Medical Training

Let’s also not forget that these patients still require ventilation and they still require defibrillation! When this was first studied by Yost et al. in 2012, researchers discovered that the median application time was 32.5 Perkins GD, Lall R, Quinn T, et al. Rubertsson S, Lindgren E, Smekal D, et al.

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A Middle-Aged male with Chest Pain and an Unusual ECG

Dr. Smith's ECG Blog

Excerpted from Vutthikraivit et al: Acta Cardiol Sin 34:267-277, 2018 ). == Distinction is made between 2 types of Brugada ECG patterns: A B rugada - 1 ECG pattern — shows ≥2 mm coved ST elevation with sharp downslope plus T wave inversion in ≥2 anterior leads. Cardioversion/defibrillation. Electrocardiol 45:433-442, 2012 ).

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Seizure in a 30 something

Dr. Smith's ECG Blog

This episode self terminated before defibrillation was possible. See Costagliola et al — Ann Clin Transl Neurol 8(7): 1557-1568, 2021 — for more on the complex "Brain-Heart Interaction" in Epilepsy ). This run of TdP is initiated by a PVC — but it then self-terminates. Discussion : The patient in today’s case presented with "seizures".

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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al.,

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