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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. An oral airway is placed, peripheral intravenous (IV) line started successfully and the paramedic asks her partner if you want to administer IV epinephrine? JAMA 2012 and Cournoyer et al.

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The Broselow-Luten System

Pediatric EM Morsels

Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. Rosenburg 2010] B-L system is designed for 12yo and younger, patients up to 80 lbs, height 46-143 cm [Meguerdichian 2012] Estimates the 50%ile weight for height (Length vs Ideal Body Weight). x exp[0.02

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IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

NAEMSP

Background Despite conflicting literature to support some pharmacological therapies in out of hospital cardiac arrest, the American Heart Association (AHA) currently recommends obtaining vascular access intravenously or intraosseously in cardiac arrest. [1] 2012 Jan;83(1):107-12. minutes versus 5.4 minutes). [5] Circulation.

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Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

AAEM RSA

For both groups, mean time to basic life support was determined to be one-minute, advanced life support started at 10 minutes, and time to ROSC at 25 minutes. Arch Intern Med 2001;161:2007-2012 13. Time to TTM was statistically significantly shorter in the IC group (2.2 Zeiner A, Holzer M, Sterz F, et al.

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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. The study included 109 hyperkalemic cardiac arrest patients from 2006 through 2012. CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. He is found to be in ventricular fibrillation (VF).

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