The Skeptics' Guide to EM

APRIL 20, 2019

The article was called “A lexicon for gender bias in academia and medicine: Mansplaining is the tip of the iceberg” It was published in the December 2018 edition of the BMJ. Esther Choo et al. Theme music is an important part of the SGEM. Background: We have busted many myths on the SGEM over the years.

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ACEP Now

JULY 7, 2023

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. 5 More recent literature defines “refractory” as VT or VF that is persistent or recurrent despite three shocks from a defibrillator, three rounds of epinephrine, and use of an antiarrhythmic (i.e.,

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Don't Forget the Bubbles

DECEMBER 25, 2023

Disease-Oriented Outcomes (DOOs) The PARAMEDIC-2 trial looked at the effectiveness of epinephrine in adult patients who suffered an out-of-hospital cardiac arrest. They found that epinephrine administration was associated with higher survival at 30 days ( 3.2% doi:10.1136/bmjebm-2018-110891 Perkins GD, Ji C, Deakin CD, et al.

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Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was administered thrombolytics and shortly after the lytics were administered, the systolic blood pressure rose to about 80mmHg with ongoing epinephrine infusion. Thrombolytics can be life saving in this situation. The below ECG (ECG #4) was recorded.

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EMDocs

JANUARY 16, 2024

The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU. Resuscitation 2018.

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REBEL EM

JULY 18, 2022

When simple maneuvers fail, we proceed to topical agents such as lidocaine with epinephrine, oxymetazoline, anterior nasal packing, and electrical or chemical cauterization. Initial interventions include local pressure, ice, and forward head positioning for persistent bleeds. Read More: REBEL EM: The NoPAC Trial – TXA for Epistaxis?

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Dr. Smith's ECG Blog

JULY 24, 2018

They stated that the patient was coded for 20 minutes, including multiple doses of epinephrine, and they also gave glucose, calcium, and bicarb. As stated above, resuscitation included epinephrine, calcium, and bicarb. They achieved ROSC and wanted to transfer to our institution for post-arrest care. After ROSC achieved: Sinus rhythm.

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ECG & Echo Learning

OCTOBER 2, 2022

Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: which is best? JAMA 2018; 319:1889. Crit Care 2018; 22:131. Increases coronary blood flow.

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REBEL EM

JANUARY 23, 2023

Second-generation H1 antihistamines (cetirizine, loratadine, and fexofenadine) do not cross the blood-brain barrier as easily (Bernstein J 2018). Philadelphia: Wolters Kluwer Health; 2018. They are less sedating compared to first-generation antihistamines and have fewer associated adverse effects. Bernstein J, Leslie T. Antihistamines.

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Dr. Smith's ECG Blog

NOVEMBER 9, 2018

Chronotropic support with Isoproterenol, Epinephrine, or Dopamine to increase ventricular escape rate. John L = My Comment , by K EN G RAUER, MD ( 11/9/2018 ): = Interpretation of pacemaker tracings used to be straightforward and surprisingly simple when all the provider had to worry about were VVI pacemakers. External pacing 5.

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Dr. Smith's ECG Blog

APRIL 6, 2018

Chest compressions were continued, and the patient was given 1 round of epinephrine, calcium, bicarb, glucose. In 2018 there is generally a delay to onset of dialysis in most EDs. We could have also considered terbutaline (start at 0.25

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REBEL EM

SEPTEMBER 26, 2022

What They Did Single-center randomized controlled study design performed by the Department of Hepatology & Liver transplantation in New Delhi Study participants, investigator clinicians, data collectors, and data analysts were blinded Investigators recruited participants from February 27, 2016 – March 3, 2018. were performed.

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AAEM RSA

AUGUST 27, 2020

The trial was conducted in 25 ICUs in France between 2014 and 2018. Time to TTM was statistically significantly shorter in the IC group (2.2 Time to TTM was statistically significantly shorter in the IC group (2.2 Patients were randomized in a 1:1 ratio to either the hypothermia or normothermia groups. C to a goal of 36.5 C over 24 hours.

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FOAMfrat

OCTOBER 20, 2023

Epinephrine should be considered as the vasopressor of choice in patients with decreased myocardial function. 2018 Apr;46(4):532-539. De Jong A, Rolle A, Molinari N, Paugam-Burtz C, Constantin JM, Lefrant JY, Asehnoune K, Jung B, Futier E, Chanques G, Azoulay E, Jaber S. Crit Care Med. doi: 10.1097/CCM.0000000000002925.

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ECG & Echo Learning

JANUARY 18, 2023

positive chronotropic medication (epinephrine, vasopressin, and/or atropine) is indicated – temporary pacing is indicated in cases of failure to respond to positive chronotropic medication – urgent angiography is indicated if the patient has not received previous reperfusion therapy.

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FOAMfrat

SEPTEMBER 19, 2024

These side effects do not contraindicate antivenom administration and can be treated with antihistamines and epinephrine. Hypotension and anaphylaxis should be treated with epinephrine following your local guidelines. 2018, foamed.ebmedicine.net/podcast/episode-20-emergency-department-management-of-north-american-snake-envenomations/.

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The Skeptics' Guide to EM

MARCH 5, 2022

The level of high-quality evidence had not changed much when looking at the ACC/AHA guidelines from 2008-2018. Background: There are many things in medicine that could be considered myth or dogma. We have covered some of these over the 10 years. There were 26 guidelines with 2,930 recommendations.

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Don't Forget the Bubbles

DECEMBER 5, 2023

The study included all children born between January 1, 2010, and December 31, 2018, who received a treatment for gastroesophageal reflux disease or other gastric acid–related disorders, namely PPIs, histamine 2 receptor antagonists, or antacids/alginate. The control group had no form of femoral artery occlusion or hip flexion.

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EMDocs

JANUARY 20, 2024

doi:10.25122/jml-2018-0067 Takotsubo syndrome. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome. ESC Heart Fail. 2020 Apr;7(2):400-406.

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REBEL EM

DECEMBER 19, 2022

trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.

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EMDocs

OCTOBER 29, 2024

EPINEPHRINE-INUDCED SHOCK: LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION ON VASOPRESSORS. doi:10.1136/BCR-2018-225879 Dawood S, Hill A, Al Rawi O. m/s)—problematic and elevated > 50 mm Hg (2.5 Clin Cardiol. 2009;32(7):397-402. doi:10.1002/CLC.20594 20594 MOZELL D, SHAH N, CASTILLON JJR, GONUGUNTLA VT, AWERBUCH E. doi:10.1016/J.CHEST.2024.06.1821

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