2019, ACS and ICU - Paramedicine Now

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

REBEL EM

NOVEMBER 30, 2023

Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. References: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. May 1, 2019 , A5999-A5999. Outcomes: Primary Outcome: In-hospital mortality. 2.89, p = 0.01.

E-9-1-1

E-9-1-1 ALS ACS ICU

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

2019 Jan 24;14:263-292. Chinawa JM, Ubesie AC, Chukwu BF, Ikefuna AN, Emodi IJ. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1

E-9-1-1

E-9-1-1 ICU ACS EMS

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

Opioids do not cause ACS but they can exacerbate hypoxia in patients with ACS. Older children and adults usually present with ACS 2-3 days after hospitalisation due to pulmonary infarction (in situ sickling), hypoventilation due to rib infarction (which may be exacerbated by recent narcotic administration) or fat embolism.

E-9-1-1

E-9-1-1 ACS OR ICU

Tasty Morsels of Critical Care 072 | Cardiorenal syndrome

Emergency Medicine Ireland

JULY 3, 2023

Type 1 is the acute deterioration in kidney function seen in cardiogenic shock from ACS. It is important to realise that a referral to ICU for refractory cardiorenal syndrome may simply be a sign that the patient is reaching end of life. Circulation 139, e840–e878 (2019). I’ll let that sink in. – Mullens, W.,

Critical Care

Critical Care ACS OR ALS

ToxCard: Acute Organophosphate Toxicity

EMDocs

JUNE 7, 2023

Disposition is often admission to an intensive care unit (ICU) setting. Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. 12784 Povey AC, Rees HG, Thompson JP, Watkins G, Stocks SJ, Karalliedde L. Airway management should not be delayed. Br J Clin Pharmacol.

E-9-1-1

E-9-1-1 ICU Emergency Department ED

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

JANUARY 9, 2024

Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)? Cardioversion will address the rhythm problem immediately, also if the chest discomfort subsides when SR is restored, ischemia from ACS becomes much less likely. In either case, prompt cardioversion is indicated.

Coronary

Coronary ACS ED OR

A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

OCTOBER 25, 2023

Moreover, the Queen is only supposed to be used with a high pretest probability of ACS/OMI. The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. We just finished training version 2 with some cases of hypokalemia, so that is in the future.

Overdose

Overdose OR ACS ICU

Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

REBEL EM

FEBRUARY 2, 2023

Based on 2019 American Heart Association (AHA) guidelines, amiodarone and digoxin have been suggested as alternative options in controlling ventricular rate refractory to first-line BBs and non-DHP CCBs. 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU).

Emergency Department

Emergency Department ALS Critical Care ED

What will you do for this patient transferred to you who is now asymptomatic?

Dr. Smith's ECG Blog

MARCH 6, 2019

She did not receive any opioids (which would mask her pain without affecting any underlying ACS). I believe this is by far the most common outcome for this patient around the world in 2019. By the time the patient arrived at our facility, she had received aspirin and nitroglycerin, and her pain had apparently completely resolved.

STEMI

STEMI ALS ACS OR

"Pericarditis" strikes again

Dr. Smith's ECG Blog

DECEMBER 13, 2019

Written by Pendell Meyers A man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. The cardiologists felt that the ECG did not represent ACS, and thought it was more likely pericarditis, so they did not take him to the cath lab. in the ICU but survived with excellent function.

E-9-1-1

E-9-1-1 ACS Coronary CAD

Penetrating chest trauma

Don't Forget the Bubbles

JUNE 30, 2023

They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. 2019 Aug;31(4):683-687. The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. Trauma Surg Acute Care Open.

E-9-1-1

E-9-1-1 FFP Plasma Emergency Department

Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

SEPTEMBER 25, 2023

Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19). References: Heffner AC et al. 2019, 64:617-28. Resuscitation 2013; 84(11): 1500 – 4. PMID: 23911630 Kim WY et al. 1985, 25:347-9.

ED

ED Emergency Department ALS Paramedic

A Patient with Respiratory Failure and a Computer "Normal" ECG

Dr. Smith's ECG Blog

MARCH 11, 2019

The patient was managed in the ICU and had serial troponins. An angiogram confirmed ACS as the etiology. (THE PM CARDIO OMI AI APP) If you want this bot to help you make the early diagnosis of OMI and save your patient and his/her myocardium, you can sign up to get an early beta version of the bot here. He had no more ECGs recorded.

OR

OR ACS ICU STEMI

ABG Versus VBG in the Emergency Department

EMDocs

FEBRUARY 12, 2024

In this situation, an ABG should be obtained periodically for correlation, though this is more relevant for the intensive care unit (ICU) setting than in routine ED care (5, 9). 11) Webb RK, Ralston AC, Runciman WB. Journal of Trauma and Injury 2019; 32(4): 238-242. Epub 2019 Dec 30. Epub 2019 Jul 18. 10) Jubran A.

Emergency Department

Emergency Department E-9-1-1 ED ICU

Paramedicine Now

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

emDOCs Revamp – Acute Chest Syndrome

Trending Sources

Sickle Cell Disease Module

Tasty Morsels of Critical Care 072 | Cardiorenal syndrome

ToxCard: Acute Organophosphate Toxicity

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

A man in his 60s with syncope and ST depression. What does the ECG mean?

Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

What will you do for this patient transferred to you who is now asymptomatic?

"Pericarditis" strikes again

Penetrating chest trauma

Beyond Ketamine: When to use Facilitated Intubation in the ED

A Patient with Respiratory Failure and a Computer "Normal" ECG

ABG Versus VBG in the Emergency Department

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