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How Much O2 Is Right in COVID?

REBEL EM

Lower vs higher oxygenation target and days alive without life support in COVID-19. Population: Adult patients ( > 18 years of age) admitted to the ICU with COVID-19 and severe hypoxemia (defined as receiving supplemental O2 with a flow rate of at least 10L/min or receiving mechanical ventilation or non-invasive ventilation.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. If AFE occurs during labor, immediate delivery is recommended. Electronic address, p. “Amniotic fluid embolism: diagnosis and management.” ” Am J Obstet Gynecol 215(2): B16-24. link] j.ajog.2016.03.012

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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive. For patients who in cardiac arrest standard Advanced Cardiac Life Support (ACLS) should be initiated. McGraw Hill Companies, Inc; 2019. 2022;59:42-48. BMJ Case Rep.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU. Higher Survival Chances of Hypothermic vs. Normothermic cardiac arrest patients with ECLS re-warming, Resuscitation, Volume 134, 2019, Pages 161-162, ISSN 0300-9572. doi: 10.1097/MAT.0000000000001518

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The Science on Targeted Temperature Management

ACEP Now

3,4 The Hyperion trial in 2019 demonstrated that TTM at 33 degrees Celsius was efficacious for non-shockable rhythms, reinforcing the guidelines recommendation for post-arrest TTM. Changing target temperature from 33 °C to 36 °C in the ICU management of out-of-hospital cardiac arrest: A before and after study. N Engl J Med.

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

REBEL EM

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).

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POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., 2019 Oct-Dec;29(4):169-171. 2014 May;145(5):950-957. doi: 10.1378/chest.13-1087. PMID: 24092475.

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