Pediatric EM Morsels

JULY 19, 2024

Soak the gauze with epinephrine (1:10,000) or TXA (our THIRD route of administration) Apply pressure laterally to the tonsillar fossa with the gauze covered Magill forceps. 2020 Sep;38(9):1943. Epub 2020 Jan 29. . < 25 kg = 250 mg up to 3x > 25 kg = 500 mg up to 3x Direct Pressure Always the best way to stop bleeding.

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E-9-1-1 Epinephrine Emergency Department OR 286

EMDocs

JANUARY 23, 2024

2020 Aug;59(2):216-223. Remember to treat all components of the disease, including the underlying cause, once identified. References: Farkas JD, Long B, Koyfman A, Menson K. BRASH Syndrome: Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalemia. J Emerg Med. doi: 10.1016/j.jemermed.2020.05.001. 2020.05.001.

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Epinephrine Overdose OR 87

Pediatric EM Morsels

OCTOBER 27, 2023

DeBoer 2020] Now seen as industry standard in pediatric emergency care. Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. Published 2020 Feb 12.

E-9-1-1 269

E-9-1-1 Emergency Medical Services Life Support ALS 269

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? Date: January 5th, 2021 Reference: Grunau et al. Reference: Grunau et al.

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Date: September 16th, 2020 Guest Skeptics: Dr. Robert Goulden and Dr. Audrey Marcotte are Chief Residents from the Royal College of Emergency Medicine Program at McGill University. The Lancet 2020 This was an SGEM Journal Club episode recorded live at McGill University Grand Rounds.

Epinephrine 130

Epinephrine Emergency Department EMS ALS 130

ACEP Now

NOVEMBER 6, 2024

mg/kg IV epinephrine, or 0.05–0.1 Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. ET tube size should be 2.5 mm for neonates under 1,000 grams, 3.0 mm for 1,000–2,000 grams, and 3.5 for neonates over 2,000 grams. 3 Dr. Adv Med Educ Pract.

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Epinephrine Emergency Department EMS OR 98

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.

Coronary 125

Coronary ACS Emergency Department Defibrillator 125

The Skeptics' Guide to EM

FEBRUARY 25, 2023

1] The SGEM has covered the use of epinephrine, vasopressin, methylprednisolone, and calcium for cardiac arrest in SGEM#238 , SGEM#350 , and SGEM#353. Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Today we are focusing on sodium bicarbonate.

CPR 130

CPR ICU Critical Care Defibrillator 130

The Skeptics' Guide to EM

APRIL 4, 2020

Date: April 4th, 2020 It has been just over a year since Dr. Salim Razaie (REBEL EM) and I stepped into the ring for a boxing matched theme debate in Sydney, Australia. Date: April 4th, 2020 It has been just over a year since Dr. Salim Razaie ( REBEL EM) and I stepped into the ring for a boxing matched theme debate in Sydney, Australia.

Critical Care 130

Critical Care Epinephrine CPR Ambulance 130

The Skeptics' Guide to EM

FEBRUARY 20, 2021

SGEM#317: Dese bones gonna heal again, with or without a non-selective NSAID Reference: George et al. Risk of Nonunion with Nonselective NSAIDs, COX-2 Inhibitors, and Opioids. J Bone Joint Surg Am.

Epinephrine 130

Epinephrine ALS OR 130

REBEL EM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Resuscitation. 2012 PMID: 21893125. 9 Zhang W et al. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. Medicine (Baltimore). PMID: 33350794 10 Meilandt C.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. American Journal of Emergency Medicine 2019 [9] Finally, a prospective study in 2020 compared outcomes in OHCA in patients who received IV+IO access versus patients who received only IV access.

E-9-1-1 52

E-9-1-1 Advanced Life Support Epinephrine Life Support 52

Core EM

JANUARY 25, 2024

Published June 2020. 15-30 5-24 Adverse effects : Infection Vascular injury including hematoma or pseudoaneurysm formation Nerve damage Local anesthesia systemic toxicity (LAST) – confusion, anxiety, headache, drowsiness, hypotension, arrhythmias including ventricular tachycardia or fibrillation. J Emerg Trauma Shock. 2012;5(1):28-32.

Epinephrine 246

Epinephrine ED OR Emergency Department 246

The Overrun Podcast

MARCH 28, 2021

Check out Dr. Antevy’s stuff at: [link] Early epinephrine administration improving outcomes: [link] We talk about the AHA PALS guidelines for 2020, here they are: [link] The Polk County study on pediatric OHCA: [link] Time on scene in pediatric arrest matters: [link] Ed and Dan sit down with Dr.

Epinephrine 52

Epinephrine Paramedic ED EMS 52

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.,

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

EMDocs

OCTOBER 19, 2024

2][3] Bacterial tracheitis should be suspected over croup if nebulized racemic epinephrine or steroids do not improve the clinical course. [2][3][8] Published 2020. However, these patients often present with drooling and a preference for the tripod position, which is uncommon in bacterial tracheitis. [2][3] Georgiaemsacademy.com.

EMS 87

EMS E-9-1-1 Epinephrine OR 87

NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. 2020) thus lending itself to a potential drug for cardiac arrest. 2020), but IV Calcium is still used routinely in some cases in the critical care setting, such as congenital heart disease. 2020, Sep 4). Kaufman, C.,

E-9-1-1 52

E-9-1-1 Advanced Life Support Overdose CPR 52

Dr. Smith's ECG Blog

JULY 21, 2024

Epinephrine infusion was begun. As I review in My Comment in the January 16, 2020 post of Dr. Smith's ECG Blog ( and have reproduced in Figure-2 below ) — the ECG of patients with acute LMCA occlusion may be varied. You can see Left Main and Proximal LAD obstruction, but with some flow, which is saving this patient's life.

Defibrillator 113

Defibrillator Coronary ALS STEMI 113

FOAMfrat

OCTOBER 20, 2023

Epinephrine should be considered as the vasopressor of choice in patients with decreased myocardial function. 2020 Fall;20(3):97-102. 2020) Risk factors for and prediction of post-intubation hypotension in critically ill adults: A multicenter prospective cohort study. 2020 Jul;125(1):e18-e21. Epub 2020 May 8.

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E-9-1-1 ALS ACS OR 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury.

E-9-1-1 52

E-9-1-1 STEMI Coronary ALS 52

REBEL EM

JANUARY 23, 2023

Ann Emerg Med 2020. Article: Abella BS et al. Intravenous Cetirizine Versus Intravenous Diphenhydramine for the Treatment of Acute Urticaria: A Phase III Randomized Controlled Noninferiority Trial. Patients were randomized in a 1:1 ratio. A contraindication, known allergy, or suspected intolerability to the study medication.

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

ACEP Now

NOVEMBER 14, 2023

2020 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants: A report of the American College of Cardiology solution set oversight committee. 13,14 The typical regimen is 500 mg three times daily. Gopinath B, Mishra PR, Aggarwal P, et al. 2023;163(5):1176-1184.

E-9-1-1 52

E-9-1-1 ALS Emergency Department OR 52

Dr. Smith's ECG Blog

APRIL 29, 2020

She was given 3 mg IV epinephrine and multiple rounds of ACLS over approximately 20 minutes. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. A 60-something woman presented after a witnessed cardiac arrest. CPR was started immediately.

Defibrillator 52

Defibrillator Epinephrine Coronary Overdose 52

Dr. Smith's ECG Blog

JANUARY 19, 2020

At about 30 minutes after presentation, the patient had acceptable vital signs with the TVP and low dose epinephrine drip. Consider thrombolytics for OMI when PCI is not an option. == MY Comment by K EN G RAUER, MD ( 1/19/2020 ): == There is a LOT to talk about regarding the series of tracings in this unfortunate case. mm STE with 9.5

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E-9-1-1 STEMI ED EMS 52

AAEM RSA

AUGUST 27, 2020

Douglas, MD; Taylor Conrad, MD, MS; Theodore Segarra, MD; Christianna Sim, MD, MPH Editors: Kelly Maurelus MD FAAEM, Kami Hu MD FAAEM Originally published: Common Sense July/August 2020 Introduction The ability to obtain good neurological outcomes after cardiac arrest is often limited.

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

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. 2020, www.cdc.gov/niosh/topics/snakes/types.html. Medscape , emedicine.medscape.com/article/771701-treatment.

Emergency Department 90

Emergency Department Epinephrine OR Plasma 90

EMDocs

JANUARY 4, 2024

In 2020, bupropion was the 18 th most-prescribed medication in the USA. Other Norepinephrine or epinephrine are preferred vasopressors when needed. References: The Top 200 Drugs of 2020. How long should a patient be observed after a bupropion overdose? Consider lidocaine for associated dysrhythmias. Accessed 12/18/2022.

Overdose 66

Overdose E-9-1-1 ALS Emergency Department 66

EMDocs

JANUARY 20, 2024

2020 Apr;7(2):400-406. 2020 Jan 3;12(1):e6556. 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. J Med Life. Eur Heart J.

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E-9-1-1 EMS Coronary ACS 74

REBEL EM

DECEMBER 19, 2022

That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here. At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Now that same group has published the results of their full randomized control trial. N Engl J Med.

Defibrillator 52

Defibrillator Paramedic CPR EMS 52