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. Came out in 1986. x exp[0.02

E-9-1-1 269

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

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. Neonatal resuscitation is common; 10 percent of the four million newborns in the U.S. each year will require at least some intervention. 2016;8:11-19.

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Epinephrine Emergency Department EMS OR 98

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.

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.

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Epinephrine Emergency Department EMS ALS 130

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. Below (Figure A) I have marked the end of the QRS complexes by drawing a vertical line through the J-point of the standard and precordial leads.

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. . * Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU). But it’s not that straightforward.

CPR 130

CPR ICU Critical Care Defibrillator 130

REBEL EM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

Core EM

JANUARY 25, 2024

Published June 2020. Written by: Sadakat Chowdhury MD Edited by: Mak Sarich MD, Jay Lin MD, Jonathan Kobles MD Background: Ultrasound (US) guided nerve blocks offer an applicable option for achieving analgesia in the emergency department. Blocks with larger volumes of anesthetic carry higher risk of LAST. mL/kg over 1 min, then 0.25

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Epinephrine ED OR Emergency Department 246

The Skeptics' Guide to EM

FEBRUARY 20, 2021

Myth #1: The use of non-selective NSAIDs will cause a nonunion in long bone fractures When bones break, they usually heal with either surgical or non-surgical management. Sometimes the healing process can take longer than usual (delayed union), does not heal (non-union) or in poor alignment (malunion). J Bone Joint Surg Am.

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Epinephrine ALS OR 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

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.

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

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] Question: What’s the next step in your evaluation and treatment, and what is the potentially life-threatening diagnosis? 2] Bacterial infection usually preceded by viral infection.

EMS 86

EMS E-9-1-1 Epinephrine OR 86

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. mEq/L (OR: 51.11; 95% CI: 3.12−1639.16;

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

Dr. Smith's ECG Blog

JULY 21, 2024

Epinephrine infusion was begun. You can see Left Main and Proximal LAD obstruction, but with some flow, which is saving this patient's life. Immediately after contrast injection into the LMCA, the patient had circulatory collapse, with a precipitous drop in blood pressure. Subsequent PCI of the LMCA and LAD was performed.

Defibrillator 113

Defibrillator Coronary ALS STEMI 113

FOAMfrat

OCTOBER 20, 2023

Of note, in the paper by Russotto et al., the patients had to have an oxygen saturation greater than 80%, a blood pressure of 90 SYS/MAP 65 or higher, and not have required intubation due to cardiac arrest prior to the intubation procedure for inclusion. How Do I Predict Physiologically Difficult Airways? Recommendations : 1. are at high risk.

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E-9-1-1 ALS ACS OR 52

ACEP Now

NOVEMBER 14, 2023

The definition of massive hemoptysis is variable across publications with expectorated blood volumes ranging from 100 to 1,000 mL per 24 hours, as these volumes are difficult to estimate for any given patient. 2 Death from hemoptysis is akin to drowning, so airway considerations usually take precedence over hemodynamic considerations.

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E-9-1-1 ALS Emergency Department 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.

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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

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

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.

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E-9-1-1 CPR ICU ALS 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

FOAMfrat

SEPTEMBER 19, 2024

Background and Epidemiology In the United States, roughly 9,000 snake bites are reported annually, with approximately 3,000 being attributed to venomous species and less than 10 resulting in death. Many bites are associated with (human) consumption of alcohol. Fortunately, overall prognosis for snake envenomation within the U.S. Neither will the ER.

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. How long should a patient be observed after a bupropion overdose? Background: Bupropion is used increasingly as an antidepressant and is used for weight management, smoking cessation, ADHD and eating disorders. 3 Seizures are dose-dependent. EMIT II immunoassay).

Overdose 66

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

EMDocs

JANUARY 20, 2024

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.

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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.

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Defibrillator Paramedic CPR EMS 52