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 104

ALS Epinephrine Critical Care Emergency Department 104

Core EM

JANUARY 25, 2024

Treasure Island (FL): StatPearls Publishing; July 31, 2021. [7] Gulec, Nazey. 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. mL/kg over 1 min, then 0.25 In: StatPearls.

Epinephrine 246

Epinephrine ED OR Emergency Department 246

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.

Defibrillator 84

Defibrillator CPR Epinephrine Life Support 84

NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. Resuscitation 2021 [1] In a separate study, Clemency et al performed a retrospective chart review which showed comparable rates of ROSC in patients who received IO vs IV (19.9% minutes).

E-9-1-1 52

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

Dr. Smith's ECG Blog

APRIL 2, 2024

link] __ Case continued There was hypotension, initially controlled with an epinephrine infusion. Angiogram in 2021 was normal. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines. Here is the initial ED ECG. What do you think? Rhythm : Residents asked me why it is not VT. So it must be atrial fibrillation.

Defibrillator 132

Defibrillator Coronary Epinephrine CPR 132

FOAMfrat

OCTOBER 1, 2023

We’re going to be discussing all things DROP FACTOR, including tubing and formula calculations! This is your warning. This is a MATH BLOG. Drop factors can be intimidating if we don’t have a good understanding of how med math works or what drop tubing is. That being said, today we will cover what drop factor tubing is. Infusion pumps are safer.

OR 52

OR Epinephrine 52

ECG & Echo Learning

OCTOBER 2, 2022

Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 J Intensive Care Med 2021; 36:101. Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: which is best? Minimal chronotropic effect. Increases coronary blood flow.

E-9-1-1 52

E-9-1-1 ALS Coronary Epinephrine 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 117

Defibrillator Coronary ALS STEMI 117

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. Date: January 5th, 2021 Reference: Grunau et al. This has included things like therapeutic hypothermia ( SGEM#54 , SGEM#82 , SGEM#183 and SGEM#275 ), supraglottic devices ( SGEM#247 ), crowd sourcing CPR ( SGEM#143 and SGEM#306 ), and epinephrine ( SGEM#238 ).

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. Additionally, low ionized calcium levels have been correlated with increasing mortality in sepsis and other critical illnesses in adults and children (Bora, Ramazan, Oznur, Emre, & Basar, 2021), (Sanchez, et al.,

E-9-1-1 52

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

REBEL EM

NOVEMBER 6, 2023

to 1mg/kg/hr) Information regarding the vasopressors used in the study is as follows: Norepinephrine equivalents = norepinephrine mcg/kg/min + (phenylephrine mcg/kg/min/10) + epinephrine mcg/kg/min + (vasopressin units/min x2.5) This dysregulation of vasodilation is associated with a mortality of close to 25%.

Epinephrine 70

Epinephrine ICU ALS OR 70

FOAMfrat

OCTOBER 20, 2023

However, for myself, my go-to recommendation/source is from the Society of Airway Management’s Consensus Recommendations article in February 2021, published by the International Anesthesia Research Society. Of note, in the paper by Russotto et al., How Do I Predict Physiologically Difficult Airways? Two or more IVs are suggested, typically.

E-9-1-1 52

E-9-1-1 ALS ACS OR 52

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. The systematic review and meta-analysis by Janapala et al (2) was performed in April of 2021 and concluded that TXA is beneficial in the cessation of epistaxis.

E-9-1-1 52

E-9-1-1 Epinephrine ED ALS 52

Broome Docs

APRIL 6, 2023

2022 Dec 16:emermed-2021-211946. doi: 10.1136/emermed-2021-211946. Epinephrine metered-dose inhaler for pediatric croup. Casey The CLOVERS trial: National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, et al. N Engl J Med.

Epinephrine 52

Epinephrine ED Emergency Department ALS 52

EMDocs

DECEMBER 18, 2023

The most recent surviving sepsis campaign (SSC) guidelines were released in 2021, which provided 93 recommendations for evidence-based sepsis management. 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

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E-9-1-1 ALS Emergency Department Plasma 65