2023, ALS and Life Support - Paramedicine Now

Extracorporeal Life Support in Infarct-Related Cardiogenic Shock

EMOttawa

JANUARY 29, 2024

5 Thiele H, et al. 2023 Oct 5;389(14):1286-1297. Methods: Open label RCT with 417 patients comparing 30-day all-cause mortality between ECLS versus standard […] The post Extracorporeal Life Support in Infarct-Related Cardiogenic Shock appeared first on EMOttawa Blog. Methodology: 4/5 Usefulness: 3.5/5 N Engl J Med.

Life Support

Life Support ALS Critical Care

SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs

The Skeptics' Guide to EM

OCTOBER 14, 2023

Reference: Brennan L et al. March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom. Reference: Brennan L et al. Time to change the reference ranges of children’s physiological observations in emergency care?

Life Support

Life Support Advanced Life Support Emergency Department ALS

SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

The Skeptics' Guide to EM

JANUARY 13, 2024

Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Resuscitation 2023. Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Resuscitation 2023. On your arrival, first responders from the fire department are performing high-quality basic cardiac life support.

CPR

CPR Defibrillator First Responder Epinephrine

The Broselow-Luten System

Pediatric EM Morsels

OCTOBER 27, 2023

PAWPER was more accurate than EPLS (European life support formula) as well. Available at: [link] (Accessed: 26 October 2023). Available at: [link] (Accessed: 27 October 2023). link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al.

E-9-1-1

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

SGEM#443: Don’t Stop Me Now – REBOA for Hemorrhage Control in Trauma Patients?

The Skeptics' Guide to EM

JUNE 15, 2024

Reference: Jansen et al. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program. You wonder what the evidence is for this additional approach.

Life Support

Life Support Emergency Department ALS

2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

NOVEMBER 6, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. COR 2a, LOE C-LD.

Naloxone

Naloxone OR Overdose BLS

SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking

The Skeptics' Guide to EM

MARCH 11, 2023

Date: March 8, 2023 Reference: Smida et al. Date: March 8, 2023 Reference: Smida et al. Prehospital Emergency Care 2023 Guest Skeptic: Dr. Chris Root is a third-year resident physician in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM.

CPR

CPR Defibrillator BLS Paramedic

Reference ranges of paediatric heart rate and respiratory rate

Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al.

Life Support

Life Support Advanced Life Support ALS Emergency Department

The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

REBEL EM

SEPTEMBER 14, 2023

Revascularization of the culprit lesion remains one of the few established treatments though there are numerous other unproven modalities including extracorporeal life support (ECLS). Zeymer HT et al. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. References: Zeymer HT et al.

Life Support

Life Support Coronary CPR ICU

I smell a pool, we don't have a pool.

FOAMfrat

JULY 3, 2024

If they are not already there, get ALS-level care to the patient as soon as possible. Physical exam findings for acute exposures to chlorine (generally > 5 ppm): (Guldner GT, 2023) Tachypnea Cyanosis Wheezes, Intercostal retractions Decreased lung sounds, Rales, nasal flaring, stridor Hemorrhage in the respiratory tract, and rhinorrhea.

Life Support

Life Support ALS Emergency Response OR

EMS vs. EMT: Clarifying Roles in Emergency Healthcare

EMT Training Station

FEBRUARY 11, 2024

This could range from basic life support, typically managed by EMTs, to more advanced life support provided by paramedics and other medical specialists. EMTs, for example, are trained in basic life support, while paramedics receive more advanced training, including in pharmacology, cardiology, and trauma care.

EMT

EMT EMT Emergency Medical Technician Emergency Medical Services

Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

JANUARY 16, 2024

Carsten L, et al. link] Published February 12, 2023. Accessed September 30, 2023. Extracorporeal Life Support in Accidental Hypothermia with Cardiac Arrest—A Narrative Review. link] Published April 13, 2023. Accessed September 30, 2023. Monika BM, Martin D, Balthasar E, et al. 2009;338:b2085.

Defibrillator

Defibrillator CPR Epinephrine Life Support

EM@3AM: Amniotic Fluid Embolism

EMDocs

JUNE 22, 2024

Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. 2023 Dec 13;52(2):126-135. doi: 10.1515/jpm-2023-0365. If AFE occurs during labor, immediate delivery is recommended. Amniotic fluid embolism: a reappraisal. J Perinat Med. PMID: 38082418. link] j.ajog.2016.03.012

EMS

EMS Ambulance FFP ICU

Hypothermia and drowning

Don't Forget the Bubbles

JUNE 30, 2023

Mazur P, Kosinski S, Podsiadlo P, et al.: Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. Meert et al. American Thoracic Society, 2020 Mazur P, Kosinski S, Podsiadlo P, et al.: Meert et al. The “sweet spot” is between 0.5-2⁰C

CPR

CPR Life Support Critical Care ALS

The Pediatric Airway: Considerations and Challenges

ACEP Now

OCTOBER 11, 2024

8 The 2023 Pediatric Advanced Life Support (PALS) guidelines recommend the following formulas for ET tubes. Kerrey BT, Rinderknecht AS, Geis GL, et al. Rinderknecht AS, Mittiga MR, Meinzen‐Derr J, et al. Bertrand P, Navarro H, Caussade S, et al. Peyton J, Park R, Staffa SJ, et al. Ann Emerg Med.

E-9-1-1

E-9-1-1 Emergency Department Advanced Life Support ALS

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

NOVEMBER 27, 2023

Although historically used quite frequently, dopamine is no longer recommended by advanced life support guidelines for septic shock unless adrenaline/noradrenaline are unavailable. Treasure Island (FL): StatPearls Publishing; January 30, 2023. Published Online First: 02 August 2023. Hibberd O, Kanaris C. 2021;25(1):146.

Advanced Life Support

Advanced Life Support ED ALS OR

Case Report: a High-Voltage Victim

ACEP Now

MARCH 14, 2024

Thus, unstable patients should be stabilized based on a physician’s trauma expertise; whether through Advanced Trauma Life Support, Trauma Combat Casualty Care, or one’s own trauma assessment. 2023 Jul 17. Treasure Island (FL): StatPearls Publishing; 2023 Jan– PMID: 28846317. Tintinalli JE, Stapczynski J, Ma O, et al.

Operating Room

Operating Room ACS Critical Care Coronary

POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

APRIL 22, 2024

Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). Alerhand et al described ten individual echocardiographic findings of RV strain that suggest PE. Available from: [link] Meneveau, Nicolas, et al. 2023 May 27;35(2):135-143.

ED

ED NARCAN ALS OR

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

JANUARY 11, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the critical care management of post ROSC patients. 2023 Dec 1. However, early risk assessment may help guide clinical interventions.

Critical Care

Critical Care E-9-1-1 OR ICU

Glasgow Coma Scale in Children

Pediatric EM Morsels

JULY 21, 2023

Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Holmes, James F et al. Conzelmann M, Hoidis A, Bruckner T , et al. 1976 May 15;1(7968):1031-4. doi: 10.1016/s0140-6736(76)92215-7. PMID: 57446. Jain S, Iverson LM. Glasgow Coma Scale. Updated 2022 Jun 21]. In: StatPearls [Internet]. Acad Emerg Med. 2016 Aug;23(8):878-84.

Critical Care

Critical Care ALS Life Support OR

Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

JULY 7, 2023

More recent literature and guidelines support the use of lidocaine as an alternative agent, and currently both are included in standard advanced cardiovascular life support. References Tsao CW, et al. Benjamin EJ, et al. Kimblad H, et al. Sakai T, et al. Kudenchuk PJ, et al. Lee YH, et al.

Defibrillator

Defibrillator OR ALS Epinephrine

MCS Series: ECMO Basics

FOAMfrat

MAY 17, 2024

Extracorporeal Life Support: The Elso Red Book. Extracorporeal Life Support Organization, 2023. As always, I welcome any feedback, questions, comments, or suggestions for future blog posts. You can reach me at bcress@foamfrat.com Brian Cress, CCP, LP, FP-C, NRP References: Brogan, Thomas V., Lich, Bryan V.,

Life Support

Life Support OR ALS EMS

The Science on Targeted Temperature Management

ACEP Now

APRIL 3, 2024

Current International Resuscitation Recommendations In August 2023, the American Heart Association and the International Liaison Committee on Resuscitation published a scientific advisory that derived three conclusions. In a multisite retrospective cohort study, a study by Nishikimi, et al., Group W, Nolan JP, et al.

Advanced Life Support

Advanced Life Support ALS Life Support CPR

Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

APRIL 19, 2023

Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al., Calcium acts as a vasopressor and inotropic agent (Lindqwister, et al., risk ratio >1) was 4% for ROSC, 6% for 30 day survival, and 4% for survival with a favorable neurologic outcome at 30 days (Vallentin, et al.,

E-9-1-1

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

Paramedicine Now

Extracorporeal Life Support in Infarct-Related Cardiogenic Shock

SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs

Trending Sources

SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

The Broselow-Luten System

SGEM#443: Don’t Stop Me Now – REBOA for Hemorrhage Control in Trauma Patients?

2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking

Reference ranges of paediatric heart rate and respiratory rate

The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

I smell a pool, we don't have a pool.

EMS vs. EMT: Clarifying Roles in Emergency Healthcare

Hypothermic Cardiac Arrest: Pearls and Pitfalls

EM@3AM: Amniotic Fluid Embolism

Hypothermia and drowning

The Pediatric Airway: Considerations and Challenges

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Case Report: a High-Voltage Victim

POCUS findings of hemodynamically unstable PE with cardiac arrest

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

Glasgow Coma Scale in Children

Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

MCS Series: ECMO Basics

The Science on Targeted Temperature Management

Calcium in Out-of-Hospital Cardiac Arrest

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