Remove ACS Remove Defibrillator Remove Epinephrine
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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% Then assume there is ACS. This patient was witnessed by bystanders to collapse.

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2023 AHA Update on ACLS

EMDocs

Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. It is reasonable to administer epinephrine 1 mg every 3 to 5 minutes for cardiac arrest. High-dose epinephrine is not recommended for routine use in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R.

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Ventricular Fibrillation, ICD, LBBB, QRS of 210 ms, Positive Smith Modified Sgarbossa Criteria, and Pacemaker-Mediated Tachycardia

Dr. Smith's ECG Blog

He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. There was no bystander CPR. The QRS is extremely wide.

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A man with chest pain off and on for two days, and "No STEMI" at triage.

Dr. Smith's ECG Blog

The patient is started on epinephrine infusion for cardiogenic shock and cardiology took the patient to the cath lab. During angiogram in the cath lab, the patient suffered two episodes of ventricular fibrillation for which he was successfully defibrillated. The Queen of Hearts seems really really good at finding subtle OMI.

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Cardiac Arrest, acute ST elevation and depression superimposed on LVH, but NOT due to ACS

Dr. Smith's ECG Blog

He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. ACS would be highly unusual in a young athlete, and given the information on his race bib, one must first suspect that the abnormal ST elevation is due to demand ischemia, not ACS. His initial ECG is shown here.

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What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

ACEP Now

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Problem What is the best defibrillation strategy to treat refractory ventricular fibrillation? 7 In attempts to improve survival of this devastating condition, investigators have reported alternative defibrillation techniques.

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Management of STEMI (ST-Elevation Acute Myocardial Infarction)

ECG & Echo Learning

I B ECG monitoring should start immediately and a defibrillator must be ready. I C Glucose-lowering therapy should be considered in ACS patients with glucose levels >10 mmol/L (>180 mg/dL), while episodes of hypoglycaemia (defined as glucose levels <_3.9 STEMI , ST-segment elevation acute myocardial infarction ).

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