REBEL EM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. References: Jaff MR et al. PMID: 21422387 Wan S et al. PMID: 15262836 Sharifi M et al. PMID: 27422214 Wang C et al. PMID: 19741062 Kucher N et al. PMID: 24226805 Piazza G et al. Clin Exp Emerg Med 2023. CHEST 2010.

ALS 136

ALS ACS OR CPR 136

EMDocs

NOVEMBER 6, 2023

It is reasonable to administer vasodilators (eg, nitrates, phentolamine, calcium channel blockers) for patients with cocaine-induced coronary vasospasm or hypertensive emergencies. Editorial Comment : Use standard BLS/ALS measures, especially if in cardiac arrest. COR 2a, LOE C-LD. COR 2a, LOE C-LD. COR 1, LOE C-LD. COR 1, LOE C-EO.

Naloxone 115

Naloxone OR BLS Overdose 115

Dr. Smith's ECG Blog

JULY 14, 2023

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

E-9-1-1 98

E-9-1-1 Defibrillator CPR STEMI 98

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

See this paper by Widimsky et al, which shows the high association of RBBB, especially with LAFB, with LAD occlusion. Furthermore, among 35 patients with acute left main coronary artery occlusion, 9 presented with RBBB (mostly with LAH) on the admission ECG. New RBBB + LAFB is a very bad sign.

CPR 52

CPR STEMI Coronary ALS 52

REBEL EM

MARCH 30, 2023

Clinical Question : In patients who suffer an OHCA without ST-segment elevation on the post-resuscitation ECG, will early coronary angiogram (CAG) vs. delayed CAG improve outcomes? Article: How-Berlemont C, Lamhaut L, Diehl J, et al. Early coronary angiography and survival after out-of-hospital cardiac arrest. Nallamothu, B.

Coronary 66

Coronary CPR OR ICU 66

Dr. Smith's ECG Blog

OCTOBER 28, 2013

It was witnessed, and CPR was performed by trained individuals. She arrived in the ED 37 minutes after 911 was called, with continuing CPR. Updates on the Electrocardiogram in Acute Coronary Syndromes. Electrocardiogram patterns in acute left main coronary artery occlusion. see below). References : 1. Nikus KC, Eskola MJ.

Defibrillator 52

Defibrillator ACS CPR STEMI 52

AAEM RSA

AUGUST 27, 2020

1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Nielsen N, Wetterslev J, Cronberg T et al. By the time of the study by Nielsen et al. New Engl J Med.

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. Rather it is due to coronary insufficiency due to a tight left main or 3-vessel disease with inadequate coronary flow. Kurkciyan et al. Kurkciyan et al., A middle-age woman with h/o hypertension was found down by her husband.

STEMI 52

STEMI Coronary ACS Emergency Department 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. And so it is wise to look at the coronary arteries. This ECG certainly looks like myocarditis, and was due to myocarditis, but missing acute coronary occlusion is not acceptable. 3–8 Shi et al.

E-9-1-1 52

E-9-1-1 STEMI Coronary ALS 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

Is there likely to be fixed coronary stenosis that led to demand ischemia during pneumonia? --Was See this paper by Widimsky et al, which shows the high association of RBBB, especially with LAFB, with LAD occlusion. 30 minutes later, this ECG was recorded: There is less high lateral ST elevation And another 3.5

STEMI 40

STEMI CPR CAD Coronary 40

EMDocs

JANUARY 11, 2024

Data that do not establish neurological risk stratification in the first 6 hours after CA include the patient’s age, duration of CPR, seizure activity, serum lactate level or pH, Glasgow motor subscore in patients who received NMB or sedation, pupillary function in patients who received atropine, and optic nerve sheath diameter (95.3%, 20/21).

Critical Care 97

Critical Care E-9-1-1 OR ICU 97

Dr. Smith's ECG Blog

MARCH 11, 2016

Raitt MH, et al. Methods: Oliva et al. (94) Patients who received CPR or experienced reinfarction or very small infarcts due to thrombolysis also displayed Type II T-wave evolution. Methods: Oliva et al. Mauri F, Gasparini M, Barbonaglia L, et al. Am J Cardiol 1989; 63:1291-1295 Methods: Mauri et al.

ALS 52

ALS STEMI OR CPR 52

REBEL EM

SEPTEMBER 5, 2022

Paper 1: Schmidt HJ et al. PMID: 360027567 [ Access on Read by QxMD ] Paper 2: Kjaergaard J et al. References: Schmidt HJ et al. PMID: 360027567 [ Access on Read by QxMD ] Kjaergaard J et al. A higher MAP may offer advantages due to improved cerebral perfusion pressure, however data is lacking. Liberal O2: 33.9%

ICU 52

ICU ALS OR CPR 52

Dr. Smith's ECG Blog

JUNE 11, 2021

Jesse McLaren (@ECGcases), of Emergency Medicine Cases Reviewed by Pendell Meyers and Steve Smith An 85yo with a history of hypertension developed chest pain and collapsed, and had bystander CPR. This ALONE is very strong evidence of acute coronary occlusion. Any indications for cath lab activation?

EMR 52

EMR STEMI CPR ED 52

Dr. Smith's ECG Blog

APRIL 8, 2016

the associated loss is double, at 200-400 mEq.* [ Sterns RH, et al. We could not resuscitate her, but we did have excellent perfusion with LUCAS CPR, such that pulse oximetry had excellent waveform and 100% saturations, end tidal CO2 was 35, and cerebral perfusion monitoring was near normal throughout the attempted resuscitation.

STEMI 52

STEMI Plasma Defibrillator OR 52

Don't Forget the Bubbles

DECEMBER 5, 2023

Nizami T, Beaudoin F, Suner S, et al. Reviewed by: Vicki Currie Article 5: Does occluding the femoral artery during neonatal CPR increase the likelihood of ROSC? (In Both were partly delivered via caesarian section, flow probes inserted into carotid, pulmonary and left circumflex coronary arteries. Crocker, B.C.S.,

Coronary 111

Coronary Epinephrine CPR Emergency Department 111