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 83

Coronary CPR OR ICU 83

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 91

E-9-1-1 Defibrillator CPR STEMI 91

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 95

Naloxone OR Overdose BLS 95

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

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

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

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

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 52

STEMI CPR CAD Coronary 52

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 75

Critical Care E-9-1-1 OR ICU 75

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 ED 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 109

Coronary Epinephrine CPR Emergency Department 109