The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med. Pediatric Crit Care Med.

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The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. first appeared on The Skeptics Guide to Emergency Medicine. Date: September 8th, 2021 Reference: Desch et al.

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The Skeptics' Guide to EM

DECEMBER 2, 2017

[display_podcast] Date: November 24th, 2017 Reference: Andersen et al. JAMA 2017 Guest Skeptic: Dr. Bob Edmonds is an Emergency Physician in the US Air Force. He is currently deployed, practicing emergency medicine in an undisclosed location. display_podcast] Date: November 24th, 2017 Reference: Andersen et al.

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CPR Defibrillator ALS Emergency Response 100

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests first appeared on The Skeptics Guide to Emergency Medicine. JAMA Sept 2021.

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Epinephrine Critical Care Life Support Emergency Department 100

ACEP Now

JANUARY 4, 2025

The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established. ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in C booththe main trauma roomwith an ED tech administering CPR. West J Emerg Med.

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ED Emergency Department Ambulance CPR 52

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Date: November 6th, 2019 Reference: Lascarrou et al. NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Reference: Lascarrou et al.

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ALS CPR ICU EMS 100

ACEP Now

DECEMBER 6, 2024

After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia. This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm.

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Coronary Life Support ALS Emergency Department 98

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. References 1) Liu D, Ahmet A, Ward L, et al. Which one do you select?

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EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Carsten L, et al. Monika BM, Martin D, Balthasar E, et al.

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Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jun 3:S2352-4642(24)00104-4.

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CPR Operating Room OR Emergency Department 124

ACEP Now

AUGUST 15, 2023

Staff interrupt you while you’re in Room 3 with a patient you’ve placed on BiPAP, “We have an incoming patient with CPR in progress in five minutes,” the nurse says before adding, “Room 4’s family really wants to talk with you again.” Dr. Koo is an emergency physician and attending at MedStar Washington Hospital Center in Washington, and St.

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ALS Emergency Department OR CPR 90

ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 3 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Pediatr Emerg Med Pract.

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ALS Emergency Department Emergency Medical Services ED 52

NAEMSP

APRIL 19, 2023

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. However, evidence emerged in the 1980’s demonstrating that calcium chloride had no effect on return of spontaneous circulation (ROSC) rates, and in fact could be detrimental (Landry, Foran, & Koyfman, 2014).

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NCOAE

AUGUST 12, 2022

Here, we present them in alphabetical order: ABC – Airway, Breathing and Circulation – “This is the Golden Rule of emergency medical professionals” AED – Automated External Defibrillator – The device that delivers electric shock to the heart of patients experiencing sudden cardiac arrest A-EMT – Advanced EMT ALS – Advanced Life Support Anaphylaxis— (..)

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Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%.

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Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

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ALS ED OR CPR 98

REBEL EM

NOVEMBER 20, 2023

Paper: Jansen JO, Hudson J, Cochran C, et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. References: Butler FK Jr, Holcomb JB, Shackelford SA, et al.

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OR Emergency Medical Technician CPR Emergency Medical Services 91

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. Kirkegaard et al.

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EMDocs

JANUARY 17, 2024

When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). Kim I, Goulding M, Tian F, Karami S, Pham T, Cheng C, et al. Vet Hum Toxicol.

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E-9-1-1 Overdose Emergency Medical Services Life Support 84

Dr. Smith's ECG Blog

OCTOBER 20, 2013

Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. Kurkciyan et al. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes. Kurkciyan et al., A middle-age woman with h/o hypertension was found down by her husband. Results: Over 8.5

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STEMI Coronary ACS Emergency Department 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Widimsky P et al. Knotts et al. References 7.

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Coronary STEMI ACS 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. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury.

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E-9-1-1 STEMI Coronary ALS 52

Don't Forget the Bubbles

MAY 3, 2023

Forestell B, Battaglia F, Sharif S, et al. Prekker ME, Bjorklund AR, Myers C, et al. Ann Emerg Med. This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergency department (ED). Resuscitation.

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CPR Emergency Department ALS ICU 52

Don't Forget the Bubbles

DECEMBER 5, 2023

Nizami T, Beaudoin F, Suner S, et al. Emergency Medicine Journal 2023;40:564-568. Data was collected at 2 emergency departments in America and included assessment by both clinicians and patients for a total of 31 patients. Wounds are a common presentation to both adult and paediatric emergency departments.

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Coronary Epinephrine CPR Emergency Department 111

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. 1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). Larribau R, Deham H, Niquille M, et al.

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Defibrillator E-9-1-1 ALS Epinephrine 52

ACEP Now

OCTOBER 30, 2023

ESEM’s Founding The founding of ESEM was greeted with enthusiastic support from the emergency medicine community. Under the leadership of Dr. Saleh Fares Al-Ali, the first emergency physician from UAE to be certified by both the Canadian and American boards, the organization grew exponentially.

Emergency Department 52

Emergency Department ALS CPR Critical Care 52

REBEL EM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. N Engl J Med.

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NAEMSP

MARCH 13, 2023

An ALS crew arrives on scene to find a woman who is tachypneic, hypoxic, tachycardic, and hypotensive, with diffuse rales and rhonchi throughout her lung fields. They begin CPR en route to the emergency department where the patient’s rhythm deteriorates into asystole. Prehospital Emergency Medicine Secrets.

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EMS Emergency Medical Services EMT EMT 52

Core EM

FEBRUARY 2, 2025

Evidence from the Literature New England Journal of Medicine study on Family Presence During Cardiopulmonary Resuscitation (Jabre et al., 79% of relatives in the intervention group witnessed CPR compared to 43% in the control group. Family members who did not witness CPR had a higher likelihood of PTSD symptoms (adjusted OR 1.7,

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CPR Critical Care Emergency Department ALS 130

FOAMfrat

DECEMBER 31, 2024

With that being said, the manufacturers say that CPR, medications, Defibrillation, Cardioversion, and Anything you would normally do are OKAY. The age-old question of CPR it depends. Manufacturer recommendations and several other PubMed articles state it is okay to perform CPR. alarms, vitals, rhythms). 2017); PMID: 31914051).

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CPR Defibrillator Emergency Department Emergency Transportation 64

Core EM

JANUARY 16, 2025

(Salem 2001) Other unexpected events that can occur: Purple on inspiration and expiration: either you tubed the esophagus , or your patient is dead, and getting poor CPR, and not getting enough blood flow into the lungs to increase the pulmonary CO2 content above ambient levels. et al (2022). Am J Emerg Med. Baker JB, et al.

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Don't Forget the Bubbles

JANUARY 6, 2025

Hughes-Davies H, Ukwatte U, Fanshawe TR, Roberts N, Turner PJ, Hayward GN, Bird C et al. Reviewed by: Mikaeel Jaffer Article 2: Does the duration of pre-hospital CPR affect neurological outcomes? Of the 1007 eligible children in the data set, 252 achieved ROSC after CPR was started. Ultrasound. 2024 Oct 29; Whats it about?

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