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SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR?

The Skeptics' Guide to EM

Date: October 18th, 2022 Reference: Moore et al. Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying […] The post SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR? Date: October 18th, 2022 Reference: Moore et al.

CPR 130
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Transcutaneous Pacing: Part 2

EMS 12-Lead

In this call, paramedics arrived on scene to find a patient apneic and pulseless with CPR in progress by first responders (AED had an unknown unshockable rhythm). Patient had an unwitnessed cardiac arrest without bystander CPR performed. Epinephrine administered intravenously. They administered 10 mcg of push-dose epinephrine.

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

The Skeptics' Guide to EM

Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation 2023. Resuscitation 2023.

CPR 230
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Transcutaneous Pacing: Part I

EMS 12-Lead

The paramedics begin CPR. CPR is performed with manual compressions as no mechanical CPR device is available. After administering 1mg of epinephrine ROSC is noted with a bradycardic rhythm ( Figure 2 ). They are unable to feel a pulse and resume CPR. Intubation is attempted, but unsuccessful. Current 85mA.

CPR 312
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SGEM#353: At the COCA, COCA for OCHA

The Skeptics' Guide to EM

” Reference: Vallentin et al. Bystander CPR is being performed. The paramedics performed high-quality CPR and follow their ACLS protocol. Intraosseous access is quickly obtained, and a dose of epinephrine is provided. CPR is continued while a supraglottic airway is placed successfully.

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SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular Fibrillation?

The Skeptics' Guide to EM

Date: February 7, 2023 Reference: Cheskes et al. Date: February 7, 2023 Reference: Cheskes et al. He confirms pulselessness, initiates CPR, gets a colleague to call 911, and intubates the patient on the floor. Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation.

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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

Date: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. Date: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. JAMA 2009, Hagihara et al. JAMA 2012 and Cournoyer et al.