ALS, CPR and ICU - Paramedicine Now

SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community College paramedic program.

ICU

ICU Defibrillator CPR Paramedic

SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al. Your team begins high quality cardiopulmonary resuscitation (CPR). Pediatric Crit Care Med.

CPR

CPR ICU Critical Care Epinephrine

TAME Trial: Mild Hypercapnia vs Normocapnia in Out-of-Hospital Cardiac Arrest

REBEL EM

AUGUST 21, 2023

This trial aimed to assess whether targeted therapeutic mild hypercapnia (TTMH) applied during the initial 24 hours of mechanical ventilation in the ICU can enhance neurological outcomes at the 6-month mark, as compared to standard care, which involves targeted normocapnia (TN). Paper: Eastwood G, et al. link] Petran J, et al.

E-9-1-1

E-9-1-1 Critical Care CPR ALS

SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

The Skeptics' Guide to EM

JUNE 4, 2017

[display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. Huber-Wagner et al ( Lancet 2009 ) showed a mortality reduction in a retrospective database study of patients who have had a pan scan. Reference: Sierink et al. Lancet August 2016.

OR

OR ALS CPR ICU

SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Date: November 6th, 2019 Reference: Lascarrou et al. Date: November 6th, 2019 Reference: Lascarrou et al. She had a witnessed arrest, and CPR was initiated by bystanders. Unfortunately, that study failed to demonstrate a benefit of therapeutic hypothermia for adult patients admitted to the ICU with convulsive status epilepticus.

ALS

ALS CPR ICU EMS

Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

JANUARY 16, 2024

He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU. 2,11 There are cases of patients recovering after hours of time without a pulse with good CPR. 2,11 There are cases of patients recovering after hours of time without a pulse with good CPR.

Defibrillator

Defibrillator CPR Epinephrine Life Support

The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

REBEL EM

SEPTEMBER 14, 2023

Zeymer HT et al. Did they get bystander CPR? References: Zeymer HT et al. The benefits of this strategy may be outweighed by the risk of the device-related complications (i.e. bleeding, stroke, limb ischemia, and hemolysis). The evidence for this practice has been sparse until now. Control: 53.4% D ECLS: 18.2% Control 8.7%

Life Support

Life Support Coronary CPR ICU

Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

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.

E-9-1-1

E-9-1-1 CPR ICU ALS

The BOX Trial: BP & O2 Targets in Comatose Survivors of Cardiac Arrest

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

ICU ALS OR CPR

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

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

Critical Care E-9-1-1 OR ICU

REBEL Cast Ep119: A Discussion with Scott Weingart on the CT FIRST Trial

REBEL EM

JUNE 29, 2023

Available at: HERE Branch KHR et al. The CT FIRST Trial: Should We Pan-CT After ROSC?, REBEL EM Blog, June 1, 2023. Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study.

CPR

CPR ICU EMS ALS

The Science on Targeted Temperature Management

ACEP Now

APRIL 3, 2024

7 TTM2 is generally interpreted as favoring normothermia for post-arrest care, but the question is whether this trial is broadly applicable to many countries with less developed community CPR involvement. In a multisite retrospective cohort study, a study by Nishikimi, et al., Group W, Nolan JP, et al. Soar J, Berg KM, et al.

Advanced Life Support

Advanced Life Support ALS Life Support CPR

The 70th Bubble Wrap – DFTB x MSc in PEM

Don't Forget the Bubbles

MAY 3, 2023

Forestell B, Battaglia F, Sharif S, et al. Prekker ME, Bjorklund AR, Myers C, et al. Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children? O’Connell KJ, Sandler A, Dutta A, et al. O’Connell et al. O’Connell et al. Which way should we go?

CPR

CPR Emergency Department ALS ICU

The ‘Hidden C’

Don't Forget the Bubbles

JUNE 17, 2024

The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%. Frich JC, Brewster AL, Cherlin EJ, Bradley EH. How do you manage this situation? British journal of nursing.

E-9-1-1

E-9-1-1 Critical Care CPR ICU

External Validation of Pittsburgh Cardiac Arrest Category (PCAC) Illness Severity Score

REBEL EM

JULY 14, 2022

Paper: Nassal MMJ, et al. An example using a real case I had while on call in the ICU: A 61-year-old female had a post-induction arrest on the wards/hospital telemetry floor after being intubated for airway protection. REFERENCES: Nassal MMJ, et al. PMID: 34968531 Rittenberger JC, et al. PMID: 21756969 Coppler PJ, et al.

ICU

ICU ALS OR CPR

The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

REBEL EM

MARCH 30, 2023

Article: How-Berlemont C, Lamhaut L, Diehl J, et al. Comparator: Delayed CAG: Patients were admitted to the ICU, and CAG was performed after 48-96 hours. 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?

Coronary

Coronary CPR OR ICU

Paramedicine Now

SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?

SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

Trending Sources

TAME Trial: Mild Hypercapnia vs Normocapnia in Out-of-Hospital Cardiac Arrest

SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest

Hypothermic Cardiac Arrest: Pearls and Pitfalls

The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

The BOX Trial: BP & O2 Targets in Comatose Survivors of Cardiac Arrest

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

REBEL Cast Ep119: A Discussion with Scott Weingart on the CT FIRST Trial

The Science on Targeted Temperature Management

The 70th Bubble Wrap – DFTB x MSc in PEM

The ‘Hidden C’

External Validation of Pittsburgh Cardiac Arrest Category (PCAC) Illness Severity Score

The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

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