REBEL EM

JUNE 8, 2023

1-4 The PDPs, phenylephrine and epinephrine, result in vasoconstriction and increased cardiac contractility. They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. Paper: Singer S, et al. Am J Emerg Med. 2022 Sep 5.

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Epinephrine Emergency Department ALS Critical Care 98

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. and Seaver, M. Rosenberg, M.S.

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E-9-1-1 Emergency Medical Services Life Support ALS 271

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med.

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CPR ICU Critical Care Epinephrine 130

Critical Care Scenarios

MAY 31, 2020

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. To hemodynamically manage RV failure without worsening RV afterload, consider the Rule of 8s cocktail:* Epinephrine.08 Figure 1 from Srour et al (vide infra).

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Critical Care Epinephrine ED ALS 100

REBEL EM

APRIL 29, 2024

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.

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Epinephrine ALS Critical Care Emergency Department 105

ACEP Now

JULY 7, 2023

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. 5 More recent literature defines “refractory” as VT or VF that is persistent or recurrent despite three shocks from a defibrillator, three rounds of epinephrine, and use of an antiarrhythmic (i.e.,

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

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). The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field.

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Defibrillator CPR Epinephrine Life Support 110

EMDocs

JANUARY 4, 2024

Other Norepinephrine or epinephrine are preferred vasopressors when needed. In: Brent J, et al. Critical Care Toxicology. Starr P, Klein-Schwartz W, et al. e4 Livshits Z, Feng Q, Chowdhury F, et al. Gosselin S, Hoegberg L, Hoffmann R, et al. PMID: 26856351 Stranges D, Lucerna A, Espinosa J, et al.

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Overdose E-9-1-1 ALS Emergency Department 94

ECG & Echo Learning

OCTOBER 2, 2022

Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 References Overgaard, Dzavik et al. Jentzer et al. Pharmacotherapy Update on the Use of Vasopressors and Inotropes in the Intensive Care Unit. Müllner M, Urbanek B, Havel C, et al. Circulation 2011.

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E-9-1-1 ALS Coronary Epinephrine 52

ACEP Now

NOVEMBER 7, 2023

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. References Go AS, Mozaffarian D, Roger VL, et al. Larribau R, Deham H, Niquille M, et al. Margey R, Browne L, Murphy E, et al. Kudenchuk PJ, Brown SP, Daya M, et al. Spies DM, Kiekenap J, Rupp D, et al. Circulation.

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Defibrillator E-9-1-1 ALS Epinephrine 52

NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al., Calcium acts as a vasopressor and inotropic agent (Lindqwister, et al., He is found to be in ventricular fibrillation (VF).

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E-9-1-1 Advanced Life Support Overdose CPR 52

AAEM RSA

AUGUST 27, 2020

Nielsen N, Wetterslev J, Cronberg T et al. By the time of the study by Nielsen et al. However, the decade since the original Hypothermia after Cardiac Arrest trial had seen significant advances in pre-hospital, emergency department, and critical care that may have contributed to these outcomes. Kirkegaard et al.

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E-9-1-1 CPR ICU ALS 52

Dr. Smith's ECG Blog

APRIL 8, 2016

the associated loss is double, at 200-400 mEq.* [ Sterns RH, et al. Crit Care Med. 1991 May;19(5):694-9 Objective: To evaluate the efficacy and safety of potassium replacement infusions in critically ill patients. Setting: Multidisciplinary critical care unit. mEq/L is 100-200 mEq of total body K, and from 3.0

STEMI 52

STEMI Plasma Defibrillator OR 52

The Skeptics' Guide to EM

NOVEMBER 30, 2024

Date: November 10, 2024 Reference: Couper et al. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington's MEDEX program. The paramedic is trying to get intravenous (IV) access to give epinephrine per the protocol. Reference: Couper et al.

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Epinephrine OR CPR Paramedic 251

EMDocs

MARCH 18, 2025

Consultation needed for definitive management: Pulmonology/critical care, IR, and cardiothoracic surgery; admission to the critical care setting (likely requires transfer). Bronchoscopy can be used for bleeding control with cold saline, epinephrine, activated factor VIIa, or TXA. J Thorac Dis. Can Respir J.

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E-9-1-1 FFP Critical Care ALS 82

EMDocs

OCTOBER 29, 2024

Anaesth Intensive Care. doi:10.1016/S0033-0620(05)80036-2 Balik M, Novotny A, Suk D, et al. Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. doi:10.3390/JCM13185344 Yamagishi T, Tanabe T, Fujita H, et al. 2017;45(1):12-20.

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E-9-1-1 ICU Epinephrine EMS 98

EMOttawa

JANUARY 6, 2025

Methodology: 4/5 Usefulness: 3/5 Couper K, et al. N Engl J Med. 2024 Oct 31:10.1056/NEJMoa2407780. Question and Methods:This multi-center, open label randomized control trial aimed to assess 30-day survival in patients with out of hospital cardiac arrest (OOHCA) who received IO versus IV access first.

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ALS Critical Care Epinephrine 82