Critical Care Scenarios

MARCH 29, 2020

Cardiothoracic critical care PA Brendan Riordan (@concernecus) shows us his initial approach to the patient in cardiogenic shock, including initiating mechanical support, managing ECMO (plus Impella), and eventual weaning and discontinuation of support. Monitoring Hemostasis During Extracorporeal Life Support.

Critical Care 100

Critical Care Life Support ALS OR 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. JAMA Sept 2021. JAMA Sept 2021. Cardiopulmonary resuscitation (CPR) is in progress. The monitor shows a non-shockable rhythm.

Epinephrine 100

Epinephrine Critical Care Life Support Emergency Department 100

Don't Forget the Bubbles

JUNE 30, 2023

CRITICAL CARE CASE REPORTS: METABOLIC, RENAL, AND ENDOCRINE , pp. Mazur P, Kosinski S, Podsiadlo P, et al.: Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. Meert et al. Meert et al. Kattih, Z., Altschul, and B.

CPR 145

CPR Life Support Critical Care ALS 145

ACEP Now

JULY 7, 2023

More recent literature and guidelines support the use of lidocaine as an alternative agent, and currently both are included in standard advanced cardiovascular life support. References Tsao CW, et al. Benjamin EJ, et al. Kimblad H, et al. Sakai T, et al. Kudenchuk PJ, et al. Lee YH, et al.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

EMT Training Station

FEBRUARY 11, 2024

Once activated, EMS ensures that the appropriate level of care is dispatched to the patient. This could range from basic life support, typically managed by EMTs, to more advanced life support provided by paramedics and other medical specialists. EMTs, on the other hand, primarily focus on basic life support.

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EMT EMT Emergency Medical Technician Emergency Medical Services 98

EMDocs

JUNE 22, 2024

Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. If AFE occurs during labor, immediate delivery is recommended. ” Obstet Gynecol 123(2 Pt 1): 337-348. link] Society for Maternal-Fetal Medicine. Electronic address, p. link] j.ajog.2016.03.012

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EMS Ambulance FFP ICU 111

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). Carsten L, et al. Extracorporeal Life Support in Accidental Hypothermia with Cardiac Arrest—A Narrative Review. Forti A, Brugnaro P, Rauch S, et al.

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Defibrillator CPR Epinephrine Life Support 110

Critical Care Scenarios

NOVEMBER 15, 2020

Yes, temporize with supportive care while you go through the process, but do the work—find a legitimate representative or documentation of the patient’s wishes to determine what they’d want before you commit them to lengthy, aggressive life support. References Patel KK, Young L, Howell EH, et al.

ICU 100

ICU Life Support Emergency Department ED 100

NAEMSP

APRIL 19, 2023

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., risk ratio >1) was 4% for ROSC, 6% for 30 day survival, and 4% for survival with a favorable neurologic outcome at 30 days (Vallentin, et al.,

E-9-1-1 52

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

REBEL EM

FEBRUARY 2, 2023

Paper: Mason JM, et al. PMID: 36115743 Clinical Question: What is the effectiveness of IV amiodarone vs IV digoxin used as second line therapy in critically ill emergency department patients with atrial fibrillation/flutter where first-line BB use has failed? These results were corroborated with other another study by Gritensko et al.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ACEP Now

APRIL 3, 2024

Several recent studies yield insights into this hypothesis: In a single site retrospective cohort study, Callaway et al demonstrated that TTM efficacy may be impacted by arrest severity.10 In a multisite retrospective cohort study, a study by Nishikimi, et al., Group W, Nolan JP, et al. Nielsen N, Wetterslev J, et al.

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Advanced Life Support ALS Life Support CPR 40

EMDocs

APRIL 22, 2024

Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). Alerhand et al described ten individual echocardiographic findings of RV strain that suggest PE. Critical Care Emergency Medicine, McGraw-Hill, pgs 129-132, 2nd ed.,

ED 98

ED NARCAN ALS OR 98

ACEP Now

OCTOBER 11, 2024

8 The 2023 Pediatric Advanced Life Support (PALS) guidelines recommend the following formulas for ET tubes. Kerrey BT, Rinderknecht AS, Geis GL, et al. Rinderknecht AS, Mittiga MR, Meinzen‐Derr J, et al. Bertrand P, Navarro H, Caussade S, et al. Peyton J, Park R, Staffa SJ, et al. Pediatr Crit Care Med.

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E-9-1-1 Emergency Department Advanced Life Support ALS 52

ACEP Now

MARCH 14, 2024

Thus, unstable patients should be stabilized based on a physician’s trauma expertise; whether through Advanced Trauma Life Support, Trauma Combat Casualty Care, or one’s own trauma assessment. Tintinalli JE, Stapczynski J, Ma O, et al. Critical Care Medicine. Arnoldo BD, Purdue GF, Kowalske K, et al.

Operating Room 52

Operating Room ACS Critical Care Coronary 52

AAEM RSA

AUGUST 27, 2020

Nielsen N, Wetterslev J, Cronberg T et al. By the time of the study by Nielsen et al. For both groups, mean time to basic life support was determined to be one-minute, advanced life support started at 10 minutes, and time to ROSC at 25 minutes. Kirkegaard H, Soreide E, de Haas, I et al.

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

Don't Forget the Bubbles

FEBRUARY 24, 2025

In a prospective multi-centre study, Berger et al. Rowlands et al. This heightened risk underscores the need for vigilant supportive care and proactive management in these cases. About PICSTAR PICSTAR is a trainee-led research network open to all doctors, nurses and allied health trainees within Paediatric Intensive Care.

ALS 59

ALS Critical Care OR Life Support 59