The Skeptics' Guide to EM

SEPTEMBER 29, 2018

[display_podcast] Date: September 21st, 2018 Reference: Kawano et al. display_podcast] Date: September 21st, 2018 Reference: Kawano et al. One defibrillation for ventricular fibrillation (VF) is provided but the patient remains in VF. Bystander CPR is initiated prior to EMS arrival.

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BLS Defibrillator Critical Care CPR 130

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. Date: February 26th, 2019 Reference: Benger et al. Key to survival is high-quality CPR and early defibrillation. Reference: Benger et al, Effect of a Strategy of a Supraglottic Airway Device
vs. Effect of a Strategy of a Supraglottic Airway Device
vs.

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The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. Date: January 5th, 2021 Reference: Grunau et al. This has included things like therapeutic hypothermia ( SGEM#54 , SGEM#82 , SGEM#183 and SGEM#275 ), supraglottic devices ( SGEM#247 ), crowd sourcing CPR ( SGEM#143 and SGEM#306 ), and epinephrine ( SGEM#238 ).

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EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Reference: Cashen K, Reeder RW, Ahmed T, et al. Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Pediatric Crit Care Med. Pediatric Crit Care Med.

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CPR ICU Critical Care Epinephrine 130

EMDocs

JANUARY 16, 2024

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. The patient is moved over to the stretcher and connected to the monitors and defibrillator. Carsten L, et al. Monika BM, Martin D, Balthasar E, et al.

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Defibrillator CPR Epinephrine Life Support 108

Dr. Smith's ECG Blog

JULY 21, 2024

Epinephrine infusion was begun. He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. You can see Left Main and Proximal LAD obstruction, but with some flow, which is saving this patient's life.

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Defibrillator Coronary ALS STEMI 131

ACEP Now

DECEMBER 6, 2024

After the fourth defibrillation attempt, 200 mcg IV NTG was administered, resulting in immediate return of spontaneous circulation with a junctional bradycardia rhythm. Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. Click to enlarge.)

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Coronary Life Support ALS Emergency Department 98

Dr. Smith's ECG Blog

OCTOBER 28, 2013

She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device. at the time of the ECG. see below). References : 1.

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Defibrillator ACS CPR STEMI 52

REBEL EM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Article: Moore JC et al. References: Moore JC et al. It is imperative that we continue to look at ways to improve cardiac arrest resuscitation.

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CPR Defibrillator EMS Epinephrine 52

NAEMSP

APRIL 19, 2023

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. 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.,

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ECG Medical Training

DECEMBER 4, 2016

Let’s also not forget that these patients still require ventilation and they still require defibrillation! When this was first studied by Yost et al. Start an IV and give epinephrine? Perkins GD, Lall R, Quinn T, et al. Rubertsson S, Lindgren E, Smekal D, et al. The take-home message is this. The Lancet.

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CPR E-9-1-1 Defibrillator Ambulance 52

Dr. Smith's ECG Blog

JUNE 19, 2023

Armstrong et al. The patient is started on epinephrine infusion for cardiogenic shock and cardiology took the patient to the cath lab. During angiogram in the cath lab, the patient suffered two episodes of ventricular fibrillation for which he was successfully defibrillated.

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STEMI ACS Coronary Epinephrine 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

With ventilations and epinephrine, she regained a pulse. She was never seen to be in ventricular fibrillation and was never defibrillated. Kurkciyan et al. Kurkciyan et al., A middle-age woman with h/o hypertension was found down by her husband. She was hypotensive in the ED and her bedside echo showed a normal RV and LV.

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STEMI Coronary ACS Emergency Department 52

Dr. Smith's ECG Blog

APRIL 8, 2016

At cath, he immediately had incessant Torsades de Pointes requiring defibrillation 7 times and requiring placement of a transvenous pacer for overdrive pacing at a rate of 80. the associated loss is double, at 200-400 mEq.* [ Sterns RH, et al. He was given amiodarone and lidocaine load and drip and K and Mg drips.

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ECG & Echo Learning

JANUARY 18, 2023

I B ECG monitoring should start immediately and a defibrillator must be ready. This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST-segment elevations (i.e STEMI , ST-segment elevation acute myocardial infarction ). due to reciprocal ST-segment depressions in V1, V2, V3).

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STEMI Coronary OR Defibrillator 40

ACEP Now

NOVEMBER 7, 2023

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Problem What is the best defibrillation strategy to treat refractory ventricular fibrillation? 7 In attempts to improve survival of this devastating condition, investigators have reported alternative defibrillation techniques.

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Defibrillator E-9-1-1 ALS Epinephrine 52

REBEL EM

DECEMBER 19, 2022

Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. N Engl J Med.

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Dr. Smith's ECG Blog

DECEMBER 22, 2010

After epinephrine, atropine, and defibrillation x 2, there was a return of pulses. Plummer D et al. A 65 yo woman had felt ill for 36 hours, had seen her MD but without undergoing a cardiac evaluation. She collapsed and 911 was called; she was found pulseless. Exact rhythm during arrest is uncertain.

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STEMI Epinephrine Defibrillator Emergency Department 40

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Resuscitated with chest compressions, epinephrine. including epinephrine, and there was ROSC. This is what the providers in the ED understood on patient arrival: Patient called 911 for syncope, then had witnessed PEA arrest after medics arrived. Not a shockable rhythm. They laid her on the floor and called 911.

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STEMI Paramedic E-9-1-1 Epinephrine 89

ACEP Now

OCTOBER 29, 2024

He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. A repeat ECG (see figure 3) was performed utilizing the technique described by Sangwatanaroj et al., He underwent placement of a dual chamber, implantable, cardioverter-defibrillator (ICD) placement on hospital day 5.

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E-9-1-1 Defibrillator ALS Epinephrine 52