ALiEM

NOVEMBER 29, 2023

Xylazine is an alpha-2 agonist similar to clonidine that inhibits the release of norepinephrine and epinephrine resulting in decreased vascular tone and heart rate [4]. PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al.

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Naloxone Overdose Epinephrine ALS 169

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA?

CPR 130

CPR Firefighter Paramedic Defibrillator 130

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

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EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

[display_podcast] Date: September 12th, 2017 Reference: Sinert et al. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine. display_podcast] Date: September 12th, 2017 Reference: Sinert et al. Reference: Sinert et al.

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Epinephrine ALS Emergency Department EMS 130

REBEL EM

APRIL 29, 2024

A study by Lee et al ( 7) compared femoral CVC placement to IO and demonstrated a first-pass success pass rate with IO of 90.3% In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Labs can be drawn from an IO to help with rapid diagnosis in emergencies. Iserson KV et al.

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Epinephrine ALS Critical Care Emergency Department 105

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med. Pediatric Crit Care Med.

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CPR ICU Critical Care Defibrillator 130

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Reference: Roberts et al. The first visit was back in 2013 for SGEM#50 : Under Pressure – Vasopressin, Steroids and Epinephrine in Cardiac Arrest. Alongside his EM residency, he is doing a PhD in epidemiology. Audrey’s academic interests include trauma and resuscitation. Outside of medicine, Audrey likes to play rugby and run.

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Epinephrine Emergency Department EMS ALS 130

Core EM

JANUARY 25, 2024

Written by: Sadakat Chowdhury MD Edited by: Mak Sarich MD, Jay Lin MD, Jonathan Kobles MD Background: Ultrasound (US) guided nerve blocks offer an applicable option for achieving analgesia in the emergency department. J Emerg Trauma Shock. link] [3] Morrison RS, Magaziner J, Gilbert M, et al. 2012;5(1):28-32.

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Epinephrine ED Emergency Department Ambulance 246

REBEL EM

SEPTEMBER 13, 2023

patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. PMID 25629740 Hassen GW et al.

Frozen Plasma 101

Frozen Plasma Allergic Reaction FFP Plasma 101

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. References Tsao CW, et al. Benjamin EJ, et al. Kimblad H, et al.

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Defibrillator OR ALS Epinephrine 98

ACEP Now

DECEMBER 6, 2024

Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. References Prinzmetal M, Kennamer R, Merliss R, et al.

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Coronary Life Support ALS Emergency Department 98

The Skeptics' Guide to EM

APRIL 20, 2019

Date: April 17th, 2019 Reference: Little et al. Injury 2019 Guest Skeptic: Alison Armstrong is a Certified Emergency Nurse, Trauma Program Coordinator and TNCC Course Director. Talk Trauma is a […] The post SGEM#253: Everybody’s Working on the Weekend first appeared on The Skeptics Guide to Emergency Medicine.

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Epinephrine ALS Emergency Department EMS 100

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). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Carsten L, et al. Monika BM, Martin D, Balthasar E, et al.

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Defibrillator CPR Epinephrine Life Support 104

ACEP Now

NOVEMBER 6, 2024

A gravid woman presents to your emergency department (ED). mg/kg IV epinephrine, or 0.05–0.1 Aziz K, Lee HC, Escobedo MB, et al. Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. How do you stabilize this patient?

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Epinephrine Emergency Department EMS OR 98

REBEL EM

JULY 18, 2022

When simple maneuvers fail, we proceed to topical agents such as lidocaine with epinephrine, oxymetazoline, anterior nasal packing, and electrical or chemical cauterization. Paper: Zahed R, Moharamzadeh P, Alizadeharasi S et al. Am J Emerg Med. Ann Emerg Med. 2013 Sep;31(9):1389-92. Epub 2013 Jul 30. 2021;77(6):631-640.

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E-9-1-1 Epinephrine ED ALS 52

ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. Atchinson PRA, Hatton CJ, Roginski MA, et al. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med. Ittrich H, Bockhorn M, Klose H, et al.

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E-9-1-1 ALS Emergency Department Epinephrine 52

NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. However, evidence emerged in the 1980’s demonstrating that calcium chloride had no effect on return of spontaneous circulation (ROSC) rates, and in fact could be detrimental (Landry, Foran, & Koyfman, 2014).

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

REBEL EM

JANUARY 23, 2023

Article: Abella BS et al. Ann Emerg Med 2020. Multicenter study of emergency department visits for insect sting allergies. Multicenter study of emergency department visits for food allergies. Moreover, the FDA approved intravenous (IV) cetirizine to treat acute urticaria in 2019. J Allergy Clin Immunol.

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Allergic Reaction ED E-9-1-1 Emergency Department 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

With ventilations and epinephrine, she regained a pulse. Kurkciyan et al. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes. Kurkciyan et al., A middle-age woman with h/o hypertension was found down by her husband. Of these, ischemic ST depression was found in 52%.

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STEMI Coronary ACS Emergency Department 52

Broome Docs

APRIL 6, 2023

Casey The CLOVERS trial: National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, et al. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. Acad Emerg Med. N Engl J Med.

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Epinephrine ED Emergency Department ALS 52

FOAMfrat

OCTOBER 20, 2023

And according to a paper from Russotto et al. Of note, in the paper by Russotto et al., Epinephrine should be considered as the vasopressor of choice in patients with decreased myocardial function. 2023) The Walls Manual of Emergency Airway Management. Sackles et al. De Jong A, Molinari N, Terzi, et al.

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E-9-1-1 ALS ACS OR 52

Dr. Smith's ECG Blog

JUNE 19, 2023

Written by Kaley El-Arab MD, edits by Pendell Meyers and Stephen Smith A 61-year-old male with hypertension and hyperlipidemia presented to the emergency department for chest tightness radiating to the back of his neck that has been intermittent for the past day or two. Armstrong et al. What do you think?

STEMI 52

STEMI ACS Coronary Defibrillator 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

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury.

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E-9-1-1 STEMI Coronary ALS 52

ECG & Echo Learning

JANUARY 18, 2023

IIa C Pre-hospital logistics Management Recommendation Level of evidence The pre-hospital care of STEMI patients should be organized regionally (including all components from the emergency medical dispatch to catheterization laboratory) in order to provide reperfusion therapy as early as possible.

STEMI 40

STEMI Coronary OR Defibrillator 40

FOAMfrat

SEPTEMBER 19, 2024

These side effects do not contraindicate antivenom administration and can be treated with antihistamines and epinephrine. Hypotension and anaphylaxis should be treated with epinephrine following your local guidelines. Rattlesnake Envenomation Treatment & Management: Prehospital Care, Emergency Department Care, Consultations.”

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Emergency Department Epinephrine OR Plasma 95

EMDocs

DECEMBER 18, 2023

1 The rationale for the shift away from normal saline in 2021 derived from multiple trials, including the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer’s or Plasma-Lyte in the Emergency Department (SALT ED). References Evans L, Rhodes A, Alhazzani W, et al.

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E-9-1-1 ALS Emergency Department Plasma 83

EMDocs

JANUARY 4, 2024

Other Norepinephrine or epinephrine are preferred vasopressors when needed. Case Follow-up: The patient required a dose of lorazepam in the emergency department. In: Brent J, et al. Starr P, Klein-Schwartz W, et al. Am J Emerg Med. American Journal of Emergency Medicine. Clin Toxicol (Phila).

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Overdose E-9-1-1 ALS Emergency Department 84

Don't Forget the Bubbles

MAY 8, 2024

Dell KM, et al. Eisen S et al. Fielder AR, et al. Bm MV, et al. Toepfner N, et al. Toniutti M, et al. Meoli M, et al. Ashton JJ, et al. Ding G et al. Tanti DC, et al. Ahlqvist VH, et al. Chiang HL, et al. Wong J, et al. Fuller S et al. Koenis MM et al.

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E-9-1-1 ALS Emergency Department Epinephrine 69

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. 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. Circulation.

Defibrillator 52

Defibrillator E-9-1-1 ALS Epinephrine 52

Don't Forget the Bubbles

DECEMBER 5, 2023

Nizami T, Beaudoin F, Suner S, et al. Emergency Medicine Journal 2023;40:564-568. Data was collected at 2 emergency departments in America and included assessment by both clinicians and patients for a total of 31 patients. Wounds are a common presentation to both adult and paediatric emergency departments.

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Coronary Epinephrine CPR Emergency Department 111

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. Emergency Department Two-Dimensional Echocardiography in the Diagnosis of Nontraumatic Cardiac Rupture. A 65 yo woman had felt ill for 36 hours, had seen her MD but without undergoing a cardiac evaluation.

STEMI 40

STEMI Defibrillator Epinephrine Emergency Department 40

REBEL EM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. The fragility index of these findings found to be 1 for VC and 9 for DED Obtaining a second defibrillator in the emergency department or intensive care unit can be very easy to do.

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Defibrillator Paramedic CPR EMS 52

EMDocs

JANUARY 20, 2024

Takotsubo syndrome is often exceedingly difficult to distinguish from acute myocardial infarction in the emergency department, as there is significant overlap in many clinical and diagnostic features. Rosh Review Website Link Further Reading Further FOAMed: [link] [link] References: Ahmad SA, Brito D, Khalid N, et al.

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E-9-1-1 EMS Coronary ACS 93

EMDocs

JANUARY 22, 2025

Is there an ideal observation period in the emergency department after reversal with naloxone? DOI: [link] O’Donnell J, Tanz LJ, Miller KD, et al. Al-Azzawi M, Alshami A, Douedi S, Al-Taei M, Alsaoudi G, Costanzo E. Available at: [link] October 19, 2023 Kelly A, Kerr D, Dietze P, et al. Ann Emerg Med.

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Naloxone E-9-1-1 Overdose NARCAN 91

ACEP Now

OCTOBER 29, 2024

He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. Initial echocardiogram (ECG) on arrival (see figure 2) to our emergency department revealed normal sinus rhythm, mild interventricular conduction delay (RSR’), and possible right ventricular hypertrophy. Click to enlarge.)

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E-9-1-1 Defibrillator ALS Epinephrine 52