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. Adverse Effects: No serious adverse events were noted. Am J Emerg Med. 2013 Sep;31(9):1389-92.

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E-9-1-1 Epinephrine ED ALS 52

REBEL EM

JANUARY 23, 2023

Article: Abella BS et al. T5 (3.9%) patients with adverse events were reported in the IV Cetirizine group compared to 18 (3.9%) in the IV diphenhydramine group. Moreover, the FDA approved intravenous (IV) cetirizine to treat acute urticaria in 2019. Ann Emerg Med 2020. The mean time spent at a treatment center in hours was 1.7

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 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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Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: In a large randomized trial of dopamine vs. norepinephrine (11) for shock which was published after the above-mentioned recommendations, dopamine had more adverse events (especially severe dysrhythmias, and especially atrial fibrillation). Taglieri N, Marzocchi A, Saia F, et al. Kosuge M, Ebina T, Hibi K, et al.

Coronary 40

Coronary ACS ALS STEMI 40

Core EM

JANUARY 25, 2024

HIET improves contractility without increasing SVR, while vasopressin and epinephrine transiently increase SVR/MAP but worsen cardiac output in anesthetized dogs given propranolol (Holger 2007). References: Yuan TH, Kerns WP, Tomaszewski CA, et al. von Lewinski D, Bruns S, Walther S, et al. Disposition to ICU. Circulation.

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Overdose ALS Epinephrine Critical Care 246

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Reference: Roberts et al. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Audrey’s academic interests include trauma and resuscitation.

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Epinephrine Emergency Department EMS ALS 130

REBEL EM

MAY 29, 2023

Paper: Ibarra-Estrada, M et al. The study was too small to make strong conclusions about adverse events. References: Ibarra-Estrada, M et al. PMID: 36915146 [ Access on Read by QxMD ] Kirov MY et al. PMID: 11588440 Memis D et al. PMID: 12500513 Lopez A et al. Crit Care 2023. 95% CI 15.4 95% CI 15.4

ICU 145

ICU ALS Epinephrine OR 145

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. units/minute.

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E-9-1-1 ALS Emergency Department Plasma 93

FOAMfrat

OCTOBER 20, 2023

And according to a paper from Russotto et al. titled “Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries,” at least one major critical event occurred after intubation in 45.2% Of note, in the paper by Russotto et al., are at high risk.

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ECG Medical Training

DECEMBER 4, 2016

Let me preface this by saying that these are my opinions which are based on my review of the medical literature and my real life experiences using mechanical CPR at the system level, including post-event analysis of resuscitations in which mechanical CPR was used. When this was first studied by Yost et al. Resuscitation. 2015;92:32–37.

CPR 52

CPR E-9-1-1 Defibrillator Ambulance 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. 3–8 Shi et al. Sandoval Y, Smith SW, Sexter A, et al. Shi S, Qin M, Shen B, et al. Guo T, Fan Y, Chen M, et al. Lala A, Johnson KW, Russak AJ, et al.

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REBEL EM

SEPTEMBER 26, 2022

Article: Kumar M et al. It’s unclear whether interventions such as cauterization, clip placement, epinephrine injection, etc., References De Pietri L, Bianchini M, Montalti R, et al. PMID: 31229583 Kumar M, Ahmad J, Maiwall R, et al. PMID: 31148204 Rout G, Shalimar, Gunjan D, et al. Hepatology. 2020;71(1):235-246.

FFP 52

FFP E-9-1-1 ICU ALS 52

AAEM RSA

AUGUST 27, 2020

Nielsen N, Wetterslev J, Cronberg T et al. By the time of the study by Nielsen et al. The authors also investigated harms in both groups and determined no significant difference in adverse events between both groups. Kirkegaard H, Soreide E, de Haas, I et al. Kirkegaard et al. New Engl J Med. 2017;318(4):341–350.

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E-9-1-1 CPR ICU ALS 52

ECG & Echo Learning

JANUARY 18, 2023

IIa B In STEMI patients with stent implantation and an indication for oral anticoagulation, triple therapyd should be considered for 1–6 months (according to a balance between the estimated risk of recurrent coronary events and bleeding).

STEMI 40

STEMI Coronary OR Defibrillator 40

EMDocs

JANUARY 20, 2024

Rosh Review Website Link Further Reading Further FOAMed: [link] [link] References: Ahmad SA, Brito D, Khalid N, et al. doi:[link] Kosuge M, Ebina T, Hibi K, et al. Additional fluids will not improve her condition and may worsen it. Takotsubo Cardiomyopathy. Updated 2023 Jan 9]. In: StatPearls [Internet]. 2014;8:CMC.S14086.

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Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Resuscitated with chest compressions, epinephrine. Here is the written paramedic report available after all the events were over: Patient was seen by witnesses to become unresponsive. including epinephrine, and there was ROSC. Mistaking such cases as an acute cardiac event is not uncommon because of these ECG changes.

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STEMI Paramedic E-9-1-1 Epinephrine 88

EMDocs

MARCH 18, 2025

Studies from the 1980s and 1990s found 5-14% of patients with hemoptysis had a life-threatening event (7,8). Bronchoscopy can be used for bleeding control with cold saline, epinephrine, activated factor VIIa, or TXA. Ittrich H, Bockhorn M, Klose H, et al. Mondoni M, Carlucci P, Job S, et al. Lee TW, Wan S, Choy DK, et al.

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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., References Sangwatanaroj S, Prechaway S, Sunsaneewitayakul B, et al. Antzelevitch C, Brugada P, Borggrefe M, et al.

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E-9-1-1 Defibrillator ALS Epinephrine 52