ALS, Epinephrine and Life Support

SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

The Skeptics' Guide to EM

JANUARY 13, 2024

Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Reference: Snyder BD, Van Dyke MR, Walker RG, et al. On your arrival, first responders from the fire department are performing high-quality basic cardiac life support. Resuscitation 2023. Resuscitation 2023. We have looked at OHCA more than a dozen times on the SGEM.

CPR

CPR Defibrillator First Responder Epinephrine

SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

DECEMBER 7, 2018

Date: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. Date: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. JAMA 2009, Hagihara et al. JAMA 2012 and Cournoyer et al.

Epinephrine

Epinephrine Life Support Advanced Life Support Defibrillator

The Broselow-Luten System

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. PAWPER was more accurate than EPLS (European life support formula) as well. x exp[0.02 x exp[0.02

E-9-1-1

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

SGEM#350: How Did I Get Epi Alone? Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests

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. Epinephrine is provided and you quickly place an advanced airway. JAMA Sept 2021. JAMA Sept 2021. The monitor shows a non-shockable rhythm.

Epinephrine

Epinephrine Critical Care Emergency Department Life Support

SGEM#189: Bring Me To Life in OHCA

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

[display_podcast] Date: September 19th, 2017 Reference: Cournoyer et al. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. display_podcast] Date: September 19th, 2017 Reference: Cournoyer et al. JAMA 2009 * Jacobs et al. Resuscitation 2011 * Hagihara et al.

Life Support

Life Support CPR Advanced Life Support Defibrillator

SGEM#231: You’re So Vein – IO vs. IV Access for OHCA

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. EMS arrives on scene and initiates high quality basic life support (BLS). As part of their protocol, they attempt vascular access to administer epinephrine and an antidysrhythmic.

BLS

BLS Defibrillator Critical Care CPR

Hypothermic Cardiac Arrest: Pearls and Pitfalls

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. He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU. Carsten L, et al.

Defibrillator

Defibrillator CPR Epinephrine Life Support

IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

NAEMSP

JANUARY 5, 2023

Background Despite conflicting literature to support some pharmacological therapies in out of hospital cardiac arrest, the American Heart Association (AHA) currently recommends obtaining vascular access intravenously or intraosseously in cardiac arrest. [1] 1] Table from Hamam et al. 9] Figure from Clemency et al. minutes). [5]

E-9-1-1

E-9-1-1 Advanced Life Support Epinephrine Life Support

ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

APRIL 10, 2024

1,2] Consider using a physiological marker to help identify inadvertent vascular injection, such as epinephrine. [3] Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive. 5,8] In one review the incidence of LAST was estimated to be 2.7

E-9-1-1

E-9-1-1 Plasma Epinephrine Life Support

Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

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

E-9-1-1 CPR ICU ALS

Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

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

Defibrillator OR ALS Epinephrine

Extreme shock and cardiac arrest in COVID patient

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. He was started on Extracorporeal Life Support ("VA ECMO") Here is the ECG on ECMO: Very low voltage On Day 3, the EF recovered (that seems quick!) 3–8 Shi et al. Angiogram was negative.

E-9-1-1

E-9-1-1 STEMI Coronary ALS

Calcium in Out-of-Hospital Cardiac Arrest

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).

E-9-1-1

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

REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

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. REFERENCES: Cheskes S, et al. 2022 Nov 6 PMID: 36342151 Cheskes S, et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. N Engl J Med.

Defibrillator

Defibrillator Paramedic CPR EMS

Paramedicine Now

SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

SGEM#238: The Epi Don’t Work for OHCA

Trending Sources

The Broselow-Luten System

SGEM#350: How Did I Get Epi Alone? Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests

SGEM#189: Bring Me To Life in OHCA

SGEM#231: You’re So Vein – IO vs. IV Access for OHCA

Hypothermic Cardiac Arrest: Pearls and Pitfalls

IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

ToxCard: Local Anesthetic Systemic Toxicity

Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

Extreme shock and cardiac arrest in COVID patient

Calcium in Out-of-Hospital Cardiac Arrest

REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

Stay Connected