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How Much O2 Is Right in COVID?

REBEL EM

Paper: Nielsen FM et al. Lower vs higher oxygenation target and days alive without life support in COVID-19. Adverse events in the ICU within 90 days (new shock, cerebral ischemia, myocardial infarction, or intestinal ischemia). This data supports current practice of targeting a lower O2 sat.

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The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

REBEL EM

Revascularization of the culprit lesion remains one of the few established treatments though there are numerous other unproven modalities including extracorporeal life support (ECLS). Zeymer HT et al. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. References: Zeymer HT et al. D ECLS: 18.2%

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Episode 19: Emergency medicine with Seth Trueger

Critical Care Scenarios

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. ICU time and ED time are different. JAMA Intern Med.

ICU 100
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EM@3AM: Amniotic Fluid Embolism

EMDocs

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. ” Am J Obstet Gynecol 215(2): B16-24.

EMS 95
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The Science on Targeted Temperature Management

ACEP Now

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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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

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. Extracorporeal Life Support in Accidental Hypothermia with Cardiac Arrest—A Narrative Review. Monika BM, Martin D, Balthasar E, et al. 2009;338:b2085.

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

AAEM RSA

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.

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