The Skeptics' Guide to EM

MARCH 11, 2023

A fire company is on scene providing high-quality cardiopulmonary resuscitation (CPR) and has defibrillated twice with an automated external defibrillator (AED). Background: Airway management strategies for out of hospital cardiac arrest (OHCA) have been hotly debated since the dawn of CPR. Reference: Smida et al.

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The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Bystander CPR is initiated prior to EMS arrival. One defibrillation for ventricular fibrillation (VF) is provided but the patient remains in VF. We now know that an emphasis on the basics (high quality chest compressions and defibrillation) are the most important aspects of resuscitation.

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BLS Defibrillator Critical Care CPR 130

Dr. Smith's ECG Blog

JULY 9, 2024

His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration.

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Defibrillator STEMI CPR EMS 100

The Skeptics' Guide to EM

MARCH 2, 2019

It required multiple attempts which caused several prolonged interruptions in CPR. Key to survival is high-quality CPR and early defibrillation. After the patient is stabilized the medic asks you how he can improve his airway management skills during a cardiac arrest as it was difficult to intubate during compressions.

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CPR Firefighter Paramedic Defibrillator 130

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation. Case: A 51-year-old man experiences a cardiac arrest on the street. He is unsuccessfully shocked.

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Epinephrine Life Support Advanced Life Support Defibrillator 130

Handtevy

MARCH 13, 2024

A recent case has highlighted the extraordinary potential of a novel intervention: triple-sequential defibrillation. The Case Unfolds Despite 82 minutes of high-quality CPR and Advanced Cardiovascular Life Support (ACLS) management, standard and dual-sequential defibrillation failed to restore the patient’s heartbeat.

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Defibrillator CPR Life Support EMS 52

The Skeptics' Guide to EM

JULY 22, 2023

We should focus more on high-quality CPR and early defibrillation for shockable rhythms and less on type of supraglottic airway device. Your assessment is that the patient will likely be a physiologically, but not anatomically, difficult airway. Should you go with video or direct laryngoscope?

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Emergency Medical Services Defibrillator CPR EMS 166

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Your team begins high quality cardiopulmonary resuscitation (CPR). Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Sodium bicarbonate has historically been used during CPR with the goal of alkalizing blood pH and treating metabolic acidosis.

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The Skeptics' Guide to EM

JANUARY 9, 2021

CPR is currently in progress with a single shock having been delivered. 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

Dr. Smith's ECG Blog

MAY 19, 2020

She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). ECMO Flow was achieved after approximately 1 hour of high quality CPR. After good ECMO flow was established, she was successfully defibrillated. The K was normal. myocarditis).

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Defibrillator CPR Coronary CAD 52

Dr. Smith's ECG Blog

JULY 25, 2024

They started CPR. He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. See these related cases: Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR. This patient was witnessed by bystanders to collapse. After 1 mg of epinephrine they achieved ROSC.

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Defibrillator Coronary Epinephrine ACS 108

ECG Medical Training

DECEMBER 4, 2016

Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. In today’s episode I’d like to talk about mechanical CPR, which is a frequent topic of conversation in the Resuscitation group on Facebook and the #FOAMed community on Twitter. So, mechanical CPR is a no-brainer, right?

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Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. An elderly man collapsed.

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Defibrillator Coronary Epinephrine CPR 128

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). Half of these arrests are witnessed with the other half being un-witnessed.

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The Skeptics' Guide to EM

DECEMBER 2, 2017

SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine? Cardiac Arrest: Pulselessness requiring chest compressions and/or defibrillation, with a hospital wide or unit based emergency response. He is currently deployed, practicing emergency medicine in an undisclosed location.

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CPR Defibrillator ALS Emergency Response 100

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. Head Up (HUP) CPR may be the next critical improvement. Head Up (HUP) CPR may be the next critical improvement. Resuscitation 2022; 179: 9-17.

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Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc. Then the patient would have been taken to the critical care area with a defibrillator at his side while waiting for the cath lab to be ready. He reports feeling nauseated with emesis. There is ischemic ST depression in V4-V6.

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Defibrillator Coronary STEMI CPR 129

EMDocs

JANUARY 8, 2024

With respect to timing, for cardiac arrest with a shockable rhythm, it may be reasonable to administer epinephrine after initial defibrillation attempts have failed. Consider administering epinephrine after defibrillation in those with shockable rhythms. For patients with OHCA, use of steroids during CPR is of uncertain benefit.

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Epinephrine Defibrillator Coronary CPR 83

REBEL EM

JUNE 1, 2023

Known cardiac defibrillator. Bystander CPR, a known predictor of good outcomes, was more common in the SDCT cohort than in the standard care cohort. Design: Prospective, observational, before and after implementation of a protocol study. Excluded: Obvious cause for OHCA prior to SDCT or on hospital arrival. Pre-existing DNR order.

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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. What would your next steps be? His point-of-care labs return with a potassium of 3.4

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ESO

DECEMBER 18, 2024

After reviewing over 12 million EMS incidents that took place in 2023 , the 2024 ESO EMS Index highlights two critical areas that demand attention: Early CPR and Opioid Use Disorder (OUD). The importance of early CPR The earlier CPR is performed, the better the outcome. Gender disparities were also found. Want to learn more?

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Naloxone CPR Overdose Defibrillator 52

Dr. Smith's ECG Blog

JULY 14, 2023

He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated with both with only a fraction of one second separating each defibrillation.

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E-9-1-1 Defibrillator CPR STEMI 83

FOAMfrat

DECEMBER 31, 2024

With that being said, the manufacturers say that CPR, medications, Defibrillation, Cardioversion, and Anything you would normally do are OKAY. The age-old question of CPR it depends. Manufacturer recommendations and several other PubMed articles state it is okay to perform CPR. Is The LVAD Functioing?

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CPR Defibrillator Emergency Department Emergency Transportation 64

EM Didactic

NOVEMBER 19, 2018

age, co-morbidities, trauma) (3) speed of cooling (4) environment (air, water, snow) (5) CA features (body temperature; whether hypoxia preceded arrest; delay before instituting CPR, and CPR quality) (6) rescue considerations (e.g. This improves the brain ’ s tolerance for low- or no blood-flow states. Many arrhythmias (e.g.

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CPR Defibrillator ALS OR 52

Peter Canning

JANUARY 14, 2024

I recerted CPR, ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) late in December. When you are doing CPR and running cardiac arrests on a regular basis, it seems unnecessary to sit through a 2 hour class on CPR and 4 hour classes on ACLS and PALS. The certs are good for two years. mg via syringe.*

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CPR Naloxone EMT EMT 52

Paramedics Unlimited

APRIL 19, 2018

And it becomes impossible to treat multi-system injuries, such as doing chest compression (CPR) while trying to open an airway or control bleeding. Paramedics can also provide full cardiac monitoring and interpretation, including cardiac defibrillation, as well as advanced airway management, including endotracheal intubation and cricotomy.

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BLS ALS Emergency Medical Technician Advanced Life Support 52

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. After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia. Click to enlarge.)

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Coronary Life Support ALS Emergency Department 98

K.S. Chew

MAY 25, 2019

This is a potentially fatal mistake because for VF, the one intervention besides CPR that is proven to increase survival to hospital discharge is defibrillation (but not for PEA). AHA CPR Guideline 2015: In addition to high-quality CPR,

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CPR Defibrillator OR 40

EMT Training Station

FEBRUARY 10, 2024

They often engage in public education, teaching CPR and first aid, and participating in health and wellness fairs. They learn to operate sophisticated life-saving tools, from defibrillators to advanced airway management devices. Climbing the Ladder A career as an EMT is a gateway to numerous opportunities within the medical field.

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EMT EMT Emergency Medical Technician First Responder 98

Utah's Paramedic and EMS Academy

OCTOBER 23, 2023

Upon arrival, you quickly assess the situation and spring into action, working to save a man's life through CPR and defibrillation. This includes checking monitors, defibrillators, airway management equipment, and other essential tools for stabilizing and transporting critically ill patients. And the best part?

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EMT EMT Emergency Medical Technician Defibrillator 52

Dr. Smith's ECG Blog

OCTOBER 28, 2013

It was witnessed, and CPR was performed by trained individuals. She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She arrived in the ED 37 minutes after 911 was called, with continuing CPR. See image with lines below). It was stented.

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Defibrillator ACS CPR STEMI 52

EMT Training Station

FEBRUARY 11, 2024

It focuses on essential lifesaving skills, such as CPR (cardiopulmonary resuscitation), controlling bleeding, and managing shock. This equipment ranges from basic first aid supplies to sophisticated devices like defibrillators, oxygen therapy units, and advanced airway management tools.

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EMT EMT Emergency Medical Technician Emergency Medical Services 98

NCOAE

AUGUST 12, 2022

That’s because one of our areas of focus here at The National Center for Outdoor & Adventure Education (NCOAE) is emergency medicine training and education. The post Most EMS Terminology Comes Down to Initials, Abbreviations and Acronyms appeared first on National Center for Outdoor & Adventure Education.

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EMS EMT EMT Emergency Medical Technician 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

On arrival, CPR was continued and core temperature was measured at 18° C (64.4° The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt. Chest compressions and ventilation were begun.

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CPR Defibrillator Life Support ED 40

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. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. 1639.16; p=0.01).

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

NCOAE

MARCH 8, 2021

covering prehospital medical providers — recognizes three levels of EMTs/paramedics: EMT: EMTs provide non-invasive life-support services, such as cardiopulmonary resuscitation (CPR), administering oxygen, performing automated external defibrillation, basic and advanced airway management, and administering authorized medications.

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EMT EMT Emergency Medical Technician AEMT 52

EMT Training Station

FEBRUARY 11, 2024

If the victim is unresponsive, CPR is initiated immediately. Hidden Dangers and Visible Clues Unlike thermal burns, electrical burns can cause significant internal damage while leaving minimal external signs. The entry and exit wounds are key indicators, but they can be small or hidden under clothing.

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EMT EMT Emergency Medical Technician First Aid 98