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On arrival, you find a 35-year-old male, pulseless and apneic with cardio-pulmonary resuscitation (CPR) in progress by a bystander. You and your partner initiate high-quality CPR, place a supraglottic airway, establish intra-osseous (IO) access and administer epinephrine. There is drug paraphernalia scattered around the room.
Navy veteran, he specializes in pediatric trauma care Takehome Points Differentiate Between Traumatic and Medical Cardiac Arrest: The approach to traumatic cardiac arrest is distinct from medical arrest, with hemorrhage control and volume resuscitation taking precedence over standard CPR and epinephrine administration.
They started CPR. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% This patient was witnessed by bystanders to collapse. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. sodium bicarbonate.
Today on the emDOCs cast Brit Long interviews Zachary Aust on the use of a mental model in post ROSC patients. Episode 98: Post ROSC Mental Model What’s the problem?
This is being posted now because a high-definition video is available on YOUTUBE for those who could not attend or for those who want to watch this epic match again. How the world has changed with COVID19. You can see the original SGEM Xtra post from March 2019. It has more details about each issue we discussed and our slides.
It was witnessed, and CPR was performed by trained individuals. Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device. Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device.
trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.
CPR was started immediately. She was given 3 mg IV epinephrine and multiple rounds of ACLS over approximately 20 minutes. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. EMS arrived and found her in a wide complex PEA rhythm.
They had a difficult time getting a definitive airway pre-hospital. It required multiple attempts which caused several prolonged interruptions in CPR. Key to survival is high-quality CPR and early defibrillation. Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient.
Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. With ventilations and epinephrine, she regained a pulse. A middle-age woman with h/o hypertension was found down by her husband. She was never seen to be in ventricular fibrillation and was never defibrillated.
That’s definitely not something I want to be awake for, in fact, it looks painful even when patients have it done under anesthetics. Doctor: “Start CPR. More epinephrine went in via IV. So the nurse drew up the medication as the doctor prepares for the procedure. We all knew things weren’t quite right.
After starting cardiopulmonary resuscitation (CPR), you note pulseless electrical activity (PEA) on the monitor. The paramedic is trying to get intravenous (IV) access to give epinephrine per the protocol. Epinephrine has long been a cornerstone in the management of OHCA. Reference: Couper et al.
He was given 50 mcg epinephrine with good response in both heart rate and blood pressure. His heart rate had improved to the 80s after epinephrine administration. CPR was initiated and he underwent 1 round of ACLS (CPR + 1 mg epi). During CPR, he started moving all four extremities spontaneously.
In the standard care of anaphylactoid reactions, we administer Epinephrine, Diphenhydramine, steroids, and bronchodilators. Definitive care for an intrapartum cardiac arrest is a maternal perimortem cesarian section, which may be performed by any emergency physician. Could this work for the AFE patient?
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