The Skeptics' Guide to EM

APRIL 27, 2024

When emergency department (ED) staff roll her to remove her clothing her humeral intraosseous (IO) is dislodged. This is because of the ease of finding anatomic landmarks and their location away from other procedures like defibrillation, CPR, and airway management. The classic location for IO placement is the tibial plateau.

ICU 231

ICU Defibrillator Paramedic CPR 231

Emergency Medicine Cases

MARCH 14, 2017

I remember when I started practicing emergency medicine a decade and a half ago it seemed that any kid who came to our ED in cardiac arrest died. I know, depressing thought. But, over the past 15 years, survival to discharge from pediatric cardiac arrest has markedly improved, at least for in-hospital arrests.

CPR 130

CPR ED EMS 130

REBEL EM

JUNE 29, 2023

The CT FIRST Trial: Should We Pan-CT After ROSC?, REBEL EM Blog, June 1, 2023.

CPR 145

CPR ICU EMS ALS 145

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. Your team begins high quality cardiopulmonary resuscitation (CPR). Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU). Pediatric Crit Care Med.

CPR 130

CPR ICU Critical Care Epinephrine 130

The Skeptics' Guide to EM

MAY 20, 2023

Case: You are working at the community emergency department (ED) when you receive a call from the local Emergency Medicine Service (EMS) team that they are bringing a 2-year-old boy who had a cardiac arrest at home. They started cardiopulmonary resuscitation (CPR) until EMS arrived.

CPR 130

CPR ALS Emergency Department EMS 130

EMergucate

JULY 2, 2018

50 year old male presents to ED after a heroin OD. The patient had CPR on scene and responded to … Continue reading →

CPR 100

CPR ED Naloxone 100

EMergucate

FEBRUARY 6, 2023

75 year old man was brought to ED by ambulance in VF cardiac arrest , CPR in progress. His venous blood gases showed the following PH = 7.14 pCO2 = 53 mmHg

CPR 100

CPR Ambulance ED 100

EMergucate

JULY 5, 2021

A 4 week old is brought to ED post cardiac arrest – the child was found in her cot not breathing. The parents performed CPR immediately and on arrival the child had ROSC. The child has been unwell …

CPR 100

CPR ED 100

EMergucate

JULY 7, 2021

A 4 week old is brought to ED post cardiac arrest – the child was found in her cot not breathing. The parents performed CPR immediately and on arrival the child had ROSC. The child has been unwell …

CPR 100

CPR ED 100

EMergucate

JANUARY 1, 2019

85 years old lady with history of COPD, brought to ED with low GCS after VF cardiac arrest and return of spontaneous circulation after 3 minutes of CPR and a single DC shock. Her VBG on arrival sho…

CPR 100

CPR ED 100

EMergucate

NOVEMBER 14, 2022

85 years old lady with history of COPD, brought to ED with low GCS after VF cardiac arrest followed by return of spontaneous circulation after 3 minutes of CPR and a single DC shock. Her VBG on arr…

CPR 100

CPR ED 100

EMergucate

MAY 8, 2018

A 7 year old boy is brought to ED with his mother with a 4 day history of abdominal pain and vomiting. O/E BP 90/50 HR 115 Sats 97% RA Temp 37 RR 30 CPR 4 seconds. He has no PMH. The child has sunk…

CPR 100

CPR ED 100

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

Here is the case: Report from EMS was witnessed syncope, his son did CPR, but the patient had pulses when EMS arrived. When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. Here is the ED ECG (a photo of the paper printout) What do you think? No Chest Pain, but somnolent.

EMS 114

EMS CPR ED Coronary 114

The Skeptics' Guide to EM

JANUARY 9, 2021

Case: During a busy emergency department (ED) shift the paramedic phone rings. CPR is currently in progress with a single shock having been delivered. On the other end of the line is one of your local crews who have responded to a 54-year-old male with a witnessed cardiac arrest.

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

AUGUST 14, 2021

Missy is also now the director for Difficult Airway EMS course in Washington State Case: An EMS crew arrives to your emergency department (ED) with a 58-year-old female who suffered a witnessed ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA). Background: We have covered OHCA multiple times on the SGEM.

BLS 130

BLS CPR Paramedic ALS 130

EMDocs

APRIL 2, 2024

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?

CPR 115

CPR STEMI Epinephrine ICU 115

NAEMSP

JANUARY 19, 2025

Authors: Rebecca Dupree, DO and Emerson Franke, MD FAEMS FAAEM Case The dreaded scenario: youre performing high quality CPR in the field, youve successfully intubated the patient, and suddenly you hear, I found their DNR form! These may result in an ED extubation or admission to the hospital for comfort care and terminal extubation.

EMS 52

EMS Emergency Department CPR ED 52

Critical Care Scenarios

MAY 24, 2023

Listen to the ED ECMO podcast on ECPR here Find us on Patreon here! Listen to the ED ECMO podcast on ECPR here Find us on Patreon here! No-flow time without CPR should be very brief (witnessed is best), but low-flow time (with CPR) can actually be very long and still have good outcomes with ECPR. Buy your merch here!

CPR 100

CPR ED EMS OR 100

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation.

EMR 130

EMR Coronary Defibrillator Life Support 130

ACEP Now

JANUARY 4, 2025

I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr. Clarke said. ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in C booththe main trauma roomwith an ED tech administering CPR. Click to enlarge.)

ED 52

ED Emergency Department Ambulance CPR 52

EMOttawa

JULY 11, 2024

CPR was ongoing, and their ETA was 10 minutes. We prepared the ED for the patient’s arrival. In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. It’s Backkkk (Part 1) appeared first on EMOttawa Blog.

CPR 77

CPR EMS ED Critical Care 77

Don't Forget the Bubbles

JUNE 30, 2023

She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Despite good quality CPR, there is no ROSC. Despite good quality CPR, there is no ROSC. Despite good quality CPR, there is no ROSC. Emergency Medical Services found her apneic and pulseless.

CPR 145

CPR Life Support Critical Care ALS 145

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). This is referred to as CPR I nduced C onsciousness ( CPRIC ).

E-9-1-1 135

E-9-1-1 Emergency Department ED CPR 135

Don't Forget the Bubbles

JUNE 19, 2024

CASP checklist for Clinical Prediction Rule (CPR) studies Is CPR clearly defined? A proportion of participants were missed because the ED provider refused enrollment or said “Other,” but this is not well described. I am hopeful it will also improve the flow in the ED.”

CPR 124

CPR Operating Room OR Emergency Department 124

Chicago EMT Training

AUGUST 6, 2021

Duties include but are not limited to stocking, cleaning, transporting patients, performing EKGs, blood draws, and CPR. It's important to keep in mind that you are not functioning as an EMT when you're an ED Tech/Assistant.

EMT 130

EMT EMT Paramedic Plasma 130

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Guest Skeptic: Dr. Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care […] The post SGEM#350: How Did I Get Epi Alone? Cardiopulmonary resuscitation (CPR) is in progress. JAMA Sept 2021.

Epinephrine 100

Epinephrine Critical Care Life Support Emergency Department 100

Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines.

Defibrillator 133

Defibrillator Coronary Epinephrine CPR 133

The Overrun

JULY 5, 2019

They carry the same CPR card in their wallets as I do, they readily use the brains between their ears, so why are we made to perform futile efforts on a patient who didn’t want the help to begin with? A clinically primitive mindset; no heartbeat bad, CPR good, liability avoided. Does that mean a little more training or continuing ed?

CPR 52

CPR OR BLS EMT 52

Dr. Smith's ECG Blog

JULY 25, 2024

They started CPR. The patient was brought to the ED and had this ECG recorded: What do you think? This patient was witnessed by bystanders to collapse. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. sodium bicarbonate.

Defibrillator 124

Defibrillator Coronary Epinephrine ACS 124

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). His blood sugar was normal en route to the ED, and his initial rhythm on the cardiac monitor was asystole. It is unclear how long he was down.

Defibrillator 110

Defibrillator CPR Epinephrine Life Support 110

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest. She had a witnessed arrest, and CPR was initiated by bystanders. The patient achieved return of spontaneous circulation (ROSC) on arrival to the ED.

CPR 100

CPR ALS ICU EMS 100

Dr. Smith's ECG Blog

MAY 19, 2020

ECMO Flow was achieved after approximately 1 hour of high quality CPR. For clarity — I’ll again show the initial ECG done in the ED in Figure-1. She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support).

Defibrillator 52

Defibrillator CPR Coronary CAD 52

EMDocs

MARCH 20, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. “Code,” “No Code,” “CPR,” “resuscitation,” etc. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

CPR 105

CPR ALS OR ED 105

Dr. Smith's ECG Blog

JULY 9, 2024

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

Defibrillator 116

Defibrillator STEMI CPR EMS 116

Dr. Smith's ECG Blog

APRIL 30, 2024

Bystander CPR. He went in and out of arrest until arrival at the ED. Here is the only prehospital 12-lead: Sinus tachycardia, somewhat wide QRS, Ischemia Here is the first ED ECG: What is the rhythm here? A patient was found down approximately 30 minutes after taking methamphetamine. Medics found patient in PEA arrest.

CPR 108

CPR EMS ED OR 108

EMDocs

JANUARY 8, 2024

This post will focus on the key parts of the guideline that affect ED evaluation and management. For patients with OHCA, use of steroids during CPR is of uncertain benefit. Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline Updates for 2023 were just published.

Epinephrine 98

Epinephrine Defibrillator Coronary CPR 98

Dr. Smith's ECG Blog

JULY 14, 2023

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

E-9-1-1 98

E-9-1-1 Defibrillator CPR STEMI 98