The Skeptics' Guide to EM

DECEMBER 7, 2018

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). He is unsuccessfully shocked.

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The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? CPR is currently in progress with a single shock having been delivered.

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The Skeptics' Guide to EM

DECEMBER 25, 2021

Case: An EMS crew arrives at the home of a 68-year-old suffering from a witnessed out-of-hospital cardiac arrest (OHCA). Bystander CPR is being performed. The paramedics performed high-quality CPR and follow their ACLS protocol. The paramedics performed high-quality CPR and follow their ACLS protocol.

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Emergency Medicine Cases

MAY 24, 2022

In this first part of our 2-part series on Cardiac Arrest Controversies Rob Simard, Bourke Tillman, Sara Gray and Scott Weingart discuss with Anton how best to ensure high quality chest compressions, the pros and cons of mechanical CPR, the literature on dual sequential defibrillation and optimizing pad placement, epinephrine vs vasopressin, amiodarone (..)

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The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. You need to recognize an arrest and activate your EMS system. vs. 66.8%, p=0.73).

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The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

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The Skeptics' Guide to EM

MARCH 2, 2019

Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. It required multiple attempts which caused several prolonged interruptions in CPR. Key to survival is high-quality CPR and early defibrillation. They had a difficult time getting a definitive airway pre-hospital.

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The Skeptics' Guide to EM

APRIL 4, 2020

Date: April 4th, 2020 It has been just over a year since Dr. Salim Razaie (REBEL EM) and I stepped into the ring for a boxing matched theme debate in Sydney, Australia. Date: April 4th, 2020 It has been just over a year since Dr. Salim Razaie ( REBEL EM) and I stepped into the ring for a boxing matched theme debate in Sydney, Australia.

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Dr. Smith's ECG Blog

JULY 25, 2024

They started CPR. EMS arrived and found him in Ventricular Fibrillation (VF). 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. He was defibrillated into VT. sodium bicarbonate.

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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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Handtevy

MARCH 14, 2018

911 is called and EMS professionals are 7 minutes away. All patients were treated on scene and epinephrine was administered within 5 minutes of arrival on scene. The post Pediatric High Performance CPR appeared first on Handtevy. What changed? Confidence of the providers leveled up with that of the adult patient.

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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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The Overrun Podcast

MAY 23, 2019

Dan recaps the MD1 EMS Conference and shares what he learned from a room full of EM/EMS physicians speaking to EMS clinicians! link] Ultrasound in Cardiac Arrest: [link] Happy EMS Week! We're heading to the MD1/EMS and Disaster Medicine Fellowship Conference at Newark Beth Israel Medical Center!

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EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

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Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. link] __ Case continued There was hypotension, initially controlled with an epinephrine infusion. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. An elderly man collapsed. Medics found him in ventricular fibrillation.

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Handtevy

APRIL 10, 2019

Bystander CPR, 2. Telephone CPR (T-CPR), and 3. On-scene EMS resuscitation. Bystander CPR In the United States today, children in cardiac arrest have less than a 50% likelihood of receiving bystander CPR. Resolution of this problem is beyond the scope of this write-up.

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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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NAEMSP

JANUARY 5, 2023

Meyer MD Clinical Scenario You are dispatched to a 57-year-old male with a witnessed cardiac arrest and bystander CPR being performed. Your partner deploys the cardiac monitor and while CPR is continued you turn your attention to establishing vascular access. Ross EM, Mapp J, Kharod C, Wampler DA, Velasquez C, Miramontes DA.

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TIMER

SEPTEMBER 28, 2022

EMS workers saving accident victims or tending to a patient experiencing a medical emergency. EMT courses, NYC or paramedic level certifications are held by the majority of EMS personnel. They have received training in performing CPR and basic medical care. Thinking about the paramedic vs. EMT debate? It’s not just you.

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NCOAE

NOVEMBER 13, 2021

What an EMT Must Learn While nearly anyone can attempt to become an EMT, in order to qualify to take and pass the National Registry of Emergency Medical Technicians certification exam, candidates must first complete an approved EMS education program. How to stop bleeding, perform CPR, and assist breathing.

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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.

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Dr. Smith's ECG Blog

APRIL 29, 2020

CPR was started immediately. EMS arrived and found her in a wide complex PEA rhythm. 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.

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Dr. Smith's ECG Blog

OCTOBER 10, 2022

CPR was initiated immediately. The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonary embolism). On epinephrine and norepinephrine drips." CT angiogram showed extensive saddle pulmonary embolism.

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The Skeptics' Guide to EM

JUNE 24, 2017

His background includes working as a Research Assistant with the Ottawa Hospital Research Institute, Professor at Fanshawe College and currently, Superintendent of Education for Middlesex-London EMS, in London, Ontario, Canada. By-standard CPR is started and EMS is called. They arrive quickly and take over the resuscitation.

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ACEP Now

NOVEMBER 7, 2023

EMS physicians report he was found in ventricular fibrillation. Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Simon EM, Tanaka K. A 67-year-old man presents to the emergency department (ED) in cardiac arrest. He was found by bystanders after he collapsed and 911 was called.

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REBEL EM

DECEMBER 19, 2022

At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here.

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The Skeptics' Guide to EM

NOVEMBER 30, 2024

Case: You’re doing a ride along with your local emergency medical service (EMS) crews and responding to an out-of-hospital cardiac arrest (OHCA). After starting cardiopulmonary resuscitation (CPR), you note pulseless electrical activity (PEA) on the monitor. Epinephrine has long been a cornerstone in the management of OHCA.

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FOAMfrat

NOVEMBER 25, 2024

Earlier in the summer, I wrote a blog discussing the challenges, intricacies, and educational pitfalls of postpartum hemorrhage in EMS. In the standard care of anaphylactoid reactions, we administer Epinephrine, Diphenhydramine, steroids, and bronchodilators. I even know of cases that my colleagues have managed!

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