emDOCs Podcast – Episode 98: Post ROSC Mental Model
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 Epinephrine STEMI 
115 
Resuscitated from ventricular fibrillation. Should the cath lab be activated?
Dr. Smith's ECG Blog
JULY 25, 2024
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% Cardiac arrest #3: ST depression, Is it STEMI? This patient was witnessed by bystanders to collapse. EMS arrived and found him in Ventricular Fibrillation (VF).
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2023 AHA Update on ACLS
EMDocs
JANUARY 8, 2024
Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. It is reasonable to administer epinephrine 1 mg every 3 to 5 minutes for cardiac arrest. High-dose epinephrine is not recommended for routine use in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R.
STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Dr. Smith's ECG Blog
APRIL 8, 2016
Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? Comments: STEMI with hypokalemia, especially with a long QT, puts the patient at very high risk of Torsades or Ventricular fibrillation (see many references, with abstracts, below). There is atrial fibrillation.
Cardiac arrest: even after the angiogram, the diagnosis is not always clear
Dr. Smith's ECG Blog
OCTOBER 28, 2013
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.
Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?
Dr. Smith's ECG Blog
OCTOBER 20, 2013
Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. With ventilations and epinephrine, she regained a pulse. Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. Also note that they allow ST depression c/w posterior MI to be a STEMI equivalent.
A man in his 30s with cardiac arrest and STE on the post-ROSC ECG
Dr. Smith's ECG Blog
OCTOBER 10, 2022
CPR was initiated immediately. Decision was made to push tPA after approximately 25 minutes of CPR, and after approximately 25 minutes after tPA was given, O2 saturation increased to 97%, and the patient was no longer cyanotic, converted to normal sinus rhythm with anterior lateral T wave inversions with ST depressions."
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