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. There is evidence that taking those patients with ROSC and EKG showing STEMI directly for angiography +/- angioplasty is associated with positive patient-oriented outcomes.

EMR 130

EMR Coronary Defibrillator Life Support 130

REBEL EM

SEPTEMBER 14, 2023

Revascularization of the culprit lesion remains one of the few established treatments though there are numerous other unproven modalities including extracorporeal life support (ECLS). Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. Did they get bystander CPR? Zeymer HT et al. Control: 53.4%

Life Support 133

Life Support Coronary CPR ICU 133

EMDocs

JANUARY 8, 2024

For patients with OHCA, use of steroids during CPR is of uncertain benefit. Extracorporeal CPR Use of ECPR for patients with cardiac arrest refractory to standard ACLS is reasonable in select patients when provided within an appropriately trained and equipped system of care. COR 2b, LOE B-R. COR 2b, LOE C-LD. Circulation. 2023 Dec 18.

Epinephrine 98

Epinephrine Defibrillator Coronary CPR 98

ESO

JANUARY 19, 2024

Working towards better detection Another area ESO has identified as an opportunity to improve is how EMS services detect a possible STEMI or NSTEMI with a 12-lead EKG. Currently, conventional EMS education tends to center symptoms of a STEMI or NSTEMI for males as “typical” and females as “atypical.”

CPR 52

CPR Advanced Life Support Life Support STEMI 52

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. This is a troponin I level that is almost exclusively seen in STEMI. Troponin I rose to 44.1

Defibrillator 52

Defibrillator CPR Coronary CAD 52

EMDocs

JANUARY 11, 2024

Statements: Early risk stratification is not intended as a tool for triage to withdraw life support and is not used for that purpose (90.5%, 19/21). Evaluate for mechanical support in those with refractory hypotension (ECMO). Get your cardiologist on board early.

Critical Care 97

Critical Care E-9-1-1 OR ICU 97

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. He was started on Extracorporeal Life Support ("VA ECMO") Here is the ECG on ECMO: Very low voltage On Day 3, the EF recovered (that seems quick!) He was intubated and then went pulseless.

E-9-1-1 52

E-9-1-1 STEMI Coronary ALS 52