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Defibrillation Strategies for Refractory Ventricular Fibrillation. Defibrillation Strategies for Refractory Ventricular Fibrillation. Research interests include simulation-based assessment, transport medicine, and criticalcare analgesia. Defibrillation Strategies for Refractory Ventricular Fibrillation.
Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a criticalcare paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a criticalcare paramedic and first year medical student at Rocky Vista University in Colorado.
JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and criticalcare 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? first appeared on The Skeptics Guide to Emergency Medicine.
Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric CriticalCare Attending at Cincinnati Children’s Hospital Medical Center. Pediatric Crit Care Med. Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU).
2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.
Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Problem What is the best defibrillation strategy to treat refractory ventricular fibrillation? 7 In attempts to improve survival of this devastating condition, investigators have reported alternative defibrillation techniques.
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/criticalcare pod of your emergency department (ED). The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field.
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. 2020), but IV Calcium is still used routinely in some cases in the criticalcare setting, such as congenital heart disease.
At cath, he immediately had incessant Torsades de Pointes requiring defibrillation 7 times and requiring placement of a transvenous pacer for overdrive pacing at a rate of 80. Crit Care Med. 1991 May;19(5):694-9 Objective: To evaluate the efficacy and safety of potassium replacement infusions in critically ill patients.
Takeaway lessons * In any sudden loss of pulse/consciousness, particularly in a known cardiac patient, the presumption should be for a shockable arrhythmia and rapid defibrillation should be prioritized above all else. If you’re above this DBP, just skip epinephrine, which will probably merely be toxic (ie promoting arrhythmias). *
In the standard care of anaphylactoid reactions, we administer Epinephrine, Diphenhydramine, steroids, and bronchodilators. Sure, we still do CPR, defibrillate as needed, and give Epinephrine based upon our local guidance. CriticalCare Medicine, 33 (10), S279-S285. Could this work for the AFE patient?
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