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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.
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. Tips for use of dual sequence defibrillation 11 : Use the same model of defibrillator.
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.
Once activated, EMS ensures that the appropriate level of care is dispatched to the patient. This could range from basic lifesupport, typically managed by EMTs, to more advanced lifesupport provided by paramedics and other medical specialists.
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.
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