Core EM

JANUARY 25, 2024

HIET improves contractility without increasing SVR, while vasopressin and epinephrine transiently increase SVR/MAP but worsen cardiac output in anesthetized dogs given propranolol (Holger 2007). Insulin versus vasopressin and epinephrine to treat β-blocker toxicity. Strong trend across different study designs for superiority of HIET.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

Pediatric EM Morsels

SEPTEMBER 22, 2023

Both norepinephrine and epinephrine can be used. Epinephrine is key if there is significant bradycardia. Crystalloid may help, but neurogenic shock may not respond to fluid administration. Alpha 1 agonists are necessary to maintain appropriate blood pressure.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

Broome Docs

NOVEMBER 17, 2024

PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest. PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest. Resuscitation. 2024 Aug;201:110266.

Epinephrine 62

Epinephrine Emergency Department Critical Care ICU 62

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? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

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.

BLS 130

BLS Defibrillator Critical Care CPR 130

REBEL EM

APRIL 29, 2024

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

The Skeptics' Guide to EM

APRIL 4, 2020

We went four rounds punching and counter punching arguments about critical care controversies. We both agree that the patient deserves the best care, based on the best evidence. It is an example of mixing education and entertainment for some great knowledge translation. The REBEL took the fight to the Skeptic.

Critical Care 130

Critical Care Epinephrine CPR Ambulance 130

EMDocs

OCTOBER 29, 2024

Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. EPINEPHRINE-INUDCED SHOCK: LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION ON VASOPRESSORS. m/s)—problematic and elevated > 50 mm Hg (2.5 J Thorac Dis. 2015;7(9):E365-E369. J Clin Med.

E-9-1-1 86

E-9-1-1 ICU Epinephrine EMS 86

Pediatric EM Morsels

JULY 19, 2024

Soak the gauze with epinephrine (1:10,000) or TXA (our THIRD route of administration) Apply pressure laterally to the tonsillar fossa with the gauze covered Magill forceps. . < 25 kg = 250 mg up to 3x > 25 kg = 500 mg up to 3x Direct Pressure Always the best way to stop bleeding. Don’t await for fancy meds to arrive from pharmacy.

E-9-1-1 286

E-9-1-1 Epinephrine Emergency Department OR 286

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. [Krug 2007] What If the Child is Obese or Emaciated? There are other systems that account for body habitus.

E-9-1-1 269

E-9-1-1 Emergency Medical Services Life Support ALS 269

ACEP Now

JULY 7, 2023

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. 5 More recent literature defines “refractory” as VT or VF that is persistent or recurrent despite three shocks from a defibrillator, three rounds of epinephrine, and use of an antiarrhythmic (i.e.,

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care 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.

Defibrillator 84

Defibrillator CPR Epinephrine Life Support 84

Critical Care Scenarios

NOVEMBER 29, 2020

Be aggressive with fluid resuscitation and consider epinephrine up to 0.06–0.08 .* Adding an inotrope can be somewhat diagnostic, as patients with mere myocardial stunning will improve, whereas patients with tamponade will generally have little response.* Give calcium chloride freely to the unstable post-cardiac surgery patient.*

ICU 100

ICU Epinephrine OR ED 100

Handtevy

MARCH 14, 2018

If we remove these decades old requirements we can begin to reshape human behavior at the point of care, where it matters most. In this video we describe a step by step approach to pediatric critical care using training that is specifically geared towards System 2 elimination. What changed?

CPR 52

CPR Epinephrine Critical Care EMS 52

NAEMSP

APRIL 19, 2023

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 critical care setting, such as congenital heart disease. Pediatric Critical Care Medicine, 23 (11), 860-871. Kay, J., & Blalock, A.

E-9-1-1 52

E-9-1-1 Advanced Life Support Overdose CPR 52

ECG & Echo Learning

OCTOBER 2, 2022

Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: which is best? Crit Care Med 2003; 31:1659. Use of inotropes in the critical care setting.

E-9-1-1 52

E-9-1-1 ALS Coronary Epinephrine 52

AAEM RSA

AUGUST 27, 2020

However, the decade since the original Hypothermia after Cardiac Arrest trial had seen significant advances in pre-hospital, emergency department, and critical care that may have contributed to these outcomes. These results suggest that targeting a lower temperature of 33ºC confers no additional benefit to targeting 36ºC.

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

EMDocs

JANUARY 4, 2024

Other Norepinephrine or epinephrine are preferred vasopressors when needed. Critical Care Toxicology. Consider lidocaine for associated dysrhythmias. 8 Consider intravenous lipid emulsion (ILE) for cardiotoxicity not responsive to other treatments. 9-12 Do not use this prophylactically in bupropion overdoses. 2014;52(9):969-72.

Overdose 65

Overdose E-9-1-1 ALS Emergency Department 65

ACEP Now

NOVEMBER 7, 2023

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. 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. EMS physicians report he was found in ventricular fibrillation.

Defibrillator 52

Defibrillator E-9-1-1 ALS Epinephrine 52