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Answer : Brugada Syndrome Epidemiology and Etiology Rare genetic disorder that affects approximately 1 in 5,000 individuals worldwide 1. More common in males than females, with a male-to-female ratio of approximately 8:11. Type 1 “Brugada sign” The only type that is considered diagnostic.
mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 Upon arrival to the emergencydepartment, a senior emergency physician looked at the ECG and said "Nothing too exciting." She was defibrillated and resuscitated. Learning Points: 1. What do you think?
Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. 2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. PMID: 35942482 earing gloves, hands on defibrillation is probably safe.
Defibrillation Strategies for Refractory Ventricular Fibrillation. PMID: 33933300 Khan A, Saleem MS, Willner KD, Sullivan L, Yu E, Mahmoud O, Alsaid A, Matsumura ME. Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among EmergencyDepartment Patients With Modest Elevations of High-Sensitivity Troponin.
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. References: 1. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. Ramazan, K.,
A 67-year-old man presents to the emergencydepartment (ED) in cardiac arrest. Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Problem What is the best defibrillation strategy to treat refractory ventricular fibrillation? The primary outcome was survival to hospital discharge.
EMS found the patient pulseless and apneic, with an initial rhythm showing ventricular fibrillation (see figure 1). He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. Figure 1: The EMS rhythm strip. Type 3 is indicated by J point and ST elevation < 1 mm.
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