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EM@3AM: Brugada Syndrome

EMDocs

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 8:1 1. Type 1 “Brugada sign” The only type that is considered diagnostic.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

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 emergency department, 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?

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First10EM Journal Club: October 2022

Broome Docs

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.

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First10EM Journal Club: January 2023

Broome Docs

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 Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin.

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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

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.,

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What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

ACEP Now

A 67-year-old man presents to the emergency department (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.

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Case Report: Cardiac Arrest in a Child’s Structurally Normal Heart

ACEP Now

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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