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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.

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SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

The Skeptics' Guide to EM

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 at Tacoma Community College. Case: During a busy emergency department (ED) shift the paramedic phone rings.

EMS 130
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SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

The Skeptics' Guide to EM

Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Pediatric Crit Care Med.

CPR 130
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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?

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REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

REBEL EM

Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. N Engl J Med.

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Case Report: Coronary Vasospasm-Induced Cardiac Arrest

ACEP Now

After the fourth defibrillation attempt, 200 mcg IV NTG was administered, resulting in immediate return of spontaneous circulation with a junctional bradycardia rhythm. Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. Click to enlarge.)

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Cardiac Arrest, acute ST elevation and depression superimposed on LVH, but NOT due to ACS

Dr. Smith's ECG Blog

He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. He arrived in the emergency department hemodynamically stable. This young male had ventricular fibrillation during a triathlon. On his bib it stated that he had a congenital heart disorder. His initial ECG is shown here.

ACS 52