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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% This patient was witnessed by bystanders to collapse. They started CPR. sodium bicarbonate.

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2023 AHA Update on ACLS

EMDocs

Calcium is associated with harm but is still necessary in certain situations (hyperkalemia, calcium channel blocker overdose) (Level 3 recommendation: no benefit). Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R. COR 2b, LOE B-R.

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Recerts and New Protocols

Peter Canning

For all the fancy changes over the year, the bottom line has always been to provide good CPR compressions and timely defibrillation. The pediatric epinephrine and norepinephrine infusion rates have been lowered to 0.1-0.5 The pediatric epinephrine and norepinephrine infusion rates have been lowered to 0.1-0.5 mg via syringe.*

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

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. The patient is moved over to the stretcher and connected to the monitors and defibrillator. What would your next steps be?

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

Epinephrine infusion was begun. He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. An ICD ( Implantable Cardioverter Defibrilator ) was placed prior to discharge. What do you think?

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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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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. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. References: 1. Ramazan, K.,

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