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The Guidelines Graveyard: What gets chosen, what gets buried?

Handtevy

On November 14, 2024, ILCOR released their latest recommendations for adult and pediatric basic and advanced life support. Yet at the same time, despite a large-scale Holmberg study involving over 6,000 patients suggesting potential harm, epinephrine remained part of the pediatric symptomatic bradycardia protocol. The result?

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

ACEP Now

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.,

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REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

REBEL EM

trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.

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Dual Sequential Defibrillation

Core EM

Definition: Refractory Ventricular Arrhythmias Persistent ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) despite 3 shocks, appropriate CPR, vasopressors, and anti-arrhythmics. Administer epinephrine every 35 minutes. link] Advanced Cardiovascular Life Support. N Engl J Med. 2022;387(21):19471956.