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SGEM#453: I Can’t Go For That – No, No Narcan for Out-of-Hospital Cardiac Arrests

The Skeptics' Guide to EM

Naloxone is a well-established medication used primarily for reversing opioid overdoses. Traditionally, naloxone has been used in cases of suspected opioid overdose where patients exhibit signs of severe respiratory depression or loss of consciousness (LOC). Today’s study looks at the role of naloxone in OHCA.

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REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

REBEL EM

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning Click here for Direct Download of the Podcast Definition and Physiology Standard definition of a wide QRS is anything > 120 msec (3 small boxes on the ECG) In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. Boehnert 1985 ). N Engl J Med.

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

Dr. Smith's ECG Blog

Confirmation of sinus tachycardia should be easy to verify when the heart rate slows a little bit ( as the patient's condition improves ) — allowing clearer definition between the T and P waves.

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Opioid overdose remains the leading cause of cardiac arrest due to poisoning in North America. For a patient with suspected opioid overdose who has a definite pulse but no normal breathing or only gasping (ie, a respiratory arrest), in addition to providing standard BLS and/or ALS care, it is reasonable for responders to administer naloxone.

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Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

Dr. Smith's ECG Blog

There is definite reperfusion. There was definite evolution of the ECG. There was a new r egional wall motion abnormality-apical septum, inferior, lateral, and anterior, akinetic with dyskinetic apex. This confirms LAD Occlusion. Another ECG was recorded at 120 minutes, S-wave reconstituted T-wave and STE are normalizing.

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Choosing Wisely – Investigations for Paediatric Patients presenting with Psychiatric Symptoms

Don't Forget the Bubbles

Another study observed that children and young people who received unnecessary medical screening laboratory investigations would have received definitive psychiatric care on average 6.8 A single-centre retrospective US study reported similar results, including 1,082 children. hours earlier had these not been undertaken.

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

Dr. Smith's ECG Blog

There is no definite evidence of acute ischemia. (ie, This is an important finding related to the etiology and treatment of these malignant arrhythmias — since by definition, PMVT with a prolonged QTc is classified as Torsades de Pointes ( and entails different treatment recommendations ).