Dr. Smith's ECG Blog

JANUARY 19, 2020

Her family called EMS and EMS recorded hypotension and this ECG: What do you think? At about 30 minutes after presentation, the patient had acceptable vital signs with the TVP and low dose epinephrine drip. Another ECG was obtained during pacing: Mostly paced rhythm with PVCs (#3, #6, #9, #12). mm STE with 9.5

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REBEL EM

JULY 18, 2022

When simple maneuvers fail, we proceed to topical agents such as lidocaine with epinephrine, oxymetazoline, anterior nasal packing, and electrical or chemical cauterization. TXA has become the standard practice in the ED based on small RCTs, though larger trials have not demonstrated the same benefit ( REBEL EM review ). Ann Emerg Med.

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REBEL EM

SEPTEMBER 26, 2022

2020;71(1):235-246. Plt 37×10^9/L and 40×10^9/L, SOC and TEG, respectively) All patients enrolled had an upper endoscopy and verified the source of bleeding. Article: Kumar M et al. Thromboelastography-Guided Blood Component Use in Patients With Cirrhosis With Nonvariceal Bleeding: A Randomized Controlled Trial.

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REBEL EM

JANUARY 23, 2023

Patients were randomized in a 1:1 ratio. Noninferiority trials, covered here on REBEL EM , are helpful when the experimental treatment offers a distinct advantage over the standard treatment. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. 2005 Sep;116(3):643-9. 2010 Apr;65(4):459-66.

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FOAMfrat

OCTOBER 20, 2023

As reported within the 6th edition Manual of Emergency Airway Management, there are cardiac arrest rates between 1% and 4%, with other complications (mostly hypoxemia and hypotension) as high as 30% in patients with first-pass success [1, pg 29; 4-10]. Recommendations : 1. Why is Physiologic Optimization Important?

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NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. This CI does include 1; and further and further analysis of the data showed that the likelihood that calcium has a beneficial effect (e.g. References: 1. He is found to be in ventricular fibrillation (VF). Ramazan, K.,

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ACEP Now

NOVEMBER 14, 2023

1 However, it is important to understand that death from hemoptysis is almost always due to hypoxia or asphyxiation (blood impedes gas exchange in the lungs, typically because of bleeding from high-pressure bronchial arteries into the lungs) as opposed to hemodynamic instability. These patients are at imminent risk of respiratory failure.

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ECG Medical Training

DECEMBER 4, 2016

Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. Alongside tracheal intubation , response times , and fire-based EMS, this is one of the most controversial topics in prehospital medicine. Start an IV and give epinephrine? I’m your host Tom Bouthillet.

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EMDocs

JANUARY 20, 2024

We’ll keep it short, while you keep that EM brain sharp. She describes the pain as left-sided, non-radiating, and 9/10 in severity. A 67-year-old female with past medical history of hypertension presents with acute onset of chest pain without associated symptoms. ECG shows ST-segment elevation in V3-V6 only with depression in aVR.

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EMDocs

JANUARY 4, 2024

1 In addition to intentional overdoses, there are multiple case studies of abuse (ingestion, insufflation, injection). QRS > 100 msec can give sodium bicarbonate 1-2 mEq/kg IV boluses. 9-12 Do not use this prophylactically in bupropion overdoses. Other Norepinephrine or epinephrine are preferred vasopressors when needed.

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EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1). These include C-reactive protein, procalcitonin, interleukin-6, CD64, presepsin, and sTREM-1. She had a fever of 38.7 °C

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ACEP Now

NOVEMBER 7, 2023

EMS physicians report he was found in ventricular fibrillation. Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. 2018;13(9):e0204169. Margey R, Browne L, Murphy E, et al. Simon EM, Tanaka K. Cortez E, Krebs W, Davis J, et al. Larribau R, Deham H, Niquille M, et al.

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EMDocs

OCTOBER 29, 2024

Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA), Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

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ACEP Now

OCTOBER 29, 2024

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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