EMDocs

APRIL 10, 2024

1-5] Since then, many more medications have been developed and deployed. 1-5] This post focuses on the identification and management of Local Anesthetic Systemic Toxicity (LAST). 3-5,7] Symptom onset is usually within 1 minute of intravascular injection but can be delayed if multiple injections or continuous infusion. [5]

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REBEL EM

SEPTEMBER 13, 2023

Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation. J Allergy Clin Immune Tract 2017; 5(5): 1402-9. of people who take NSAIDs ( Nzeako 2010 ).

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NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. 1] Table from Hamam et al. 9] Figure from Clemency et al. 1] References 1. minutes versus 5.4 minutes). [5] vs 19.7%) access (figure below).

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Don't Forget the Bubbles

MAY 8, 2024

You will find the list is broken down into four sections: 1.Reviews 2024 Apr 9. Associations of excessive internet use, sleep duration and physical activity with school absences: a cross-sectional, population-based study of adolescents in years 8 and 9. 2024 Apr 9:S0890-8567(24)00184-9. 2024 Apr 9.

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ECG & Echo Learning

OCTOBER 2, 2022

Most agents exhibit both vasopressor and inotropic effects (Figure 1). Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 De Backer D, Creteur J, Silva E, Vincent JL.

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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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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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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. 2021;42(1):145-159. Life-threatening hemoptysis.

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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. 2013 Sep;31(9):1389-92. PMID: 33612282 Janapala RN, Tran QK, Patel J, Mehta E, Pourmand A. Paper: Zahed R, Moharamzadeh P, Alizadeharasi S et al.

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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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REBEL EM

JANUARY 23, 2023

Patients were randomized in a 1:1 ratio. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. 2005 Sep;116(3):643-9. PMID: 32653333 What They Did Multi-center, double-blind, randomized, phase 3 clinical trial with a parallel-group, active-controlled, non-inferiority design. 2010 Apr;65(4):459-66.

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Dr. Smith's ECG Blog

JANUARY 19, 2020

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). Figure-1: ECG #1 — recorded by EMS on the scene ( See text ). mm STE with 9.5

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Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Vittinghoff, E. Metoprolol and atenolol are overwhelmingly beta-1 cardioselective. Beta-1 blockade decreases inotropy and chronotropy and has no vasoconstrictive effects. The prohibition against beta blockade in cocaine toxicity, causing "unopposed alpha" stimulation, needs to be re-examined. is intuitive, and not surprising.

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Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Here they are: Learning Points: 1. Type 1 and 2 Myocardial Infarction and Myocardial Injury: Clinical Transition to High-Sensitivity Cardiac Troponin I. Am J Med [Internet] 2017;130(12):1431–9.e4.

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AAEM RSA

AUGUST 27, 2020

1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Kirkegaard H, Soreide E, de Haas, I et al. De Fazio C, Skrifvars MB, Soreide E et al. 2019;23(1):1–9.

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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. Start an IV and give epinephrine? References Levy M, Yost D, Walker RG, Scheunemann E, Mendive SR. doi:10.1016/s0140-6736(14)61886-9. Rubertsson S, Lindgren E, Smekal D, et al. 2014;311(1):53. 2012;20(1):39.

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EMDocs

JANUARY 20, 2024

She describes the pain as left-sided, non-radiating, and 9/10 in severity. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome.

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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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EMDocs

DECEMBER 18, 2023

This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1). 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

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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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ACEP Now

NOVEMBER 7, 2023

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. 1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). 2018;13(9):e0204169.

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