Silk City Blog

DECEMBER 6, 2022

Written by Amanda Hall, DO This post first appeared on REBEL EM Background: Epistaxis is a common ailment experienced by millions worldwide. When simple maneuvers fail, we proceed to topical agents such as lidocaine with epinephrine, oxymetazoline, anterior nasal packing, and electrical or chemical cauterization. Am J Emerg Med.

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EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

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Dr. Smith's ECG Blog

APRIL 2, 2024

He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines. Here is the initial ED ECG. Patient received 11 shocks by ICD and was in V-fib when EMS arrived.

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The Overrun Podcast

MARCH 28, 2021

For most places in EMS, how we treat cardiac arrests in adults is drastically different than how we do it in pediatric patients. Ed and Dan sit down with Dr. Peter Antevy and talk about how we can do better with pediatric arrests. And the results show it.

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Handtevy

DECEMBER 3, 2021

I’ll never forget that Sunday morning in the ED when I opened up the printer tray to grab a clean 8.5” I paced in the ED racking my brain on how to overcome the difficulties of medication dosing during high stress moments, until it hit me like a ton of bricks, “Just do what Bob Hickey used to do.”

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Dr. Smith's ECG Blog

APRIL 6, 2018

EMS report was that the patient had unknown down time with unwitnessed arrest, found initially in VFib arrest, defibrillated x1 followed by PEA arrest alternating with asystolic arrest during transport. Chest compressions were continued, and the patient was given 1 round of epinephrine, calcium, bicarb, glucose. Learning Points: 1.

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REBEL EM

JUNE 8, 2023

1-4 The PDPs, phenylephrine and epinephrine, result in vasoconstriction and increased cardiac contractility. They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine.

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Dr. Smith's ECG Blog

JANUARY 19, 2020

Her family called EMS and EMS recorded hypotension and this ECG: What do you think? On arrival in the ED, she was profoundly hypotensive, nearly obtunded, and bradycardic. At about 30 minutes after presentation, the patient had acceptable vital signs with the TVP and low dose epinephrine drip. mm STE with 9.5

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The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

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Dr. Smith's ECG Blog

JULY 24, 2018

They stated that the patient was coded for 20 minutes, including multiple doses of epinephrine, and they also gave glucose, calcium, and bicarb. As stated above, resuscitation included epinephrine, calcium, and bicarb. He had been given 3 grams Ca gluconate by EMS. After ROSC achieved: Sinus rhythm. QRS much more narrow.

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REBEL EM

JANUARY 23, 2023

Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 7 (5.5%) patients in the IV cetirizine group returned to any ED or clinic within 48 hours compared to 19 (14.1%) in the IV diphenhydramine group; P=0.02

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The Overrun

APRIL 19, 2021

The call involved a sick patient where the student, who was on the verge of going to boards, pulled out the wrong concentration of epinephrine. As they told the story, a couple conversations with the director of EMS, the medical director, and the clinical management, and the student was gone. But not in this case. 3) Anxiety.

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ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.

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REBEL EM

SEPTEMBER 13, 2023

In: UptoDate, Feldweg AM (ed.) PMID 18768946 Post Created By: Anand Swaminathan MD, MPH (Twitter @EMSwami ) Post Peer Reviewed By: Salim Rezaie MD (Twitter @SRRezaie) The post REBEL Core Cast 108.0 – Angioedema appeared first on REBEL EM - Emergency Medicine Blog. UpToDate, Waltham, MA. Clinical practice. N Engl J Med.

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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 ).

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ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. Bourke Tillmann and Scott Weingart for their expertise on the EM Cases podcast that inspired this column. 13,14 The typical regimen is 500 mg three times daily. A special thanks to Drs.

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ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. EMS physicians report he was found in ventricular fibrillation. Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. On ED presentation, he is unresponsive and the monitor shows ventricular fibrillation.

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Dr. Smith's ECG Blog

APRIL 29, 2020

EMS arrived and found her in a wide complex PEA rhythm. She was given 3 mg IV epinephrine and multiple rounds of ACLS over approximately 20 minutes. I was texted this ECG in real time, but it turns out to actually be the 2nd one recorded in the ED. A 60-something woman presented after a witnessed cardiac arrest.

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EMDocs

MAY 26, 2023

But what about the patient who is agitated, and is a potential danger to themselves or to the ED staff? Avoid Trying to Reason With Them When agitated, a child’s prefrontal cortex is suppressed by the cortisol and epinephrine induced fight-or-flight reaction. Do we Redirect?

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EMDocs

JANUARY 20, 2024

We’ll keep it short, while you keep that EM brain sharp. Prior to this intervention, management in the ED is mainly supportive of the patient’s hemodynamic and cardiac status. link] Lee VH, Connolly HM, Fulgham JR, Manno EM, Brown RD Jr, Wijdicks EF. Journal of the American College of Cardiology. 2010;55(22):2514-2516.

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EMDocs

JANUARY 4, 2024

Other Norepinephrine or epinephrine are preferred vasopressors when needed. Eds (2017). Consider lidocaine for associated dysrhythmias. 8 Consider intravenous lipid emulsion (ILE) for cardiotoxicity not responsive to other treatments. 9-12 Do not use this prophylactically in bupropion overdoses. Clin Toxicol (Phila). 2014;52(9):969-72.

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Dr. Smith's ECG Blog

OCTOBER 10, 2022

He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. On epinephrine and norepinephrine drips." CPR was initiated immediately. CT angiogram showed extensive saddle pulmonary embolism.

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Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension. Folland ED, et al. Annals of Emergency Medicine.

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EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. On arrival to the ED, her blood pressure is 84/36 mmHg with a heart rate of 110 beats per minute. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. She had a fever of 38.7 °C F) in the ambulance.

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