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!

E-9-1-1 87

E-9-1-1 ICU Epinephrine EMS 87

Dr. Smith's ECG Blog

JULY 25, 2024

EMS arrived and found him in Ventricular Fibrillation (VF). After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% The patient was brought to the ED and had this ECG recorded: What do you think? They started CPR. He was defibrillated into VT.

Defibrillator 113

Defibrillator Coronary Epinephrine ACS 113

EMS 12-Lead

MARCH 30, 2024

After administering 1mg of epinephrine ROSC is noted with a bradycardic rhythm ( Figure 2 ). On ED arrival ROSC is achieved. Two paramedics are in the rear of the ambulance managing resuscitation (another crew had arrived and provided support with a driver). Junctional Rhythm, occasional PAC's, and artifact.

CPR 312

CPR Paramedic Ambulance Defibrillator 312

ACEP Now

NOVEMBER 6, 2024

A gravid woman presents to your emergency department (ED). mg/kg IV epinephrine, or 0.05–0.1 3 Dr. Turner , originally trained at the Medical University of South Carolina, is an EM intern at Hershey Medical Center in Hershey, Pa. Garvey AA, Dempsey EM. The neonate is apneic and has a heart rate of 48. Adv Med Educ Pract.

Epinephrine 98

Epinephrine Emergency Department EMS OR 98

EMDocs

APRIL 10, 2024

Authors: Alex Rogers, MD (EM Resident Physician, Christus Spohn/Texas A&M University School of Medicine, Corpus Christi, TX); J.D. These medications are a vital tool in the care of ED patients, from simple local analgesia for a laceration repair to regional analgesia for painful procedures. lidocaine) or an ester (e.g.,

E-9-1-1 94

E-9-1-1 Plasma Epinephrine Life Support 94

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

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

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.

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

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.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh.

E-9-1-1 269

E-9-1-1 Emergency Medical Services Life Support ALS 269

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.

Epinephrine 40

Epinephrine EMS ED ALS 40

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.

Defibrillator 85

Defibrillator CPR Epinephrine Life Support 85

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.

Epinephrine 52

Epinephrine Paramedic ED EMS 52

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.

Defibrillator 130

Defibrillator Coronary Epinephrine CPR 130

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 ).

E-9-1-1 52

E-9-1-1 Epinephrine ED ALS 52

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.”

Epinephrine 52

Epinephrine EMS ED OR 52

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.

E-9-1-1 52

E-9-1-1 ALS Emergency Department OR 52

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?

Emergency Medical Services 76

Emergency Medical Services Emergency Department OR ED 76

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.

Defibrillator 52

Defibrillator ICU EMS Plasma 52

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.

Defibrillator 52

Defibrillator Epinephrine Coronary Overdose 52

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

E-9-1-1 52

E-9-1-1 STEMI ED EMS 52

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.

Epinephrine 52

Epinephrine ICU Coronary EMS 52

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.

ACS 52

ACS CPR CAD Heart Attack 52

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.

E-9-1-1 75

E-9-1-1 EMS Coronary ACS 75

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.

Paramedic 52

Paramedic OR EMT EMT 52

ACEP Now

OCTOBER 28, 2024

Holy Foley A Rare Case of Iatrogenic Obstruction by Adam Heilmann, MD; Jessica Pelletier, DO; Jennifer Reyes Lin, MD, MPH Our patient is a 33-year-old male with spastic quadriparesis due to cerebral palsy with chronic indwelling suprapubic catheter (SPC) who presented to the emergency department (ED) due to concern for Foley catheter obstruction.

Emergency Department 52

Emergency Department Defibrillator Epinephrine EMS 52

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.

Coronary 52

Coronary ACS ALS STEMI 52

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.

E-9-1-1 66

E-9-1-1 ALS Emergency Department Plasma 66

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.

Defibrillator 52

Defibrillator E-9-1-1 ALS Epinephrine 52

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.

Overdose 66

Overdose E-9-1-1 ALS Emergency Department 66