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Episode 188: Vasopressors

Core EM

We go over the essential and complex topic of vasopressors in the ED.

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Neurogenic Shock in Children

Pediatric EM Morsels

Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. Both norepinephrine and epinephrine can be used. Epinephrine is key if there is significant bradycardia. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. 5 th Edition. Neurogenic Shock.

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Episode 189: Hyperkalemia 2.0

Core EM

Three children (2.1%) had true hyperkalemia: one had known chronic renal failure and was referred to the ED due to concern for electrolyte abnormalities; the other 2 patients had diabetic ketoacidosis (DKA).

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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

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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Year in Review: ESO Research and Data That Shaped 2024

ESO

Read the 2024 ESO EMS Index Read the 2024 ESO Fire Service Index Post-Resuscitation Epinephrine Vs. Norepinephrine in Cardiac Arrest Released in May 2024 Epinephrine and norepinephrine are both commonly used as prehospital vasopressors in the United States. Watch the video to hear directly from attendees.

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Transfusion Reactions

Core EM

In: Marx J, ed. In: Wolfson A, ed. Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3%

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Ventricular Fibrillation, ICD, LBBB, QRS of 210 ms, Positive Smith Modified Sgarbossa Criteria, and Pacemaker-Mediated Tachycardia

Dr. Smith's ECG Blog

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. What do you think? Rhythm : Residents asked me why it is not VT. Cardiology agreed.