REBEL EM

JUNE 14, 2023

to 0.5mg (1mg/mL) IV Bolus: 5 to 20mcg (10mcg/mL) IV Infusion: 1 to 20mcg/min If Poor Response to Conventional Therapy Consider Epinephrine 100mcg IV bolus Norepinephrine infusion 0.1mcg/kg/min Vasopressin 0.01

Allergic Reaction 145

Allergic Reaction Epinephrine OR EMS 145

The Skeptics' Guide to EM

JANUARY 13, 2024

Date: January 11, 2024 Guest Skeptic: Dr. Chris Root is an EMS fellow in the Department of Emergency Medicine at the University of New Mexico Health […] The post SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. Resuscitation 2023.

CPR 227

CPR Defibrillator First Responder Epinephrine 227

Handtevy

MAY 10, 2024

In the fast-paced world of emergency medical services (EMS), precision in pediatric medication dosing can mean the difference between life and death. The Monroe-Livingston Regional EMS (MLREMS) has spearheaded a transformative approach that ensures the safest and most effective treatment for our youngest patients during emergency situations.

EMS 52

EMS Emergency Medical Services Epinephrine ALS 52

The Skeptics' Guide to EM

OCTOBER 22, 2022

Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying […] The post SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR? Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival.

CPR 130

CPR Epinephrine Defibrillator Firefighter 130

The Skeptics' Guide to EM

MAY 8, 2021

He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. first appeared on The Skeptics Guide to Emergency Medicine.

Epinephrine 130

Epinephrine CPR EMS 130

EMDocs

MARCH 9, 2024

1: Epinephrine or Airway First in OHCA? Spoon Feed In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine. JAMA Netw Open.

Epinephrine 83

Epinephrine EMS OR 83

REBEL EM

OCTOBER 11, 2023

” If the patient has compromise to airway, breathing or circulation, they should get immediate epinephrine. In anaphylaxis, think, “If A, B or C, give E.” D-dimer can effectively rule out a larger portion of low risk patients if age adjustment or the YEARS criteria are employed.

Epinephrine 113

Epinephrine EMS OR 113

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Both norepinephrine and epinephrine can be used. Epinephrine is key if there is significant bradycardia. Never fear.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

The Skeptics' Guide to EM

DECEMBER 25, 2021

Case: An EMS crew arrives at the home of a 68-year-old suffering from a witnessed out-of-hospital cardiac arrest (OHCA). Intraosseous access is quickly obtained, and a dose of epinephrine is provided. JAMA 2021 This was an SGEM Journal Club and all the slides from the presentation can be downloaded using this LINK.

Epinephrine 130

Epinephrine CPR ALS Emergency Department 130

The Skeptics' Guide to EM

DECEMBER 7, 2018

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). Date: December 6th , 2018 Reference: Perkins et al.

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

Emergency Medicine Cases

JANUARY 18, 2022

The post EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update appeared first on Emergency Medicine Cases.

EMS 130

EMS Epinephrine 130

Emergency Medicine Cases

MAY 24, 2022

In this first part of our 2-part series on Cardiac Arrest Controversies Rob Simard, Bourke Tillman, Sara Gray and Scott Weingart discuss with Anton how best to ensure high quality chest compressions, the pros and cons of mechanical CPR, the literature on dual sequential defibrillation and optimizing pad placement, epinephrine vs vasopressin, amiodarone (..)

Defibrillator 130

Defibrillator Epinephrine CPR EMS 130

The Skeptics' Guide to EM

OCTOBER 31, 2020

She is the host of EM Bootcamp in Las Vegas, as well as a usual speaker and faculty member for The Center for Continuing Medical Education (CCME). She is the host of EM Bootcamp in Las Vegas, as well as a usual speaker and faculty member for The Center for Continuing Medical Education ( CCME ). Reference: Vent et al. lumbar punctures).

Epinephrine 130

Epinephrine Emergency Department EMS ALS 130

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% This patient was witnessed by bystanders to collapse. They started CPR. He was defibrillated into VT. sodium bicarbonate.

Defibrillator 105

Defibrillator Coronary Epinephrine ACS 105

Emergency Medicine Cases

OCTOBER 22, 2019

We discuss that the palpation technique is poor at determining whether or not a patient has a pulse, that the POCUS pulse is more accurate and as rapid compared to the palpation technique at determining whether or not a patient has a pulse, the difference between true PEA arrest, PseudoPEA and PREM, why epinephrine may be harmful in PEA, Weingart's (..)

Epinephrine 130

Epinephrine EMS OR 130

EMS 12-Lead

MARCH 30, 2024

After administering 1mg of epinephrine ROSC is noted with a bradycardic rhythm ( Figure 2 ). Two paramedics are in the rear of the ambulance managing resuscitation (another crew had arrived and provided support with a driver). During transport, the paramedic not dedicated to compressions is able to establish IV access in the patient's hand.

CPR 312

CPR Paramedic Ambulance Epinephrine 312

Pediatric EM Morsels

JULY 19, 2024

Soak the gauze with epinephrine (1:10,000) or TXA (our THIRD route of administration) Apply pressure laterally to the tonsillar fossa with the gauze covered Magill forceps. The post Post-Tonsillectomy Hemorrhage: ReBaked Morsel appeared first on Pediatric EM Morsels. Don’t await for fancy meds to arrive from pharmacy.

E-9-1-1 285

E-9-1-1 Epinephrine Emergency Department OR 285

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. 1,2] Consider using a physiological marker to help identify inadvertent vascular injection, such as epinephrine. [3] If epinephrine is used, small initial doses ( <1 ug/kg) are preferred.

E-9-1-1 94

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

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

BLS 130

BLS Defibrillator Critical Care CPR 130

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Alongside his EM residency, he is doing a PhD in epidemiology. Alongside his EM residency, he is doing a PhD in epidemiology. The first visit was back in 2013 for SGEM#50 : Under Pressure – Vasopressin, Steroids and Epinephrine in Cardiac Arrest. Robert’s academic interests include research and evidence-based medicine.

Epinephrine 130

Epinephrine Emergency Department EMS ALS 130

Pediatric EM Morsels

OCTOBER 27, 2023

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. 2020) The Times & Tapes Are a-Changin’: The Latest Broselow-Luten Tape for EMS , EMS World.

E-9-1-1 268

E-9-1-1 Emergency Medical Services Life Support ALS 268

The Skeptics' Guide to EM

APRIL 4, 2020

Date: April 4th, 2020 It has been just over a year since Dr. Salim Razaie (REBEL EM) and I stepped into the ring for a boxing matched theme debate in Sydney, Australia. Date: April 4th, 2020 It has been just over a year since Dr. Salim Razaie ( REBEL EM) and I stepped into the ring for a boxing matched theme debate in Sydney, Australia.

Critical Care 130

Critical Care Epinephrine CPR Ambulance 130

REBEL EM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Rezaie, MD (Twitter/X: @srrezaie ) The post Don’t Forget About the IO in the Critically Ill Patient appeared first on REBEL EM - Emergency Medicine Blog.

Epinephrine 104

Epinephrine ALS Critical Care Emergency Department 104

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.

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

Peter Canning

JANUARY 14, 2024

The pediatric epinephrine and norepinephrine infusion rates have been lowered to 0.1-0.5 EMS may transport children with behavioral emergencies aged 4 to 18 directly to urgent crisis centers, provided they meet criteria and the service has sponsor hospital approval.* AEMTs may administer epinephrine IV in cardiac arrest.*

CPR 52

CPR Naloxone Advanced Life Support EMT 52

REBEL EM

JUNE 12, 2024

Insulin versus vasopressin and epinephrine to treat beta-blocker toxicity. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy appeared first on REBEL EM - Emergency Medicine Blog. Circulation. 2005;111(20):2588-2595. doi:10.1161/CIRCULATIONAHA.104.497461 Clin Toxicol (Phila).

Epinephrine 103

Epinephrine Overdose OR ALS 103

REBEL EM

SEPTEMBER 1, 2022

PMID: 35917866 [ Access on Read by QxMD ] For More Thoughts on This Topic Checkout: REBEL Cast Ep106: The COCA Trial – Calcium in Cardiac Arrest Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami ) The post COCA Trial Follow-Up: Calcium vs Placebo on Long-Term Outcomes of OHCA appeared first on REBEL EM - Emergency Medicine Blog.

Epinephrine 52

Epinephrine Overdose ALS OR 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. You need to recognize an arrest and activate your EMS system. vs. 66.8%, p=0.73).

Life Support 130

Life Support CPR Advanced Life Support Defibrillator 130

The Skeptics' Guide to EM

MARCH 2, 2019

Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. There is no evidence for a patient-oriented benefit with epinephrine ( SGEM#238 ), other ACLS drugs ( SGEM#64 ), pre-hospital therapeutic hypothermia ( SGEM#54 , SGEM#183 ), or mechanical CPR ( SGEM#136 ).

CPR 130

CPR Firefighter Epinephrine Defibrillator 130

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. And the results show it. Ed and Dan sit down with Dr. Peter Antevy and talk about how we can do better with pediatric arrests. On another note, go to [link] to see the talk that inspired this episode.

Epinephrine 52

Epinephrine Paramedic ED EMS 52

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

He is also part of REBEL EM, The Teaching Course, […] The post SGEM#188: Icatibant Bites the Dust – For ACE-I Induced Angioedema first appeared on The Skeptics Guide to Emergency Medicine. He is also part of REBEL EM , The Teaching Course , EMRAP and CoreEM. display_podcast] Date: September 12th, 2017 Reference: Sinert et al.

Epinephrine 130

Epinephrine ALS Emergency Department EMS 130

The Skeptics' Guide to EM

APRIL 20, 2019

Talk Trauma is a two-day conference for nurses, allied health and EMS professionals involved in providing care for the adult and paediatric trauma patient. Case: A 52-year-old man presents to the emergency department via EMS after a motor vehicle collision while driving home from the city. You suspect he has been drinking.

Epinephrine 100

Epinephrine ALS Emergency Department EMS 100

The Skeptics' Guide to EM

JUNE 24, 2017

His background includes working as a Research Assistant with the Ottawa Hospital Research Institute, Professor at Fanshawe College and currently, Superintendent of Education for Middlesex-London EMS, in London, Ontario, Canada. By-standard CPR is started and EMS is called. They arrive quickly and take over the resuscitation.

CPR 100

CPR Epinephrine ALS Paramedic 100

REBEL EM

SEPTEMBER 19, 2022

Some look promising (ie eCPR and application of US) while others have been considerably less effective or inconsistent (ie epinephrine and targeted temperature management). Population: Patients > 18 years of age w/ OHCA treated by 10 EMS systems in in the US. EMS systems from multiple states in the US increasing external validity.

CPR 52

CPR Defibrillator EMS Epinephrine 52

NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. Ross EM, Mapp J, Kharod C, Wampler DA, Velasquez C, Miramontes DA. Editing by James Li, MD EMS MEd Editor The post IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

E-9-1-1 52

E-9-1-1 Advanced Life Support Epinephrine Life Support 52

Dr. Smith's ECG Blog

APRIL 2, 2024

link] __ Case continued There was hypotension, initially controlled with an epinephrine infusion. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. It is not yet available, but this is your way to get on the list. Finally , the pacer is a biventricular pacer for " CRT = cardiac resynchronization therapy."

Defibrillator 124

Defibrillator Coronary Epinephrine CPR 124