The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM. Before attending medical school, he was a New York City Paramedic. There is drug paraphernalia scattered around the room.

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Naloxone NARCAN Overdose CPR 238

First 10 EM

NOVEMBER 11, 2024

In the most recent BroomeDocs podcast, we talk about an attempt to use the IM route to give cardiac arrest victims epinephrine faster. The podcast and Research Roundups blog post might actually come out next week.)

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Epinephrine EMS 132

Emergency Medicine Cases

JANUARY 14, 2020

The post EM Quick Hits 12 AFib Early vs Delayed Cardioversion, Snake Bites, Ovarian Torsion Myths, Crystal Meth, Aortic Dissection, Severe Asthma Meds appeared first on Emergency Medicine Cases.

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Epinephrine EMS Emergency Management Emergency Manager 130

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

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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.

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CPR Defibrillator First Responder Epinephrine 218

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.

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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.

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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.

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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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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.

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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.

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Epinephrine EMS OR 83

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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Epinephrine Emergency Department ALS Critical Care 98

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.

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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.

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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.

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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.

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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).

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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 (..)

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Defibrillator Epinephrine CPR EMS 130

Emergency Medicine Cases

JULY 3, 2018

In anticipation of EM Cases Episode 112 on Tachydysrhthmias with Amal Mattu and Paul Dorion, Melanie Baimel tells her Best Case Ever of a previously healthy young man who presents in refractory ventricular fibrillation after receiving multiple single shocks, ongoing chest compressions, several rounds of epinephrine, amiodarone and dual sequence defibrillation (..)

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Defibrillator Epinephrine EMS 130

The Overrun Podcast

MAY 23, 2019

Dan recaps the MD1 EMS Conference and shares what he learned from a room full of EM/EMS physicians speaking to EMS clinicians! link] Ultrasound in Cardiac Arrest: [link] Happy EMS Week! We're heading to the MD1/EMS and Disaster Medicine Fellowship Conference at Newark Beth Israel Medical Center!

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EMS Plasma Epinephrine CPR 52

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.

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Defibrillator Coronary Epinephrine ACS 113

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 (..)

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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!

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E-9-1-1 ICU Epinephrine EMS 87

ACEP Now

NOVEMBER 6, 2024

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. ET tube size should be 2.5 mm for neonates under 1,000 grams, 3.0 mm for 1,000–2,000 grams, and 3.5 for neonates over 2,000 grams.

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Epinephrine Emergency Department EMS OR 98

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.

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CPR Paramedic Ambulance Defibrillator 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.

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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.

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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.

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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.

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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.

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

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.

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Critical Care Epinephrine CPR Ambulance 130

FOAMfrat

NOVEMBER 25, 2024

Earlier in the summer, I wrote a blog discussing the challenges, intricacies, and educational pitfalls of postpartum hemorrhage in EMS. In the standard care of anaphylactoid reactions, we administer Epinephrine, Diphenhydramine, steroids, and bronchodilators. I even know of cases that my colleagues have managed!

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Epinephrine CPR Operating Room Plasma 106

REBEL EM

SEPTEMBER 13, 2023

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.

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Frozen Plasma Allergic Reaction FFP Plasma 105

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.

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ALS Epinephrine Critical Care Emergency Department 105

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.

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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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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.*

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CPR Naloxone Advanced Life Support EMT 52