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

REBEL EM

DECEMBER 5, 2023

How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis? Bottom Line Up Top: After prompt recognition and appropriate treatment with IM epinephrine, the risk of biphasic reactions are exceedingly low. At the time of discharge, appropriate patient education and prescriptions for IM epinephrine are essential.

Epinephrine 81

Epinephrine Allergic Reaction Emergency Department Emergency Manager 81

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.

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

EMDocs

OCTOBER 19, 2024

We’ll keep it short, while you keep that EM brain sharp. A 3-year-old male with no previous past medical history, born full term, and unvaccinated presents after 6 days of cough, fever, myalgias, and rhinorrhea. Question: What’s the next step in your evaluation and treatment, and what is the potentially life-threatening diagnosis?

EMS 110

EMS E-9-1-1 Epinephrine OR 110

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. Set up suction x2 in the room! Headlamps can also be helpful!

E-9-1-1 290

E-9-1-1 Epinephrine Emergency Department OR 290

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

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

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. ” Reference: Vallentin et al. As a reminder, here are the five rules for SGEM JC. Bystander CPR is being performed.

Epinephrine 130

Epinephrine CPR ALS Emergency Department 130

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

Emergency Medicine Cases

OCTOBER 22, 2019

The post Ep 131 PEA Arrest, PseudoPEA and PREM – With Simard and Weingart appeared first on Emergency Medicine Cases.

Epinephrine 130

Epinephrine EMS OR 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-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

ACEP Now

JULY 7, 2023

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. 5 More recent literature defines “refractory” as VT or VF that is persistent or recurrent despite three shocks from a defibrillator, three rounds of epinephrine, and use of an antiarrhythmic (i.e.,

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

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.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

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

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 103

Epinephrine EMS OR 103

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 98

Epinephrine EMS OR 98

ESO

DECEMBER 19, 2024

Earlier in the year, we released the 2024 ESO EMS, Fire Service, and Hospital Trend Reports , which forecasted the trends ESO experts believed would shape each industry. With contributions from over 2,700 EMS agencies, fire departments, and hospitals across the U.S., This year, we released When Do Minutes Matter?

Epinephrine 103

Epinephrine Firefighter First Responder Public Safety 103

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 124

Defibrillator Coronary Epinephrine ACS 124

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).

CPR 130

CPR Life Support Advanced Life Support Defibrillator 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

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 ). Chest compression fraction.

CPR 130

CPR Firefighter Paramedic Epinephrine 130

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 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

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] 2] This linking group can be either an amide (e.g., lidocaine) or an ester (e.g.,

E-9-1-1 111

E-9-1-1 Plasma Epinephrine Life Support 111

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

REBEL EM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.

Epinephrine 105

Epinephrine ALS Critical Care Emergency Department 105

REBEL EM

SEPTEMBER 13, 2023

of people who take NSAIDs ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 of people who take NSAIDs ( Nzeako 2010 ). Typically involves the mouth, larynx, pharynx, and subglottic tissue ( Kostis 2005 ).

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

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. Neonatal resuscitation is common; 10 percent of the four million newborns in the U.S. ET tube size should be 2.5 Adv Med Educ Pract.

Epinephrine 98

Epinephrine Emergency Department EMS OR 98

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

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.

Defibrillator 109

Defibrillator CPR Epinephrine Life Support 109

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. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines. Here is the initial ED ECG. What do you think? So it must be atrial fibrillation.

Defibrillator 133

Defibrillator Coronary Epinephrine CPR 133

REBEL EM

MAY 29, 2023

appeared first on REBEL EM - Emergency Medicine Blog. What They Did: Single-center, parallel, double blind, randomized controlled trial performed in a medical-surgical ICU (Mexico) Both groups received: Adjunctive vasopressin initiated at a dose of 0.03 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4 95% CI 15.4

ICU 145

ICU ALS Epinephrine OR 145

TIMER

SEPTEMBER 28, 2022

EMS workers saving accident victims or tending to a patient experiencing a medical emergency. EMT courses, NYC or paramedic level certifications are held by the majority of EMS personnel. Thinking about the paramedic vs. EMT debate? It’s not just you. Both perform their work in a range of capacities and healthcare environments.

EMT 40

EMT EMT Paramedic Emergency Medical Technician 40

REBEL EM

NOVEMBER 6, 2023

to 1mg/kg/hr) Information regarding the vasopressors used in the study is as follows: Norepinephrine equivalents = norepinephrine mcg/kg/min + (phenylephrine mcg/kg/min/10) + epinephrine mcg/kg/min + (vasopressin units/min x2.5) This dysregulation of vasodilation is associated with a mortality of close to 25%.

Epinephrine 72

Epinephrine ICU ALS OR 72

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. Epinephrine infusion was begun. Written By Magnus Nossen — with edits by Ken Grauer and Smith. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck.

Defibrillator 131

Defibrillator Coronary ALS STEMI 131

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

EMDocs

MAY 26, 2023

But what about the patient who is agitated, and is a potential danger to themselves or to the ED staff? Do we Redirect? Patient that are agitated should always be treated with dignity and respect. This entails utilizing the least invasive non-pharmacologic means of assisting them, before moving to physical or chemical restraints.

Emergency Medical Services 97

Emergency Medical Services Emergency Department OR ED 97