REBEL EM

MAY 29, 2023

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 It also reduced length of stay in ICU and hospital without adverse effects. NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

ICU 145

ICU ALS Epinephrine OR 145

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) Until further evidence presents itself, what this study offers is building upon what we do know.

ICU 72

ICU Epinephrine ALS OR 72

Core EM

OCTOBER 16, 2024

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% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 145

Allergic Reaction Plasma ED Epinephrine 145

EMDocs

APRIL 10, 2024

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. Hemodynamics slowly begin to stabilize, and the patient is transferred to the ICU for further post-cardiac arrest care.

E-9-1-1 93

E-9-1-1 Plasma Epinephrine Life Support 93

EMDocs

APRIL 2, 2024

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

CPR 92

CPR STEMI Epinephrine ICU 92

Core EM

OCTOBER 2, 2024

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% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

REBEL EM

SEPTEMBER 26, 2022

The TEG group had a shorter ICU length of stay in the first admission. Patients exclusively managed in the ICU which decreases applicability for patients in other locations Very small sample size of 96 patients No definition was provided for exclusion criteria of significant cardiopulmonary disease. were performed.

FFP 52

FFP E-9-1-1 ICU ALS 52

EMDocs

OCTOBER 19, 2024

2][3] Bacterial tracheitis should be suspected over croup if nebulized racemic epinephrine or steroids do not improve the clinical course. [2][3][8] However, these patients often present with drooling and a preference for the tripod position, which is uncommon in bacterial tracheitis. [2][3]

EMS 87

EMS E-9-1-1 Epinephrine OR 87

EMDocs

JANUARY 16, 2024

The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU.

Defibrillator 84

Defibrillator CPR Epinephrine Life Support 84

AAEM RSA

AUGUST 27, 2020

The 48-hour group had a significantly longer length of stay in the ICU and time on mechanical ventilation amongst survivors, both of which were expected since they were kept at target temperature for longer, requiring more resources. Time to TTM was statistically significantly shorter in the IC group (2.2

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

ECG & Echo Learning

OCTOBER 2, 2022

Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 Most agents exhibit both vasopressor and inotropic effects (Figure 1). mg/kg) IM: (1:1000): 0.1

E-9-1-1 52

E-9-1-1 ALS Coronary Epinephrine 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. They achieved ROSC and wanted to transfer to our institution for post-arrest care. After ROSC achieved: Sinus rhythm.

Epinephrine 52

Epinephrine ICU Coronary EMS 52

ACEP Now

NOVEMBER 14, 2023

If it is determined that the bleeding originates from one lung it is recommended to position the patient in lateral decubitus with the bleeding lung down to avoid contamination of the contralateral lung. Portable chest X-ray may help determine from which lung the bleeding originates. 13,14 The typical regimen is 500 mg three times daily.

E-9-1-1 52

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

Dr. Smith's ECG Blog

APRIL 6, 2018

Chest compressions were continued, and the patient was given 1 round of epinephrine, calcium, bicarb, glucose. He made it to the ICU, however the patient unfortunately expired approximately 24 hours after ICU admission. No other cause of arrest was identified based on lab results or pan-CT scan.

Defibrillator 52

Defibrillator ICU EMS Plasma 52

EMDocs

DECEMBER 18, 2023

34 If a MAP of 65 mmHg is still not achieved, epinephrine should be added as a third agent (Figure 1). For patients with septic shock and cardiac dysfunction that are persistently hypotensive, it is appropriate to use norepinephrine and dobutamine or epinephrine alone. 32,33 Once the dose of norepinephrine is between 0.25-0.5

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65