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The Broselow-Luten System

Pediatric EM Morsels

Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. PAWPER was more accurate than EPLS (European life support formula) as well. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Validation study done in Italy.

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2023 AHA Update on ACLS

EMDocs

Calcium is associated with harm but is still necessary in certain situations (hyperkalemia, calcium channel blocker overdose) (Level 3 recommendation: no benefit). Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R. COR 2b, LOE B-R.

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Recerts and New Protocols

Peter Canning

I recerted CPR, ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) late in December. The pediatric epinephrine and norepinephrine infusion rates have been lowered to 0.1-0.5 AEMTs may administer epinephrine IV in cardiac arrest.* The certs are good for two years.

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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

1,2] Consider using a physiological marker to help identify inadvertent vascular injection, such as epinephrine. [3] Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive. Poisoning & Drug Overdose. J Med Toxicol.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

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. doi: 10.1097/MAT.0000000000001518

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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. This continues to be supported by new literature. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

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REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

REBEL EM

trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.