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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

While not specifically reviewed in this post, check out the methemoglobinemia tox card for more information about one of the other known events that can occur with local anesthetic administration. Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive.

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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

Evaluate and treat seizures or SE after CA in the context of other available clinical information because other systemic factors may influence the occurrence of seizures or SE and the effectiveness of treatment (90%, 18/20). Digestive Management Takeaway: Start enteral feeds when the patient gets to the ICU. Start low and go slow.

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Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

REBEL EM

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Am J Emerg Med. 2022 Sep 7. Epub ahead of print.

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The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

REBEL EM

Revascularization of the culprit lesion remains one of the few established treatments though there are numerous other unproven modalities including extracorporeal life support (ECLS). Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU. Extracorporeal Life Support in Accidental Hypothermia with Cardiac Arrest—A Narrative Review. The patient is extubated and decannulated four days later. doi: 10.1097/MAT.0000000000001518

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POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., EMS verbalized concern to EPs that an “intracranial bleed” may have precipitated the event. 10,11 Vid 1.

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Resident Journal Review: Available Evidence Regarding Targeted Temperature Management (TTM)

AAEM RSA

For both groups, mean time to basic life support was determined to be one-minute, advanced life support started at 10 minutes, and time to ROSC at 25 minutes. Secondary outcomes included mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS), infections, and hematologic adverse events.

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