ICU and Life Support - Paramedicine Now

Lightning rounds #27: Our favorite FOAM

Critical Care Scenarios

MAY 10, 2023

Podcasts * CORE IM * EMcrit * Gobbet ‘o Pus * Simulcast * Intensive Care Network * ACCRAC * Blood Bank Guy Essentials * Traumacast * Maryland Critical Care Project * PulmPEEPS * IBCC podcast * Pharmacy Joe’s Elective Rotation * Trauma ICU Rounds * PulmCast * Jeff Guy’s ICU Rounds * SMACC/CODA * Ultrasound Podcast/Core Ultrasound Blogs/websites (..)

Critical Care

Critical Care ICU Life Support

Episode 19: Emergency medicine with Seth Trueger

Critical Care Scenarios

NOVEMBER 15, 2020

Yes, temporize with supportive care while you go through the process, but do the work—find a legitimate representative or documentation of the patient’s wishes to determine what they’d want before you commit them to lengthy, aggressive life support. ICU time and ED time are different.

ICU

ICU Life Support Emergency Department ED

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

REBEL EM

SEPTEMBER 14, 2023

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.

Life Support

Life Support Coronary CPR ICU

How Much O2 Is Right in COVID?

REBEL EM

APRIL 22, 2024

Lower vs higher oxygenation target and days alive without life support in COVID-19. Population: Adult patients ( > 18 years of age) admitted to the ICU with COVID-19 and severe hypoxemia (defined as receiving supplemental O2 with a flow rate of at least 10L/min or receiving mechanical ventilation or non-invasive ventilation.

Life Support

Life Support ICU EMS OR

EM@3AM: Amniotic Fluid Embolism

EMDocs

JUNE 22, 2024

Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. If AFE occurs during labor, immediate delivery is recommended.

EMS

EMS FFP Ambulance ICU

ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

APRIL 10, 2024

Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive. For patients who in cardiac arrest standard Advanced Cardiac Life Support (ACLS) should be initiated. Acidemia from hypoventilation or tissue hypoxia will worsen LAST.

E-9-1-1

E-9-1-1 Plasma Epinephrine Life Support

Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

JANUARY 16, 2024

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

Defibrillator

Defibrillator CPR Epinephrine Life Support

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

AAEM RSA

AUGUST 27, 2020

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.

E-9-1-1

E-9-1-1 CPR ICU ALS

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

EMDocs

JANUARY 11, 2024

Statements: Early risk stratification is not intended as a tool for triage to withdraw life support and is not used for that purpose (90.5%, 19/21). Digestive Management Takeaway: Start enteral feeds when the patient gets to the ICU. Statements: Initiate EN as soon as possible after ICU admission (100%, 20/20).

Critical Care

Critical Care E-9-1-1 OR ICU

Suicide Attempt in the Terminally Ill Cancer Patient with Advance Directive

ACEP Now

DECEMBER 10, 2023

You ultimately begin a slow naloxone infusion and admit him to the medical ICU. Patients after SA who require intubation, continuous life support, or are permanently obtunded, pose a different challenge for physicians. You order IV potassium and magnesium. The patient’s respiratory rate decreases and he becomes more somnolent.

Naloxone

Naloxone Life Support Paramedic ALS

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

REBEL EM

FEBRUARY 2, 2023

2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Based on 2019 American Heart Association (AHA) guidelines, amiodarone and digoxin have been suggested as alternative options in controlling ventricular rate refractory to first-line BBs and non-DHP CCBs. 2022 Sep 7.

Emergency Department

Emergency Department ALS Critical Care ED

The Science on Targeted Temperature Management

ACEP Now

APRIL 3, 2024

Temperature management after cardiac arrest an advisory statement by the advanced life support task force of the international liaison committee on resuscitation and the American Heart Association emergency cardiovascular care committee and the council on cardiopulmonary, critical care, perioperative and resuscitation. N Engl J Med.

Advanced Life Support

Advanced Life Support ALS Life Support CPR

POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

APRIL 22, 2024

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. doi: 10.1378/chest.13-1087.

ED

ED NARCAN ALS OR

Paramedicine Now

Lightning rounds #27: Our favorite FOAM

Episode 19: Emergency medicine with Seth Trueger

Trending Sources

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

How Much O2 Is Right in COVID?

EM@3AM: Amniotic Fluid Embolism

ToxCard: Local Anesthetic Systemic Toxicity

Hypothermic Cardiac Arrest: Pearls and Pitfalls

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

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

Suicide Attempt in the Terminally Ill Cancer Patient with Advance Directive

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

The Science on Targeted Temperature Management

POCUS findings of hemodynamically unstable PE with cardiac arrest

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