ECLS-Shock – Extracorporeal Life Support in Infarct-Related Cardiogenic Shock
The Bottom Line
SEPTEMBER 22, 2023
Extracorporeal Life Support in Infarct-Related Cardiogenic Shock Thiele H. NEJM 2023; Online ahead of print.
Life Support Related Topics 
Extracorporeal Life Support in Infarct-Related Cardiogenic Shock
EMOttawa
JANUARY 29, 2024
Methods: Open label RCT with 417 patients comparing 30-day all-cause mortality between ECLS versus standard […] The post Extracorporeal Life Support in Infarct-Related Cardiogenic Shock appeared first on EMOttawa Blog.
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AHA and Red Cross Life Support Certifications Should Both Be Accepted
ACEP Now
NOVEMBER 7, 2024
For decades, only one major organization—the American Heart Association (AHA)—provided standardized training and certifications in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS). In 2015, it introduced Basic Life Support (BLS) training and certification for EMS personnel.
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SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs
The Skeptics' Guide to EM
OCTOBER 14, 2023
Vital sign ranges from common guidelines such as Pediatric Advanced Life Support (PALS) [1] or Advanced Pediatric Life Support (APLS) [2] can differ. However, there remains variation regarding what the “normal” ranges of vital signs can be for pediatric patients.
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An Intro to Advanced Life Support
NHCPS Save a Life
MAY 30, 2023
Immense value resides within advanced life support training courses. While these courses are traditionally reserved for health professionals, more people are turning to advanced life support training to improve their career outlook and save lives.
Defining Appropriate Responses in a Tiered System
High Performance EMS
AUGUST 9, 2024
The very low risk calls can typically be satisfied with basic life support (BLS) capabilities. In fact, sending advanced life support (ALS) providers that are in short supply to one of these calls can leave citizens exposed when a critical request is received after that resource is committed.
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SGEM#443: Don’t Stop Me Now – REBOA for Hemorrhage Control in Trauma Patients?
The Skeptics' Guide to EM
JUNE 15, 2024
You initiate standard, simultaneous assessment and resuscitation following the Advanced Trauma Life Support (ATLS) principles. On arrival at the trauma center, the patient’s vital signs and symptoms remain essentially unchanged from those on scene. You wonder what the evidence is for this additional approach.
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SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest
The Skeptics' Guide to EM
JANUARY 13, 2024
On your arrival, first responders from the fire department are performing high-quality basic cardiac life support. The patient is a 54-year-old man who collapsed in front of his family after complaining of chest pain for several hours. You continue with compressions and defibrillations and your partner places an advanced airway.
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The Broselow-Luten System
Pediatric EM Morsels
OCTOBER 27, 2023
PAWPER was more accurate than EPLS (European life support formula) as well. Validation study done in Italy. PAWPER was an accurate estimate of weight except in extreme weight categories (malnourished or obese). Broselow-Luten System: Evidence in Other Countries Doesn’t work as well in Indian children. x exp[0.02 x exp[0.02
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American Burn Association Stands Ready to Support Burn Care Response Amid California Wildfires and Recent Disasters
American Burn Association
JANUARY 10, 2025
” The ABA encourages first responders and healthcare providers to enhance readiness by completing the Advanced Burn Life Support (ABLS) Now course. This on-demand program provides essential skills for the immediate care of burn patients, focusing on life-saving techniques during the critical first 24 hours post-injury.
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"I Need a Medic!"
Chicago EMT Training
NOVEMBER 8, 2023
A quick breakdown on the differences between an EMT-B(asic) and an EMT-P(aramedic) Basic Life Support (BLS) vs Advanced Life Support (ALS) So there it is. It's encouraging to hear that there is still interest in becoming first responders! The two main levels of care you would probably see in the prehospital setting.
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Best Case Ever 52 – Pediatric Hypothermia Cardiac Arrest
Emergency Medicine Cases
DECEMBER 6, 2016
In anticipation of EM Cases Episode 90 on the Pediatric Advanced Life Support (PALS) guidelines with the lead author Dr. Allan DeCaen and Dr. Anthony Crocco, Dr. DeCaen tells his Best Case Ever showing us the value of orchestrated team work and a great example of the saying, "they're not dead until they're warm and dead".
SGEM#189: Bring Me To Life in OHCA
The Skeptics' Guide to EM
SEPTEMBER 23, 2017
Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the […] The post SGEM#189: Bring Me To Life in OHCA first appeared on The Skeptics Guide to Emergency Medicine.
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SGEM#238: The Epi Don’t Work for OHCA
The Skeptics' Guide to EM
DECEMBER 7, 2018
This was a before and after study to see if advanced cardiac life support (ACLS) techniques, including IV epinephrine, would improve survival to discharge. While there was an improvement in return of spontaneous circulation (ROSC) and survival to hospital admission there was not an increased survival to hospital discharge.
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AIMHI Editorial on Expectations and Realities
High Performance EMS
OCTOBER 18, 2024
Great OpEd published by AIMHI about how our industry is changing and leading to “EMS On Life Support: The Alarming Gap Between Expectations and Reality.” ” [link] I have been writing a lot this year that “ a stopwatch is not a valid instrument for summarizing the measure of care that a patient receives.
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Targeted Temperature Management in Paediatric Traumatic Brain Injury
Don't Forget the Bubbles
NOVEMBER 11, 2024
Although this can be beneficial initially, it also increases the risk of infectious complications and coagulopathy with prolonged hypothermia. What do the guidelines recommend?
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ACMT Toxicology Visual Pearl: Salt, not Shock
ALiEM
FEBRUARY 20, 2024
Flecainide toxicity–treatment with intravenous fat emulsion and extra corporeal life support. PMID: 17448102. Sivalingam SK, Gadiraju VT, Hariharan MV, Atreya AR, Flack JE, Aziz H. Acute Card Care. 2013 Dec;15(4):90-2. doi: 10.3109/17482941.2013.841949. Epub 2013 Nov 7. PMID: 24200150. Bruccoleri RE, Burns MM.
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EMS vs. EMT: Clarifying Roles in Emergency Healthcare
EMT Training Station
FEBRUARY 11, 2024
This could range from basic life support, typically managed by EMTs, to more advanced life support provided by paramedics and other medical specialists. EMTs, for example, are trained in basic life support, while paramedics receive more advanced training, including in pharmacology, cardiology, and trauma care.
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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.
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Traumatizing Patients with Trauma Activations
ACEP Now
OCTOBER 9, 2023
Throughout the Advanced Trauma Life Support manual, a mere three sentences relate to the murky ethics of trauma consent: “Consent is sought before treatment, if possible. In life-threatening emergencies, it is often not possible to obtain such consent. Advanced Trauma Life Support: Student Course Manual.
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Systemic Steroids: An ED Focused Overview
EMDocs
OCTOBER 9, 2023
2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.
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The Guidelines Graveyard: What gets chosen, what gets buried?
Handtevy
DECEMBER 23, 2024
On November 14, 2024, ILCOR released their latest recommendations for adult and pediatric basic and advanced life support. Theres a lot to unpack, and Ill be highlighting the key changes during our upcoming webinar. If you havent registered yet, follow the CLICK HERE and join us for an in-depth review.
PulmCrit Wee – Urine toxicology screens should be removed from brain death guidelines
EMCrit Project
JULY 18, 2022
Failure to recognize that a patient is intoxicated could lead to an incorrect diagnosis of brain death that in turn can lead to withdrawal of life support – thereby […]. One important confounder is intoxication. EMCrit Project by Josh Farkas.
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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 (..)
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SGEM#306: Fire Brigade and the Staying Alive App for OHCAs in Paris
The Skeptics' Guide to EM
OCTOBER 24, 2020
Unfortunately, most patients don’t receive these crucial interventions.
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SGEM#231: You’re So Vein – IO vs. IV Access for OHCA
The Skeptics' Guide to EM
SEPTEMBER 29, 2018
EMS arrives on scene and initiates high quality basic life support (BLS). Case: A 46-year-old man has a cardiac arrest at home, witnessed by family. Bystander CPR is initiated prior to EMS arrival. One defibrillation for ventricular fibrillation (VF) is provided but the patient remains in VF.
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SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations?
The Skeptics' Guide to EM
SEPTEMBER 11, 2021
The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She has a history of hypertension and non-insulin dependent diabetes mellitus. She arrives in the emergency department (ED) with decreased level of consciousness and shock.
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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning
EMDocs
NOVEMBER 6, 2023
Treatment of cardiac arrest and life-threatening toxicity due to poisoning often requires specialized treatments that most clinicians do not use frequently such as antidotes and venoarterial extracorporeal membrane oxygenation, in addition to effective basic and advanced life support. COR 2a, LOE C-LD. COR 2a, LOE C-LD.
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BCLS vs BLS Certification: Key Differences and Choosing the Right One
NHCPS Save a Life
AUGUST 20, 2024
To help you learn what your basic life support certification options are and which one is best for you, consider the following details. If you are looking to prepare to work as a rescuer in any situation, you may be considering your BCLS certification. What is it? Why do you need it?
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BCLS vs BLS Certification: Key Differences and Choosing the Right One
NHCPS Save a Life
AUGUST 20, 2024
To help you learn what your basic life support certification options are and which one is best for you, consider the following details. If you are looking to prepare to work as a rescuer in any situation, you may be considering your BCLS certification. What is it? Why do you need it?
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52 Episode 5: Cardiogenic shock and ECMO with Brendan Riordan
Critical Care Scenarios
MARCH 29, 2020
Monitoring Hemostasis During Extracorporeal Life Support. Consider leaving the Impella if there are any lingering concerns. Resources References * How to monitor anticoagulation during ECMO: Saifee NH, Brogan TV, McMullan DM, et al. 2020;66(2):230–237.
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SGEM#243: Enough is Enough (O2 Saturation of 94-96%)
The Skeptics' Guide to EM
FEBRUARY 2, 2019
This was measured by FiO2, PaO2, arterial oxygen saturation measured by blood analysis or peripheral oxygen saturation measured by pulse oximeter. Comparison: The lower oxygen target (conservative group) * Outcomes: The authors do not report any one outcome as a primary outcomes, but instead listed morbidity and mortality.
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SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking
The Skeptics' Guide to EM
MARCH 11, 2023
The fire-based crew has basic life support (BLS) airway supplies including the King Laryngeal Tube, the paramedic crew carries iGel supraglottic airways (SGAs) in addition to their intubation equipment.
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Case Report: Coronary Vasospasm-Induced Cardiac Arrest
ACEP Now
DECEMBER 6, 2024
Advanced cardiac life support protocol was initiated, and the patient was intubated. Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. Overall, cardiac arrest in the setting of coronary vasospasm is thought to be relatively uncommon.
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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. Intervention: Target PaO2 = 60 mm Hg Control: Target PaO2 = 90 mm Hg Outcome (primary): Absolute number of days without life support in 90 days defined as the absence of mechanical ventilation, circulatory support, or kidney replacement.
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Common Pediatric Cardiac Emergencies: A PALS Approach
NHCPS Save a Life
NOVEMBER 30, 2023
Pediatric Advanced Life Support (PALS) training emerges as a cornerstone in equipping healthcare […] The post Common Pediatric Cardiac Emergencies: A PALS Approach appeared first on SaveaLife.com.
Reference ranges of paediatric heart rate and respiratory rate
Don't Forget the Bubbles
AUGUST 7, 2023
Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., Paediatric advanced life support Guidelines [Internet]. Emerg Med J. 2021 Feb;38(2):132–8. Resuscitation Council UK.
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What Are and How to Memorize ACLS Drugs?
NHCPS Save a Life
JULY 30, 2023
This time, we delve into a topic that’s essential for any healthcare professional dealing with Advanced Cardiac Life Support (ACLS) – we will help you to answer important questions on how to memorize ACLS drugs.
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PEA vs Asystole: Understanding the Key Differences
NHCPS Save a Life
APRIL 28, 2023
It is crucial for healthcare providers who are new to the Advanced Cardiac Life Support (ACLS) algorithm to understand the difference between pulseless electrical activity and asystole. ACLS is a set of protocols and interventions used to treat patients in cardiac arrest or other life-threatening medical emergencies.
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BLS Renewal: Key Facts and Must-Know Information
NHCPS Save a Life
OCTOBER 31, 2023
In the emergency medical care sector, Basic Life Support (BLS) stands as a critical cornerstone. It comprises a comprehensive repertoire of life-saving techniques and essential tools, each honed to perfection in the action of high-stress situations.
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52 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. Emergency staff have limited bandwidth.
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A Cross-Sectional Analysis of ALS/ BLS Care in Low Acuity 9-1-1 Response by Geography and Insurance Status Utilizing the 2019 NEMSIS Dataset
International Journal of Paramedicine
OCTOBER 8, 2024
EMS responses (n = 4,375,568) were analyzed comparing patient acuity and CMS Service level, Advanced Life Support (ALS) vs Basic Life Support (BLS), to assess for associations in acuity and CMS Service level using logistic regression. Discussion.
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The Incidence and Outcomes of Adult Syncope Presentations to Emergency Medical Services
International Journal of Paramedicine
APRIL 3, 2024
Exclusion criteria were all non-primary studies, patients given an alternative provisional diagnosis or who received life supporting interventions, studies that examined only presyncope presentations or were limited to paediatric patients, or that examined syncope within highly specific non-generalisable settings.
Hypothermia and drowning
Don't Forget the Bubbles
JUNE 30, 2023
Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. The “sweet spot” is between 0.5-2⁰C Saczkowski, R.,
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