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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

A retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009 in the US revealed that less than one-half of patients undergoing ETI in the ED received sedative drugs while in the ED. This is referred to as CPR I nduced C onsciousness ( CPRIC ).

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Riding the Waves: End-Tidal CO2 Monitoring

Taming the SRU

Cardiac Arrest As mentioned before, tidal CO2 is a function of metabolic rate and cardiac output, so capnography can be utilized during CPR to monitor the effectiveness of chest compressions. 2006): e1170-e1178. Continuous monitoring allows for rapid recognition of tube displacement. Annals of emergency medicine 63.2 2014): 247-258.

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Episode 28: LOST

PHEM Cast

Use of CPR in hemorrhagic shock, a dog model. Annals of Emergency Medicine; 2006. EMJ; 2005: 22-24. Morrison et al. Resuscitative thoracotomy following wartime injury. Jeffcoach DR et al. Lockey et al. Traumatic cardiac arrest: who are the survivors? Grasner et al. Critical Care; 2011.

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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

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). She has a history of hypertension and non-insulin dependent diabetes mellitus.

EKG/ECG 52
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Electrical injuries

Don't Forget the Bubbles

Prolonged CPR should be considered as outcomes are generally good, even if asystole is the presenting rhythm. The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. In most paediatric cardiac arrests, the primary cause is respiratory – not so in cases of electrocution.

Burns 80
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The Technologically Dependent Child in the ED

Pediatric Emergency Playbook

The main thing for us is to suspect it, detect it, control it, and if the child arrests, to do vigorous CPR to mechanically disrupt the bubbles. Paediatric Resp Rev (2006) 7, 162–168 Wright SE,VanDahm K. Some references advocate for hyperbarics to allow the embolus to resolve, others comment on using a needle to aspirate air.

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Mouth-to-Airway (adjunct)

Advanced Emergency Nursing from AENJ

The lips of the dead and the ‘kiss of life’: the contemporary deathbed and the aesthetic of CPR. Photo from which, by kind permission of Allen Press, shown above of early mouth-to-airway devices. Probably only Internet-accessible extant photo of the Gordon Airway. O’Donnell, C. Gibson, A. T., & Davis, P. Tercier, J. Waters, R.