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SGEM#189: Bring Me To Life in OHCA

The Skeptics' Guide to EM

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. Bystander high-quality CPR can buy you some time until defibrillation.

CPR 52
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SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). There was also no increase in survivors with good neurological outcomes with ACLS. JAMA 2009, Hagihara et al. Case: A 51-year-old man experiences a cardiac arrest on the street.

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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 ). MD * ; Rueger, Johannes M.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

Patients can have excellent outcomes despite prolonged resuscitation. 10 The score predicts the probability of survival to hospital discharge using a number of factors including CPR duration, serum potassium, core temperature, age, and suspected mechanism of hypothermia. Published 2009 Jun 10. 2009;338:b2085. Carsten L, et al.

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SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

The Skeptics' Guide to EM

Huber-Wagner et al ( Lancet 2009 ) showed a mortality reduction in a retrospective database study of patients who have had a pan scan. There is no validated clinical decision tool to help guide our decisions. Many studies (most retrospective) have assessed the use of pan scanning as an initial radiologic evaluation. Reference: Sierink et al.

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Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?

Dr. Smith's ECG Blog

Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. Methods: Between June 2007 - July 2009 all NT-OHCA patients aged >18, transported to our hospital, an urban, level one trauma teaching hospital were included. A middle-age woman with h/o hypertension was found down by her husband.

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The Nose: the other route to the lungs

Advanced Emergency Nursing from AENJ

factor than oral (which still suffers from the too-personal-contact-reluctance of the lay rescuer, as in “hands only CPR”), and to the more euphonious persuasion of “Mouth to Mouth” and “Kiss of Life.” At that time, too, it was felt that the cause, or —at least, the major focus of investigation, of Upper Airway Obstruction was the tongue.