Dr. Smith's ECG Blog

OCTOBER 20, 2013

Because the patient had asystole, was resuscitated without difficulty, and had no neurologic function, suspected a cerebral hemorrhage was suspected as the etiology of the arrest, specifically subarachnoid hemorrhage. She went for a head CT and had a severe subarachnoid hemorrhage (SAH) due to ruptured aneurysm. Sprenkle M. Bachour FA.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Emergency Department 52

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Cardiovasc Intervent Radiol 32 , 155–158 (2009). Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. Sagoschen, I.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

JANUARY 16, 2024

Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation. 2,3 If the patient meets criteria for resuscitation, they generally are not declared dead until their core temperature is above 32℃ (“warm and dead”).

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

Don't Forget the Bubbles

NOVEMBER 29, 2023

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. While some studies showed that CPRIC is associated with increased survival to hospital discharge, administering muscle relaxants during resuscitation increased mortality. Another attempt led to an oesophageal intubation.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EMDocs

SEPTEMBER 7, 2023

2,10 Initial stabilization of DEG toxicity includes correcting acid-base abnormalities, electrolyte abnormalities, and volume resuscitation. Volume resuscitation as needed while adjusting for any developing acute kidney injury. 6, 8 July 2009, pp. Pay careful attention to fluid balance, as DEG has osmotic diuretic effects.

Poisoning 92

Poisoning CDC Administration Emergency Department 92

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. 2009 Sep 11;2(3):155–60. J Emerg Med.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

Dr. Smith's ECG Blog

OCTOBER 8, 2024

She could not be resuscitated. 2009;Available from: [link] 4. She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. Later the next day, she went into cardiac arrest again. Heart [Internet].

EKG/ECG 123

EKG/ECG Documentation/Coding Resuscitation Shock 123

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

This basically means rapid access to ACLS type resuscitation skills (intubation and intravenous drug therapy). JAMA 2009 * Jacobs et al. Resuscitation 2011 * Hagihara et al. We know that rapid application of electricity to defibrillate shockable arrhythmias save lives.

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). JAMA 2009, Hagihara et al. published in Resuscitation 2011. Case: A 51-year-old man experiences a cardiac arrest on the street. He is unsuccessfully shocked. JAMA 2012 and Cournoyer et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. From 2004 to 2009, prescriptions in the US increased by 50%. If the patient does not respond to resuscitative measures, cardiopulmonary bypass and extracorporeal membrane oxygenation may be considered.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Reid, C (2011) Prehospital resuscitative hysterotomy op.cit. Geoff Jara-Almonte, MD and Hilary Fairbrother, MD // Editor: Alex Koyfman, MD Resuscitation of the Pregnant Trauma Patient – Pearls and Pitfalls www.emdocs.net 2/6/2015 Desjardins, G. 2009) Trauma in the Obstetrical Patient. Stafford, I. Leibowitz, A. Nickson, C.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Pediatric Emergency Playbook

AUGUST 1, 2017

2009; 197:211-215. 2009 Jun;123(6):1548-55 Chinn WM, Zavala DC, Ambre J. Evid Based Rev Surg. 2013;216(3):501-505. Petroianu A. Diagnosis of acute appendicitis. Int J Surg. 2012; 10:115-119. Mazeh H et al. Tip appendicitis: clinical implications and management. Amer J Surg. Puig S et al. Semin Roentgenol. 2008; 22-28. Pediatrics.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9% Do not prepare a sterile field (but be as clean as possible). Do not transport to an alternative location.

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Taming the SRU

MAY 5, 2023

There was also an advantage of using MAP as an endpoint, which is a significant advantage as this is a standard resuscitation and hemodynamic end point in routine clinical care of patients in shock. Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial."

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

FEBRUARY 19, 2024

One such study of 263 patients without hypertensive emergencies treated in a resuscitation unit found that 40% of patients had a MAP difference ≥ 10 mmHg between IABP and NIBP measurements. Arterial or cuff pressure: clinical predictors among patients in shock in a critical care resuscitation unit. Gelmann, D., Raffman, A., Gelmann, D.,

Shock 59

Shock Resuscitation Ultrasounds Research 59

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

The latter 1950s and 1960s, quested for nerve gas defense studying expired air resuscitation and modern resuscitology; developing intensive care units. To me, it harkens a new scientific renaissance of resuscitation science, emergency care, and creating systems for care. 1950s & 1960s Resuscitation Research. 10/20/2013.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

PulmCCM

FEBRUARY 19, 2024

Panelists called this “low certainty evidence from five before-after studies that this intervention may be associated with lower mortality and fewer unsuccessful resuscitation events.” ” But even that watered-down statement is unjustified. Let’s take a closer look. Family-Activated METs in Adults Halves Mortality?

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

RebelEM

MARCH 27, 2023

What They Did: Retrospective, observational cohort study in a single high-volume academic hospital The ED had a 5 bed area used for ongoing management and resuscitation of patients who clinically deteriorate while boarding or while actively undergo a workup in other sections of the ED. J Crit Care. Crit Care Explor. Crit Care Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2017

Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. 2009; 8:67-69. 2009; 24:156-8. 2009; 27:942-947. Acute myocarditis mimicking acute myocardial infarction associated with pandemic 2009 (H1N1) influenza virus. 2004; 90:e17. Canale LS et al. Güvenç O et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Emergency Playbook

APRIL 1, 2017

34 “The mother, or other trusted adult, places her mouth over the child’s open mouth, forming a firm seal as if about to perform mouth-to-mouth resuscitation. Nonfatal Choking on Food Among Children 14 Years or Younger in the United States, 2001–2009. Published July 2009. Pediatrics. 2013;132(2):275-281. doi:10.1542/peds.2013-0260.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Don't Forget the Bubbles

JUNE 10, 2024

Initial Management Supportive Care : Initial management involves stabilising the infant, which includes fluid resuscitation, cessation of enteral feeds, and provision of total parenteral nutrition (TPN) to rest the bowel and meet the nutritional needs of the infant. How do you treat necrotising enterocolitis? Fitzgibbons, S.C., Gordon, P.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. coliO157 and factors influencing the development of typical haemolytic uraemic syndrome: a retrospective cohort study, 2009–2012. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. What causes haematuria in children?

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. As with other cases of shock, initial fluid resuscitation may be considered. NEJM 362(9):779; March 4, 2009. NEJM 362(9):779; March 4, 2009. In the cath lab, the patient’s blood pressure remained low. link] 13.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Pediatric Emergency Playbook

APRIL 1, 2016

2009; (55) 12:2098–2112. Early Lactate Elevations Following Resuscitation From Pediatric Cardiac Arrest Are Associated With Increased Mortality. Pediatr Emer Care. 2014;30: 493-495. Kelley WE, Januzzi JL, Christenson RH. Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure. Pediatr Cardiol.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Mind The Bleep

FEBRUARY 29, 2024

200ml/hr for 2 consecutive hours), there are a few potential explanations; -they may be appropriately excreting any excess fluid they had previously been given (de-resuscitating)- for example, were they given 5 litres of crystalloid in resus the day prior? 2009) Oxford Handbook of Critical Care. Resources and References Singer, M.

Documentation/Coding 52

Documentation/Coding Hospitals Wellness Best Practices 52

EMDocs

DECEMBER 18, 2023

13,14 Fluids Fluid resuscitation is a mainstay of sepsis therapy, as the condition is commonly associated with both absolute and relative hypovolemia. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation. Additionally, the recommendation to use a 30 cc/kg bolus was downgraded.

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

EMDocs

OCTOBER 7, 2023

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min. Published June 2009. Critical Care.

EMS 97

EMS Fluid Resuscitation Fractures Resuscitation 97

EMDocs

DECEMBER 16, 2023

Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Ice water immersion and iced peritoneal lavage are additional methods used to lower temperature but are more invasive or can prevent additional resuscitative efforts.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

EMDocs

JANUARY 20, 2024

This patient’s recent diarrheal illness raises suspicion for hypovolemia, which would be treated with fluid resuscitation (D) , but her moist oral mucosa and dilated inferior vena cava suggest an eu- or hypervolemic state. Which of the following is the best next step in the management of this patient’s condition? Am Heart J. Am Heart J.

EMS 101

EMS Fluid Resuscitation Shock EKG/ECG 101

EMDocs

JUNE 3, 2023

5 Initial Evaluation The key to the initial resuscitation of the unstable pelvic trauma patient is to rapidly identify and treat the most life-threatening pathology. 13 Massive transfusion protocols (MTP) are hallmarks of trauma resuscitation, and they are critical to the unstable pelvic fracture patient.

Fractures 64

Fractures Resuscitation Operations EMS 64

RebelEM

MAY 15, 2024

Neutropenic Fever: Fever (one reading of 38.3C Give appropriate fluids, vasopressors, and antibiotics.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Pediatric Emergency Playbook

JANUARY 1, 2017

Further, children participate in and absorb their family’s culture and specific personality from a very young age ( Finley 2009 ). Some children are ultra-rapid-metabolizers of codeine to morphine, causing a rapid “bolus” of the available drug, with respiratory depression and death in some cases ( Ciszkowski 2009 , Racoosin 2013 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Downeast Emergency Medicine

MARCH 13, 2022

Key Concepts Quickly rule out life-threatening emergencies that require immediate resuscitation. Abdominal pain is the most common chief complaint for adult patients in the ED. [1] Think aortic aneurysm dissection, bowel perforation, STEMI (especially in elderly female patients!), ruptured ectopic pregnancy, etc. Silverio, Luz. Full Tex t] 3.

Ultrasounds 52

Ultrasounds EKG/ECG Radiology Radiology 52

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 2x maintenance rate

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

Taming the SRU

MARCH 3, 2025

Because inhalational injuries often co-occur with large cutaneous burns, aggressive fluid resuscitation can rapidly worsen upper airway edema making airway management especially challenging. 2009 Jun 1;3(3):283-297. Effect of inhalation injury on fluid resuscitation requirements after thermal injury. To intubate or not?

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Her rejoinder was “I didn’t think to blow through the nose, but, boy, did I blow between the teeth! ” The nose in Early Modern Expired Air Resuscitation: Early teaching in expired-air resuscitation was three-fold. Few people now remember that a strong early proposal in the move for expired air resuscitation was Mouth to Nose.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40