Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. This subsequently led the FDA to issue a Black Box Warning in 2010 which warned that the capsules resemble candy and may be visually appealing to young children. The Case: A 4-year-old boy born with no past medical history presents in cardiac arrest.

Seizures 52

Seizures Administration Resuscitation EMS 52

RebelEM

JUNE 19, 2023

We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures). This should continue to make TXA part of standard trauma resuscitation while additional studies are performed. Lancet 2010; 376(9734): 23-32.

Outcomes 104

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 104

EMDocs

JANUARY 17, 2024

She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). Upon ED arrival, she had a heart rate (HR) of 160 and blood pressure (BP) of 80s/40s.

Poisoning 67

Poisoning Seizures Pediatrics EMS 67

PHEM Cast

JULY 27, 2021

Intensive Care Med 2010; 36: 1475-83. Kenji Inaba. 2015 Marik PE, Cavallazzi R. Does central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Cavallaro F, Sandroni C, Marano C, et al.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

EMDocs

FEBRUARY 12, 2024

Trauma surgeons have traditionally relied on ABGs to assess acid-base status for overall prognostication of trauma injury severity and to screen for occult injury or malperfusion, as this might alter management and aggressive resuscitation. Resuscitation from a pH of 6.5: Lancet Respir Med. 2022 Nov;10(11):1086-1098. Epub 2022 Aug 29.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Pediatric Emergency Playbook

MARCH 1, 2016

Resuscitative Pearls Our goal here is damage control. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery. How Children are Different in Trauma In adults, we speak of “permissive hypotension” (also called “balanced resuscitation” or “damage control resuscitation”).

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

PHEM Cast

JANUARY 4, 2017

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. Bredmose PP, Habig K, Davies G, Grier G, Lockey D. Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Patterson MD, Geis GL, Falcone RA, LeMaster T, Wears RL.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

ETM Course

JUNE 28, 2015

Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. Intra-Aortic Balloon Occlusion to Salvage Patients with Life-Threatening Hemorrhagic Shocks from Pelvic Fractures J Trauma 2010; 68(4): 942–8 (full article free text) 3. Stannard A, Eliason JL, Rasmussen TE. Martinelli et al.

Hospitals 52

Hospitals Resuscitation Shock Military 52

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. 1, 2010, pp. 2,10 If patient requires hemodialysis, then the dosing interval should be every 4 hours.

Poisoning 66

Poisoning CDC Administration Emergency Department 66

PHEM Cast

MAY 3, 2020

Where trained and equipped to use level 3 PPE, this may be used where it will not cause a delay commence resuscitation where this is indicated by local clinical guidance. From the Resuscitation Council: Click here for more from the Resus Council on COVID-19. Volume 31, Issue 5 May 2010 , pp. Lisa Casanova (a1), William A.

PPE 52

PPE Airway Management Resuscitation Hospitals 52

Taming the SRU

FEBRUARY 12, 2024

Discussion of Evidence for Management Initial management of DOAC overdose centers around establishing large-bore intravenous access and providing adequate resuscitation for hemodynamically unstable patients. This does not deviate from general resuscitation principles for acute hemorrhage. BMC Pharmacol Toxicol. May 2; 19(1): 19.

Administration 79

Administration Fractures Anaphylaxis Head Injuries 79

EMDocs

JULY 30, 2024

Treat the DKA as you would with any other patient; insulin, appropriate fluid resuscitation, and electrolyte repletion. Elsevier; 2010:2153-2217. Niacin has been used but has a lower bioavailability than nicotinamide and can cause hypotension when given. Orthostatic hypotension can persist for months after ingestion. Rodenticides.

Poisoning 56

Poisoning Seizures Fluid Resuscitation Pediatrics 56

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

Don't Forget the Bubbles

MAY 6, 2024

This multicentre retrospective cohort study looked at 202 children in California aged 1- 24 months who presented acutely between 2010 and 2021. The mean time to randomisation was 2 hours, which excludes the initial resuscitation window. However, this study did not include the acute resuscitation period or non-ventilated children.

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Northwestern EM Blog

FEBRUARY 14, 2022

Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. Expert Review of Cardiovascular Therapy 2010; 8(12): 1723-9 PMID: 21108554 Santacruz CA, Pereira AJ, Celis E, Vincent JL. NEJM 2008; 358(9): 877 – 87.

Shock 52

Shock Resuscitation Sepsis Fluid Resuscitation 52

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.” Well … no. ” But even that watered-down statement is unjustified. Let’s take a closer look.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

Advanced Emergency Nursing from AENJ

APRIL 29, 2015

Every five years, a conference determines the current state of the art for resuscitation recommendations. In 2010, the AHA recommendation for pediatrics was : ”Hyperoxia can be toxic, particularly to the preterm infant. For babies born at term, it is best to begin resuscitation with room air rather than 100% oxygen. Cornet, A.

Resuscitation 40

Resuscitation Pediatrics Administration Emergency Nursing 40

PulmCCM

JANUARY 22, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. How would YOU interpret her post-resuscitation ECG? Figure-1: The initial ECG in today's case — obtained following resuscitation from cardiac arrest of an 18-year old woman. About A RVC/ A RVD.

EKG/ECG 364

EKG/ECG Resuscitation Documentation/Coding Hospitals 364

PHEM Cast

JULY 6, 2017

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 21 , 43. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 21 , 59. [link] Langvad, S., Hyldmo, P. Nakstad, A. E., & Sandberg, M. Emergency cricothyrotomy–a systematic review. link] Nakstad, A. Bredmose, P. P., & Sandberg, M.

Airway Management 52

Airway Management Academics Operations Resuscitation 52

PHEM Cast

MARCH 17, 2016

2010; Grant S, Khan F, Keijzers G, Shirran M, Marneros L. Effects of face mask ventilation in apneic patients with a resuscitation ventilator in comparision with a bag-valve-mask. Annals of Emergency Medicine. 2014; 65(4): 349-355. Weingart SD. Preoxygenation, reoxygenation, and delayed sequence intubation in the Emergency Department.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

Taming the SRU

OCTOBER 1, 2023

Observation: A 2010 systematic review of 3 RCTs found no difference in mortality, progression of PTX size, or length of hospital stay between chest tube and observation for stable trauma patients with occult PTX [33]. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. Resuscitation. Ann Emerg Med.

Fractures 95

Fractures COPD Hospitals Emergency Department 95

PHEM Cast

DECEMBER 1, 2017

Pleural decompression and drainage during trauma reception and resuscitation. Initial Management and Resuscitation of Severe Chest Trauma. Devices used for decompression: Dressings available for covering an open pneumothorax +/- thoracostomy in a spontaneously breathing patient: References Ball, C. Wyrzykowski, A. Kirkpatrick, A.

Academics 52

Academics Radiology Radiology Resuscitation 52

PulmCCM

JANUARY 24, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

Mind The Bleep

MAY 12, 2023

9 There is no role for Tranexamic acid in upper GI bleeding and its use is harmful to patients 11 Escalate to a senior early for consideration of a higher level of care Refer for early endoscopy after resuscitation with haemodynamic stability. 2010 Feb;12(1):1-6. On Day 3 (i.e. 48 hours later) albumin is administered at 1g/kg.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Downeast Emergency Medicine

APRIL 26, 2021

The primary outcome was 30-day mortality with secondary outcomes looking at 24 hour in-hospital mortality, blood resuscitation at 6 and 24 hours, incidence of multiorgan failure, ARDS, nosocomial infection, early seizures, PE/DVT, crystalloid resuscitation after 24 hours, and the incidence of coagulopathy. Lancet 2010; 376:23-32.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

PHEM Cast

SEPTEMBER 6, 2017

Qvigstad et al showed in again in Resuscitation in 2013, confirming inter-individual variation in effectiveness of CPR using ETCO2 as a surrogate for CO Trauma Deakin et al. (J. N Cardiopulmonary resuscitation: capnogram showing positive waveforms during each compression suggesting effective cardiac compression generating pulmonary blood.

CPR 52

CPR Resuscitation Operations Wellness 52

Don't Forget the Bubbles

JUNE 26, 2023

The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. The seminal trial addressing this in the Norwood population was The Single Ventricle Reconstruction Trial, published in 2010.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

EMDocs

APRIL 22, 2024

During this resuscitation two different ultrasound machines were used to capture images due to a malfunction with the first machine after initial images were captured. 2010 Apr;38(4 Suppl):S495-501. Cardiac Thrombus Formation During Cardiopulmonary Resuscitation for Cardiac Arrest: Is It Time for Ultrasound-Enhanced Algorithms?

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

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

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form. Pulmotor is 1907.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 40

Dr. Smith's ECG Blog

SEPTEMBER 20, 2011

He was resuscitated after fairly prolonged down time, but regained consciousness, though he was confused. This 80 year old with a history of CABG had a cardiac arrest. He did not state he had chest pain, but, then again, he couldn't remember anything. Here is the prehospital ECG at 1935: Sinus rhythm with left bundle branch block (LBBB).

EKG/ECG 52

EKG/ECG Ultrasounds Resuscitation Wellness 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. Bisanzo, M. C., & Hutson, H. The Journal of emergency medicine, 36(2), 141-147.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Dr. Smith's ECG Blog

JANUARY 21, 2023

In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. Heart Rhythm 2010 Hudzik B, Gasior M. The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. ECG met STEMI criteria and was labeled STEMI by computer interpretation. J wave syndromes. J-waves in hypothermia.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Advanced Emergency Nursing from AENJ

MAY 27, 2014

This is the fourth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. The select bibliography will provide ample links to extend your reading. “Carbon Dioxide Resuscitation?” You think to yourself, “ What could that be?” In 1927, H.W.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Taming the SRU

MARCH 31, 2023

Yates Anaphylaxis Pathophysiology Type 1 Hypersensitivity Reaction IgE-mediated Mast-cell degranulation of vasoactive materials Reaction occurs in minutes Clinical Definition: Acute onset of illness with involvement of the skin, mucosal tissue or both + one of the following Respiratory compromise Reduced BP Or, acute onset of illness with at least (..)

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

RebelEM

SEPTEMBER 26, 2022

As described in the CONSORT statement, the use of p-values in table 1 is inappropriate as the study is not powered to show a difference in baseline characteristics between the treatment and control group in an RCT (Schulz 2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med.

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52