Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

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Leadership Resuscitation Teamwork Patient Safety 105

Ken Grauer, MD

MARCH 23, 2023

She underwent cardiopulmonary resuscitation for VT/VFib — with ROSC ( R eturn O f S pontaneous C irculation ) following defibrillation and treatment with Epinephrine and Amiodarone. A series of cardiac arrhythmias were seen during the course of her resuscitation — including the interesting arrhythmia shown in the long lead II of Figure-1.

EKG/ECG 195

EKG/ECG Resuscitation Hospitals 195

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

PHEM Cast

APRIL 16, 2018

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

ETM Course

JUNE 28, 2015

Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. 2011 Dec;71(6):1869-72 (full article free text) 2. Survival of severe blunt trauma patients treated with resuscitative endovascular balloon occlusion of the aorta compared with propensity score-adjusted untreated patients.

Hospitals 52

Hospitals Resuscitation Shock Military 52

PHEM Cast

SEPTEMBER 19, 2016

Fanily presence during cardiopulmonary resuscitation. The educational intervention “GRIEV_ING” improves the death notification skills of residents. Journal of Academic Emergency Medicine. 2005; 12: 296-301. Jabre P, Belpomme V, Azoulay E et al. The New England Journal of Medicine. 2013: 368 (11): 1008-1018.

Ambulance Services 52

Ambulance Services Resuscitation Academics 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. 2011 Dec;71(6):1869-72. Pediatrics.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

Greater Sydney Area HEMS

FEBRUARY 20, 2024

2011; 106 : 732–737. [iv] Right Brachiocephalic Vein Origin Access for the Resuscitation of Shocked Adult Trauma Patients. iv] Breschan C, Graf G, Jost R et al. A retrospective analysis of the clinical effectiveness of supraclavicular, ultrasound-guided brachiocephalic vein cannulations in preterm infants. Green et al.

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Ultrasounds Shock Research Operations 98

Taming the SRU

FEBRUARY 12, 2024

DISCUSSION Epidemiology and Background Rivaroxaban, along with other direct oral anticoagulants (DOACs), has become a mainstay of treatment for pro-thrombotic conditions since 2011. [1] This does not deviate from general resuscitation principles for acute hemorrhage. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.

Administration 79

Administration Fractures Anaphylaxis Head Injuries 79

PHEM Cast

DECEMBER 12, 2016

pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Taming the SRU

JULY 2, 2023

2011): 544-549. Part 1: executive summary: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care." 2011): 189-196. "Capnography in the emergency department: a review of uses, waveforms, and limitations." The Journal of emergency medicine 53.6 2017): 829-842.

Emergency Department 88

Emergency Department Pediatrics CPR Administration 88

EMDocs

SEPTEMBER 7, 2024

Laborator evaluation: CBC, CMP, lipase, type and screen, coagulation panel Treatment: 1-3 Resuscitation with blood products as necessary for hemodynamic stability. However, this patient’s response to fluid resuscitation, though only minimal to modest, indicates his ongoing bleeding is temporized with typical volume-mediated resuscitation.

EMS 75

EMS Fluid Resuscitation Resuscitation Radiology 75

RebelEM

SEPTEMBER 23, 2024

You decide to intubate the patient after resuscitation. However, it is well-established that even a single dose of etomidate can cause adrenal suppression ( Albert 2011 ). Clinical Scenario: A 48 year old man presents with fever, hypotension, hypoperfusion and hypoxemia. What Your Gut Says: It probably doesn’t make any difference.

EMS 74

EMS Outcomes Resuscitation Wellness 74

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

FEBRUARY 25, 2021

Tipton & Golden (2011). Resuscitation. Prognostication Better outcomes: Rescued and BLS commenced < 5-10 min Children Those who have not aspirated Water temperature < 10 o C, core body temperature 33-35 o C Neurologically intact on arrival at hospital Minimum blood pH > 7.1, New Engl J Med. 366: 2102–10. 82: 819-824.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

PHEM Cast

DECEMBER 1, 2017

Pleural decompression and drainage during trauma reception and resuscitation. Initial Management and Resuscitation of Severe Chest Trauma. Prehospital needle aspiration and tube thoracostomy in trauma victims: a six-year experience with aeromedical crews. The Journal of Emergency Medicine , 13 (2), 155–163. Beckett, A., Pannell, D.,

Academics 52

Academics Radiology Radiology Resuscitation 52

The Skeptics' Guide to EM

JANUARY 9, 2021

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

Pediatric Emergency Playbook

MARCH 1, 2017

Resuscitation. 2011 Oct;41(4):369-73. Supraglottic airway devices during neonatal resuscitation: an historical perspective, systematic review and meta-analysis of available clinical trials. Resuscitation. 2011 Dec;66 Suppl 2:45-56. How much force is required to dislodge an alternate airway? Prehosp Emerg Care.

Airway Management 52

Airway Management Pediatrics Resuscitation Hospitals 52

EMDocs

DECEMBER 6, 2024

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline. Basic assessment: airway, breathing, circulation. Antiemetics as needed. Consider GI decontamination with whole bowel irrigation (WBI). Hosking CS.

Poisoning 76

Poisoning Fluid Resuscitation Seizures Resuscitation 76

ACEP Now

JANUARY 13, 2024

As a member of the Air Force, deployed to Afghanistan in 2011, I have seen war where I should have seen it—in a designated war zone. Those of us who were on shift at the time of the suicide attempted to resuscitate our colleague while still treating many other sick patients simultaneously.

Emergency Department 52

Emergency Department Resuscitation Patient Safety Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

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

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). published in Resuscitation 2011. Case: A 51-year-old man experiences a cardiac arrest on the street. A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2011; 364(3):255-264. 2011; 29:1136-1140.:205-211. 2011; 523-527. 2011; 24: 552-561. 2011; 146(6):660-665. Necrotizing Enterocolitis. N Eng J Med. Niño DF et al. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Management of childhood intussusception after reductiion by enema. J Emerg Med.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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. 2011; 6(11): e27932. Lisa Casanova (a1), William A. Sobsey (a1).

PPE 52

PPE Airway Management Resuscitation Hospitals 52

PHEM Cast

APRIL 21, 2021

Resuscitation. 2011 Dec;82(12):1519-24. Epub 2011 Jul 2. Resuscitation. Breckwoldt J, Klemstein S, Brunne B, Schnitzer L, Mochmann HC, Arntz HR. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. doi: 10.1016/j.resuscitation.2011.06.028. 2011.06.028. PMID: 21749908.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. Resuscitation Council UK. However, there has been continued debate on what ‘normal’ is in relation to HR and RR. What did previous studies show? and one in the US by Bonafide et al. Emerg Med J.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

ETM Course

JUNE 17, 2015

Delaying urinary catheter insertion in the reception and resuscitation of blunt multitrauma and using a full bladder to tamponade pelvic bleeding. Injury 2011 Sep;42(9):913-6 We also cover the oft-misunderstood procedure of retrograde urethrogram (RUG). This is a great locally written article and I’d recommend you check it out!

Fractures 40

Fractures Emergency Department Resuscitation Research 40

PHEM Cast

APRIL 10, 2016

It is worth noting, that with “Sepsis 3” many of these terms will become out-of-date – but validation work is required… The Rivers’ paper can be accessed here: [link] It was a single centre study which compared standard care with protocolised resuscitation packaged together as early goal-directed therapy (EGDT).

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Emergency Medicine Ireland

JUNE 10, 2024

Resuscitate and investigate as you would any sick patient. A follow up trial in 2011 by ICU steroid guru Djilalli Annane did not find a benefit. Intensive Care Medicine 37 , 486–492 (2011). Resuscitate and investigate as you would any sick patient. Expect a high lactate given the disruption of oxidative metabolism.

Poisoning 52

Poisoning EMS Burns Shock 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. N Cardiopulmonary resuscitation: capnogram showing positive waveforms during each compression suggesting effective cardiac compression generating pulmonary blood.

CPR 52

CPR Resuscitation Operations Wellness 52

PHEM Cast

JULY 6, 2017

British Journal of Anaesthesia (2011) 106 (5): 617-631. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 21 , 43. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 21 , 59. Il Giornale Di Chirurgia , 35 (7-8), 165–170. Woodall, N., & Frerk, C. link] Dover, K., Howdieshell, T.

Airway Management 52

Airway Management Academics Operations Resuscitation 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. Nguyen, H. Steele, R., & Walters, E. de Boisblanc, B., & Suresh, M.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

ACEP Now

OCTOBER 9, 2024

However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation. Given his history, it could have been easy to attribute his current presentation to his known mental health conditions. Eur J Cardiothorac Surg. Burns E, Buttner R.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Outcomes 52

Don't Forget the Bubbles

MAY 6, 2024

The data was collected from a cohort from 2011- 2015 (nearly ten years ago). 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. Is this truly reflective of the current population?

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Broome Docs

OCTOBER 31, 2022

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. 2011 Dec 15;343:d7506. 2018 Sep 11;362:k3843. doi: 10.1136/bmj.k3843. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. N Engl J Med. 2022 Sep 15;387(11):989-1000. doi: 10.1056/NEJMoa2202884.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

EMDocs

JANUARY 29, 2024

Case Resolution: In addition to standard measures for resuscitation, the patient is started on a nicardipine drip to target an SBP < 160 mmHg and neurosurgery is urgently consulted. 2011 Sep;15(2):211-40. Nimodipine has been shown to have morbidity and mortality benefits through the reduction of DCI in patients with aneurysmal SAH.

Stroke 73

Stroke Outcomes EMS Seizures 73

RebelEM

MARCH 13, 2023

Grasner 2011; Zwingmann 2012) Their data pools overlap considerably with previous studies; it would have been concerning if the data differed significantly. However, we might expect on-scene advanced trauma resuscitation to prolong prehospital time sizably. Cardiopulmonary resuscitation traumatic cardiac arrest—there are survivors.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52