Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. Its use in the prehospital environment is not well known or studied and may be an interesting area for future research. [i] 2011; 106 : 732–737. [iv] i] Leibowitz A, Oren-Grinberg A, Matyal R. Green et al.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

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. Just give whichever agent you’ve got.

EMS 77

EMS Resuscitation Outcomes Wellness 77

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

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. Resuscitative thoracotomy is for penetrating trauma with signs of life wthin 10-15 minutes of arrival. Pediatrics.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

PHEM Cast

FEBRUARY 25, 2021

In the UK sea water is very unlikely to be icy or cold enough – however, small areas of water may well be, particularly in the winter months. Tipton & Golden (2011). Resuscitation. References Szpilman D, Bierens JJ, Handley AJ, Orlowski JP (2012) Drowning. New Engl J Med. 366: 2102–10. 82: 819-824.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

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. However, that guidance needs to take into account the influence of emotion, environment, body temperature, as well as the underlying disease process, on vital signs, especially in younger infants.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

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

EMDocs

JANUARY 29, 2024

However, other sources suggest that the optimal blood pressure target is not well established and may vary depending on the individual patient’s characteristics and the type of hemorrhagic transformation [7]. 2011 Sep;15(2):211-40. This includes intraparenchymal hemorrhage and subarachnoid hemorrhage (SAH). N Engl J Med.

Stroke 101

Stroke Outcomes EMS Seizures 101

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Pediatric Emergency Playbook

AUGUST 1, 2017

2011; 364(3):255-264. 2011; 29:1136-1140.:205-211. 2011; 523-527. 2011; 24: 552-561. 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. Am J Emerg Med. Chien M et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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

EMDocs

JANUARY 4, 2024

3 Bupropion blocks the reuptake of dopamine and norepinephrine, as well as antagonizes acetylcholine at nicotinic receptors. 2011; 109: 418-422. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Basic Clin Pharmacol Toxicol. PMID: 17766009.

Seizures 94

Seizures EKG/ECG Poisoning Shock 94

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. H Spontaneously breathing carbon dioxide waveforms where phase III is not well delineated. I Dual capnogram in one lung transplantation patient.

CPR 52

CPR Resuscitation Operations Shock 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. 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. Not in the textbook, but it worked. Nguyen, H. EMCrit.org.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

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 Pediatrics Outcomes Documentation/Coding 75

PulmCCM

SEPTEMBER 9, 2021

Sylvia Plath Background Implicit in resuscitation is speed. Yet in 2011 a landmark randomized, controlled trial measured the effect that an intravenous bolus had on mortality in children with severe febrile illness in 3 African countries. saline as well as to two different infusion rates of said fluids. Jon-Emile S.

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

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. If RV pressure is extreme, it can exceed LV pressure causing paradoxical septal wall motion toward the LV as well. 2011 Mar;123(16):1788-1830. Circulation.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

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

Pediatric Emergency Playbook

OCTOBER 1, 2016

Well appearing? Consider allergic proctocolitis if the child is well. Think -- pink stain, without clot: Infants and Young Children Well appearing? Actively bleeding : radio-labeled red blood-cell scan (resuscitate and call your surgeons!) Neonates Well appearing? Infants, and Young Children Well appearing?

Pediatrics 52

Pediatrics Wellness Shock Resuscitation 52

Mind The Bleep

FEBRUARY 9, 2024

She is moderately frail with a few well-managed comorbidities, and states that she would not want to live if she was not able to do her gardening or hold her grandchildren. Because she would not be for intubation, they discuss resuscitation status because, naturally, care during- and post-arrest would involve airway support.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 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. 2011 Feb 15; Epub 2010 Aug 27. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Pediatric Emergency Playbook

NOVEMBER 1, 2015

We have a few minutes to optimize, to resuscitate before we intubate. Ketamine is reasonable as well: there is no contraindication to ketamine except for known hydrocephalus. The goal is a good general perfusion and a balanced resuscitation, ensuring enough cerebral perfusion without disrupting nascent clots.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

PEMBlog

JUNE 5, 2024

Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. 2011 Aug;58(2):145-55. Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. Resuscitate with volume and blood. MMWR Recomm Rep.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Dr. Smith's ECG Blog

JUNE 1, 2020

Pleomorphic VT is less well known than the other morphologic forms of VT. He could not be resuscitated. — Although IV Mg++ is also indicated as initial treatment of PMVT with a normal QT — it is clearly less likely to respond to IV Mg++, than when the QT interval is prolonged.

EKG/ECG 52

EKG/ECG Resuscitation Shock Outcomes 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is not possible during acute resuscitation or at any time before a complete investigation, or even trial, to know who is innocent, guilty, or what occurred during the altercation. If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer. Gustafson, C.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. Welcome to your first day with the neonates! Upon arriving for your initial shift, you set down your bag, and shortly after, you’re asked to evaluate Baby A.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

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. Heart 2011; 97 : 838-843 [link] 14. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Pediatric Emergency Playbook

APRIL 1, 2017

Look for a small tip diameter (to fit in the ear canal as well as the nose) and a strong “hold” (at least a 3-lb hold). 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. Thieme; 2011. 2014;207(5):754-759; discussion 759.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

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.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

EMDocs

OCTOBER 5, 2024

ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants. IV fluid resuscitation as needed. In: PostTW, ed.

EMS 98

EMS Infectious Diseases Sepsis Hospitals 98

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. For children greater than one year who are preverbal, a well performing scale is the FLACC score: Face, Legs, Activity, Cry, Consolability ( Table 3 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EB Medicine

JANUARY 2, 2019

Nachi: All unstable patients or those with suspected or proven ectopic or heterotopic pregnancies should be immediately resuscitated and taken for surgical intervention. Per a 2010 and 2011 Cochrane review, there is not evidence to recommend one antibiotic over another, so let your local antibiograms guide your treatment.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

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

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Resuscitated with chest compressions, epinephrine. Resuscitation was begun with chest compressions, etc., Moreover, when someone has immediate resuscitation of an arrest witnessed by paramedics, they rarely have a GCS of 3 (deep coma). Moreover, it does not follow a coronary distribution very well. Not a shockable rhythm.

EKG/ECG 89

EKG/ECG Resuscitation EMS Seizures 89