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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. A 2012 study on paediatric patients showed that approximately 42% were intubated without medications, and 2% were intubated with paralysis only in the ED. This is referred to as CPR I nduced C onsciousness ( CPRIC ).

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Episode 28: LOST

PHEM Cast

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.

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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). JAMA 2012 and Cournoyer et al. published in Resuscitation 2011. Case: A 51-year-old man experiences a cardiac arrest on the street. He is unsuccessfully shocked. JAMA 2009, Hagihara et al.

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ToxCard: Benzonatate

EMDocs

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). 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

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Episode 26 – Blunt Cardiac Injury: Emergency Department Diagnosis and Management (Trauma CME)

EB Medicine

And one last quick note on echo: in terms of guidelines, the EAST guidelines from 2012 specifically recommend an echo in hemodynamically unstable patients or those with a persistent new dysrhythmia without other sources of ongoing hemorrhage or neurologic etiology of instability. Jeff: Great point. Let’s move on to treatment.

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Oxygen Powered Resuscitators

Advanced Emergency Nursing from AENJ

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.

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SGEM#183: Don’t RINSE, Don’t Repeat

The Skeptics' Guide to EM

By-standard CPR is started and EMS is called. They arrive quickly and take over the resuscitation. They continue CPR, get intravenous access, give a round of epinephrine and then wonder if they should start rapid cooling en-route to the hospital with some cold saline. She is not in a shockable rhythm. Reference: Bernard et al.