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Grand Rounds Recap 9.6.23

Taming the SRU

ETT onto a fiberoptic scope.

CPR 90
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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

This is referred to as CPR I nduced C onsciousness ( CPRIC ). 2013 Jan;31(1):222-6. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. In some patients, highly effective chest compressions may lead to regained consciousness. Am J Emerg Med.

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Systemic Steroids: An ED Focused Overview

EMDocs

1 Though hydrocortisone is often included in ‘crash carts,’ the most recent consensus on cardiopulmonary resuscitation (CPR) has a weak recommendation against the use of corticosteroids during CPR. Published 2013 Aug 15. Given its mineralocorticoid properties, hydrocortisone is traditionally used for adrenal insufficiency.

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STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

RebelEM

STREAM-2: Half-Dose Tenecteplase or Primary Percutaneous Coronary Intervention in Older Patients With ST-Segment-Elevation Myocardial Infarction: A Randomized, Open-Label Trial. PMID: 37439219 Armstrong P et al. Fibrinolysis or Primary PCI in ST-Segment elevation Myocardial Infarction. appeared first on REBEL EM - Emergency Medicine Blog.

EKG/ECG 138
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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

10 The score predicts the probability of survival to hospital discharge using a number of factors including CPR duration, serum potassium, core temperature, age, and suspected mechanism of hypothermia. 2,11 There are cases of patients recovering after hours of time without a pulse with good CPR. 2013 Jan 24;368(4):394].

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SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest?

The Skeptics' Guide to EM

CPR is initiated and a hospital rapid response team is called. This contrasts with what the public sees watching CPR being done on TV. Use of Corticosteroids in Cardiac Arrest – A Systematic Review and Meta-Analysis. The resuscitation team arrives and ACLS protocols are continued.

CPR 52
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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

Am J Cardiol 2013. A Randomized Trial of the Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Intermediate-Reisk Pulmonary Embolism: The OPTALYSE PE Trial. JACC Cardiovasc Interv 2018. PMID: 30025734 Sharifi M et al. Moderate Pulmonary Embolism Treated with thrombolysis (from the “MOPETT” Trial). Clin Exp Emerg Med 2023.

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