EMDocs

AUGUST 17, 2023

Additionally, 80% of patients in the control group required open label NE use indicating that NE was going to be needed in most of these patients regardless of initial resuscitation method. I will continue to reach for pressors early in resuscitation of the septic shock patient. vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

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Northwestern EM Blog

MARCH 1, 2025

Hemodynamic instability and ongoing cardiac arrhythmias are a strong contraindication as chest access for cardiopulmonary resuscitation is limited (Koulouras et. 2013; Mi et. 2013 Jun 6;368(23):2159-68. The PROSEVA study is the most recent and famous randomized control trial. N Engl J Med. Blog Post References Caputo, N.D.,

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

EMDocs

JANUARY 11, 2025

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. The two highest predictors of increased mortality in the literature include a large area of colonic involvement >40cm and perforation (32-60% mortality rate). link] Chakravartty, S.,

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% First aid done pre-hospital. This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. 2013 May;74(5):1363-6. Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Czech Military resuscitation kit, 1969, mfr.

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Resuscitation Military Operations Emergency Nursing 40

PHEM Cast

APRIL 27, 2023

: Anesthesia & Analgesia Blood pressure in trauma resuscitation: ‘pop the clot’ vs. ‘drain the brain’? – Wiles – 2017 – Anaesthesia Blood pressure management in trauma: from feast to famine?

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Resuscitation Shock Operations Hospitals 52

Ken Grauer, MD

OCTOBER 27, 2023

My Immediate Impression — was that this elderly woman with a several week history of symptoms would most likely leave the hospital with a pacemaker. She was successfully resuscitated — with a post-arrest rhythm similar to that seen in Figure-1. PEARL # 2: Interpretation of the 12-lead ECG in Figure-1 is no easy task!

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EKG/ECG Resuscitation Hospitals Wellness 257

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. 2013 Sep;184(1):352-7. Pediatrics.

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Resuscitation Pediatrics Fractures Emergency Department 40

PHEM Cast

JANUARY 4, 2017

Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2013; 22: 468-477. Patterson MD, Geis GL, Falcone RA, LeMaster T, Wears RL. BMJ Quality & Safety. Boet S, Bould MD, Layat Burn C, Reeves S.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

EMDocs

OCTOBER 9, 2023

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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Basic Life Support CPR Fractures Emergency Department 108

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

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

Taming the SRU

FEBRUARY 12, 2024

She initially agreed to be transported to the hospital by ambulance, but jumped from the moving vehicle and was subsequently struck and pinned under the fuselage for 10-15 minutes. Hospital Course Based on the primary survey, no acute airway interventions were undertaken. Rivaroxaban and the EINSTEIN clinical trial programme.

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Administration Fractures Anaphylaxis Head Injuries 80

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope.

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CPR Burns Airway Management Wellness 90

The Skeptics' Guide to EM

MAY 8, 2021

CPR is initiated and a hospital rapid response team is called. The resuscitation team arrives and ACLS protocols are continued. Background: Cardiac arrests have high morbidity and mortality rates both in-hospital cardiac arrests (IHCAs) and out of hospital cardiac arrests (OHCAs).

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

PHEM Cast

FEBRUARY 23, 2017

Prehospital Blood Product Resuscitation for Trauma. Weaver AE, Eshelby S, Norton J, Lockey DJ: The introduction of on-scene blood transfusion in a civilian physician-led pre-hospital trauma service. Scand J Trauma Resusc Emerg Med 21(Suppl1):S27, 2013. Lots to think about! 2016 Jul;46(1):3–16. Prehosp Emerg Care 19(1):1–9, 2015.

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Blood Transfusions Head Injuries Resuscitation Radiology 52

Pediatric Emergency Playbook

MARCH 1, 2017

An update on out-of-hospital airway management practices in the United States. Resuscitation. 2013 Sep 9;(9):CD010105. Supraglottic airway devices during neonatal resuscitation: an historical perspective, systematic review and meta-analysis of available clinical trials. Resuscitation. 2013 Jun;84(6):722-30.

Airway Management 52

Airway Management Pediatrics Resuscitation Hospitals 52

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. 2013 Apr 1;131(4):e1150–7. Resuscitation Council UK. Pediatrics.

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Sepsis Pediatrics Urgent Care Emergency Department 98

The Skeptics' Guide to EM

JUNE 24, 2017

Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline).

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia CPR Resuscitation EMS 40

ACEP Now

APRIL 3, 2024

Targeted temperature management (TTM) for patients following cardiac arrest resuscitation has gone through several dosing iterations in the past two decades. Recent Clinical Evidence on Post-Arrest TTM The accumulated post-arrest care literature makes clear that careful fever avoidance following resuscitation is essential.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Don't Forget the Bubbles

JUNE 26, 2023

Staged reconstructions are a topic in itself (click here for a nice summary by Children’s Hospital of Philadelphia), but here we focus on Stage 1. The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. 2014;129(20):2013-2020. 2018;37(7):879-885.

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Operations Research Hyperthermia / Hypothermia Hospitals 128

Taming the SRU

MARCH 30, 2023

Background Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. The first, considered the “primary cohort”, included 337 patients with septic shock requiring vasopressor support in a single ICU from a hospital in Columbia, South America.

Shock 52

Shock Outcomes Sepsis Resuscitation 52

Mind The Bleep

DECEMBER 19, 2023

Therefore, they require fluid resuscitation to restore blood pressure, correct the ketonemia and electrolyte abnormalities, and oliguria. Throughout therapy it is important to monitor fluid input and urine output so that fluid resuscitation measures can be adjusted. It is also vital to do a fluid balance assessment. 2018, November ).

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Dehydration Fluid Resuscitation Shock Resuscitation 98

PulmCCM

FEBRUARY 19, 2024

Let Families Activate Rapid Response Teams, Says SCCM The Society of Critical Care Medicine (SCCM) issued a new guideline on how hospitals and care teams should respond to emergencies outside the ICU or ED (i.e., SCCM now suggests this should be a standard practice at most hospitals. on the medical and surgical wards). Read it here.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2013; 95(6): 474-477. 2013; 48:1789-1793. Management of the child after enema-reduced intussusception: hospital or home? 2013; 44(1):53-57. Mercer AE, Phillips R. Can a conservative approach to the treatment of hypertrophic pyloric stenosis with atropine be considered a real alternative to pyloromyotomy? Arch Dis Child.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

PulmCCM

JANUARY 22, 2024

Although those studies only included out of hospital cardiac arrests due to ventricular fibrillation, induced hypothermia was rapidly and widely adopted and applied to most cardiac arrest patients, regardless of initial rhythm or location of arrest. °C despite acetaminophen, etc).

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

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. Blood Pressure Variability Predicts Poor In-Hospital Outcome in Spontaneous Intracerebral Hemorrhage. 2013 Jul;44(7):1846-51. Epub 2013 May 23.

Stroke 99

Stroke Outcomes EMS Seizures 99

PHEM Cast

APRIL 21, 2021

Resuscitation. The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

ACEP Now

OCTOBER 30, 2023

ESEM hosted the second Global Network Collaborative Conference on Emergency Medicine in 2013 and organized its first large scientific conference in Dubai in December 2014. Launched in 2013, the bi-annual newsletter from ESEM marked a significant stride in promoting the field of emergency medicine in the Middle East.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2016

Peter Josef Safar in 2003, who is often called "The Father of Cardiopulmonary Resuscitation," or noted citations of his work in articles written and references given by me here at AENJournal.com and the Advanced Emergency Nursing Blog. " established that exhaled air was a satisfactory gas for resuscitation.

Resuscitation 40

Resuscitation CPR Emergency Nursing Basic Life Support 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Still, except for the public hospital, other hospitals did little emergency work and would have unattended first aid or treatment room in which one could meet one's physician or have an intern provide care in the meanwhile. 1950s & 1960s Resuscitation Research. and professional commercial ambulances for private patients.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Dr. Smith's ECG Blog

OCTOBER 28, 2013

The patient was resuscitated for 50 minutes, and then this ECG was recorded: Sinus rhythm. Current Emergency and Hospital Medicine Reports (2013) 1:4352. The ST elevation in V1, with RBBB pattern and inverted T-wave also suggests Brugada syndrome, but does not fit with the remainder of the ECG. References : 1. J Electrocardiol.

EKG/ECG 52

EKG/ECG CPR Resuscitation Research 52

Northwestern EM Blog

SEPTEMBER 12, 2022

Written by: August Grace, MD (NUEM ‘24) Edited by: Andrew Rogers, MD, MBA (NUEM ‘22) Expert Commentary by : Andra Farcas, MD (NUEM ‘21) Introduction In the setting of trauma, most hospitals are adept at treating and managing patients with a variety of injuries. Time begins after the first patient arrives at the hospital [8].

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

ACEP Now

OCTOBER 10, 2023

Hospitals should incorporate this approach into clinical practice as part of active management for this serious condition.” Results A total of 7,036 patients were recruited from 121 hospitals that could be included in the modified intention-to-treat analysis. Goal-directed resuscitation for patients with early septic shock.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

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 lines require specialized monitoring and nursing resources which are not available in all hospital settings. Gelmann, D., Raffman, A.,

Shock 59

Shock Resuscitation Ultrasounds Research 59

PulmCCM

JANUARY 24, 2024

Although those studies only included out of hospital cardiac arrests due to ventricular fibrillation, induced hypothermia was rapidly and widely adopted and applied to most cardiac arrest patients, regardless of initial rhythm or location of arrest. °C despite acetaminophen, etc).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

Pediatric Emergency Playbook

APRIL 1, 2016

Cardiology in the Young; 2013. 2013; 88(10): 1127–1140. Effectiveness of predicting in-hospital mortality in critically ill children by assessing blood lactate levels at admission. 2013; 29:715-719. Early Lactate Elevations Following Resuscitation From Pediatric Cardiac Arrest Are Associated With Increased Mortality.

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Pediatrics Sepsis Shock Outcomes 52