ETM Course

JUNE 28, 2015

Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. Survival of severe blunt trauma patients treated with resuscitative endovascular balloon occlusion of the aorta compared with propensity score-adjusted untreated patients. J Trauma Acute Care Surg 2013; 75(3): 506–11 5.

Hospitals 52

Hospitals Resuscitation Shock Military 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. 2013 Sep;184(1):352-7. Pediatrics.

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Resuscitation Pediatrics Fractures Emergency Department 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?

Resuscitation 52

Resuscitation Shock Operations Hospitals 52

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.

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Resuscitation Shock Ultrasounds CPR 52

PHEM Cast

JANUARY 4, 2017

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

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Teamwork Burns Emergency Department Resuscitation 52

Northwestern EM Blog

APRIL 15, 2024

As with any high stress situation in resuscitation, it helps to fall back onto our ABCs, airway being of principle importance here. Resuscitating the tracheostomy patient in the ED. This is to minimize the risk of creating a false passage. Borrowed from: Morris, L.L., Whitmer, A., & McIntosh, E. Critical care nurse, 33 5 , 18-30.

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Emergency Department Resuscitation Pediatrics Outcomes 98

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).

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Sepsis Fluid Resuscitation Resuscitation Emergency Department 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 93

Advanced Emergency Nursing from AENJ

APRIL 29, 2015

Every five years, a conference determines the current state of the art for resuscitation recommendations. For babies born at term, it is best to begin resuscitation with room air rather than 100% oxygen. Emergency Medicine News: November 2013 - Volume 35 - Issue 11 - p 12–13. January 22, 2013 Shiang-Hu, Ang.

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Resuscitation Pediatrics Administration Emergency Nursing 40

PHEM Cast

JUNE 6, 2016

Resuscitation Council UK. Parry R, Asmussen T, Smith JE. Perimortem caesarean section. 2016; 33: 224-229. Clark SL, Cotton DB, Pivarnik JM et al.

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Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Audrey’s academic interests include trauma and resuscitation. Audrey’s academic interests include trauma and resuscitation. The first visit was back in 2013 for SGEM#50 : Under Pressure – Vasopressin, Steroids and Epinephrine in Cardiac Arrest. Robert’s academic interests include research and evidence-based medicine.

Academics 52

Academics Resuscitation EMS Stroke 52

PHEM Cast

JULY 27, 2021

Crit Care Med 2013; 41: 1774-81. Kenji Inaba. 2015 Marik PE, Cavallazzi R. Does central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Cavallaro F, Sandroni C, Marano C, et al.

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Ultrasounds Fractures Resuscitation EMS 52

PHEM Cast

FEBRUARY 23, 2017

Prehospital Blood Product Resuscitation for Trauma. Scand J Trauma Resusc Emerg Med 21(Suppl1):S27, 2013. In patients with penetrating trauma permissive hypotension may remain useful for longer or at least until a patient can be differentiated and the bleeding controlled. Lots to think about! 2016 Jul;46(1):3–16.

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Blood Transfusions Head Injuries Resuscitation Radiology 52

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.

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Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Taming the SRU

FEBRUARY 12, 2024

Discussion of Evidence for Management Initial management of DOAC overdose centers around establishing large-bore intravenous access and providing adequate resuscitation for hemodynamically unstable patients. This does not deviate from general resuscitation principles for acute hemorrhage. Blood Coagul Fibrinolysis. Apr; 30(3): 85–95.

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Administration Fractures Anaphylaxis Head Injuries 79

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. Marcdante, R.

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Dehydration Fluid Resuscitation Shock Resuscitation 98

RebelEM

JANUARY 25, 2023

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Taming the SRU

MARCH 30, 2023

Background Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. and hepatic encephalopathy), advanced liver cirrhosis, atrial fibrillation, presence of ventricular dysrhythmia, use of pacemaker, and those with do-not-resuscitate orders. 1967;165(4):504-17.

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Shock Outcomes Sepsis Resuscitation 52

Emergency Medicine Ireland

JUNE 21, 2021

They even have a set of consensus guidelines published back in 2013 that provide a wonderful template for an exam answer even if they aren’t supported by the highest level evidence. If muscular tone is worsening things then get rid of it * optimise fluid resuscitation. So a few basics to start with. optimise perfusion.

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Fluid Resuscitation Resuscitation Wellness 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Holbrook MD September 01, 2013 Umbilical Cord Prolapse and Other Cord Emergencies Marybeth Lore, MD Complications of Labor and Delivery by Jeanie Ward Pulmonary Embolism: Evaluation in the pregnant patient Journal of Emergencies, Trauma and Shock, 3(1), 39. Emergency medicine international, 2013. 2013) Trauma and Pregnancy.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

The Skeptics' Guide to EM

MAY 8, 2021

The resuscitation team arrives and ACLS protocols are continued. SGEM#50 looked at a RCT published in JAMA 2013 looking to see if a vasopressin, steroids, and epinephrine (VSE) protocol for IHCAs could improve survival with favorable neurologic outcome compared to epinephrine alone.

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CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

Don't Forget the Bubbles

AUGUST 7, 2023

2013 Apr 1;131(4):e1150–7. Resuscitation Council UK. References Bonafide CP, Brady PW, Keren R, Conway PH, Marsolo K, Daymont C. Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children. Pediatrics. Gold DL, Mihalov LK, Cohen DM. Acad Emerg Med. 2014;21(11):1249–56. Emerg Med J. 2021 Feb;38(2):132–8.

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Sepsis Pediatrics Urgent Care Emergency Department 98

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. 2013 Jul;30(7):521–6. Emerg Med J.

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Emergency Department Ultrasounds Administration Burns 91

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. A comparison of the height of spontaneous breaths compared to the mechanical breaths is useful to assess spontaneous ventilation during weaning process.

CPR 52

CPR Resuscitation Operations Wellness 52

Taming the SRU

MARCH 11, 2024

BMJCaseRep Published online: [Oct 4 2013] doi:10.1136/bcr-2013201279 Stannard JP and Schreiner AJ. 4) This classification system is more specific but may be impractical to use in an Emergency Department setting. Then, after turning attention to the affected extremity, a careful history is important to discover the mechanism of injury.

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Dislocations Emergency Department Fractures Operations 107

Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. If the patient does not respond to resuscitative measures, cardiopulmonary bypass and extracorporeal membrane oxygenation may be considered. 2013 Jan;33(1):38-43. Early consultation with the poison center is prudent. Pharmacotherapy.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% 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. J Trauma Acute Care Surg. doi: 10.1097/TA.0b013e31828b82f5.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Don't Forget the Bubbles

JUNE 26, 2023

The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. 2014;129(20):2013-2020. Frank blood is aspirated from the endotracheal tube, indicating a significant pulmonary haemorrhage, and the baby suffers a cardiac arrest at 20 hours postoperatively. Circulation.

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Operations Research Hyperthermia / Hypothermia Hospitals 128

PHEM Cast

APRIL 21, 2021

Resuscitation. Int J Emerg Med 6, 38 (2013). Resuscitation. Breckwoldt J, Klemstein S, Brunne B, Schnitzer L, Mochmann HC, Arntz HR. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. 2011 Dec;82(12):1519-24. doi: 10.1016/j.resuscitation.2011.06.028. 2011.06.028. Epub 2011 Jul 2.

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Airway Management Resuscitation EMS Hospitals 40

PulmCCM

FEBRUARY 19, 2024

Panelists called this “low certainty evidence from five before-after studies that this intervention may be associated with lower mortality and fewer unsuccessful resuscitation events.” Over six years of study (2007-2013): There were 83 MET calls activated by parents (~1.2 Let’s take a closer look.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 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.,

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EMS Sepsis Shock Fluid Resuscitation 88

PulmCCM

JANUARY 22, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

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Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Pediatric Emergency Playbook

APRIL 1, 2016

Cardiology in the Young; 2013. 2013; 88(10): 1127–1140. 2013; 29:715-719. Early Lactate Elevations Following Resuscitation From Pediatric Cardiac Arrest Are Associated With Increased Mortality. 2013; 14(8): e380–e387. J Am Coll Cardiol. 2012; 60(23): 2427-2463. Schwartz MC, Wellen S, Rome JJ et al. 23: 353–360.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 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 or cuff pressure: clinical predictors among patients in shock in a critical care resuscitation unit. Gelmann, D., Raffman, A., Gelmann, D.,

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Shock Resuscitation Ultrasounds Research 59

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. Nikus KC, Eskola MJ.

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EKG/ECG CPR Resuscitation Research 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. Recovered projectiles are preferably handled with gloved fingers, rather than toothed forceps that may alter evidentiary striations. Khoshdel, A. Modaghegh, M.

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Military Forensics Documentation/Coding Emergency Nursing 40

Pediatric Emergency Playbook

JUNE 1, 2017

Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. 2013; 34(3):489-491. 2013; 34(4). 2013; 8(2):61-63. 2013; 6(5):752-761. 2013; 57:812-819. The high-velocity object: coronary artery dissection or thrombus Direct trauma (e.g. 2014; 5(4)L631-634.

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Pediatrics EKG/ECG Wellness Seizures 52