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Giving TXA Via An Intraosseous Line?

The Trauma Pro

Seriously injured patients frequently develop coagulopathy, which makes resuscitation (and survival) more challenging. The US military has adopted its routine use at forward combat hospitals. This study used an adult swine model with hemorrhage and aortic crossclamping to simulate military injury and resuscitation.

Military 279
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Trends in survival from out-of-hospital cardiac arrest with a shockable rhythm and its association with bystander resuscitation: a retrospective study

Emergency Medicine Journal

Objective Over 300 000 cases of out-of-hospital cardiac arrests (OHCAs) occur each year in the USA and Europe. Methods We investigated four 18-month periods between 2005 and 2018. Primary outcome was survival at hospital discharge with a good neurological outcome.

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EM@3AM: Murine Typhus

EMDocs

Treatment significantly shortens the duration of illness, and early initiation of therapy can prevent severe complications and reduce the length of hospitalization. 2018 Oct-Dec;55(4):258-264. Answer : Murine Typhus Epidemiology: Murine typhus is endemic in several parts of the U.S.: pregnant patients). J Vector Borne Dis.

EMS 101
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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

3 A three-pronged management approach provides a framework for addressing post-tonsillectomy bleeds: resuscitation, early ENT consultation with transport arrangements, and temporizing measures applied to control bleeding. Dr. Helman is an emergency physician at North York General Hospital in Toronto. Published August 6, 2018.

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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Heart disease and stroke statistics—2018 update: A report from the American Heart Association. Resuscitation. Benjamin EJ, et al.

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EM@3AM: Stercoral Colitis

EMDocs

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Pediatric Emergency Care 34(9):p e159-e160, September 2018. | Disposition: Disposition is dependent on the severity of the presentation, but in most situations, admission is necessary.

EMS 94
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ECG Blog #383 — Is this Coronary Disease?

Ken Grauer, MD

He could not be resuscitated. Apparently while waiting on the hospital floor for the decision regarding optimal aortic replacement — the patient took one of his sublingual NTG ( nitroglycerin ) tablets. Unfortunately — the patient abruptly developed hypoxemia, followed by cardiac arrest with PEA.

EKG/ECG 195