The Skeptics' Guide to EM

FEBRUARY 25, 2023

Your team begins high quality cardiopulmonary resuscitation (CPR). Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Sodium bicarbonate has historically been used during CPR with the goal of alkalizing blood pH and treating metabolic acidosis.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Don't Forget the Bubbles

JUNE 26, 2023

Too much pulmonary blood flow and we will see well-oxygenated blood ( SpO2 >85% ) but insufficient systemic blood flow (pallor/mottling, cool peripheries, delayed capillary refill time, weak pulses, hypotension, narrow pulse pressure) and hypoxia (lactic acidosis). 2014;129(20):2013-2020. This is the most nuanced aspect.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Published 2020 Jul 23. Published 2020 Jan 21. Institutional resources and specialty services may further dictate the management of PTX. Ann Emerg Med.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He was admitted on oxygen and was doing fairly well with saturations of 100% on 2 L nasal cannula. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. JAMA Cardiol [Internet] 2020;Available from: [link] 4. He was intubated and then went pulseless.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

APRIL 29, 2020

CPR was started immediately. Her husband stated that she had not been feeling well in the past 2 weeks and c/o dizziness as well as diarrhea. Of note, she's on some QT prolonging medications as well as Hydroxychloroquine for Rheumatoid Arthritis, but no other known QT prolonging medications. She was never defibrillated.

EKG/ECG 52

EKG/ECG CPR Wellness Academics 52

Mind The Bleep

FEBRUARY 9, 2024

Whilst some patients may not be for CPR or intubation and ventilation, they may be appropriate for other treatment options offered in ITU, such as inotropes. She is moderately frail with a few well-managed comorbidities, and states that she would not want to live if she was not able to do her gardening or hold her grandchildren.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

Dr. Smith's ECG Blog

OCTOBER 26, 2020

In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. Here is the LAD before provocative testing: Here is the mid LAD spasm induced during the procedure: Here is a still image of the LAD spasm: The patient is now doing well on long acting nitrates and diltiazem. ICD interrogations have been unremarkable.

EKG/ECG 40

EKG/ECG Hyperthermia / Hypothermia Wellness CPR 40

RebelEM

DECEMBER 19, 2022

That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here. In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. Now that same group has published the results of their full randomized control trial.

EMS 52

EMS CPR Shock Resuscitation 52

Taming the SRU

JUNE 28, 2024

4) This higher likelihood of attaining return of spontaneous circulation (ROSC) is contingent upon high quality CPR and early defibrillation. Lastly, the study was interrupted and ended prematurely due to the COVID-19 pandemic in 2020, which affected the issues above. male 67.9%

Shock 75

Shock Hospitals CPR Outcomes 75