Taming the SRU

JUNE 28, 2024

In 2018, Cheskes et al in Canada decided to examine these therapies and compare their outcomes. They utilized paramedic services to compare outcomes of dual sequence vs vector change defibrillation in regards to survival to hospital discharge as well as termination of v fib, rates of ROSC, and neurologic outcome at discharge.

Shock 73

Shock Hospitals Outcomes CPR 73

PulmCCM

FEBRUARY 28, 2022

What they did Adult patients admitted to one of 53 intensive care units in New Zealand or Australia between September 2017 and December 2020 were eligible. Patients were thus excluded if they had indications for a specific type of IV fluid resuscitation or if they had received more than 500 mL of IV fluid in the ICU.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

PulmCCM

NOVEMBER 6, 2023

The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation). patients infected with the Wuhan/Delta variants in 2020-2021). Thromboelastometry (e.g., Limited data were available regarding its efficacy.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

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Resuscitation Fluid Resuscitation Head Injuries Shock 145

EMDocs

FEBRUARY 12, 2024

Trauma surgeons have traditionally relied on ABGs to assess acid-base status for overall prognostication of trauma injury severity and to screen for occult injury or malperfusion, as this might alter management and aggressive resuscitation. As previously noted, ABGs are not easily obtained (let alone in the critically ill trauma patient).

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Date: June 2nd, 2020 Reference: Permpikul et al. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Respir Crit Care Med 2019. increase in MAP).

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

Northwestern EM Blog

SEPTEMBER 26, 2022

In this post, we will give a brief overview of a landmark study in the ED debrief literature, which advocates for a “hot” debrief model in resuscitation cases using the STOP5 model. Any team member of the resuscitation may lead the hot debrief. No potential resuscitation cases were formally excluded. References 1. Www.Heart.Org.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. The key result was that significantly fewer patients had a favorable neurologic outcome in the IO group compared to the IV group.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

PHARM

JUNE 6, 2023

Consecutive sampling of trauma patients who underwent PHEA using a fentanyl, ketamine, rocuronium drug regime were included, 2015–2020. The variables significantly associated with PIH only account for a small proportion of the observed outcome. Read on sjtrem.biomedcentral.com/articles/10.1186/s13049-023-01091-z

Resuscitation 40

Resuscitation Administration Outcomes 40

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Date: September 16th, 2020 Guest Skeptics: Dr. Robert Goulden and Dr. Audrey Marcotte are Chief Residents from the Royal College of Emergency Medicine Program at McGill University. Audrey’s academic interests include trauma and resuscitation. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Research 52

Don't Forget the Bubbles

JUNE 30, 2023

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. American Thoracic Society, 2020 Mazur P, Kosinski S, Podsiadlo P, et al.: A5175-A5175.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Taming the SRU

MAY 5, 2023

The CLASSIC trial is a randomized controlled trial conducted in the ICU setting which compared restrictive versus standard fluid strategies with a primary outcome of death by 90 days in patients with septic shock. Safety outcomes Serious adverse event occurrences were similar in both groups. 2019, Bauer, Gerlach et al. versus 59.2%).

Sepsis 52

Sepsis Shock Administration Resuscitation 52

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Cardiopulmonary resuscitation (CPR) is in progress. A SRMA published in 2020 on the use of steroids after cardiac arrest reported an increase in ROSC and survival to discharge but was limited by the availability of adequately powered high-quality RCTs ( Liu et al JIMR 2020 ). The monitor shows a non-shockable rhythm.

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

EMDocs

MAY 15, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Causes and outcomes of the acute chest syndrome in sickle cell disease. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Published 2020 Feb 12. times maintenance. Am J Emerg Med. PMID: 35717760.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. There are few data on the outcomes of UGIB when balloon tamponade is used as a temporizing measure. Stable Patients For both stable and resuscitated patients, high-dose IV proton pump inhibitor therapy (i.e., 2020:395(10241):1927-1936. 6 Balloon tamponade (i.e., Crit Care Med.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Causes and outcomes of the acute chest syndrome in sickle cell disease. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Published 2020 Feb 12. Decreases splinting and improves tidal volumes.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. Cited June 2020]; 4 (11): 1261-1287. Cited June 2020]; Available from: [link] Hughes D. Cited June 2020]; Available from: [link] Balestracci A et al.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. He presented tachycardic and hypotensive with a capillary refill time of 5 seconds.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

The Skeptics' Guide to EM

JANUARY 25, 2020

Date: January 9th, 2020 Reference: Casey et al. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Date: January 9th, 2020 Reference: Casey et al. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. .

EMS 40

EMS Airway Management Administration Resuscitation 40

Dr. Smith's ECG Blog

AUGUST 2, 2024

the investigators reviewed outcomes in 118 patients presenting with NSTEMI. Yet recognition of acute RV MI is extremely important clinically — because emergency treatment will often require different priorities (ie, avoidance of nitroglycerine; fluid resuscitation for hypotension ). 118.007305) from Heitner et al. ,

EKG/ECG 112

EKG/ECG Fluid Resuscitation Academics Resuscitation 112

Northwestern EM Blog

FEBRUARY 14, 2022

Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion.

Shock 52

Shock Resuscitation Outcomes Fluid Resuscitation 52

EMDocs

JUNE 27, 2024

2020 Feb 12;10(1):2470. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

Taming the SRU

OCTOBER 1, 2023

As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11]. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. Published 2020 Jul 23. Published 2020 Jan 21. Resuscitation.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

Don't Forget the Bubbles

AUGUST 7, 2023

The study also did not assess outcomes for each patient, and as such, the impact on deviation from the normal range was not explored. Yes Was the outcome accurately measured to minimize bias? Resuscitation Council UK. 2020 Sep 17;8:548154. CASP checklist for Cohort studies Does this address a clearly focused issue?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Mind The Bleep

NOVEMBER 23, 2023

Management Steps Step 1 – Mother/Father’s kiss Instructions: Place your mouth over the child’s open mouth, creating a secure seal as you would during mouth-to-mouth resuscitation. Following the steps outlined in this quick reference guide can ensure the best possible outcome for your patients facing these common ENT emergencies.

Patient Safety 52

Patient Safety Resuscitation Outcomes 52

EMDocs

JUNE 7, 2023

Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. link] Updated September 14, 2020. Accessed December 14, 2020. Avoid Further Exposure Avoid cholinergic agents that will exacerbate symptoms. Pesticides and Cholinergics. In: Mattu A and Swadron S, ed.

Poisoning 83

Poisoning Airway Management Seizures PPE 83

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. JAMA Cardiol [Internet] 2020;Available from: [link] 4. JAMA Cardiol [Internet] 2020;Available from: [link] 5. 3–8 Shi et al.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Thinking Critical Care

MAY 18, 2023

This hypovolaemic shock state was to be maintained for one or two hours before the shed blood was retransfused and the effect of experimental drugs on resuscitation could be tested. [11] I do not recall one experiment getting as far as the resuscitation stage. We did not achieve a publishable consensus until 2020. 311:1137-43.

Shock 40

Shock Research Sepsis Resuscitation 40

RebelEM

NOVEMBER 30, 2023

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Outcomes: Primary Outcome: In-hospital mortality. Am J Emerg Med. 2023;73:34-39. 2.89, p = 0.01.

Sepsis 113

Sepsis Fluid Resuscitation Resuscitation Administration 113

Don't Forget the Bubbles

JUNE 10, 2024

Despite advancements in neonatal care, NEC remains a significant concern due to its association with adverse outcomes, including prolonged hospitalisation, the need for surgical intervention, and increased mortality rates. What is the pathophysiology of necrotising enterocolitis? How do you treat necrotising enterocolitis? Can we prevent NEC?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

ACEP Now

JULY 7, 2023

2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity. Resuscitation. Resuscitation. Resuscitation. 2022;175:105-112. Sakai T, et al. 2010;81(8):956-961.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

PulmCCM

DECEMBER 11, 2023

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Vitamin C did not improve outcomes among patients hospitalized with Covid-19.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

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. These cases illustrate some of the common issues associated with each shunt type, but what does the evidence say about outcomes? 2014;129(20):2013-2020. What is the best option for repair?

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

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. Finally, the guidelines support active temperature management’s (though not necessarily hypothermia) role in improving post-arrest outcomes. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic. Giancarelli et al found that 97% of patients who underwent massive transfusion protocols during trauma resuscitation were hypocalcemic (iCa < 1.1 Am J Emerg Med.

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89