EMDocs

JANUARY 16, 2024

Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation. 2,3 If the patient meets criteria for resuscitation, they generally are not declared dead until their core temperature is above 32℃ (“warm and dead”).

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

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 2021 Mar;41:104-109.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 105

RebelEM

APRIL 29, 2024

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

MARCH 18, 2025

Resuscitate prior to intubation. Bronchoscopy (Pulmonology/critical care): Used in intubated patients, those too unstable for CT despite resuscitation, or if the source of bleeding is not clear despite other imaging (CT). 2021 Dec;50:148-155. Avoid HOP killers: hypotension, hypoxemia, acidemia. Am J Emerg Med. Am J Emerg Med.

COPD 81

COPD Radiology Radiology PPE 81

RebelEM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Figure 2 : Extended Glasgow Outcome Scale (GOS-E) (credit: Doc_HG ) Secondary Modified Rankin Score Secondary outcomes included death within 6 months.

Hospitals 98

Hospitals Resuscitation Outcomes CPR 98

RebelEM

FEBRUARY 8, 2024

were they in the resuscitative phase? were they in the resuscitative phase? were they in the resuscitative phase? to 1.12; p = 0.03 for every change in 5ug/min Lower MAP Value: aOR 0.98; 95% CI 0.98 to 0.99; p <0.01 for every change in 1mmHg Higher BMI: aOR 1.04; 95% CI 1.01 to 1.09; p = 0.01 to 1.37; p <0.01

Resuscitation 125

Resuscitation Outcomes EMS Sepsis 125

Don't Forget the Bubbles

JUNE 30, 2023

In 2021, Evans and colleagues (1) compared adolescent mortality rates in adult, children’s and mixed major trauma centres across the UK. In 2021, Kulvatunyou, Bauman and colleagues compared the insertion of traditional 28-32Fr chest tubes with 14Fr pigtail catheters for drainage of traumatic haemothorax. Is he going to be OK?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EMDocs

JANUARY 25, 2025

Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. An update on the diagnosis and treatment of chronic idiopathic neutropenia. Gedefie, A.,

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

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. Emergency Medical Services found her apneic and pulseless. C and remained pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Emergency Medicine Journal

OCTOBER 26, 2023

Background Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment method for refractory out-of-hospital cardiac arrest (OHCA) requiring a complex chain of care. However, every fourth ECPR candidate and every third patient who received ECMO-facilitated resuscitation at the hospital survived with a good neurological outcome.

Hospitals 75

Hospitals CPR Resuscitation Outcomes 75

University of Maryland CC Project

NOVEMBER 24, 2021

Maryland Critical Care Conference 2021 with various talks on the topic of Resuscitation.

Resuscitation 40

Resuscitation Outcomes CPR Ultrasounds 40

PulmCCM

NOVEMBER 6, 2023

patients infected with the Wuhan/Delta variants in 2020-2021). I recall very well my (unjustified) negative view on convalescent plasma in 2020 and 2021 — it was probably minimally effective, and I would never spontaneously offer it. The intervention is called resuscitative endovascular balloon occlusion of the aorta (REBOA).

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

MAY 10, 2023

Resuscitation is a team sport. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. A study in Denmark in 2021 explored barriers to effective resuscitation in over 900 in-hospital resuscitations across six hospitals in Denmark. But resuscitation evolves.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

EM Literature of Note

JANUARY 9, 2022

The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

Emergency Medicine Cases

JANUARY 18, 2022

The post EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update appeared first on Emergency Medicine Cases.

Anaphylaxis 52

Anaphylaxis EMS Outcomes Hyperthermia / Hypothermia 52

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0 tests/hr (0.9

Operations 104

Operations Academics Fluid Resuscitation Outcomes 104

ACEP Now

JUNE 21, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. The lack of differences in the observed outcomes do not suggest one EM training length is superior. 1 Curricula with non-EM internships (i.e., 11 What should we take away?

EMS 114

EMS Academics Telemedicine Operations 114

ED ECMO

FEBRUARY 23, 2021

Outcome in refractory out-of-hospital cardiac arrest before and after implementation of an ECPR protocol. Resuscitation. 2021 Feb 10;162:35-42. Prognostic value of signs of life throughout cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest. Resuscitation. 2021 Feb 17:S0300-9572(21)00077-0.

CPR 52

CPR Resuscitation Hospitals Outcomes 52

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. Published 2021 Apr 16. After 40ml/kg of IV 0.9% The CRT is unchanged. 2021;25(1):146.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Administer O2 if necessary.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

RebelEM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. Article: How-Berlemont C, Lamhaut L, Diehl J, et al.

Hospitals 66

Hospitals Outcomes EKG/ECG Resuscitation 66

The Skeptics' Guide to EM

MARCH 11, 2023

A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Date: March 8, 2023 Reference: Smida et al.

Airway Management 52

Airway Management Basic Life Support CPR Resuscitation 52

PulmCCM

JANUARY 22, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. Date: January 5th, 2021 Reference: Grunau et al. first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. JAMA 2021 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in […] The post SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline first appeared on The Skeptics Guide to Emergency Medicine.

Outcomes 52

Outcomes Sepsis Resuscitation Administration 52

RebelEM

SEPTEMBER 29, 2022

There are also potential harms to large volume fluid resuscitation including progression of pancreatitis and fluid overload with or without respiratory failure. Though the initial recommendation for aggressive fluid resuscitation was not based on substantial evidence, clinicians have been slow to pivot away from this approach.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

The Skeptics' Guide to EM

MAY 8, 2021

Date: May 7th, 2021 Guest Skeptic: Dr. Ryan Stanton is a community emergency physician with Central Emergency Physicians in Lexington, KY. Date: May 7th, 2021 Guest Skeptic: Dr. Ryan Stanton is a community emergency physician with Central Emergency Physicians in Lexington, KY. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Date: August 12th, 2021 Reference: Daya et al. Date: August 12th, 2021 Reference: Daya et al. The key result was that significantly fewer patients had a favorable neurologic outcome in the IO group compared to the IV group. Missy is also now the director […] The post SGEM#340: Andale, Andale Get An IO, IO for Adult OHCA?

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

Don't Forget the Bubbles

MAY 6, 2024

This multicentre retrospective cohort study looked at 202 children in California aged 1- 24 months who presented acutely between 2010 and 2021. Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. Why does it matter?

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Taming the SRU

MAY 5, 2023

2021, Jarczak, Kluge et al. 2021, Im, Kang et al. 2021), although this is based on low-quality evidence rather than high-quality randomized trials and has remained a controversial aspect of treatment of patients with sepsis given the potential harms of large-volume fluid administration. N Engl J Med. 2023;388(6):499-510.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes. doi: 10.1161/01.str.0000014509.11540.66.

Stroke 99

Stroke Outcomes EMS Seizures 99

Emergency Medicine Journal

JUNE 20, 2024

Background Analgesia is an important component for patient well-being, but commonly delayed during trauma resuscitation. The primary outcome was the proportion of patients who had first dose analgesia within 30 min compared using the 2 test. to 1.71; p=0.042). Trial registration number ACTRN12621000338864.

Resuscitation 40

Resuscitation EMS Outcomes Hospitals 40

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. JAMA Sept 2021. JAMA Sept 2021. Cardiopulmonary resuscitation (CPR) is in progress. The monitor shows a non-shockable rhythm.

Advances Cardiac Life Support (ACLS) 40

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

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? 2021 Feb;38(2):132–8. Resuscitation Council UK. CASP checklist for Cohort studies Does this address a clearly focused issue?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

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. 2021, August 16).

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 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. 5,6 In 2021, the TTM2 trial was published. 5,6 In 2021, the TTM2 trial was published. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

PulmCCM

JANUARY 24, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52