EMCrit

SEPTEMBER 30, 2022

All of the resuscitation and acute critical care goodness for Sept 2022. EMCrit Project by Scott Weingart, MD FCCM.

Resuscitation 80

Resuscitation 80

Dr. Smith's ECG Blog

JULY 14, 2023

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

Resuscitation 98

Resuscitation EKG/ECG CPR Outcomes 98

EMDocs

DECEMBER 1, 2024

January 2022. Answer : Murine Typhus Epidemiology: Murine typhus is endemic in several parts of the U.S.: Revisiting doxycycline in pregnancy and early childhood–time to rebuild its reputation? Expert Opin Drug Saf. 2016;15(3):367-82. Food and Drug Administration. Doxycycline Capsules USP. Available at: [link].

EMS 105

EMS Infectious Diseases Shock Airway Management 105

Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. 2022; 23( 7): 835- 856. Lesson = treat early! Pediatr Diabetes.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

Pediatric EM Morsels

SEPTEMBER 22, 2023

While we may allow permissive hypotension in damage control resuscitation of hemorrhagic shock, in neurogenic shock you should maintain an age-appropriate blood pressure. Updated 2022 Feb 10]. Updated 2022 Mar 3]. Alpha 1 agonists are necessary to maintain appropriate blood pressure. 5 th Edition. Neurogenic Shock.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

ACEP Now

JANUARY 5, 2025

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. 2022 ;279(3):1601-1607. He is the founder and host of the Emergency Medicine Cases podcast and website.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

EM Ottawa

JUNE 29, 2023

In this post, we are going to touch on: […] The post Don’t go Breaking my Heart: 2022 Heart Failure Guidelines appeared first on EMOttawa Blog. This is why it is important for ER Physicians to remain updated on the latest AHA/ACC/HFSA guidelines for the management of heart failure.

Emergency Department 98

Emergency Department Resuscitation 98

EMDocs

JANUARY 25, 2025

Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. Philadelphia, PA: Elsevier; 2022:1-11. 101,33 (2022): e30116. Updated 2022 Nov 14]. Disposition is based on overall clinical presentation, inciting etiology, and consultant evaluation.

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

Dr. Smith's ECG Blog

JULY 9, 2024

He underwent resuscitation including vasopressors, inotropic support, and intubation. Despite anticipation by many that the initial post-resuscitation ECG will show an obvious acute infarction — this expected "STEMI picture" is often not seen. The Post-Resuscitation ECG: I thought the initial ECG in today's case was not obvious.

EKG/ECG 116

EKG/ECG Resuscitation Shock CPR 116

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

Broome Docs

OCTOBER 31, 2022

2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. 2022 Sep 15;387(11):989-1000. 2022 Sep 18. 2022 Aug;41(4):101096. Epub 2022 Apr 28. 2022 Aug 3;11:100284. 2022 Jul 26:emermed-2021-211540. Intensive Care Med. Epub 2021 Dec 14.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

RebelEM

MAY 15, 2023

Frantically look through the assisted care documents for do-not-resuscitate paperwork Place a chest tube on the left side Place a chest tube on the right side Start noninvasive or mechanical ventilation FOR THE RIGHT ANSWER CLICK ON THE ROSH REVIEW LOGO BELOW References: Dixon A. Accessed October 19, 2022. Accessed October 19, 2022.

EMS 98

EMS Documentation/Coding Resuscitation 98

ACEP Now

JULY 7, 2023

17,18 Given this, the advent of extracorporeal membrane oxygenation (ECMO) presents an opportunity to bridge care between traditional resuscitation of refractory VF patients in the ED and more definitive management in the catheterization lab. Heart disease and stroke statistics-2022 update: A report from the American Heart Association.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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

Don't Forget the Bubbles

FEBRUARY 5, 2025

According to the latest figures (2022), there were approximately 6,000 recorded offences where a child was a victim of violence, including physical assault, sexual abuse, and homicide. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Auscultate, percuss and palpate chest.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

EMDocs

MARCH 4, 2025

Start resuscitating with fluids, and add a vasopressor like norepinephrine. Epub 2022 Dec 28. MAP minus the ICP equals CPP. The target CPP is at least 60. So, if the patient has an elevated ICP of 20, you want a MAP of about 80. That gives a CPP of 60. MAP 80-ICP 20= CPP 60). If you know the ICP, you can titrate the MAP.

Infectious Diseases 83

Infectious Diseases Seizures Poisoning Sepsis 83

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). EMRA Antibiotic Guide.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Greater Sydney Area HEMS

NOVEMBER 4, 2023

In 2022, we achieved: 95% overall first pass success rate (first pass of laryngoscope into mouth results in successful intubation, from both prehospital and inter hospital cases, including cold tube and RSI. This patient was intubated as part of resuscitation after drowning. This older child had a reduced GCS.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

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. 2022 Mar 2;83(3):1-12. Epub 2022 Mar 4. Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. Br J Hosp Med (Lond).

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

FEBRUARY 20, 2024

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. 2022 Sep 15;387(11):989-1000. Question:In adults with acute pancreatitis, does moderate fluid resuscitation compared to aggressive resuscitation reduce the development of moderately severe or severe pancreatitis? N Engl J Med. vs. 17.3%, aRR1.30 (0.78-2.18)

Fluid Resuscitation 98

Fluid Resuscitation Resuscitation Outcomes Hospitals 98

Don't Forget the Bubbles

MARCH 31, 2025

Sepsis is a significant cause of mortality in children, and fluid resuscitation is a key treatment strategy. It also emphasizes the need for better fluid management strategies, including early de-resuscitation in high-risk patients. Why does it matter? The secondary outcome was children who required mechanical ventilation.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

RebelEM

MAY 29, 2023

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. 95% CI 15.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

Northwestern EM Blog

MARCH 1, 2025

This maneuver improves oxygenation and gas exchange via three main mechanisms (Malhotra, 2022): 1. It is the distending force of the lungs, opposing the innate inward elastic recoil of the lung parenchyma (Neupane and Jamil, 2022). What are the physiologic effects of proning?

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 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

EMDocs

NOVEMBER 29, 2023

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. 2022 Sep 15;387(11):989-1000. Question:In adults with acute pancreatitis, does moderate fluid resuscitation compared to aggressive resuscitation reduce the development of moderately severe or severe pancreatitis? N Engl J Med. vs. 17.3%, aRR1.30 (0.78-2.18)

Fluid Resuscitation 93

Fluid Resuscitation Resuscitation Outcomes Hospitals 93

PulmCCM

DECEMBER 11, 2023

LOVIT-COVID and REMAP-CAP ) Twice-daily oral zinc reduced mortality, ICU admission rate, and hospital length of stay in patients with Covid-19 in Tunisia in 2022. Read in NEJM ECMO provided no detectable benefit when applied to patients failing resuscitations from out-of-hospital cardiac arrests due to ventricular arrhythmias.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

Taming the SRU

MARCH 27, 2024

Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial. In this study, the authors aim to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients.

Resuscitation 99

Resuscitation CPR Outcomes Hospitals 99

PulmCCM

NOVEMBER 17, 2023

Operating point guided resuscitation How do we make sense of this? The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR]. Put another way, because the OP is comprised of both P ra and CO/SV, both values are quantified or qualified at each step of resuscitation. Ultrasound J 2022, 14(1):36.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

Don't Forget the Bubbles

JUNE 30, 2023

In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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. Treasure Island (FL): StatPearls Publishing; July 26, 2022. Treasure Island (FL): StatPearls Publishing; October 17, 2022.

Basic Life Support 108

Basic Life Support CPR Fractures Emergency Department 108

Pediatric EM Morsels

JUNE 9, 2023

Of course, we all have a healthy respect for post-tonsillectomy hemorrhage and we like to talk about Damage Control Resuscitation. Epub 2022 Dec 26. Perhaps thoughts of pelvic injuries or severe head injury dominate our considerations. References: Banc-Husu AM, Shiau H, Dike P, Shneider BL. Semin Liver Dis. 2023 Feb;43(1):100-116.

Pediatrics 154

Pediatrics Head Injuries Airway Management Resuscitation 154

Don't Forget the Bubbles

MAY 10, 2023

In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. Resuscitation is a team sport. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. This lets the team leader focus on resuscitation. Ready your team.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

EMDocs

NOVEMBER 29, 2023

2022 Aug;48(8):1009-1023. Resuscitation. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia. Intensive Care Med. Question: In adult patients admitted to the ICU with severe CAP, does methylprednisolone compared to placebo reduce 60-day all-cause? Prospective, multi center RCT.

Resuscitation 96

Resuscitation Outcomes EKG/ECG 96

ACEP Now

NOVEMBER 7, 2024

Scientific Rigor Red Cross resuscitation courses closely align with the International Liaison Committee on Resuscitation (ILCOR) recommendations. Major resuscitation organizations worldwide meet in this forum to share knowledge and best practices. All three leverage the latest educational methodologies.

Advances Cardiac Life Support (ACLS) 74

Advances Cardiac Life Support (ACLS) Military CPR Basic Life Support 74

RebelEM

JULY 24, 2023

This approach has been shown to benefit patients when agents like propofol and midazolam are used. ( Russotto 2022 , Choi 2004 ). There are many reasons for post-intubation hypotension including inadequate/incomplete resuscitation and ongoing hemorrhage. Paper: Driver BE et al.

Resuscitation 98

Resuscitation Outcomes Emergency Department EMS 98

EMDocs

SEPTEMBER 7, 2023

2,10 Initial stabilization of DEG toxicity includes correcting acid-base abnormalities, electrolyte abnormalities, and volume resuscitation. Volume resuscitation as needed while adjusting for any developing acute kidney injury. Accessed August 2022. FDA Consumer Magazine , June 1981, [link] Accessed August 2022.

Poisoning 92

Poisoning CDC Administration Emergency Department 92

EMDocs

NOVEMBER 20, 2023

Initial patient assessment and hemodynamic resuscitation should be performed simultaneously. DOAC reversal Recommendation: For patients on DOACs, we suggest reversal for the small subset of patients who present with a life-threatening LGIB that does not respond to initial resuscitation and cessation of the anticoagulant alone.

Resuscitation 104

Resuscitation Fluid Resuscitation Hospitals Research 104