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Ultrasound in Cardiac Arrest

Mount Sinai EM

Initially, data suggested that the use of ultrasound during arrest increased pauses between compressions which worsens outcomes. The ideal view depends on the patient’s comorbid conditions such as COPD, obesity, cachexia, etc. survival to hospital discharge rate.

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emDOCs Podcast – Episode 116: Massive Hemoptysis

EMDocs

Physiologic dead space higher in chronic lung disease (COPD). Poor candidates: underlying pulmonary disease like COPD, lung cancer, bronchiectasis. Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Anatomic dead space is approximately 150 mL.

COPD 81
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TAME Trial: Mild Hypercapnia vs Normocapnia in Out-of-Hospital Cardiac Arrest

RebelEM

This trial aimed to assess whether targeted therapeutic mild hypercapnia (TTMH) applied during the initial 24 hours of mechanical ventilation in the ICU can enhance neurological outcomes at the 6-month mark, as compared to standard care, which involves targeted normocapnia (TN). Paper: Eastwood G, et al. N Engl J Med. Epub 2023 Jun 15.

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A Comprehensive Guide to Surgical Clerking

Mind The Bleep

Ensure you management plan includes how you plan to rule out any immediate concerns and what the outcome is likely to be if normal. Your trust will have guidelines on the treatment regimen using chlordiazepoxide/lorazepam and pabrinex. Ensure that there is a Treatement Escalation Plan and/or a DNACPR in place if required.

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Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

It can be used to distinguish between various conditions, including chronic obstructive pulmonary disease (COPD) exacerbation, acute heart failure (AHF), pleural effusion, pulmonary edema, pericardial effusion, pneumothorax, and pneumonia [2,3]. Patients : Compared standard of care to serial US plus stand care in patients with dyspnea.

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BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED

RebelEM

AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20

COPD 133
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ECG Blog #366 — Diltiazem didn't work.

Ken Grauer, MD

Applying the Above to Today's Case: In addition to being Covid-positive — the patient in today's case had longstanding COPD. He was wheezing, and required supplemental oxygen.

EKG/ECG 195