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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. Evidence of right heart strain is important but the evidence of fibrinolysis during arrest is mixed with many studies showing no 30-day mortality benefit to lysing during a code.

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REBEL Cast Ep119: A Discussion with Scott Weingart on the CT FIRST Trial

RebelEM

Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study. The CT FIRST Trial: Should We Pan-CT After ROSC?, REBEL EM Blog, June 1, 2023. Available at: HERE Branch KHR et al.

CPR 144
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The Latest in Critical Care, 1/29/24 (Issue #27)

PulmCCM

Read the document for all the details (it’s not long). Epinephrine remains the drug of choice during CPR Epinephrine remains the first-line therapy for cardiac arrest due to non-shockable rhythms (i.e., three shocks with 2 minutes CPR in between) have been performed. ECMO used as CPR is referred to as ECPR.)

Seizures 115
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Cervical Spine Imaging in Kids – the PECARN rule

Don't Forget the Bubbles

A proportion of the patients who were initially missed using the CDR were found to actually have risk factors documented in EMS reports or the medical record. CASP checklist for Clinical Prediction Rule (CPR) studies Is CPR clearly defined? Were the predictor variables and the outcome evaluated in a blinded fashion?

CPR 124
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Issue #3: The Latest in Critical Care, 6/5/23

PulmCCM

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. There was no significant difference in survival with a favorable neurologic outcome at 30 days (20% vs 16% nominally favoring the ECMO group, P=0.52) or at 6 months. makes me long for an adequately powered randomized trial. In the U.S.,

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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 134
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Case Report: Coronary Vasospasm-Induced Cardiac Arrest

ACEP Now

After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia. This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm.