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She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. You request a 12 lead ECG and repeat a blood gas, asking for it to be run on the PICU analyser. Your trusted nurse hands you the ECG: Paediatric ECG interpretation has never been your strong suit.
In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis of occlusion MI in patients with BBB and Peter Brindley on prone CPR.
You are tidying your things […] The post SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)? The nurses started CPR immediately and place pads before you even arrived. A post-arrest ECG doesn’t show any signs of STEMI. Are we supposed to be starting hypothermia?” It was also not blinded.
On arrival, CPR was continued and core temperature was measured at 18° C (64.4° A 12-lead ECG was recorded: There is sinus rhythm with RBBB and right axis deviation. Guide to this image: 30 minutes later, at 31 C, this ECG was recorded: The RBBB has resolved. The Osborn waves on ECGs #1 and #2 are huge!
For patients with OHCA, use of steroids during CPR is of uncertain benefit. Extracorporeal CPR Use of ECPR for patients with cardiac arrest refractory to standard ACLS is reasonable in select patients when provided within an appropriately trained and equipped system of care. COR 2b, LOE B-R. COR 2b, LOE C-LD. COR 2b, LOE C-LD.
However, there are no clear guidelines for management in post-cardiac arrest patients without ST-segment elevations on ECG. Clinical Question : In patients who suffer an OHCA without ST-segment elevation on the post-resuscitation ECG, will early coronary angiogram (CAG) vs. delayed CAG improve outcomes? Bougouin, W., Varenne, O.,
In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. Here is his first ECG recorded after stable ROSC: Originally recorded in 50 mm/s (the standard in Norway), here converted to 25 mm/s. The patient received therapeutic hypothermia at 33 degrees C for 24 hours. I suspect LAD or LM.
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