Don't Forget the Bubbles

JUNE 19, 2024

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

CPR Research Documentation/Coding Outcomes 124

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

Hyperthermia / Hypothermia 104

Hyperthermia / Hypothermia Resuscitation CPR EMS 104

The Skeptics' Guide to EM

JULY 22, 2023

NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar.

EMS 88

EMS CPR Ultrasounds Research 88

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? CPR is currently in progress with a single shock having been delivered.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

RebelEM

AUGUST 21, 2023

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.

Hospitals 92

Hospitals Resuscitation Outcomes CPR 92

RebelEM

JANUARY 29, 2024

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). to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 133

Stroke Outcomes Hospitals Administration 133

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. When EMS arrived the patient was in ventricular fibrillation. Written by Willy Frick A man in his 50s was at home with his family when they heard a thud and rushed into the room to find him unconscious with agonal respirations.

EKG/ECG 120

EKG/ECG CPR EMS Hospitals 120

The Skeptics' Guide to EM

MAY 8, 2021

He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. CPR is initiated and a hospital rapid response team is called.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

RebelEM

SEPTEMBER 28, 2023

appeared first on REBEL EM - Emergency Medicine Blog. neoplasm, aneurysm, intracranial or spinal surgery) or recent trauma to head or cranium (i.e. Primary PCI: 95.7% Stents Placed: Pharmaco-Invasive Treatment: 97.4% Primary PCI: 95.7% ECG Results: Repeat ECG 90min after tenecteplase indicated 70.3% Primary PCI: 78.4% Primary PCI: 13.3%

EKG/ECG 137

EKG/ECG Allergic Reactions Shock Stroke 137

Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. The patient awoke and had a good outcome! An elderly man collapsed. Medics found him in ventricular fibrillation. Finally , the pacer is a biventricular pacer for " CRT = cardiac resynchronization therapy."

EKG/ECG 134

EKG/ECG Shock CPR Stroke 134

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

The Skeptics' Guide to EM

MARCH 11, 2023

He is a former New York City paramedic and this summer will be starting fellowship training in EMS medicine at UNM. A fire company is on scene providing high-quality cardiopulmonary resuscitation (CPR) and has defibrillated twice with an automated external defibrillator (AED). Reference: Smida et al.

Airway Management 52

Airway Management Basic Life Support CPR Resuscitation 52

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. Key to survival is high-quality CPR and early defibrillation.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

RebelEM

NOVEMBER 20, 2023

Outcome: Primary Outcome: All-cause mortality at 90 days. The primary outcome focused on patient-centered outcomes. The outcomes were predominantly binary and objective, reducing the potential for subjective interpretation and bias. 97% of patients sustained blunt trauma. 97% of patients sustained blunt trauma.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

The Skeptics' Guide to EM

AUGUST 14, 2021

Missy is also now the director for Difficult Airway EMS course in Washington State Case: An EMS crew arrives to your emergency department (ED) with a 58-year-old female who suffered a witnessed ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA). Background: We have covered OHCA multiple times on the SGEM.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

PEMBlog

AUGUST 20, 2024

This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. So, eCPR, extracorporeal cardiopulmonary resuscitation, is an advanced medical procedure used in cases of cardiac arrest where traditional CPR has failed.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. You need to recognize an arrest and activate your EMS system. vs. 5.1%, p=0.83).

CPR 52

CPR Academics Resuscitation Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

EMS recorded the following ECG: What do you see? It is highly associated with proximal LAD occlusion and bad outcomes. A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. I have annotated it here: The lines mark the end of the QRS and beginning of the ST segment.

CPR 52

CPR Resuscitation EKG/ECG Outcomes 52

The Skeptics' Guide to EM

DECEMBER 25, 2021

Case: An EMS crew arrives at the home of a 68-year-old suffering from a witnessed out-of-hospital cardiac arrest (OHCA). Bystander CPR is being performed. The paramedics performed high-quality CPR and follow their ACLS protocol. The paramedics performed high-quality CPR and follow their ACLS protocol.

CPR 52

CPR Administration Outcomes Hospitals 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). There was also no increase in survivors with good neurological outcomes with ACLS. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service. He is unsuccessfully shocked.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

MAY 20, 2023

Case: You are working at the community emergency department (ED) when you receive a call from the local Emergency Medicine Service (EMS) team that they are bringing a 2-year-old boy who had a cardiac arrest at home. They started cardiopulmonary resuscitation (CPR) until EMS arrived.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Advanced Emergency Nursing from AENJ

NOVEMBER 27, 2017

AHA statements are labeled with" [AHA]" We can now expect more frequent and closer cycling and knowledge translation from the laboratory workbench or studies of cases and outcomes to our own practice. DISPATCH-ASSISTED COMPRESSION-ONLY CPR COMPARED WITH DISPATCH-ASSISTED CONVENTIONAL CPR (ADULTS): CONSENSUS ON SCIENCE.

CPR 40

CPR Basic Life Support Resuscitation Pediatrics 40

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. The TOMAHAWK Investigators.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

PHEM Cast

APRIL 16, 2018

The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Use of CPR in hemorrhagic shock, a dog model. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. Anneals of EM; 2015: 297-307. 2012; 73: 102-10.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

The Skeptics' Guide to EM

NOVEMBER 16, 2019

NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Research Documentation/Coding 40

The Skeptics' Guide to EM

DECEMBER 2, 2017

SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine? From a patient oriented outcome perspective, more than 80% of adults with IHCA who do survive end up having a favorable neurologic outcome at discharge. The survival rate for adults to hospital discharge is 24.8%.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

Ziqitza HealthCare Ltd

MARCH 26, 2024

In this critical field of emergency medical services (EMS), Ziqitza Health Care Limited leads from the front, providing top-notch ambulance services across various regions. Whether it’s administering medications, performing CPR, or managing airway obstructions, simulation allows for targeted skill development and feedback.

Mass Casualty Incidents 52

Mass Casualty Incidents Ambulance Services Teamwork Basic Life Support 52

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. 1.15; P= 0.32 1.15; P= 0.31

Hospitals 59

Hospitals Outcomes EKG/ECG Resuscitation 59

All Ohio EM

OCTOBER 26, 2018

The criteria to start ECMO are witnessed arrest with bystander CPR within 10 minutes, ECMO started within 75 minutes (!), In the 25 years since CTPA became readily available to us in the ED, we’ve increased the diagnosis of PE 10-fold without decreasing the number of bad outcomes at all. no terminal conditions or DNR.

CPR 52

CPR Sepsis Stroke EMS 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

EMS recorded the following ECG: What do you see? It is highly associated with proximal LAD occlusion or severe left main ACS and with bad outcomes. Unfortunately, I don't know the answer to those questions, but this ST elevation should be assumed to be ischemic until proven otherwise. So this is diagnostic of proximal LAD occlusion.

EKG/ECG 40

EKG/ECG CPR Resuscitation Outcomes 40

AED Leader

SEPTEMBER 26, 2024

In sudden cardiac arrest cases, this device steps in where CPR alone can’t do the job. S-ICDs received FDA approval in 2012 and have improved implantation techniques for shorter procedural times and better cosmetic outcomes. for those shocked by emergency medical services (EMS)? That’s pretty remarkable, right?

Shock 52

Shock CPR Hospitals EMS 52

AED Leader

SEPTEMBER 27, 2024

These devices can be used by trained laypersons, allowing more individuals within communities to provide immediate assistance during emergencies, ultimately contributing to better outcomes and increased chances of survival for those experiencing sudden cardiac arrest. minutes compared to an average EMS response time of 9.8

Shock 52

Shock Operations CPR Outcomes 52

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

If doing what was called "the one-man-band resurrection shuffle" [single person CPR in the back of a moving ambulance], this worked very well, as the bag would stay hanging there on the patient's face. These indices would have reinforced the clinical decision progress and avoided bad outcomes from unsuccessful estimates.

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

EB Medicine

MARCH 1, 2019

Jeff: And don’t forget to get the crash details from the EMS crew before they depart! As a side note, for anyone taking oral boards in a few months, don’t forget to ask the EMS crew for the details!!! Early defibrillation is linked to better outcomes. of cases and contributed to the death of 45.2% of those patients.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Intensive Blog

MARCH 13, 2024

However, as practice has been refined and populations of patients who may benefit have been identified 5 , the use of extracorporeal CPR (ECPR) has been rapidly growing. The Steps of CPR reported in the Journal of Iowa Medical Society in 1964 by Peter Safar. Image source: File:Steps of CPR-1964.jpg jpg – Wikimedia Commons.

CPR 130

CPR Resuscitation Hospitals Outcomes 130

Don't Forget the Bubbles

MAY 3, 2023

Results of this study showed that the use of low-dose insulin infusion led to similar clinical outcomes and fewer adverse events compared to the standard-dose insulin infusion. Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children? Why does it matter? Resuscitation.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

RebelEM

DECEMBER 19, 2022

At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here.

EMS 52

EMS CPR Shock Resuscitation 52