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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

They started CPR. EMS arrived and found him in Ventricular Fibrillation (VF). For clarity in Figure-1 — I've reproduced today's ECG — obtained following successful resuscitation of out-of-hospital cardiac arrest. This patient was witnessed by bystanders to collapse. He was defibrillated into VT.

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SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

The Skeptics' Guide to EM

Resuscitation 2023. Date: January 11, 2024 Guest Skeptic: Dr. Chris Root is an EMS fellow in the Department of Emergency Medicine at the University of New Mexico Health […] The post SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

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EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Drowning, Polio, Head-up CPR

Emergency Medicine Cases

In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain management in the polytrauma, Nour Khatib on a rural EM case on management of near-drowning patient, Sara Reid delivers a polio primer, Anand Swaminathan on head-up CPR.

CPR 52
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SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

Case: You’re doing a ride along with your local emergency medical service (EMS) crews and responding to an out-of-hospital cardiac arrest (OHCA). After starting cardiopulmonary resuscitation (CPR), you note pulseless electrical activity (PEA) on the monitor.

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SGEM#453: I Can’t Go For That – No, No Narcan for Out-of-Hospital Cardiac Arrests

The Skeptics' Guide to EM

Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM. On arrival, you find a 35-year-old male, pulseless and apneic with cardio-pulmonary resuscitation (CPR) in progress by a bystander.

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A man in his 50s with unwitnessed VF arrest, defibrillated to ROSC, and no STEMI criteria on post ROSC ECG. Should he get emergent angiogram?

Dr. Smith's ECG Blog

His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. He underwent resuscitation including vasopressors, inotropic support, and intubation. What do you think?

EKG/ECG 119
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Heads Up! There is No Association with Improved Outcomes for Head Up CPR: Why We Must Read Past the Abstract

RebelEM

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. It is imperative that we continue to look at ways to improve cardiac arrest resuscitation. Head Up (HUP) CPR may be the next critical improvement.

CPR 52