Emergency Medicine Journal

OCTOBER 26, 2023

Background Extracorporeal cardiopulmonary resuscitation (ECPR) is a treatment method for refractory out-of-hospital cardiac arrest (OHCA) requiring a complex chain of care. All patients received mechanical CPR, epinephrine and/or amiodarone. Cases of hypothermic cardiac arrest were excluded. –6.9)

Hospitals 75

Hospitals CPR Resuscitation Outcomes 75

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. N Engl J Med. Epub 2023 Jun 15.

Hospitals 96

Hospitals Resuscitation Outcomes CPR 96

Emergency Medicine Journal

OCTOBER 26, 2023

Objective Over 300 000 cases of out-of-hospital cardiac arrests (OHCAs) occur each year in the USA and Europe. Primary outcome was survival at hospital discharge with a good neurological outcome. Conclusion In a two-tiered rescue system, survival from OHCA at hospital discharge doubled over a 13-year study period.

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

RebelEM

SEPTEMBER 19, 2022

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. Over the years, we as a scientific community have worked extensively to find other interventions that improve outcomes. Article: Moore JC et al.

CPR 52

CPR Outcomes Resuscitation EMS 52

RebelEM

JUNE 1, 2023

Background: Achieving ROSC in out of hospital cardiac arrest (OHCA) is no easy feat but, care doesn’t end with ROSC. Post-ROSC management is nuanced and challenging but helps to ensure good outcomes. In theory, rapid identification of the underlying cause should improve outcomes by allowing clinicians to tailor management.

Outcomes 145

Outcomes Resuscitation Hospitals CPR 145

Don't Forget the Bubbles

JUNE 30, 2023

She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Despite good quality CPR, there is no ROSC. Despite good quality CPR, there is no ROSC. Despite good quality CPR, there is no ROSC. Emergency Medical Services found her apneic and pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

PulmCCM

JANUARY 29, 2024

automated external cooling system) for all arrest patients (with any presenting rhythm, occurring in- or out-of-hospital) maintained for at least 24 hours; longer periods of fever prevention (which AHA now calls “temperature control”) for persistently comatose patients are also considered reasonable. PEA and asystole).

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care.

Resuscitation 93

Resuscitation Airway Management EMS Outcomes 93

Emergency Medicine Journal

JULY 24, 2023

Background Improving out-of-hospital cardiac arrest (OHCA) prognosis within the working-age population is important, but no studies have investigated the effects of COVID-19 pandemic specifically on the working-age population with OHCAs. The primary outcome was neurologically favourable 1-month survival (cerebral performance category 1 or 2).

Resuscitation 52

Resuscitation Outcomes CPR Hospitals 52

ACEP Now

MARCH 10, 2025

Dedication to your community may expand into areas of passion and/or vocation as you create CPR education workshops for your communitys daycares and schools. Dr. Koo is faculty and an emergency physician at MedStar Washington Hospital Center in Washington, D.C., Marys Hospital in Leonardtown, Maryland. References Nyanchama V.

Academics 85

Academics Wellness CPR Hospitals 85

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 136

Stroke Outcomes Hospitals Administration 136

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. JAMA Cardiol.

Hospitals 62

Hospitals Outcomes EKG/ECG Resuscitation 62

Taming the SRU

MARCH 27, 2024

Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial. The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. Crit Care 2024;28(1):28. There were 114 patients included in the final analysis.

Resuscitation 99

Resuscitation CPR Outcomes Hospitals 99

Don't Forget the Bubbles

NOVEMBER 29, 2023

A retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009 in the US revealed that less than one-half of patients undergoing ETI in the ED received sedative drugs while in the ED. This is referred to as CPR I nduced C onsciousness ( CPRIC ). MD * ; Rueger, Johannes M.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

RebelEM

SEPTEMBER 14, 2023

to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% Did they get bystander CPR? Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81 Control: 9.6% D ECLS: 18.2%

Shock 136

Shock Outcomes Resuscitation Stroke 136

Don't Forget the Bubbles

JUNE 19, 2024

This may limit the generalisability of the results in regional/community hospital settings. CASP checklist for Clinical Prediction Rule (CPR) studies Is CPR clearly defined? Were the predictor variables and the outcome evaluated in a blinded fashion? What were the limitations of the study?

CPR 124

CPR Research Documentation/Coding Outcomes 124

The Skeptics' Guide to EM

FEBRUARY 25, 2023

2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

The Bottom Line

FEBRUARY 27, 2023

In patients with refractory out-of-hospital cardiac arrest (OHCA) and an initial ventricular arrhythmia, does extracorporeal cardiopulmonary resuscitation (ECPR), as compared with conventional CPR (CCPR), improve survival with a favourable neurologic outcome

CPR 65

CPR Resuscitation Outcomes Hospitals 65

Don't Forget the Bubbles

DECEMBER 18, 2023

We might consider how long the child has been in cardiac arrest – the longer the time, particularly if there was any time without CPR, the less likely they are to regain circulation. There are many reasons we may continue resuscitation beyond the period when we hope for a good outcome. Maybe that’s still a form of good outcome?

Resuscitation 131

Resuscitation Outcomes CPR Hospitals 131

EMDocs

JANUARY 16, 2024

He subsequently walks out of the hospital with a normal neurologic exam two weeks after admission. Patients can have excellent outcomes despite prolonged resuscitation. Our patient’s HOPE Score estimated he had a 78% chance of survival to hospital discharge. The patient is extubated and decannulated four days later.

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

Critical Care Now

JULY 14, 2024

Several meta-analyses examining the efficacy of eCPR have been published, including either patient data from RCTs or data from both RCTs and observational trials, with the results indicating either a statistically significant benefit in neurologically favorable survival, or no difference with eCPR compared to conventional CPR.

Resuscitation 98

Resuscitation CPR Outcomes Sepsis 98

PulmCCM

JUNE 5, 2023

veterans’ hospitals did not show a mortality reduction from low-dose methylprednisolone. Patients receiving hydrocortisone required more insulin, but did not have higher observed rates of hospital-acquired infections or gastrointestinal bleeding. iatrogenic or hospital-acquired) were excluded. In the U.S.,

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

Taming the SRU

MAY 10, 2024

r4 Capstone WITH Dr. Stark Learn from your poor patient outcomes. hypovolemia, PTX, and cardiac tamponade are common causes of death in the setting of a traumatic arrest and CPR is unlikely to be beneficial in any of these causes based on available animal studies. who may benefit from CPR in traumatic arrest? Role of epi in TCA?

Leadership 84

Leadership CPR Head Injuries Hospitals 84

RebelEM

SEPTEMBER 28, 2023

In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact. In these cases, thrombolysis is recommended to improve morbidity and mortality. Primary PCI: 95.7%

EKG/ECG 138

EKG/ECG Allergic Reactions Shock Stroke 138

The Skeptics' Guide to EM

FEBRUARY 3, 2023

Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital. Circulation. Circulation.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Documentation/Coding CPR 52

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope. ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

RebelEM

NOVEMBER 20, 2023

Outcome: Primary Outcome: All-cause mortality at 90 days. Patients in the standard care alone group had more intensive care unit-free and hospital-free days. The primary outcome focused on patient-centered outcomes. 97% of patients sustained blunt trauma. 97% of patients sustained blunt trauma.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. He was intubated in the field and sedated upon arrival at the hospital. At his family's request, he was transferred to a hospital closer to his home to continue care. When EMS arrived the patient was in ventricular fibrillation.

EKG/ECG 118

EKG/ECG CPR EMS Hospitals 118

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. The episode highlights the importance of understanding eCPR as a critical therapy for both in-hospital and out-of-hospital cardiac arrests. cardiac rhythms.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

The Skeptics' Guide to EM

DECEMBER 2, 2017

Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival. DISCLAIMER: The views and opinions of this podcast do not […] The post SGEM#197: Die Trying – Intubation of In-Hospital Cardiac Arrests first appeared on The Skeptics Guide to Emergency Medicine. Reference: Andersen et al.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

The Skeptics' Guide to EM

JULY 22, 2023

The conclusion from that episode was it’s still uncertain if using etomidate decreases the patient-oriented outcome of survival with good neurologic function in critically ill patients requiring emergent endotracheal intubation. The take home message from those two episodes was that the airway is less important in adult OHCAs.

EMS 98

EMS CPR Ultrasounds Research 98

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. They had a difficult time getting a definitive airway pre-hospital. It required multiple attempts which caused several prolonged interruptions in CPR.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

Taming the SRU

OCTOBER 5, 2023

morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS (..)

Stroke 91

Stroke EKG/ECG Seizures CPR 91

The Skeptics' Guide to EM

MAY 8, 2021

CPR is initiated and a hospital rapid response team is called. Background: Cardiac arrests have high morbidity and mortality rates both in-hospital cardiac arrests (IHCAs) and out of hospital cardiac arrests (OHCAs). This contrasts with what the public sees watching CPR being done on TV.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

The Skeptics' Guide to EM

FEBRUARY 11, 2023

NEJM 2022 Guest Skeptic: Dr. Sean Moore is an emergency physician working in Kenora Ontario, where he is Chief of Staff at Lake of the Woods District Hospital, Northern Medical Director for the Ornge air medical transport program and associate medical director with CritiCall Ontario. An anesthetist is working with him for the procedures.

Shock 57

Shock CPR Hyperthermia / Hypothermia Hospitals 57

ED ECMO

FEBRUARY 23, 2021

Make sure to get CPR Certification Cleveland so you can always be prepared in case of any emergency. Zack invited Brian Grunau to discuss these topics as well as a recent ECPR paper out of Norway and study dealing with signs of life during CPR. What strategy gives the most benefit to the most people? Resuscitation. 2021.01.038.

CPR 52

CPR Resuscitation Hospitals Outcomes 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? Some specific considerations could be: Team Who will be the trauma team leader? Do I need a trauma team activation?

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59