Dr. Smith's ECG Blog

JULY 25, 2024

They started CPR. 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. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT.

Resuscitation 106

Resuscitation EKG/ECG CPR Shock 106

RebelEM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. Paper: Eastwood G, et al. N Engl J Med. Epub 2023 Jun 15.

Hospitals 93

Hospitals Resuscitation Outcomes CPR 93

Emergency Medicine Journal

NOVEMBER 21, 2024

Background Because of their young age and lack of known comorbidities, paediatric patients with out-of-hospital cardiac arrest (OHCA) often undergo prolonged cardiopulmonary resuscitation (CPR). We aimed to determine the association between prehospital and in-hospital CPR duration and neurological outcomes.

Hospitals 52

Hospitals Outcomes Resuscitation CPR 52

Greater Sydney Area HEMS

APRIL 15, 2023

It is a rare but confronting situation where a pre-hospital and retrieval medicine team are presented with a sick newborn. As a pre-hospital and retrieval service, it’s rare for us to even be around in the first few minutes of a baby’s life, but as our colleagues described, not impossible.

Hospitals 85

Hospitals Resuscitation Hyperthermia / Hypothermia Teamwork 85

Dr. Smith's ECG Blog

JULY 14, 2023

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

Resuscitation 81

Resuscitation EKG/ECG CPR Outcomes 81

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

NOVEMBER 30, 2024

The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. 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). Date: November 10, 2024 Reference: Couper et al.

Administration 86

Administration CPR Airway Management Outcomes 86

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. Population: Patients successfully resuscitated from OHCA without a clear diagnosis on presentation who were stable for CT. Excluded: Obvious cause for OHCA prior to SDCT or on hospital arrival.

Outcomes 144

Outcomes Resuscitation Hospitals CPR 144

The Skeptics' Guide to EM

OCTOBER 22, 2022

Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival. Resuscitation 2022 Guest Skeptic: Clay Odell is a Paramedic, Firefighter, and registered nurse (RN). Resuscitation 2022 Guest Skeptic: Clay Odell is a Paramedic, Firefighter, and registered nurse (RN).

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

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. 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

CPR Outcomes Resuscitation EMS 52

Don't Forget the Bubbles

JUNE 30, 2023

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. 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. C and remained pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Mind The Bleep

DECEMBER 27, 2024

Im currently in my third year of working in a rural district general hospital Accident and Emergency Department, and one of the things that has struck me most is the use of pre-hospital medicine. Ive always had a keen interest in pre-hospital medicine. Enter Nith Inshore Rescue!

Hospitals 52

Hospitals Ambulance Services Operations Teamwork 52

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. to 1.14)), along with DAI-CPR attempts (59.5% vs 62.3% (crude OR 1.12, 95% CI 1.09

Resuscitation 52

Resuscitation Outcomes CPR Hospitals 52

EMDocs

MARCH 20, 2024

Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights Speaking in “Code” Discussing resuscitation options with patients nearing end of life “A kinder, gentler approach would benefit everyone.” “Code,” “No Code,” “CPR,” “resuscitation,” etc.

Documentation/Coding 91

Documentation/Coding Hospice Resuscitation CPR 91

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. In this study, the authors aim to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients.

Resuscitation 97

Resuscitation Outcomes CPR Hospitals 97

Don't Forget the Bubbles

DECEMBER 18, 2023

I think we should stop resuscitation. How long should you try to resuscitate? There are no hard and fast rules as to how long a resuscitation attempt should be carried out. We might continue resuscitation attempts longer than usual to allow family members to arrive and hold the child’s hand or be at the bedside when we stop.

Resuscitation 131

Resuscitation Outcomes CPR Hospitals 131

Emergency Medicine Journal

SEPTEMBER 27, 2023

Jiun-Hao Yu and colleagues’ study 2 also mentioned that before and during the pandemic, the performance of bystander CPR in public places remained similar, whereas bystander CPR at home increased during the pandemic period. However, research conducted by Keita Shibahashi’s group suggests otherwise.

Resuscitation 40

Resuscitation Hospitals CPR Research 40

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Reference: Cashen K, Reeder RW, Ahmed T, et al.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

ACEP Now

DECEMBER 6, 2024

Before nitroglycerin (NTG) could be administered, the patient became unresponsive and was transferred to the resuscitation bay, where the monitor revealed a ventricular fibrillation arrest. After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

Don't Forget the Bubbles

NOVEMBER 29, 2023

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This is referred to as CPR I nduced C onsciousness ( CPRIC ). Education and re-education should be offered where this information or knowledge is lacking, whether in the pre-hospital or hospital settings.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Emergency Medicine Journal

MAY 23, 2023

Background Whether and how bystander cardiopulmonary resuscitation (CPR) modifies the cardiac rhythm after out-of-hospital cardiac arrest (OHCA) over time remains unclear. Results Of 309 900 patients with witnessed OHCA of cardiac origin, 71 887 (23.2%) received bystander CPR. to 1.69; p<0.001). to 1.69; p<0.001).

Resuscitation 40

Resuscitation CPR Hospitals Documentation/Coding 40

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. February 2024.

Resuscitation 74

Resuscitation Airway Management EMS Outcomes 74

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

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.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 40

EMDocs

JANUARY 16, 2024

He subsequently walks out of the hospital with a normal neurologic exam two weeks after admission. Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

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

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 88

CPR Burns Airway Management Wellness 88

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.

Advances Cardiac Life Support (ACLS) 96

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

ACEP Now

NOVEMBER 7, 2024

Despite the broad acceptance of Red Cross certifications by national accrediting bodies, state agencies, and thousands of hospitals and clinics, some medical centers, nursing schools, and community colleges have policies that do not recognize both organizations’ certifications. All three leverage the latest educational methodologies.

Advances Cardiac Life Support (ACLS) 74

Advances Cardiac Life Support (ACLS) Military CPR Basic Life Support 74

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

RebelEM

SEPTEMBER 14, 2023

Did they get bystander CPR? At our institution patients do not go for diagnostic heart catheterization and then get put on ECMO, they are initiated on ECMO during the time of their initial resuscitation and then go for heart catheterization once they are stabilized. Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 9.6%

Shock 134

Shock Outcomes Resuscitation Stroke 134

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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. Resuscitation. Resuscitation. Resuscitation. Resuscitation.

CPR 52

CPR Resuscitation Hospitals Outcomes 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 60

Hospitals Outcomes EKG/ECG Resuscitation 60

Emergency Medicine Cases

MARCH 14, 2017

But, over the past 15 years, survival to discharge from pediatric cardiac arrest has markedly improved, at least for in-hospital arrests.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

Don't Forget the Bubbles

MAY 10, 2023

They’re getting CPR. Resuscitation is a team sport. As you arrive in resus, so too do half the children’s hospital. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. This lets the team leader focus on resuscitation. It was the most phenomenal resuscitation.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91