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. Reassess again after another 30s.

Hospitals 85

Hospitals Resuscitation Hyperthermia / Hypothermia Teamwork 85

RebelEM

SEPTEMBER 28, 2023

In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. Thrombolysis in Myocardial Infarction Flow Grade 3 at Last Angiography was ≈87% in both groups Composite of Death, Shock, Heart Failure, or Reinfarction: Pharmaco-Invasive Treatment: 12.8% Primary PCI: 95.7% Primary PCI: 95.7% Primary PCI: 78.4%

EKG/ECG 138

EKG/ECG Allergic Reactions Shock Stroke 138

PulmCCM

JUNE 5, 2023

Corticosteroids for community-acquired pneumonia have been studied with inconclusive results, and expert guidelines currently advise against their use except in patients with refractory septic shock. veterans’ hospitals did not show a mortality reduction from low-dose methylprednisolone. standards of care.

Advances Cardiac Life Support (ACLS) 96

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

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

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 124

Resuscitation EKG/ECG CPR Shock 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

Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. Then the patient's electronic record from an outside hospital appeared. Patient received 11 shocks by ICD and was in V-fib when EMS arrived.

EKG/ECG 133

EKG/ECG Shock CPR Stroke 133

AED Leader

APRIL 22, 2024

It is estimated that over 350,000 cases of out-of-hospital cardiac arrests occur annually in the United States alone. The Role of AEDs in Sudden Cardiac Arrest AEDs are portable electronic devices designed to deliver an electric shock to the heart and restore its rhythm during SCA.

CPR 52

CPR Shock Resuscitation Operations 52

EMDocs

JANUARY 8, 2024

Emergent coronary angiography is not recommended over a delayed or selective strategy in patients with ROSC after cardiac arrest in the absence of ST-segment elevation, shock, electrical instability, signs of significant myocardial damage, and ongoing ischemia (Level 3: no benefit). o C recommended (Level 1: strong). COR 2b, LOE B-R.

Seizures 98

Seizures Shock CPR Hyperthermia / Hypothermia 98

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. They shocked him twice before return of spontaneous circulation. 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.

EKG/ECG 118

EKG/ECG CPR EMS Hospitals 118

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.

CPR 90

CPR Burns Airway Management Wellness 90

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. 1.15; P= 0.32

Hospitals 62

Hospitals Outcomes EKG/ECG Resuscitation 62

EMDocs

OCTOBER 9, 2023

1 Though hydrocortisone is often included in ‘crash carts,’ the most recent consensus on cardiopulmonary resuscitation (CPR) has a weak recommendation against the use of corticosteroids during CPR. 6 However, due to the vasoconstrictive effects, hydrocortisone may be useful in refractory shock. 2015;116(6):960-975.

Basic Life Support 109

Basic Life Support CPR Fractures Emergency Department 109

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

The Skeptics' Guide to EM

AUGUST 14, 2021

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Date: August 12th, 2021 Reference: Daya et al.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

AED Leader

SEPTEMBER 21, 2024

Why is defibrillation important Defibrillation is the process of delivering an electrical shock to a person experiencing life-threatening heart rhythms, like ventricular fibrillation (VF) or pulseless ventricular tachycardia. It serves as the only effective treatment outside of a hospital setting that can save lives.

CPR 52

CPR Shock Resuscitation Hospitals 52

EMDocs

JANUARY 16, 2024

He subsequently walks out of the hospital with a normal neurologic exam two weeks after admission. 10 The score predicts the probability of survival to hospital discharge using a number of factors including CPR duration, serum potassium, core temperature, age, and suspected mechanism of hypothermia. Resuscitation 2018.

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

AED Leader

OCTOBER 5, 2023

Ambulance worker Shaun McBride suddenly collapsed after strapping 72-year-old patient Tommy Stewart into a vehicle for transfer from Glen O’Dee Hospital in Banchory to Aberdeen Royal Infirmary in Scotland. Mr. Stewart couldn’t reach the horn but yelled for help until a hospital caterer came out and nurse Freya Smith-Nicol was alerted.

CPR 52

CPR Shock Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Assessment was severe sudden cardiogenic shock. He remained hypotensive and in shock. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

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

Stroke 136

Stroke Outcomes Hospitals Administration 136

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

AED Leader

JULY 19, 2023

According to 2022 statistics from the American Heart Association, there are more than 356,000 out-of-hospital cardiac arrests in the United States every year and just over 10% of EMS-treated victims survive to hospital discharge. What Are the Benefits of a WiFi AED? cprINSIGHT Analysis. cprINSIGHT Analysis. LIFELINKcentral.

CPR 52

CPR Shock EKG/ECG Hospitals 52

AED Leader

AUGUST 22, 2024

By delivering an electric shock to restore normal heart rhythm in cases of ventricular fibrillation or other arrhythmias, AEDs play a vital role in increasing survival rates following sudden cardiac arrests. If it detects such a problem, it delivers an electric shock to restore normal heart function.

CPR 52

CPR Shock Operations Outcomes 52

RebelEM

NOVEMBER 20, 2023

Military practice guidelines recommend REBOA for profound shock (SBP <90mmHg) 1 and ACEP along with the American College of surgeons recommend REBOA for traumatic life-threatening hemorrhage below the diaphragm in patients with hemorrhagic shock who are unresponsive or transiently responsive to resuscitation.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

AED Leader

SEPTEMBER 26, 2024

This device can shock the heart back into rhythm. Key takeaways Defibrillators are devices that send electrical shocks to the heart to fix dangerous rhythms. AEDs can save lives outside hospitals by giving quick shocks when someone has a sudden cardiac arrest. It sends an electrical shock to the heart.

Shock 52

Shock CPR Hospitals EMS 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). He is unsuccessfully shocked.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

JANUARY 9, 2021

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

Don't Forget the Bubbles

JULY 26, 2023

For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. Typical features include: HR >220bpm Narrow complex regular tachycardia P waves difficult to identify In this case there is no shock present so we can proceed to the right branch of the ALSG guideline.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

AED Leader

DECEMBER 2, 2024

Furthermore, regular maintenance and training in cardiopulmonary resuscitation (CPR) techniques significantly enhance the potential effectiveness of AEDs in emergencies. Defibrillation: Once a dangerous rhythm is detected, the AED delivers a controlled electric shock to help restore normal heart rhythm.

CPR 52

CPR Basic Life Support Resuscitation Hospitals 52

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. I know, depressing thought.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

AED Leader

SEPTEMBER 22, 2024

Portable defibrillators have become game-changers in saving lives during sudden cardiac arrest situations outside the hospital. They check the heart’s rhythm and send a shock to help it beat right again. When buying an AED, consider ease of use, maintenance costs, and features like CPR guidance. The neat part?

CPR 52

CPR Shock Operations Hospitals 52

RebelEM

DECEMBER 19, 2022

This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF).

EMS 52

EMS CPR Shock Resuscitation 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. Effect of adrenaline on survival in out of hospital cardiac arrest: randomised double-blind placebo controlled trial. 2012; 73: 102-10. Doi: 1098/rstb.2010.0232

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

Stop and Think

JANUARY 10, 2024

One scenario that doctors considered dire enough to use ECLS occurs when CPR does not work to restore circulation. In January, Dutch investigators published results of the INCEPTION trial, in which extracorporeal cardiopulmonary resuscitation (CPR) or conventional CPR (standard advanced cardiac life support) were compared.

CPR 44

CPR Shock Outcomes Resuscitation 44

AED Leader

SEPTEMBER 25, 2024

Features like real-time CPR feedback can make some models more expensive. AEDs work by delivering an electric shock to the heart to restore its normal rhythm – simple and quick! It checks the heart’s rhythm and can send an electric shock to the heart to try to restore a normal rhythm. It sends an electrical shock.

Emergency Medical Responders 52

Emergency Medical Responders CPR Shock Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

She was in shock with thready pulses. The rate is not fast enough to be causing shock, so if it is VT, the priority is still to treat hyperK and secondarily to cardiovert. They thought it was VT, but did not shock. On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound.

Shock 40

Shock EKG/ECG Resuscitation Ultrasounds 40

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. The TOMAHAWK Investigators.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52