The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. On arrival, you find a 35-year-old male, pulseless and apneic with cardio-pulmonary resuscitation (CPR) in progress by a bystander. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in Cali. JAMA Network Open.

Hospitals 98

Hospitals CPR EMS Outcomes 98

Emergency Medicine Journal

JULY 24, 2023

We aimed to determine the association between the 2020 COVID-19 pandemic and OHCA outcomes and bystander resuscitation efforts among the working-age population. We compared characteristics and outcome differences of the arrests between three prepandemic years (2017–2019) and the pandemic year 2020.

Resuscitation 52

Resuscitation Outcomes CPR Hospitals 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

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. Hill, J.

Resuscitation 98

Resuscitation Outcomes CPR Hospitals 98

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% 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%

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Shock Outcomes Resuscitation Stroke 130

PulmCCM

JANUARY 29, 2024

Epinephrine remains the drug of choice during CPR Epinephrine remains the first-line therapy for cardiac arrest due to non-shockable rhythms (i.e., No new evidence arose to alter the usual schedule of administering 1 mg epinephrine as quickly as possible, then every 3 to 5 minutes while CPR is ongoing. PEA and asystole).

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

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

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. Figure 2 : Extended Glasgow Outcome Scale (GOS-E) (credit: Doc_HG ) Secondary Modified Rankin Score Secondary outcomes included death within 6 months.

Hospitals 88

Hospitals Resuscitation Outcomes CPR 88

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 77

Resuscitation Airway Management EMS Outcomes 77

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

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

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

Don't Forget the Bubbles

NOVEMBER 29, 2023

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. This is referred to as CPR I nduced C onsciousness ( CPRIC ). Burgart, A.M.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

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

Dr. Smith's ECG Blog

OCTOBER 20, 2013

Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. Because the patient had asystole, was resuscitated without difficulty, and had no neurologic function, suspected a cerebral hemorrhage was suspected as the etiology of the arrest, specifically subarachnoid hemorrhage. Sprenkle M. Bachour FA.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Emergency Department 52

AED Leader

APRIL 22, 2024

Lifepak AED Defibrillators: Cutting-Edge Technology Lifepak AED defibrillators are at the forefront of AED technology, incorporating advanced features and innovations to improve outcomes in cases of sudden cardiac arrest. This feature helps rescuers optimize their CPR technique and improve the chances of a successful resuscitation.

CPR 52

CPR Shock Resuscitation Operations 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. Extracorporeal Cardiopulmonary Resuscitation. Starting an extracorporeal cardiopulmonary resuscitation program: success is in the details.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

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

The Skeptics' Guide to EM

MARCH 11, 2023

A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Date: March 8, 2023 Reference: Smida et al.

Airway Management 52

Airway Management Basic Life Support CPR Resuscitation 52

JournalFeed

MARCH 16, 2024

Source: Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis.

CPR 52

CPR Resuscitation Hospitals Outcomes 52

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

I sent it to 5 of my OMI friends without any clinical information or outcome and all 5 independently responded with exactly the same diagnosis: "reperfused inferior OMI". Resuscitative attempts were initiated quickly. There is ischemic ST depression in V4-V6. This is diagnostic of ACS; it appears to be a reperfused acute inferior OMI.

EKG/ECG 138

EKG/ECG Resuscitation CPR Emergency Department 138

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. It required multiple attempts which caused several prolonged interruptions in CPR. Key to survival is high-quality CPR and early defibrillation.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

AED Leader

JULY 5, 2024

It features a clear and intuitive interface that guides users through the resuscitation process with step-by-step voice prompts and visual instructions. Smart CPR Guidance Cardiopulmonary resuscitation (CPR) is a critical component of saving a life during a cardiac arrest.

CPR 52

CPR Resuscitation Shock Pediatrics 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 90

Stroke EKG/ECG Seizures CPR 90

PulmCCM

JUNE 5, 2023

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. There was no significant difference in survival with a favorable neurologic outcome at 30 days (20% vs 16% nominally favoring the ECMO group, P=0.52) or at 6 months. makes me long for an adequately powered randomized trial.

Advances Cardiac Life Support (ACLS) 96

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

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

His primary interests are resuscitation, prehospital critical […] The post SGEM#231: You’re So Vein – IO vs. IV Access for OHCA first appeared on The Skeptics Guide to Emergency Medicine. His primary interests are resuscitation, prehospital critical care, airway management, and point-of-care ultrasound.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

AED Leader

JULY 3, 2024

Real-Time CPR Feedback Performing cardiopulmonary resuscitation (CPR) correctly is crucial for the success of a resuscitation attempt. Cardiac Science AEDs feature real-time CPR feedback, providing users with valuable guidance during chest compressions.

CPR 52

CPR Resuscitation Pediatrics Operations 52

The Skeptics' Guide to EM

MAY 8, 2021

CPR is initiated and a hospital rapid response team is called. The resuscitation team arrives and ACLS protocols are continued. This contrasts with what the public sees watching CPR being done on TV. Improving outcomes for patients with cardiac arrests has been an ongoing challenge in pre-hospital and in hospital medicine.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

AED Leader

SEPTEMBER 21, 2024

Incorporating defibrillation into Cardiopulmonary Resuscitation (CPR) significantly enhances survival rates for victims of sudden cardiac arrest (SCA). The critical factor in improving outcomes lies in time-to-defibrillation. The defibrillator administers a shock measured in joules to the heart at precisely the right moment.

CPR 52

CPR Shock Resuscitation Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

PHEM Cast

APRIL 16, 2018

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

AED Leader

DECEMBER 2, 2024

Furthermore, regular maintenance and training in cardiopulmonary resuscitation (CPR) techniques significantly enhance the potential effectiveness of AEDs in emergencies. Rapid treatment is vital to improve survival outcomes. Cardiac arrests can happen anywhere, from public spaces to private homes.

CPR 52

CPR Basic Life Support 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

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. Bystander high-quality CPR can buy you some time until defibrillation.

CPR 52

CPR Academics Resuscitation Hospitals 52

SheMD

MAY 11, 2023

In medical emergencies, provider qualities which lead to greater performance and patient outcomes include leadership and teamwork. This study focused on gender differences in CPR performance and trialed an intervention to impact the leadership behaviors of female medical students. Meier A, Yang J, Liu J, et al. Crit Care Med.

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Leadership Documentation/Coding Teamwork CPR 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. published in Resuscitation 2011. Case: A 51-year-old man experiences a cardiac arrest on the street.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

AUGUST 14, 2021

They performed high-quality CPR and shocked the patient twice before giving amiodarone via intraosseous (IO). This has included the classic paper from Legend of EM Dr. Ian Stiell on BLS vs. ACLS ( SGEM#64 ), the use of mechanical CPR ( SGEM#136 ), and pre-hospital hypothermia ( SGEM#183 ).

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52