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 45

CPR Shock Outcomes Resuscitation 45

AED Leader

APRIL 24, 2024

Their AEDs are designed to be user-friendly, reliable, and effective in delivering life-saving shocks to restore a normal heart rhythm. It has advanced features that simplify the rescue process and improve outcomes. Let’s delve into the key features and benefits of Cardiac Science AEDs.

Shock 52

Shock CPR Pediatrics Documentation/Coding 52

AED Leader

APRIL 30, 2024

AEDs are designed to deliver a life-saving shock to the heart, restoring its normal rhythm and allowing vital organs to receive the needed oxygen. CPR Coaching and Feedback In addition to delivering a life-saving shock, the Heartsine 350P AED provides real-time CPR coaching and feedback.

CPR 52

CPR Operations Shock Resuscitation 52

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. Patients with septic shock or influenza were excluded. standards of care. 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

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

RebelEM

SEPTEMBER 28, 2023

The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a pharmaco-invasive strategy resulted in similar rates of death, shock, heart failure, or reinfarction compared to primary PCI. Primary PCI: 95.7% Primary PCI: 95.7%

EKG/ECG 131

EKG/ECG Allergic Reactions Shock Stroke 131

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. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19).

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

EMDocs

JANUARY 8, 2024

Magnesium does not improve ROSC, survival, or neurologic outcomes, no matter the presenting rhythm (Level 3: no benefit). For patients with OHCA, use of steroids during CPR is of uncertain benefit. All unresponsive adults post ROSC should have a deliberate strategy for temperature control with a continuous temperature target 32-37.5

Seizures 82

Seizures Shock CPR Hyperthermia / Hypothermia 82

The Skeptics' Guide to EM

FEBRUARY 25, 2023

He is found to be in hypoxic respiratory failure and septic shock. Your team begins high quality cardiopulmonary resuscitation (CPR). Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Parents note that he has been progressively more tired and difficult to arouse.

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. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. The patient awoke and had a good outcome! An elderly man collapsed.

EKG/ECG 129

EKG/ECG Shock CPR Stroke 129

Ziqitza HealthCare Ltd

JUNE 13, 2024

Knowledge of life-saving skills can significantly impact patient outcomes, potentially saving lives and avoiding future health complications. Rapid medical response is essential in this case to prevent long-term complications and death and improve outcomes. Immediately begin CPR if the patient stops breathing.

Stroke 52

Stroke Burns Ambulance Services Seizures 52

EMDocs

JANUARY 16, 2024

Patients can have excellent outcomes despite prolonged resuscitation. 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. Hypothermic arrest differs from cardiac arrest from other causes.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

The Skeptics' Guide to EM

FEBRUARY 3, 2023

The nurses started CPR immediately and place pads before you even arrived. The patient is in ventricular fibrillation, and you achieve return of spontaneous circulation (ROSC) on the second shock. The patient is still unconscious. A post-arrest ECG doesn’t show any signs of STEMI. This translated into an impressive NNT of 6.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Outcomes Documentation/Coding 52

AED Leader

JULY 1, 2024

It features ADAPTIV biphasic waveform technology, which adjusts energy levels based on the patient’s needs, ensuring effective and safe defibrillation shocks. With quick charging and short analysis times, the LifePak 100 allows for rapid intervention, increasing the chances of a positive outcome.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

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. Written by Willy Frick A man in his 50s was at home with his family when they heard a thud and rushed into the room to find him unconscious with agonal respirations.

EKG/ECG 107

EKG/ECG EMS CPR Hospitals 107

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 83

CPR Burns Airway Management Wellness 83

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). He is unsuccessfully shocked. There was also no increase in survivors with good neurological outcomes with ACLS. JAMA 2009, Hagihara et al. Reference: Perkins et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 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. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. Ultrasound during TCA: Cureton et al.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

Ziqitza HealthCare Ltd

MAY 14, 2024

Immediate medical assistance provided at the right time can be life-saving and also help improve patient outcomes. Quick Response: Emergency ambulance services are important in critical medical emergency situations as they provide quick response and help to those in need.

Ambulance Services 52

Ambulance Services Hospitals CPR EKG/ECG 52

Taming the SRU

SEPTEMBER 1, 2023

Lane & Mcdonough Definition of an immediate whole body CT (iWBCT) scan Shortly after patient arrival. 2015) reported a sensitivity of 98.9%

Sepsis 88

Sepsis Administration Documentation/Coding Fractures 88

EMDocs

JANUARY 11, 2024

Data that do not establish neurological risk stratification in the first 6 hours after CA include the patient’s age, duration of CPR, seizure activity, serum lactate level or pH, Glasgow motor subscore in patients who received NMB or sedation, pupillary function in patients who received atropine, and optic nerve sheath diameter (95.3%, 20/21).

Seizures 75

Seizures Shock Infectious Diseases CPR 75

Don't Forget the Bubbles

MAY 10, 2023

They’re getting CPR. A shocked friend is being ushered out of the way. The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. You know what to do, in principle, but you’ve never seen one before. …You burst into resus. A teenager lies on the resus trolley.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Taming the SRU

OCTOBER 1, 2023

As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11]. J Emerg Trauma Shock. Persistent air-leak in spontaneous pneumothorax--clinical course and outcome. Ann Emerg Med. 1983;12(6):411-412. 2008;1(1):34-41.

Fractures 89

Fractures COPD Hospitals Emergency Department 89

PHEM Cast

SEPTEMBER 6, 2017

Qvigstad et al showed in again in Resuscitation in 2013, confirming inter-individual variation in effectiveness of CPR using ETCO2 as a surrogate for CO Trauma Deakin et al. (J. trauma 2004) showed that end-tidal CO2 may be of value in predicting outcome from major trauma (19). (J.

CPR 52

CPR Resuscitation Wellness Operations 52

Don't Forget the Bubbles

JUNE 26, 2023

But, they may present postnatally with cyanosis/hypoxaemia due to insufficient pulmonary blood flow, cardiogenic shock due to insufficient systemic blood flow, or both. The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. What is the best option for repair?

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

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 89

Resuscitation Outcomes Operations Hospitals 89

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

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 Shock CPR Resuscitation 52

Dr. Smith's ECG Blog

MARCH 11, 2016

PIRP is very likely if there is premature reversal of inverted T-waves to positive deflections · Any STEMI patient in shock may have tamponade, often due to myocardial rupture. Patients who received CPR or experienced reinfarction or very small infarcts due to thrombolysis also displayed Type II T-wave evolution.

EKG/ECG 52

EKG/ECG Outcomes CPR Shock 52

EB Medicine

MARCH 1, 2019

Consider valvular injury in any patient who appears to be in cardiogenic shock, has hypotension without obvious hemorrhage, or has pulmonary edema. In those with severe injury, you may note refractory hypotension secondary to cardiogenic shock. The latter also recommend ED thoracotomy in those with refractory shock.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

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 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).

Outcomes 124

Outcomes Stroke Hospitals Administration 124

ACEP Now

APRIL 3, 2024

1,2 However, the European TTM1 trial in 2013 showed similar outcomes for those cooled to 33 degrees Celsius compared to 36 degrees Celsius, leading to a 2015 AHA class I recommendation of “cooling between 32 degrees Celsius-36 degrees Celsius.” degrees Celsius. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

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 56

Hospitals Outcomes EKG/ECG Resuscitation 56

The Skeptics' Guide to EM

JANUARY 9, 2021

CPR is currently in progress with a single shock having been delivered. This has included things like therapeutic hypothermia ( SGEM#54 , SGEM#82 , SGEM#183 and SGEM#275 ), supraglottic devices ( SGEM#247 ), crowd sourcing CPR ( SGEM#143 and SGEM#306 ), and epinephrine ( SGEM#238 ).

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

He underwent CPR and then was shocked out of VF. He was in cardiogenic shock requiring an impella for several days after cath. Sooner identification likely leads to better outcomes, and in this case may have allowed prevention of cardiac arrest and better long-term outcome. No further troponins were measured.

EKG/ECG 52

EKG/ECG Shock CPR Outcomes 52

ACEP Now

NOVEMBER 7, 2023

1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). The primary outcome was survival to hospital discharge. 2020;396(10265):1807-1816. Alaeddini J, Feng Z, Feghali G, et al.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52