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. So, eCPR, extracorporeal cardiopulmonary resuscitation, is an advanced medical procedure used in cases of cardiac arrest where traditional CPR has failed.

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. What strategy gives the most benefit to the most people? Resuscitation. 2021.01.038.

CPR 52

CPR Resuscitation Hospitals Outcomes 52

The Skeptics' Guide to EM

MAY 8, 2021

He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? Date: May 7th, 2021 Guest Skeptic: Dr. He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. Reference: Shah and Mitra.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

ACEP Now

DECEMBER 6, 2024

After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. The mechanisms in methamphetamine users are not well understood.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

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. Why do we care about this article? What does this mean?

Leadership 52

Leadership Documentation/Coding CPR Teamwork 52

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%. Civility Saves Lives The impact of incivility in healthcare cannot be understated.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

AED Leader

JULY 3, 2024

When it comes to ensuring the safety and well-being of your business and its employees, having a reliable automated external defibrillator (AED) is essential. Real-Time CPR Feedback Performing cardiopulmonary resuscitation (CPR) correctly is crucial for the success of a resuscitation attempt.

CPR 52

CPR Resuscitation Pediatrics Operations 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. Proper training can improve survival rates and patient outcomes in both public settings and hospitals.

CPR 52

CPR Basic Life Support Resuscitation Hospitals 52

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? CPR is currently in progress with a single shock having been delivered.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

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. Sodium bicarbonate has historically been used during CPR with the goal of alkalizing blood pH and treating metabolic acidosis.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Don't Forget the Bubbles

JUNE 26, 2023

Too much pulmonary blood flow and we will see well-oxygenated blood ( SpO2 >85% ) but insufficient systemic blood flow (pallor/mottling, cool peripheries, delayed capillary refill time, weak pulses, hypotension, narrow pulse pressure) and hypoxia (lactic acidosis). This is the most nuanced aspect. What is the best option for repair?

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

RebelEM

DECEMBER 19, 2022

In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. The prehospital providers in this study had an extensive amount of training.

EMS 52

EMS CPR Shock Resuscitation 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

He had history of prior MIs and CABG, as well as diabetes, hypertension, and hyperlipidemia. He underwent CPR and then was shocked out of VF. Sooner identification likely leads to better outcomes, and in this case may have allowed prevention of cardiac arrest and better long-term outcome.

EKG/ECG 52

EKG/ECG Shock CPR Outcomes 52

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

If doing what was called "the one-man-band resurrection shuffle" [single person CPR in the back of a moving ambulance], this worked very well, as the bag would stay hanging there on the patient's face. How useful these would have been to let us know how well the patient was oxygenating and ventilating!

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

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 97

Seizures Shock Infectious Diseases CPR 97

PulmCCM

APRIL 7, 2025

This is based partly on the Western ethical principle of autonomy: our family members know us well and (it’s generally agreed) can best ascertain what care we would agree to, or not. Families should be invited to be present during codes (CPR), with a dedicated staff member at their side. This is a well-established principle.

Documentation/Coding 113

Documentation/Coding Outcomes Research CPR 113

RebelEM

JUNE 29, 2023

Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study. The CT FIRST Trial: Should We Pan-CT After ROSC?, REBEL EM Blog, June 1, 2023. Available at: HERE Branch KHR et al.

CPR 145

CPR EMS Documentation/Coding Outcomes 145

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.

Hospitals 97

Hospitals Resuscitation Outcomes CPR 97

RebelEM

JUNE 1, 2023

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. Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study.

Outcomes 145

Outcomes Resuscitation CPR Hospitals 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

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

Taming the SRU

JUNE 28, 2024

4) This higher likelihood of attaining return of spontaneous circulation (ROSC) is contingent upon high quality CPR and early defibrillation. In 2018, Cheskes et al in Canada decided to examine these therapies and compare their outcomes. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse).(1,2,3)

Shock 75

Shock Hospitals CPR Outcomes 75

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Persistent air-leak in spontaneous pneumothorax--clinical course and outcome. Iatrogenic: PTX caused by medical procedures or interventions. Respir Med.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

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

Don't Forget the Bubbles

MAY 3, 2023

There was no difference between the low-dose and high-dose insulin infusion groups regarding the time to resolution of hyperglycaemia, time to resolution of acidosis as well as the rate of blood glucose change. Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children?

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

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

RebelEM

SEPTEMBER 28, 2023

neoplasm, aneurysm, intracranial or spinal surgery) or recent trauma to head or cranium (i.e. Primary PCI: 95.7% Stents Placed: Pharmaco-Invasive Treatment: 97.4% Primary PCI: 95.7% ECG Results: Repeat ECG 90min after tenecteplase indicated 70.3% to 1.0mm Median amount of ST deviations declined from 15.0 Primary PCI: 78.4% Primary PCI: 13.3%

EKG/ECG 138

EKG/ECG Allergic Reactions Shock Stroke 138

AED Leader

APRIL 30, 2024

As a responsible parent or guardian, the safety and well-being of your child are of utmost importance. 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

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". 3-vessel disease can make resuscitation very difficult, since CPR does not perfuse diseased vessels as well as one would like.

EKG/ECG 135

EKG/ECG Resuscitation CPR Emergency Department 135

The Skeptics' Guide to EM

JUNE 4, 2017

A systematic review by the authors of the present study confirmed a possible benefit of the pan scan, but it showed a need for a well-designed, large, prospective randomized clinical trial with patient oriented outcomes ( Sierink et al 2012 ). The NNT varied from 17 to 32 according to the injury severity. Reference: Sierink et al.

Radiology 52

Radiology Radiology CPR Hospitals 52

AED Leader

AUGUST 22, 2024

Drawing from my extensive experience as a CPR instructor and emergency responder, I’ve witnessed firsthand how rapid deployment and proper usage of AEDs can mean the difference between life and death during neurological emergencies. Importance of CPR training CPR training is critical for anyone responding to a medical emergency.

CPR 52

CPR Shock Operations Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He was admitted on oxygen and was doing fairly well with saturations of 100% on 2 L nasal cannula. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. An elevated troponin in a COVID patient confers about 4x the risk of mortality than a normal one.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. On arrival at hospital the child was well with normal observations. Mum (first aid trained) gave back blows and started CPR. Family history. The episode was reported to last around a minute. What are the important investigations?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Ziqitza HealthCare Ltd

MAY 14, 2024

Ambulance services staff highly qualified and well-trained medical professionals, paramedics and emergency medical technicians, especially educated to provide trauma aid. Immediate medical assistance provided at the right time can be life-saving and also help improve patient outcomes. These make ambulance services vital.

Ambulance Services 52

Ambulance Services CPR Hospitals EKG/ECG 52

Don't Forget the Bubbles

OCTOBER 7, 2024

The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. Prolonged CPR should be considered as outcomes are generally good, even if asystole is the presenting rhythm.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

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 Operations Shock 52

Don't Forget the Bubbles

MAY 10, 2023

They’re getting CPR. And then the debrief runs through STOP : Situation – a recap of the resuscitation, including the reasoning behind decisions made Things that went well Opportunities to improve Points of action – equipment issues, or whether a case review is needed And so after the hot debrief, you pause. They have been stabbed.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91