Dr. Smith's ECG Blog

MAY 19, 2020

ECMO Flow was achieved after approximately 1 hour of high quality CPR. In this case, profound shock for 1 hour would result in the same degree of infarction. The Type 2 MI would then have been a result of the prolonged severe shock while in arrest. After good ECMO flow was established, she was successfully defibrillated.

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A bedside cardiac ultrasound was normal, with no effusion. 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. What is it? There is STE in V2-V6.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

RebelEM

JANUARY 29, 2024

Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. A prospective, Single-Arm Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE II Study. CHEST 2010.

Stroke 136

Stroke Outcomes Hospitals Administration 136

PHEM Cast

APRIL 16, 2018

Ultrasound during TCA: Cureton et al. The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. 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. 2012; 73: 102-10.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 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

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.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

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 98

Seizures Shock Infectious Diseases CPR 98

Dr. Smith's ECG Blog

OCTOBER 10, 2022

CPR was initiated immediately. Decision was made to push tPA after approximately 25 minutes of CPR, and after approximately 25 minutes after tPA was given, O2 saturation increased to 97%, and the patient was no longer cyanotic, converted to normal sinus rhythm with anterior lateral T wave inversions with ST depressions."

EKG/ECG 52

EKG/ECG Resuscitation Ultrasounds CPR 52

Taming the SRU

OCTOBER 1, 2023

Common causes include central venous catheterization (subclavian or internal jugular), lung biopsy, barotrauma from PPV, thoracentesis, bronchoscopy, pacemaker insertion, CPR, and intercostal nerve block [12, 14]. J Emerg Trauma Shock. The "lung point": an ultrasound sign specific to pneumothorax. Ann Emerg Med. 2008;1(1):34-41.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Dr. Smith's ECG Blog

JUNE 11, 2021

Jesse McLaren (@ECGcases), of Emergency Medicine Cases Reviewed by Pendell Meyers and Steve Smith An 85yo with a history of hypertension developed chest pain and collapsed, and had bystander CPR. Thirty minutes later the first Troponin I came back elevated at 650 ng/L (normal <26), and bedside ultrasound found anteroseptal akinesia.

EKG/ECG 52

EKG/ECG Documentation/Coding CPR Shock 52

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. Thankfully, fatalities are declining, with just 565 in 2015.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

While Point of Care Ultrasound has made limited entry in prehospital care, largely with physician-led services and some Advanced Paramedics; it has largely been as a proof of concept rather than everyday care. An elderly lady in cardiogenic shock (BP 60/40) with no veins , I was lucky to get a 24-gauge PIV into the back of her wrist.

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

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. Jeff: Interestingly, the system I work in has prehospital physicians, who do carry US, but I can’t think of a major trauma where ultrasound changed any of the decisions we made.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Dr. Smith's ECG Blog

APRIL 8, 2016

He appeared to be in shock. Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. Angio had shown some acute disease in the saphenous vein graft to the posterior descending artery off of the RCA. He was managed medically with Clopidogrel.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Administration 52

Critical Care Now

JUNE 21, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. CPR was started immediately after the coaching staff could not find a pulse and EMS arrived to find the patient in cardiac arrest. His coach and fellow players witnessed a seizure-like activity immediately after collapsing.

Seizures 52

Seizures EKG/ECG CPR Shock 52