Emergency Medicine Cases

JUNE 7, 2022

The post Ep 170 Cardiac Arrest – PoCUS Integration, Communication Strategies, E-CPR, Calling the Code appeared first on Emergency Medicine Cases. What factors need to be taken into consideration to decide on when to terminate resuscitation of the cardiac arrest patient - when to call the code? and many more.

Documentation/Coding 52

Documentation/Coding CPR Resuscitation EMS 52

Taming the SRU

JUNE 26, 2024

Unresponsive patients with undetectable MAP or EtCO2 less than 20 should undergo CPR. Factors that improve survival rates include cardiac activity on ultrasound, initial shockable rhythm, witnessed arrest, extremity only trauma, and bystander CPR. One should ensure that the device is plugged in and an audible hum is heard.

Blood Transfusions 87

Blood Transfusions Sepsis CPR EKG/ECG 87

Ultrasound Gel

AUGUST 2, 2021

One of the gang's favorite topics - ultrasound in cardiac arrest! This seems like an important part of minimizing pauses in CPR, but how convincing is this data? link] [link] One of the gang's favorite topics - ultrasound in cardiac arrest!

CPR 52

CPR Ultrasounds 52

Taming the SRU

JUNE 24, 2024

Diaz-McDermott is a graduating PGY-4 and incoming Ultrasound Fellow at the University of Cincinnati Dr. LaFollette is an Associate Professor in Emergency Medicine at the University of Cincinnati and co-editor of TamingtheSRU.com References Adult Bradycardia Algorithm , 2020, cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/algorithms/algorithmacls_bradycardia_200612.pdf. (..)

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Shock 90

Dr. Smith's ECG Blog

MAY 19, 2020

ECMO Flow was achieved after approximately 1 hour of high quality CPR. The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. After good ECMO flow was established, she was successfully defibrillated.

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

EMDocs

JANUARY 16, 2024

VF/asystole), a pulse cannot be identified via Doppler ultrasound for a full minute, or if lack of organized cardiac activity is confirmed on bedside echocardiogram. This is a good time to utilize an arterial line or use the ultrasound to find a central pulse. Hypothermic arrest differs from cardiac arrest from other causes.

Hyperthermia / Hypothermia 104

Hyperthermia / Hypothermia Resuscitation CPR EMS 104

The Skeptics' Guide to EM

JULY 22, 2023

We should focus more on high-quality CPR and early defibrillation for shockable rhythms and less on type of supraglottic airway device. A hypothesized option of adding point of care ultrasound (POCUS) to our various methods of confirming correct placement of the endotracheal tube was covered on SGEM#249 with PA Chip Lange.

EMS 88

EMS CPR Ultrasounds Research 88

Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. Bedside ED ultrasound showed exceedingly poor global LV function, and no B lines. Medics found him in ventricular fibrillation. He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD.

EKG/ECG 134

EKG/ECG Shock CPR Stroke 134

Emergency Medicine News

AUGUST 31, 2023

An abstract is unavailable.

CPR 52

CPR Ultrasounds 52

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

Arrival at time 0 ECG 7 min Roomed in hallway at 17 min Moved to room with monitor at 37 min The patient was seen briefly by the physician, who then went to get an ultrasound machine. 3-vessel disease can make resuscitation very difficult, since CPR does not perfuse diseased vessels as well as one would like.

EKG/ECG 137

EKG/ECG Resuscitation CPR Emergency Department 137

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 133

Stroke Outcomes Hospitals Administration 133

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. Use of CPR in hemorrhagic shock, a dog model. 2012; 73: 102-10. The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Lockey et al.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

His primary interests are resuscitation, prehospital critical care, airway management, and point-of-care ultrasound. Bystander CPR is initiated prior to EMS arrival. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

Dr. Smith's ECG Blog

OCTOBER 24, 2013

He underwent immediate CPR, was found to be in ventricular fibrillation, and was successfully resuscitated. An emergency cardiac ultrasound could be very useful. The physician recorded this ECG, interpreted it as normal, and sent the patient home on an antacid. See explanation below. I do not have the post-resuscitation ECG.

EKG/ECG 52

EKG/ECG Resuscitation CPR Ultrasounds 52

EB Medicine

NOVEMBER 17, 2020

EMplify November 2020 An Evidence-Based Approach to Nonoperative Management of Traumatic Hemorrhagic Shock in the Emergency Department Authors : Christopher Pitotti, MD, FACEP Jason David, MD Topics : The Lethal Triad Prehospital Care Tourniquets - Placement and Pitfalls Stop The Bleed Hemostatic Dressings TXA Temperature Management ED Assessment Shock (..)

Emergency Department 40

Emergency Department Shock Resuscitation CPR 40

EM Curious

APRIL 29, 2015

You can view the TTE recordings for each of the 20 standard views used in a full cardiology exam and see the corresponding 3D model of the probe, ultrasound plane, heart and rib cage for that view. Part 1 Part 2 DONT STOP COMPRESSING HANDS ON DEFIBRILLATION [BLOG]: Minimizing time off the chest during CPR? Don't believe me?

Head Injuries 52

Head Injuries EMS Pediatrics CPR 52

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

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. Her point-of-care ultrasound (POCUS) shows appropriate-appearing global ejection fraction and no marked wall motion abnormalities.

EKG/ECG 52

EKG/ECG Academics EMS 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]. The "lung point": an ultrasound sign specific to pneumothorax. Published 2020 Jul 23. doi:10.1002/14651858.CD013031.pub2

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A bedside ultrasound was done by the emergency physician, using Speckle Tracking. The first time I looked at this, from afar, I did not see it, but after drawing the lines, one can clearly see abnormal ST elevation very suggestive of high lateral STEMI. Unfortunately, that video is unavailable.

EKG/ECG 40

EKG/ECG CPR Resuscitation Outcomes 40

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

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 94

Seizures Shock Infectious Diseases CPR 94

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound. What does a heart look like on ultrasound when the EKG looks like that? Here you go: It's not the world's greatest cardiac ultrasound video, but it does appear to show poor function and low volume. They transported to the ED.

Shock 40

Shock EKG/ECG Resuscitation Ultrasounds 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. I am thankful for having a career of wonderful care at supportive institutions.

Emergency Nursing 40

Emergency Nursing Seizures CPR Wellness 40

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. These aren’t your standard arrest patients though, they typically have many fewer comorbidities – so CPR tends to be more successful. Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EB Medicine

MARCH 1, 2019

Nachi: And if the prehospital team is lucky enough, or maybe unlucky enough, i don’t know, to have a credentialed provider who can perform ultrasound for those suspected of having a blunt cardiac injury, the general prehospital data on ultrasound is sparse. Jeff: Great, let’s move onto ED care, beginning with the H&P.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

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. He had the following EKG recorded: Low voltage, suggests effusion. see Ken's discussion of low voltage below) There is a QS-wave in V2.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

APRIL 8, 2016

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. Medics stated that he had not been taking his clopidogrel for 2 weeks.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Administration 52

University of Maryland CC Project

NOVEMBER 24, 2021

Maryland Critical Care Conference 2021 with various talks on the topic of Resuscitation.

Resuscitation 40

Resuscitation Outcomes CPR Ultrasounds 40

ACEP Now

OCTOBER 30, 2023

In December 2014, ESEM brought together a group of local emergency physicians with specialized training in emergency ultrasound, establishing the emergency ultrasound committee, a key step in ESEM’s mission to maintain the highest practice standards and promote professional growth in emergency medicine within the UAE.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 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

Don't Forget the Bubbles

JANUARY 6, 2025

Article 1: Is lung ultrasound a viable alternative to chest x-ray in diagnosing community-acquired pneumonia? Diagnostic accuracy of point-of-care lung ultrasound for community-acquired pneumonia in children in ambulatory settings: A systematic review and meta-analysis. Ultrasound. 2024 Oct 29; Whats it about? Whats it about?

Dislocations 59

Dislocations CPR Ultrasounds Resuscitation 59