Dr. Smith's ECG Blog

MARCH 4, 2024

link] Or use the QR code: 10 Cases: Case 1 Do you want to be interrupted to view what the computer calls normal or nonspecific ECGs? He did re-occlude and arrest but was resuscitated. It is not yet available, but this is your way to get on the list. 2 cases at once! RCA Occlusion (OMI), called normal by conventional Veritas algorithm.

EKG/ECG 126

EKG/ECG Documentation/Coding Wellness Resuscitation 126

EMDocs

SEPTEMBER 19, 2023

Airway plan discussed with resuscitation team. Reference: emDOCs – NCSE Journal of Emergency Medicine – Review Case 4: 52-year-0ld male brought in by EMS with “code STEMI” ECG demonstrates ST depressions with rocket like T waves in V2-V4. Cric is progression of the airway plan ; it is not a failure.

Seizures 97

Seizures Documentation/Coding EKG/ECG Emergency Department 97

Emergency Medicine Journal

MAY 23, 2023

Background Whether and how bystander cardiopulmonary resuscitation (CPR) modifies the cardiac rhythm after out-of-hospital cardiac arrest (OHCA) over time remains unclear. The first documented cardiac rhythm was compared between patients who received bystander CPR and those who did not, using a 1:2 propensity score-matched analysis.

Resuscitation 40

Resuscitation CPR Hospitals Documentation/Coding 40

ACEP Now

JULY 7, 2024

If you are single coverage right off the bat, you need to be familiar with your facility’s OB, peds, and difficult airway resuscitation equipment and resources. You do not want to be fumbling through the pads or OB equipment during a critical resuscitation. Ask your charge nurse or medical director to walk you through it.

Resuscitation 98

Resuscitation Risk Management Critical Access Hospitals 98

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Macroscopic T-Wave Alternans: A Red Flag for Code Blue. J Am Coll Cardiol. 2006 Jan 17;47(2):269-81. doi: 10.1016/j.jacc.2005.08.066. 2005.08.066. Epub 2006 Jan 4. PMID: 16412847. Moore PK, Raffel KE, Whitman IR. JAMA Intern Med. 2017 Oct 1;177(10):1520-1522. doi: 10.1001/jamainternmed.2017.3191. 2017.3191.

EKG/ECG 130

EKG/ECG Documentation/Coding Psychiatric EMS 130

PHEM Cast

DECEMBER 12, 2016

pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

All Ohio EM

JULY 15, 2019

By Christy Rukamp DO and Zachary Hampton DO At times, documentation feels like the bane of existence. In residency, we practice resuscitations, rehearse critical procedures, and review in-service test questions; however, we rarely learn key components of documentation. It is more than a record of the patient’s ED timeline.

Documentation/Coding 52

Documentation/Coding Wellness Emergency Department Resuscitation 52

AED Leader

JUNE 11, 2024

Philips defibrillators come with clear visual and audio prompts that guide users through each step of the resuscitation process. Smart CPR Feedback and Real-Time Monitoring Adequate cardiopulmonary resuscitation (CPR) is crucial for increasing the chances of survival during a cardiac arrest. Can Philips defibrillators guide CPR?

CPR 52

CPR Shock Resuscitation Operations 52

RebelEM

JUNE 8, 2023

APACHE II and Charlson Comorbidity) Limitations: Initially evaluated 3175 patients for inclusion but 1348 excluded due to PDP being given in OR Retrospective design – unable to control for many potential confounding factors They found an association between fluid boluses and lack of phenylephrine response, they could not evaluate patient’s fluid (..)

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Don't Forget the Bubbles

MAY 6, 2024

of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. The mean time to randomisation was 2 hours, which excludes the initial resuscitation window. Of the 74.9% 1872 children (mean age 2.5

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Mind The Bleep

MAY 1, 2024

Appropriate first line management will help protect and resuscitate the soft tissues and keep the fracture still either to allow healing or until definitive management (operative fixation) is possible. Children’s Injuries – particularly in non-ambulant children, or a suspicious history, consider non-accidental injury.

Fractures 52

Fractures Head Injuries Documentation/Coding Dislocations 52

AED Leader

JULY 3, 2024

Real-Time CPR Feedback Performing cardiopulmonary resuscitation (CPR) correctly is crucial for the success of a resuscitation attempt. Real-time feedback minimizes the risk of human error and maximizes the chances of a successful resuscitation. Yes, Cardiac Science provides a warranty on its AED defibrillators.

CPR 52

CPR Resuscitation Pediatrics Operations 52

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

Northwestern EM Blog

MARCH 1, 2025

Hemodynamic instability and ongoing cardiac arrhythmias are a strong contraindication as chest access for cardiopulmonary resuscitation is limited (Koulouras et. Document thorough skin assessment every nursing shift, and inspect weight-bearing ventral surfaces. Reattach EKG leads to back. Tilt patient into reverse Trendelenburg.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

Dr. Smith's ECG Blog

FEBRUARY 2, 2017

Here are the American Heart Association Guidelines: 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 10.1: Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." and/or in the presence of acute MI.

EKG/ECG 52

EKG/ECG Resuscitation Administration CPR 52

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. Resuscitation. Resuscitation. AAGBI Safer Prehospital Anaesthesia 2017, available here. Positioning From: [link] Recommended Rich Levitan resources Podcast 70 – Airway Management with Rich Levitan Airway axes From: McGuire B, Hodge K.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

RebelEM

MARCH 27, 2023

What They Did: Retrospective, observational cohort study in a single high-volume academic hospital The ED had a 5 bed area used for ongoing management and resuscitation of patients who clinically deteriorate while boarding or while actively undergo a workup in other sections of the ED. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Advanced Emergency Nursing from AENJ

NOVEMBER 27, 2017

AHA gives focused recommendations ​. ​ ​​ The International Liaison Committee on Resuscitation (ILCOR) has for some years been meeting and agreeing upon resuscitation practices every five years; in addition to which there is the necessary slack time before and after each meeting to produce and disseminate the newly appropriate course materials.

CPR 40

CPR Basic Life Support Resuscitation Pediatrics 40

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Mind The Bleep

FEBRUARY 29, 2024

It is worth looking through previous documentation to see whether the patient’s team or senior intensivists have set any individual cardiovascular targets. Assessing a patient’s cardiovascular status and whether we need to manipulate any aspects of it is disease process-specific and patient-specific.

Documentation/Coding 52

Documentation/Coding Hospitals Wellness Best Practices 52

EMDocs

JANUARY 11, 2024

Cardiac Management Takeaway : Perform an echo as soon as you can to guide resuscitation. These conversations should occur frequently and be clearly documented for other health care professionals who are not present during the conversations (96%, 22/23). There are no hard MAP recommendations.

Seizures 97

Seizures Shock Infectious Diseases CPR 97

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is critically important to document the physical findings in a plain-seeing, plain-speaking, non-judgmental manner that will not color or taint future investigations. Accurate time entries are important to document. Natural psycho-physiological responses may alter perceptions during the life-threatening event.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Pediatric Emergency Playbook

APRIL 1, 2016

for the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. ACCF 2012 Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations. Use and Misuse of Serum Troponin Assays in Pediatric Practice. Am J Cardiol. 2012;110:284 –289. Newby KL et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

Here are the American Heart Association Guidelines: 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 10.1: Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia."

Shock 40

Shock EKG/ECG Resuscitation Ultrasounds 40

ACEP Now

FEBRUARY 11, 2024

There have been documented cases of overdose, and of note, there is no known antidote. Management of symptoms is the same for all of these, relying upon fluid resuscitation, antiemetics, and electrolyte repletion. Semaglutide has a half-life of approximately one week; as such, it is long-acting and requires supportive measures.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation. Beck’s triad only happens all 3 together in approximately 1/3rd of patients. Smith comment : First, IV fluids are indicated to improve preload.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. How would YOU interpret her post-resuscitation ECG? Figure-1: The initial ECG in today's case — obtained following resuscitation from cardiac arrest of an 18-year old woman. About A RVC/ A RVD.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

EB Medicine

AUGUST 6, 2019

Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Jeff: For all agents, regardless of the DOAC, the initial resuscitation follows the standard principles of hemorrhage control and trauma resuscitation. Nachi: So I think that rounds out testing.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

Mind The Bleep

FEBRUARY 2, 2025

Check the resuscitation status and read the notes so you are aware of the events leading up to the patients death. Assessment A code of practice for confirmation of death exists, however, each hospital may have its own protocols which you must familiarise yourself with.

Documentation/Coding 105

Documentation/Coding Resuscitation Hospitals EKG/ECG 105

EB Medicine

JULY 8, 2019

Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications. Jeff: Resuscitation should be aimed at early fluid replacement with IV crystalloids for hypovolemic patients and packed RBC transfusions for patients presumed to be unstable from hemorrhage.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Glucose > 200 mg/dL Moderate or Large Ketonuria The severity of DKA is categorized by the degree of acidosis Mild : venous pH < 7.3 The mortality rate for cerebral edema is 21%–24%.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

RebelEM

NOVEMBER 30, 2023

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Am J Emerg Med. 2023;73:34-39. What They Did: Researchers performed a systematic review and meta-analysis.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

PulmCCM

JANUARY 29, 2024

Read the document for all the details (it’s not long). In accordance with the fraught ethical and emotional factors surrounding organ donation, this section is the tersest, least explicated section of the document. PulmCCM is not affiliated with the American Heart Association. Here’s PulmCCM’s take on the new changes.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form. Pulmotor is 1907. Beecher, M.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

ACEP Now

APRIL 9, 2025

Lastly, a policy statement by the ACEP on the use of droperidol for agitation in the ED continues to recommend droperidol use at initial doses of 5-10 mg IM/IV, regardless of initial monitoring capability or ECG availability.

Emergency Department 52

Emergency Department Administration EKG/ECG Resuscitation 52

Advanced Emergency Nursing from AENJ

MAY 27, 2014

This is the fourth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. The select bibliography will provide ample links to extend your reading. “Carbon Dioxide Resuscitation?” You think to yourself, “ What could that be?” In 1927, H.W.

Resuscitation 40

Resuscitation Poisoning Research Administration 40