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

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. This is a critical error that leads to poorer outcomes for patients in need of critical care. Unfortunately, its not clear whether the documentation came from RTs or ED providers. 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

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Resuscitation. Resuscitation. AAGBI Safer Prehospital Anaesthesia 2017, available here. Tracheal intubation. 20(12);681-686.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 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. Boluses were given in 20-40ml/kg aliquots.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Pediatric Emergency Playbook

APRIL 1, 2016

We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults. Myopericarditis in Children: Elevated Troponin I Level Does Not Predict Outcome. for the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

EMDocs

JANUARY 11, 2024

Cardiac Management Takeaway : Perform an echo as soon as you can to guide resuscitation. Centers managing patients after CA should collect data and evaluate outcomes of care (95.7%, 22/23). Validated illness severity scores may be used to optimize therapeutic interventions (88.2%, 15/17). There are no hard MAP recommendations.

Seizures 97

Seizures Shock Infectious Diseases CPR 97

EB Medicine

AUGUST 6, 2019

In the end, they reported similar rates of recurrence and bleeding outcomes for acute treatment. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. This strategy reduces hospital days and costs with otherwise similar outcomes - total win all around.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

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). Outcomes: Primary Outcome: In-hospital mortality. Am J Emerg Med. 2023;73:34-39. 2.89, p = 0.01.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

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. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. or serum bicarbonate between 11-17 mmol/L Moderate : venous pH < 7.2

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

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

APRIL 9, 2025

outcome of this is the removal of droperidol from the hospital formulary. 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. The realistic (or preferred?)

Emergency Department 52

Emergency Department Administration EKG/ECG Resuscitation 52

RebelEM

SEPTEMBER 26, 2022

Randomized study design Blind adjudication of transfusion reaction outcomes Follow-up was complete. The primary outcome was disease-oriented The enrolled cohort appears to be a convenience sample Sealed envelopes are a weak type of allocation and prone to error and manipulation. Significant coagulopathy: INR > 1.8

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

PulmCCM

JANUARY 29, 2024

Read the document for all the details (it’s not long). No strong evidence exists to suggest that detecting and treating nonconvulsive seizures improves neurologic outcomes after arrest, but there’s a compelling pathophysiologic rationale to prevent further brain injury. Here’s PulmCCM’s take on the new changes.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. Any team member of the resuscitation may lead the hot debrief. No potential resuscitation cases were formally excluded.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

Dr. Smith's ECG Blog

APRIL 8, 2016

After resuscitation, he was found to have a 90% thrombotic lesion in the same saphenous vein graft to the right posterior descending artery. The patient stabilized and had a good outcome. Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." This was stented.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Administration 52

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Sensible Medicine

JUNE 30, 2023

1] Would the outcomes be different? ” I documented those words in my progress note that day. KS died during the final one when his inpatient team failed to resuscitate him after a cardiac arrest. He had declined hospice care until the end and would not even accept “do not resuscitate” status.

Hospitals 98

Hospitals Hospice Resuscitation COPD 98

Don't Forget the Bubbles

JUNE 10, 2024

The history of necrotising enterocolitis The earliest documented cases resembling Necrotising enterocolitis (NEC) date back to the late 19th and early 20th centuries. Let’s delve into the significant challenges posed by small bellies: big battles – the not-so-simple case of necrotising enterocolitis. Can we prevent NEC?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EM Updates

JUNE 15, 2021

Every patient admitted to the EDAT was followed to the conclusion of their hospital course; the development of this unit and patient outcomes resulting from its execution are presented here. and Emergency Medicine residents, in 12 hour shifts. Clinical testing and treatment protocols changed almost every day.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

AED Leader

AUGUST 22, 2024

With around 10,000 cardiac arrests occurring annually in workplaces where approximately 50% have an AED available, their presence can make a significant difference in emergency response outcomes. Using an AED within minutes greatly enhances outcomes for victims and underscores the importance of being trained in CPR as well.

CPR 52

CPR Shock Operations Outcomes 52

EB Medicine

OCTOBER 1, 2018

And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Patient’s need adequate fluid resuscitation. Just a reminder that a history of CHF doesn’t preclude proper fluid resuscitation.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EB Medicine

MARCH 1, 2019

Post opiate hypotension in prehospital trauma patients is a rare but documented complication. Jeff: In terms of initial resuscitation, there is an ever increasing body of literature to support blood transfusion over crystalloid in patients requiring volume expansion in trauma. Early defibrillation is linked to better outcomes.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: And remember that hypothermic patients who are septic have worse outcomes than those who are hyperthermic and septic. Jeff: True.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). In contrast, ABG and pH alone are not reliable in determining the clinical futility of resuscitation after major trauma. (14,

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

EB Medicine

JANUARY 2, 2019

With opportunities to improve outcomes for both the fetus and the mother, I’m confident that this episode will be worth your time. Nachi: For patient who have a threatened miscarriage in the first trimester, there is a 2-fold increased risk of subsequent maternal and fetal adverse outcomes.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

Dr. Smith's ECG Blog

MARCH 25, 2025

Documentation indicates that the patient was shocked 4 times (with no comment on energy level) and received amiodarone 300 mg IV and magnesium 2 g IV. A 2017 trial named CULPRIT SHOCK found that in patients with cardiogenic shock, a strategy of culprit vessel PCI only was associated with better outcomes than immediate multivessel PCI.

EKG/ECG 62

EKG/ECG Shock Documentation/Coding Hospitals 62

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Her rejoinder was “I didn’t think to blow through the nose, but, boy, did I blow between the teeth! ” The nose in Early Modern Expired Air Resuscitation: Early teaching in expired-air resuscitation was three-fold. Few people now remember that a strong early proposal in the move for expired air resuscitation was Mouth to Nose.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Taming the SRU

FEBRUARY 3, 2025

Additional Treatments for Severe Electrolyte Derangements Severe Hyperuricemia If uric acid 8 mg/dL or 25% increase from baseline develops, then rasburicase should be administered in addition to IV fluid resuscitation. original document created by author of post. Tumor Lysis Syndrome. Archives of Pathology & Laboratory Medicine.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65

Dr. Smith's ECG Blog

MARCH 8, 2025

During the resuscitation, she received amiodarone 450 mg IV, lidocaine 100 mg IV, and magnesium 6 g IV. 3:07 PM, slow atrial fibrillation with electromechanical dissociation At this time, the patient's family terminated resuscitation efforts and the patient was pronounced dead. Was her outcome to be expected for ostial RCA OMI?

EKG/ECG 74

EKG/ECG CPR Resuscitation Wellness 74