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

ACEP Now

OCTOBER 29, 2024

Our nurse did not study Paul Ekman’s Facial Action Coding System for Action Units to code “fear” in the patient’s face. Caring for critically ill patients with limited information requires snap assessments and judgements for timely resuscitation and efficient emergency department throughput. Sound familiar?

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Emergency Medicine Cases

JUNE 7, 2022

In this part 2 of our 2-part podcast series on Cardiac Arrest - The When, Why & How, we discuss some of the finer art of cardiac arrest care and answer questions such as: how should we best communicate to EMS, the ED team and the family of the patient to keep the team focused, garner the most important info and keep the flow of the code going?

Documentation/Coding 52

Documentation/Coding CPR Resuscitation EMS 52

The Trauma Pro

AUGUST 15, 2023

MTP logistics include details such as who will be delivering the blood, what actually goes in each cooler, what ratios should be used, limitations imposed by the use of frozen plasma, and documentation. Documentation is critically important, both in the trauma bay and the blood bank. And there are plenty around all the time!

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Emergency Department 130

Emergency Medicine Cases

JULY 31, 2018

In anticipation of EM Cases Episode 113 Diagnosis an Workup of Pulmonary Embolism with Dr. Kerstin DeWit and Dr. Eddy Lang, we have Dr. Peter Reardon telling us his Best Case Ever (Coding in the Scanner) of a young woman who presents with a seizure followed by hemodynamic instability, who codes while in the CT scanner.

Documentation/Coding 52

Documentation/Coding Seizures EMS Resuscitation 52

Emergency Medicine Cases

MARCH 26, 2020

The single most important thing we can do as ED providers in this COVID pandemic is to protect ourselves, our colleagues, our patients, our families and our friends against transmission of the virus; and there is no higher risk of transmission that during the resuscitation of a sick COVID patient.

PPE 52

PPE Documentation/Coding Resuscitation Wellness 52

EMDocs

APRIL 2, 2024

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

Documentation/Coding 111

Documentation/Coding CPR EKG/ECG Sepsis 111

ACEP Now

DECEMBER 6, 2024

Before nitroglycerin (NTG) could be administered, the patient became unresponsive and was transferred to the resuscitation bay, where the monitor revealed a ventricular fibrillation arrest. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. N Engl J Med. 1992;326(22):1451-1455. Circulation.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

Don't Forget the Bubbles

AUGUST 23, 2023

These unprocessed emotions can lead to vicarious trauma , especially in resuscitation providers. Rather, immediately after an unsuccessful resuscitation attempt, there should be an opportunity for those involved to partake. 2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Don't Forget the Bubbles

MAY 10, 2023

Then you hear the words coming out of the speaker, “ Paediatric code black. Paediatric code black ”. You’ve heard the phrase code black before – it’s a traumatic cardiac arrest. Resuscitation is a team sport. You know a paediatric code black means paediatric traumatic cardiac arrest. …You burst into resus.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Operations 91

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 118

Sepsis Fluid Resuscitation Resuscitation Administration 118

RebelEM

MAY 15, 2023

Frantically look through the assisted care documents for do-not-resuscitate paperwork Place a chest tube on the left side Place a chest tube on the right side Start noninvasive or mechanical ventilation FOR THE RIGHT ANSWER CLICK ON THE ROSH REVIEW LOGO BELOW References: Dixon A.

EMS 95

EMS Documentation/Coding Resuscitation 95

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Czech Military resuscitation kit, 1969, mfr.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 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 Pediatrics 98

Taming the SRU

DECEMBER 8, 2023

EMS had reported she had coded en route. ED providers should be familiar with several extraction techniques for foreign bodies in the external auditory canal including the use of manual extractors, irrigation, and other methods such as adhesives and acetone. She regained pulses with warming on arrival.

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Head Injuries Resuscitation Documentation/Coding 88

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

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Provide detailed documentation of the initial assessment, treatment provided, and the patient’s response to interventions.

Burns 52

Burns Fluid Resuscitation PPE Hyperthermia / Hypothermia 52

Dr. Smith's ECG Blog

MAY 26, 2023

This was a very complex case and the details are too much for an ECG Blog, but suffice it to say that, s hortly thereafter, the patient had an asystolic arrest and was resuscitated. A NSWER : In Figure-3 — I have color-coded P waves in the long lead II rhythm strip of ECG #2. How Are the P Waves Color-Coded?

Shock 98

Shock EKG/ECG Documentation/Coding Resuscitation 98

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 90

Seizures Documentation/Coding EKG/ECG Emergency Department 90

The Skeptics' Guide to EM

AUGUST 10, 2024

A code stroke is activated, and a CT head shows a left basal ganglia hemorrhage with no vascular lesions on CT angiography. Initial evaluation by medics revealed right arm weakness, a right facial droop, and decreased responsiveness. When he arrives at your ED, the family tells you he was doing fine until dinner.

Stroke 86

Stroke Airway Management Documentation/Coding Outcomes 86

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

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

PulmCCM

JUNE 5, 2023

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. Check out the preliminary program , and use code PULMCCM15 to get 15% off the attendance fees. makes me long for an adequately powered randomized trial. They really go the extra mile in the Netherlands.

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

Taming the SRU

MAY 11, 2024

Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review.

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

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 132

EKG/ECG Documentation/Coding Psychiatric EMS 132

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 Hospitals Critical Access 98

EMDocs

JUNE 22, 2023

Remember that while mistakes in resuscitation are often dissected and analyzed, it is equally crucial to acknowledge and celebrate the moments of impeccable execution, where lives are saved and hope is restored. He is on a vasopressin infusion now after the four unit bolus from the initial resuscitation. Should be here in 5 minutes.”

Resuscitation 98

Resuscitation Ultrasounds Critical Access Radiology 98

SheMD

MAY 11, 2023

They studied the effect of gender composition of resuscitation teams with all different combinations (female-female; female-male; male-male; male-female). Transcripts were coded to sort data into “leadership occurrences” or “unrelated to leadership” as well as critical treatment decisions. Why do we care about this article?

Leadership 52

Leadership Documentation/Coding CPR Teamwork 52

SheMD

DECEMBER 1, 2023

But less physicians talk about the difficult “firsts” like failing your first test, losing your first patient, or being involved in your first code. It means a patient is dying and requires immediate resuscitation. I remember my first code blue like it was yesterday. Thirty minutes after he arrived a code blue was called.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Resuscitation 52

RebelEM

SEPTEMBER 26, 2022

Rezaie, MD (Twitter: @srrezaie ) The post TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding appeared first on REBEL EM - Emergency Medicine Blog. Significant coagulopathy: INR > 1.8 Guest Post By: Cheng Ng, MD PGY-1, Emergency Medicine Resident Nuvance Health, Poughkeepsie, New york Email : cheng.ng@nuvancehealth.org

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

Dr. Smith's ECG Blog

OCTOBER 8, 2024

She was worked as a full code, and ROSC was achieved. She could not be resuscitated. She was taken to the cath lab, where she was found to have 100% in-stent restenosis of the proximal LAD. A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock.

EKG/ECG 124

EKG/ECG Documentation/Coding Resuscitation Shock 124

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

EM Ottawa

DECEMBER 28, 2023

There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog. Trauma is the leading cause of child and youth mortality globally (1). Pediatric trauma is a high acuity but low frequency event (2).

Pediatrics 83

Pediatrics Documentation/Coding EMS Wellness 83

FOAMCast Blog

JANUARY 4, 2016

TRAUMA FAST (Focused Assessment using Sonography in Trauma) guided resuscitative – thoracotomy. Bottom Line: If a trauma code comes in and has neither […] We picked the minds of some brilliant Emergency Medicine folk and came up with this short list of important happenings. Recommended by Haney Mallemat, Rob Orman).

Documentation/Coding 40

Documentation/Coding Resuscitation 40

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

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

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