PulmCCM

NOVEMBER 17, 2023

Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. OP is operating point. Shows what happens when Ppc, Pmsf, Rcardiac and Rvr all vary [grey operating points].

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

EMDocs

DECEMBER 6, 2024

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline.

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

The Skeptics' Guide to EM

JUNE 15, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. You initiate standard, simultaneous assessment and resuscitation following the Advanced Trauma Life Support (ATLS) principles. Reference: Jansen et al.

Resuscitation 112

Resuscitation Patient Safety Operations Emergency Department 112

The Trauma Pro

APRIL 5, 2024

.” Frequently, it is possible to have a resident (at an appropriate training level) or advanced practice provider (APP) see the new patient while the surgeon is tied up, say in the operating room. They just can’t operate on them. What if the surgeon is in the OR? In my opinion, no. mangled extremity).

Operations 113

Operations Resuscitation Hospitals 113

RebelEM

APRIL 29, 2024

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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

Don't Forget the Bubbles

JUNE 30, 2023

In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

ACEP Now

JULY 7, 2023

One operator should perform defibrillation in the anterolateral position, followed by another operator providing a second shock in the anteroposterior position after a delay of less than one second. Resuscitation. Resuscitation. Resuscitation. Resuscitation. Resuscitation. 2022;175:105-112.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Greater Sydney Area HEMS

NOVEMBER 4, 2023

A change of operator or removal of the blade from the mouth ends the attempt). This patient was intubated as part of resuscitation after drowning. first pass success rate from RSI. These learning points form part of our commitments to excellence, governance and education. This older child had a reduced GCS.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

EMDocs

JANUARY 11, 2025

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

Mind The Bleep

DECEMBER 27, 2024

Air Ambulance Charities operate many air ambulances in the UK and have associated rapid response cars for when the weather doesnt allow for flying. Its operated by the ambulance service, however, some other NHS boards have their own services which leave directly from the Emergency Department (for example, NHS Lothians Medic 1).

Hospitals 52

Hospitals Ambulance Services Operations Teamwork 52

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

The Trauma Pro

JULY 10, 2023

This stream of information continues after the patient leaves the trauma bay for CT, imaging, interventional radiology, operating room, ICU, or floor bed. Once this occurs, the entire record is suspect and will not represent the true flow of the resuscitation. All of these occur during a relatively brief period of time.

Resuscitation 100

Resuscitation Radiology Radiology Operations 100

Taming the SRU

JULY 24, 2024

Population Patients were adult (18 or older) patients at a single academic emergency department who were triaged to a resuscitation bay and were not classified as a trauma, STEMI, stroke, cardiac arrest, or active labor. Importantly, only patients triaged to resuscitation bays were enrolled. sensitivity, 84.9% sensitivity, 87.2%

Sepsis 89

Sepsis Resuscitation Emergency Department Wellness 89

PulmCCM

NOVEMBER 6, 2023

Uncertainty has persisted about the ideal blood transfusion strategy to resuscitate and support trauma victims as they are prepared to undergo surgical and other mechanical interventions to achieve hemostasis. The intervention is called resuscitative endovascular balloon occlusion of the aorta (REBOA).

Blood Transfusions 98

Blood Transfusions Operations Infectious Diseases Resuscitation 98

EMDocs

SEPTEMBER 7, 2024

Laborator evaluation: CBC, CMP, lipase, type and screen, coagulation panel Treatment: 1-3 Resuscitation with blood products as necessary for hemodynamic stability. However, this patient’s response to fluid resuscitation, though only minimal to modest, indicates his ongoing bleeding is temporized with typical volume-mediated resuscitation.

EMS 93

EMS Fluid Resuscitation Resuscitation Radiology 93

Don't Forget the Bubbles

MAY 10, 2023

Resuscitation is a team sport. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. A study in Denmark in 2021 explored barriers to effective resuscitation in over 900 in-hospital resuscitations across six hospitals in Denmark. It was the most phenomenal resuscitation.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

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

Don't Forget the Bubbles

JUNE 26, 2023

Whilst waiting for an operation, they need to be managed medically. The underlying heart defect determines the precise operation performed – you might have heard of the Norwood procedure , an example used for HLHS specifically. Six hours post-operatively, they become more mottled, with weak pulses – signs of poor systemic perfusion.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

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

Don't Forget the Bubbles

NOVEMBER 29, 2023

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Awake fiberoptic intubation where the patient consents, co-operative AND the airway is prepared with local anaesthesia. Rocuronium ( a muscle relaxant ) alone was administered as he became combative. Ben was awake but paralysed.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EMDocs

NOVEMBER 1, 2023

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. 4 Fluid resuscitation and vasopressor use as appropriate.

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics.

Operations 97

Operations Academics Fluid Resuscitation Outcomes 97

Pediatric Emergency Playbook

MARCH 1, 2016

Resuscitative Pearls Our goal here is damage control. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery. How Children are Different in Trauma In adults, we speak of “permissive hypotension” (also called “balanced resuscitation” or “damage control resuscitation”).

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. It is most often blunt trauma.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

PHEM Cast

APRIL 27, 2023

Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1.

Resuscitation 52

Resuscitation Shock Operations Hospitals 52

AED Leader

JUNE 11, 2024

When faced with a life-threatening situation, every second counts, and having a defibrillator that is easy to operate can make a significant difference. Philips defibrillators come with clear visual and audio prompts that guide users through each step of the resuscitation process.

CPR 52

CPR Shock Resuscitation Operations 52

RebelEM

JUNE 19, 2023

We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures). This should continue to make TXA part of standard trauma resuscitation while additional studies are performed.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

PulmCCM

FEBRUARY 28, 2022

Further, the treating clinician must have deemed either normal saline or balanced crystalloid as appropriate resuscitation options; the patient’s expected-admission to the ICU must have been at least 3 days. saline crystalloid resuscitation, the inter-trial evaluations become murkier, though seemingly less tendentious.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

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

Intensive Blog

AUGUST 21, 2024

Outline the initial assessment of severe burns injury, including how you will calculate fluid resuscitation requirements. Outline the key considerations for the early post-operative ICU care of a patient who had open surgery for Type A aortic dissection. Operative course? (50%) Oxygen saturation targets in critical care Q2.

Burns 52

Burns Hyperthermia / Hypothermia Fluid Resuscitation Operations 52

ACEP Now

JUNE 21, 2023

Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. ultrasound and resuscitation procedures) may become a new standard for programs and require a longer training period. 15 Some of these training opportunities previously considered unique (i.e.,

EMS 114

EMS Academics Telemedicine Operations 114

AED Leader

APRIL 22, 2024

They are user-friendly and can be operated by individuals with minimal medical training. This feature helps rescuers optimize their CPR technique and improve the chances of a successful resuscitation. Lifepak AED defibrillators are designed to be user-friendly and can be operated by individuals with minimal medical training.

CPR 52

CPR Shock Resuscitation Operations 52

EMergucate

JANUARY 21, 2017

Despite resuscitation teams operating in extremely high stress environments and such stress being known to substantially impair optimal performance, historically … Continue reading →

Resuscitation 40

Resuscitation Operations 40

Greater Sydney Area HEMS

FEBRUARY 20, 2024

This would therefore remove some of the limitations (perceived or real) around time delays associated with using ultrasound for central access as there would be no need for probe covers and positioning of the portable ultrasound (which often needs the help of a second operator, a significant limitation in a small prehospital medical team).

Ultrasounds 98

Ultrasounds Shock Research Operations 98

AED Leader

JULY 3, 2024

This durability is essential, particularly for businesses operating in demanding or outdoor environments. Real-Time CPR Feedback Performing cardiopulmonary resuscitation (CPR) correctly is crucial for the success of a resuscitation attempt.

CPR 52

CPR Resuscitation Pediatrics Operations 52