Dr. Smith's ECG Blog

JULY 14, 2023

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

Resuscitation 98

Resuscitation EKG/ECG CPR Outcomes 98

EMDocs

DECEMBER 1, 2024

The disease is generally mild, but in untreated cases, it can lead to more severe outcomes, especially in patients with underlying conditions such as glucose-6-phosphate dehydrogenase deficiency. Even though the disease often resolves spontaneously, prompt antibiotic therapy is essential for optimal outcomes. pregnant patients).

EMS 105

EMS Infectious Diseases Shock Airway Management 105

Sensible Medicine

MARCH 14, 2025

Outcomes and patients The primary outcome was 90-day in-hospital mortality. Secondary outcomes included code activation, pressor therapy, initiation of HD, MDROs, and C. Process measures suggested that doctors and nurses responded to the alerts with increased testing of lactate levels and fluid resuscitation.

Sepsis 94

Sepsis Wellness Documentation/Coding Fluid Resuscitation 94

St. Emlyn

JUNE 14, 2024

The post JC: Does the outcome from refractory VF differ from recurrent VF in DOSE-VF patients? appeared first on St.Emlyn's.

Outcomes 114

Outcomes Hospitals Resuscitation 114

PulmCCM

FEBRUARY 24, 2025

Although cardiopulmonary resuscitation (CPR) is performed on more than 250,000 people in U.S. This results in a wide variation in practice—a quarter of unsuccessful resuscitations are stopped before 15 minutes, while a quarter go longer than 30 minutes. Should they also receive a different duration of CPR?

CPR 52

CPR Hospitals Resuscitation Outcomes 52

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

PulmCCM

MARCH 10, 2025

An index to all posts in the series can be found here: Introduction Although cardiopulmonary resuscitation (CPR) is performed on more than 250,000 people in U.S. This results in a wide variation in practice—25% of unsuccessful resuscitations are stopped before 15 minutes, while an equal number go longer than 30 minutes.

CPR 52

CPR Hospitals Hyperthermia / Hypothermia Resuscitation 52

Dr. Smith's ECG Blog

JUNE 27, 2024

A reliable study would keep track of all patients with shockable arrest and analyze the ones who were not enrolled to see their outcomes. Resuscitation Plus [Internet] 2020;4:100032. A patient like this one would not be enrolled because no clinician (ER doc or cardiologist) would enroll such a patient. This study failed to do so.

Resuscitation 113

Resuscitation EKG/ECG Outcomes Hospitals 113

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

Canadian EM

MAY 18, 2023

In this issue, we collaborated with CJEM team to present “Emergency department crowding negatively influences outcomes for adults presenting with chronic obstructive pulmonary disease”​1​ in a visual abstract format. Over in the resuscitation bay, a CTAS. In the ED, patients with respiratory pathology present on a shiftly basis.

COPD 75

COPD Emergency Department Outcomes Resuscitation 75

RebelEM

JUNE 1, 2023

Post-ROSC management is nuanced and challenging but helps to ensure good outcomes. In theory, rapid identification of the underlying cause should improve outcomes by allowing clinicians to tailor management. Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study.

Outcomes 145

Outcomes Resuscitation CPR Hospitals 145

Emergency Medicine Cases

APRIL 23, 2024

The post EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality appeared first on Emergency Medicine Cases.

EMS 120

EMS Resuscitation Outcomes Allergic Reactions 120

Don't Forget the Bubbles

DECEMBER 18, 2023

I think we should stop resuscitation. How long should you try to resuscitate? There are no hard and fast rules as to how long a resuscitation attempt should be carried out. We might continue resuscitation attempts longer than usual to allow family members to arrive and hold the child’s hand or be at the bedside when we stop.

Resuscitation 131

Resuscitation Outcomes CPR Hospitals 131

Don't Forget the Bubbles

MARCH 31, 2025

This was a secondary analysis of the Management and Outcome of Fever in Children in Europe (MOFICHE) study. The primary outcome measure was SBI, and 1854 children included were diagnosed with an SBI. Sepsis is a significant cause of mortality in children, and fluid resuscitation is a key treatment strategy. Whats it about?

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

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

St. Emlyn

JUNE 23, 2024

Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite […] The post JC: The impact of double sequential external defibrillation timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.

Outcomes 96

Outcomes Hospitals Resuscitation 96

Emergency Medicine Journal

OCTOBER 26, 2023

Inclusion criteria were non-traumatic cardiac arrests treated with at least one external electric shock with an automated external defibrillator from the basic life support team and resuscitated by a physician-staffed ALS team. Primary outcome was survival at hospital discharge with a good neurological outcome.

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

RebelEM

MAY 29, 2023

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. 95% CI 15.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 145

Administration Outcomes Resuscitation Radiology 145

The Trauma Pro

SEPTEMBER 21, 2023

Whole blood is the new darling of trauma resuscitation. Assembling a unit of whole blood from the components it was broken down into produces an inferior product from the standpoint of resuscitation. Reference: Whole blood on the scene of injury improves clinical outcome of the bleeding trauma patient.

Resuscitation 113

Resuscitation Outcomes 113

RebelEM

SEPTEMBER 14, 2023

to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81

Shock 136

Shock Resuscitation Outcomes Stroke 136

Pediatric EM Morsels

SEPTEMBER 22, 2023

While we may allow permissive hypotension in damage control resuscitation of hemorrhagic shock, in neurogenic shock you should maintain an age-appropriate blood pressure. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

EMDocs

OCTOBER 12, 2024

Spoon Feed For sickle cell patients (particularly Hgb SS) with a vaso-occlusive episode (VOE), large volume resuscitation (>2L) with lactated ringers (LR) has been shown to have improved outcome measures compared to normal saline (NS). Resuscitation. . #1: LR or NS for Sickle Cell Pain Crisis? 2024 Sep;202:110360.

Resuscitation 98

Resuscitation Outcomes Hospitals 98

St. Emlyn

JANUARY 27, 2025

St.Emlyn's - Emergency Medicine #FOAMed What is the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. The post JC: Do physician led prehospital teams improve outcomes? appeared first on St.Emlyn's.

Outcomes 63

Outcomes Hospitals Research Resuscitation 63

Emergency Medicine Education

NOVEMBER 3, 2024

I personally believe that having a secure line, whether a peripheral IV or central line, is essential for resuscitating a patient. A recent article in NEJM highlighted that the drug administration route—IV versus IO—matters in terms of successful resuscitation, return of spontaneous circulation (ROSC), and favorable neurological outcomes.

Resuscitation 40

Resuscitation Administration Outcomes 40

Emergency Medicine Journal

JULY 24, 2023

We aimed to determine the association between the 2020 COVID-19 pandemic and OHCA outcomes and bystander resuscitation efforts among the working-age population. We compared characteristics and outcome differences of the arrests between three prepandemic years (2017–2019) and the pandemic year 2020. to 1.44)).

Resuscitation 52

Resuscitation Outcomes CPR Hospitals 52

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care.

Resuscitation 93

Resuscitation Airway Management EMS Outcomes 93

ACEP Now

OCTOBER 29, 2024

Caring for critically ill patients with limited information requires snap assessments and judgements for timely resuscitation and efficient emergency department throughput. In this study, clinical gestalt is not only fast, but accurate for the benefit of timely resuscitation and intervention. Sound familiar?

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Ultrasound Gel

JUNE 24, 2019

Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes. Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes.

Outcomes 52

Outcomes Ultrasounds Resuscitation Research 52

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

EMDocs

FEBRUARY 20, 2024

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Question:In adults with acute pancreatitis, does moderate fluid resuscitation compared to aggressive resuscitation reduce the development of moderately severe or severe pancreatitis? N Engl J Med. 2022 Sep 15;387(11):989-1000. to 9.8L) Moderate: 5.5L (Range 4.0

Fluid Resuscitation 98

Fluid Resuscitation Resuscitation Outcomes Hospitals 98

First 10 EM

JANUARY 29, 2024

REBOA (resuscitative endovascular balloon occlusion of the aorta) has been discussed in the emergency medicine world for quite some time now, but always with very limited data. Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM.

Resuscitation 98

Resuscitation Outcomes EMS 98

The Bottom Line

JUNE 19, 2023

In patients resuscitated from out-of-hospital cardiac arrest (OOHCA) does targeted mild hypercapnia compared to targeted normocapnia improve 6-month neurological outcomes?

Resuscitation 98

Resuscitation Outcomes Hospitals 98

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

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 93

Sepsis Shock Resuscitation Fluid Resuscitation 93

ACEP Now

JULY 7, 2023

2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity. Resuscitation. Resuscitation. Resuscitation. Resuscitation. 2022;175:105-112. Sakai T, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

EMDocs

NOVEMBER 29, 2023

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Question:In adults with acute pancreatitis, does moderate fluid resuscitation compared to aggressive resuscitation reduce the development of moderately severe or severe pancreatitis? N Engl J Med. 2022 Sep 15;387(11):989-1000. to 9.8L) Moderate: 5.5L (Range 4.0

Fluid Resuscitation 93

Fluid Resuscitation Resuscitation Outcomes Hospitals 93