AED Leader

APRIL 23, 2024

In this blog post, we will explore these advanced techniques and discuss how they can be implemented to improve emergency outcomes. A manual defibrillator is a device used to deliver an electric shock to the heart to restore its normal rhythm. It consists of two paddles or electrode pads placed on the patient’s chest.

Shock 52

Shock Best Practices Outcomes Pediatrics 52

RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1% Liberal: 14.9% Liberal: 14.9%

Sepsis 89

Sepsis Shock Resuscitation Outcomes 89

RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Three outcomes were evaluated, with none being deemed the primary outcome. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 121

Sepsis Hospitals Administration Outcomes 121

Dr. Smith's ECG Blog

MAY 30, 2023

A 50-something man presented in shock with severe chest pain. The patient was in clinical shock with a lactate of 8. This confirms inferior, posterior, lateral, and RV MI RV MI often leads to shock and (systolic) hypotension. RVMI explains part of the shock. The RV is supplied during systole as well as diastole.

Shock 79

Shock EKG/ECG Academics Stroke 79

JournalFeed

JANUARY 13, 2024

Monday Spoon Feed: This expert panel from Canada has compiled a list of what they deem to be the most influential POCUS papers with regard to cardiac arrest as well as evaluation of shock. Whether you want to further educate yourself or guide your residents to learn more on the subject, this primer is a great place to start.

Shock 52

Shock Outcomes Wellness 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He was admitted on oxygen and was doing fairly well with saturations of 100% on 2 L nasal cannula. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Assessment was severe sudden cardiogenic shock. He remained hypotensive and in shock.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Sensible Medicine

AUGUST 7, 2023

It is shocking. The brave investigators in London decided to study the idea that medical therapy of heart failure has become so outstanding, that adding revascularization (fixing the obstructions with stents) might not improve outcomes. Their primary outcome was death or hospitalization for heart failure. First some background.

Shock 84

Shock Outcomes Hospitals Wellness 84

Taming the SRU

MARCH 10, 2024

critical AS, ASD, HCM) Arrhythmogenic right ventricular cardiomyopathy Pulmonary embolism Thoracic aortic dissection Transient occult shock Sepsis Hemorrhagic shock (ex. Can’t miss ED diagnosis for syncope Brady/tachy dysrhythmia, arrhythmias such as ARVC, channelopathy (Brugada) Acute MI Structural heart disease (ex.

EKG/ECG 90

EKG/ECG Shock Wellness EMS 90

Sensible Medicine

JUNE 16, 2024

I watched a case as a young doctor and came away shocked that patients survive this surgery. Well, there is less debris than I would have thought. Because you know how scary it is to try and compare outcomes in two groups of patients who were not randomized. We discuss that as well. TAVR is even more stunning.

Stroke 72

Stroke Shock Wellness Outcomes 72

AED Leader

JULY 2, 2024

They are designed to rapidly deliver a high energy level, allowing the AED to administer a life-saving shock to the heart. An AED with a weak or expired battery may not deliver the required shock to restore the heart’s normal rhythm effectively. When a cardiac emergency occurs, every second counts.

Shock 52

Shock Operations Outcomes Wellness 52

RebelEM

APRIL 22, 2024

Intervention: Target PaO2 = 60 mm Hg Control: Target PaO2 = 90 mm Hg Outcome (primary): Absolute number of days without life support in 90 days defined as the absence of mechanical ventilation, circulatory support, or kidney replacement. Outcomes (secondary): 90-day all-cause mortality. CI) Secondary Outcomes 90-day Mortality 34.7%

Outcomes 67

Outcomes Best Practices EMS Shock 67

RebelEM

SEPTEMBER 28, 2023

The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a pharmaco-invasive strategy resulted in similar rates of death, shock, heart failure, or reinfarction compared to primary PCI. Primary PCI: 95.7% Primary PCI: 95.7%

EKG/ECG 131

EKG/ECG Allergic Reactions Shock Stroke 131

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. Each subsequent one-hour delay in antimicrobial administration increases mortality by 35% in patients with septic shock (Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

PulmCCM

FEBRUARY 12, 2024

SCCM Guideline Update: Steroids for Community-Acquired Pneumonia, ARDS, Septic Shock Steroids are good medicine in the ICU, U.S. Recent studies, though, have shown steroids’ benefit in Covid pneumonia with ARDS, and for steroids improving outcomes in severe community-acquired pneumonia.

Shock 52

Shock Administration Sepsis Fractures 52

Don't Forget the Bubbles

MAY 6, 2024

Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. The primary outcome was the successful intubation on the second attempt. Secondary outcomes included tracheal intubation adverse events (TIAEs) or severe desaturation.

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

AED Leader

NOVEMBER 15, 2023

The device will perform charge and shock tests and prompt the user to press the shock button (on semi-automatic units) when required. Please note that running a manual self-test on this unit depletes the battery capacity by one shock. As the pads dry out, they may not attach as well to the skin, resulting in poor conductivity.

Shock 52

Shock CDC Pediatrics Wellness 52

AED Leader

NOVEMBER 15, 2023

The device will perform charge and shock tests and prompt the user to press the shock button (on semi-automatic units) when required. Please note that running a manual self-test on this unit depletes the battery capacity by one shock. As the pads dry out, they may not attach as well to the skin, resulting in poor conductivity.

Shock 52

Shock CDC Pediatrics Wellness 52

PulmCCM

NOVEMBER 27, 2023

Beta-blockers for septic shock (STRESS-L trial) Septic shock deranges multiple complex signaling systems in the body. A meta-analysis of 7 randomized trials (n=503) previously suggested that co-administration of esmolol to blunt vasopressor-induced tachycardia and arrhythmias could reduce mortality in septic shock by one-third.

Sepsis 52

Sepsis Shock Administration Outcomes 52

PulmCCM

JULY 31, 2023

severe hypoxemia not doing well or on a bad trajectory while receiving conventional care). is to restrict caloric delivery in patients with this degree of shock. To make that leap, I for one would need to see improved outcomes with caloric restriction in patients with less-severe shock. Usual practice in the U.S.

Shock 98

Shock Documentation/Coding Outcomes Wellness 98

AED Leader

APRIL 30, 2024

As a responsible parent or guardian, the safety and well-being of your child are of utmost importance. AEDs are designed to deliver a life-saving shock to the heart, restoring its normal rhythm and allowing vital organs to receive the needed oxygen.

CPR 52

CPR Operations Shock Resuscitation 52

Don't Forget the Bubbles

DECEMBER 11, 2023

Naturally, it can seem obvious to us now that abuse and trauma in childhood can affect your health and well-being quite significantly, but what was surprising at the time was not just that these events had an impact but how much of an impact these adverse childhood events had. Could there be an element of causation as well as correlation?

Wellness 103

Wellness Research Outcomes Shock 103

Stop and Think

JUNE 13, 2023

It’s shocking how many have subscribed and supported this newsletter. In PARAGON-HF, the new drug reduced a composite primary outcome of heart failure events and death from cardiovascular causes but the reduction failed to meet statistical significance. This will be the first of a two-part series regarding two curious studies.

Outcomes 98

Outcomes Academics Hospitals Shock 98

Dr. Smith's ECG Blog

AUGUST 9, 2024

The LCx and OM vessels are not as well visualized. Opioids associate with worse outcomes in myocardial infarction , probably because they eliminate the pain signal that informs the clinician of the urgency of revascularization. Do not treat AIVR. In fact, use of antidyrhythimcs (e.g., In fact, use of antidyrhythimcs (e.g., Washam, J.

EKG/ECG 85

EKG/ECG EMS Emergency Department Outcomes 85

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Outcomes 52

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 88

Sepsis Administration Documentation/Coding Fractures 88

Dr. Smith's ECG Blog

MARCH 30, 2014

Case A female in her 60s presented with 3 days of nausea, vomiting, and diarrhea, and not feeling well. Then the notes mention "cardiogenic shock" but without any reference to a cardiac echo or to a chest x-ray. Cardiologist note says: "Elevated troponin explained by type II MI due to her shock." Was there pulmonary edema?

EKG/ECG 52

EKG/ECG Outcomes Shock Sepsis 52

The Skeptics' Guide to EM

DECEMBER 11, 2021

. * Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. No statistical difference in their primary outcome for duration of time alive and free of vasopressor administration up to day 7 or the secondary outcome of 90-day mortality. Moskowits et al ( ACTS RCT) JAMA 2020: n=205 patients with septic shock.

Sepsis 40

Sepsis Shock Outcomes Research 40

Emergency Medicine Ireland

OCTOBER 30, 2023

Well, that time has come and it’s time to run through vasopressin. Well this is where the fun beings. Primary outcome here was kidney based rather than mortality. Vasopressin versus norepinephrine infusion in patients with septic shock. Well, that time has come and it’s time to run through vasopressin.

Shock 52

Shock Sepsis Wellness Outcomes 52

Taming the SRU

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. O: There was an association between increased diastolic shock index score and mortality at 90 days and performed similarly to more advanced measures of morbidity and mortality in septic shock including lactate levels and SOFA scores.

Shock 52

Shock Outcomes Sepsis Resuscitation 52

Ken Grauer, MD

FEBRUARY 28, 2023

These 2 settings are: i ) In patients with severe , often longstanding pulmonary disease ; and / or , ii ) In acutely ill patients with multi-system disease ( ie, sepsis, shock, electrolyte and/or acid-base disorders ). MAT almost always occurs in one of 2 common predisposing settings. Remember — 12 leads are better than one!

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

PulmCCM

DECEMBER 3, 2023

Well, that would be ground-breaking and practice-changing, to say the least. The short answer is, ventilator-free days combine two outcomes (extubation and mortality); all the patients who survived together generated thousands of ventilator-free days, which in this study, were roughly equal between groups.

Poisoning 64

Poisoning Outcomes Hospitals Academics 64

Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 83

CPR Burns Airway Management Wellness 83

Ziqitza HealthCare Ltd

MAY 14, 2024

Ambulance services staff highly qualified and well-trained medical professionals, paramedics and emergency medical technicians, especially educated to provide trauma aid. Immediate medical assistance provided at the right time can be life-saving and also help improve patient outcomes. These make ambulance services vital.

Ambulance Services 52

Ambulance Services Hospitals CPR EKG/ECG 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

He is found to be in hypoxic respiratory failure and septic shock. 4] This association seems to hold true in the pediatric literature as well. [5-6] Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. Intravenous (IV) access is obtained.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. His immunizations are current and has received all pneumococcal vaccinations. C or 100.4

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75