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Ep 139 COVID-19 Part 3 – PPE: What We Know, Conservation Strategies and Protected Code Blue

Emergency Medicine Cases

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
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Chemical Burns

Mind The Bleep

Use appropriate personal protective equipment (PPE) to avoid secondary contamination. 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.

Burns 52
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Organophosphate Poisoning

EM SIM Cases

He looks so unwell that he is placed into the resuscitation bay. The team leader must identify the toxidrome and direct the team to early PPE use and patient decontamination. Clinical Vignette A 60-year old farmer presents to the ED with a runny nose, vomiting and diarrhea. He feels short of breath and dizzy.

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Use of 20% intravenous lipid emulsion can be efficacious in the resuscitation of life-threatening local anesthetic toxicity, especially from bupivacaine. Administration of digoxin-specific immune antibody fragments can reverse life-threatening dysrhythmias from digoxin poisoning. COR 1, LOE C-LD. COR 1, LOE C-EO. COR No Benefit, LOE C-LD.

Poisoning 115
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Episode 36: COVID-19

PHEM Cast

PPE As at May 1st, the advice from PHE is ‘ There is currently sustained transmission of COVID-19 throughout the UK as defined by the four nations Public Health experts, therefore there is an increased likelihood of any patient having coronavirus infection. Here is a review of both if you’d like to read more.

PPE 52
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emDOCs Podcast – Episode 116: Massive Hemoptysis

EMDocs

Resuscitate prior to intubation. Preparation: dual large bore suction devices, full PPE, push dose pressors, prep for soilage of airway device, multiple devices, prep for cricothyrotomy. Anatomically and physiologically difficult airway; use the most experienced clinician with a technique with the highest chance of success.

COPD 81
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First10EM Journal Club: March 2024

Broome Docs

Is our PPE evidence-based? Resuscitation. Emerg Med J. 2024 Jan 22;41(2):96-102. doi: 10.1136/emermed-2023-213285. PMID: 38050078 Bottom line: High dose nitroglycerin seems to result in better outcomes in SCAPE, at least according to this small, single center, unblinded trial. 2023 Dec;193:109991. doi: 10.1016/j.resuscitation.2023.109991.

PPE 96