The Trauma Pro

JUNE 18, 2024

Early resuscitation, particularly with blood products in patients with hemorrhage, is literally a lifesaver. To facilitate this, massive transfusion protocols (MTP) have been designed to rapidly deliver sizable quantities of blood products to the trauma resuscitation bay. As each minute ticks by, survival slowly diminishes.

Pediatrics 147

Pediatrics Blood Transfusions Resuscitation Shock 147

EM Ottawa

APRIL 18, 2024

In this Prehospital Journal Club Recap, let us take a deep dive into the use of blood products, as well as the adjunct use of automated controlled elevation in CPR.

CPR 110

CPR Resuscitation Shock Wellness 110

ACEP Now

JULY 7, 2023

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. 6 What Can I Do Outside of Repeated Shocks and Standard ACLS? amiodarone or lidocaine).

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

EM Literature of Note

JANUARY 27, 2024

A brief post collating a few bits of my various work published across the interwebs … The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Apple Podcasts Google Podcasts Soundcloud Naturally, there are continuing Journal Club features, covering the (..)

Resuscitation 94

Resuscitation Emergency Department Shock Wellness 94

Dr. Smith's ECG Blog

MAY 26, 2023

A 20-something presented after a huge verapamil overdose in cardiogenic shock. He was admitted to the ICU and was unstable, in shock, overnight. 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.

Shock 91

Shock EKG/ECG Documentation/Coding Resuscitation 91

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 78

Burns Fluid Resuscitation Shock Resuscitation 78

Taming the SRU

JULY 24, 2024

Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world. They then tested the LASSO model using the remaining 20% of data to see how well it could detect sepsis at the same time points.

Sepsis 89

Sepsis Resuscitation Emergency Department Wellness 89

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 105

Sepsis Shock Resuscitation Outcomes 105

AED Leader

SEPTEMBER 23, 2024

Avoid using it on someone with a Do Not Resuscitate (DNR) order. That tiny shock given by the defibrillator? Also, if the person has a Do Not Resuscitate (DNR) order in place, using a defibrillator isn’t recommended. Before even thinking about a electric shock , check if they really need help. Safety first, always.

Shock 52

Shock Resuscitation CPR Pediatrics 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 Hospitals 105

Greater Sydney Area HEMS

FEBRUARY 20, 2024

Obtaining access in shocked trauma patients can be notoriously difficult due to circulatory collapse. Those who are shocked, shut down with limited or no other options for peripheral access require central access. The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i].

Ultrasounds 98

Ultrasounds Shock Research Operations 98

AED Leader

JUNE 27, 2024

Its user-friendly interface and clear voice prompts guide the rescuer through each step, from applying the pads to delivering a shock if necessary. Its intelligent algorithms analyze the heart’s rhythm and determine if a shock is needed. One of the standout features of the Heart Start AED is its Quick Shock capability.

CPR 52

CPR Shock Resuscitation Wellness 52

AED Leader

APRIL 29, 2024

In today’s fast-paced world, businesses must prioritize their employees’ and customers’ safety and well-being. AEDs are portable devices that can be used to deliver an electric shock to the heart in case of sudden cardiac arrest (SCA), a condition that can strike anyone, anywhere, at any time.

Shock 52

Shock Resuscitation Pediatrics CPR 52

Dr. Smith's ECG Blog

JUNE 9, 2024

Over the next 10 minutes we resuscitated with high doses of Calcium, Epinephrine, and Bicarbonate. There are no P-waves (this can also happen in hyperkalemia due to sino-ventricular rhythm), but here is it slow and even wider than 9 minutes later: The patient eventually did well and fully recovered. Also: How did this happen?

EKG/ECG 131

EKG/ECG Resuscitation Shock Wellness 131

AED Leader

SEPTEMBER 21, 2024

Why is defibrillation important Defibrillation is the process of delivering an electrical shock to a person experiencing life-threatening heart rhythms, like ventricular fibrillation (VF) or pulseless ventricular tachycardia. The defibrillator administers a shock measured in joules to the heart at precisely the right moment.

CPR 52

CPR Shock Resuscitation Hospitals 52

EM SIM Cases

SEPTEMBER 19, 2024

WHY IT MATTERS Patients in hemorrhagic shock require blood products expeditiously as well as identification and definitive management of the source of bleeding. This case provides an opportunity to practice identification and treatment of multiple sources of blood loss in hemorrhagic shock.

Shock 52

Shock Emergency Nursing Operations Administration 52

EMDocs

OCTOBER 8, 2024

Tachycardia may be present both from many medications or drugs, as well as withdrawal. Additional resuscitation Have we addressed all potential sources of shock for the patient in front of us? Does the patient require blood, a procedure to address obstructive shock, or other source control? Do they have edema?

Shock 95

Shock Emergency Department Pediatrics EKG/ECG 95

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. Guest Skeptic: Dr. Rory Spiegel (@EMNerd_) is a clinical instructor at University of Maryland, a recent graduate of Stony Brook’s Resuscitation Fellowship, and a current Critical Care fellow at University of Maryland. NEJM January 2018. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

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

EMDocs

JUNE 25, 2024

Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion.

Burns 74

Burns Fluid Resuscitation Resuscitation Poisoning 74

AED Leader

JULY 10, 2024

In today’s fast-paced world, businesses must prioritize their employees’ and customers’ safety and well-being. AEDs are portable devices that can be used to deliver an electric shock to the heart in the event of sudden cardiac arrest (SCA), potentially saving a person’s life.

CPR 52

CPR Shock Operations Resuscitation 52

Taming the SRU

JANUARY 12, 2024

Often AE-ILD is idiopathic, but treatable causes must be excluded (PNA, PE, volume overload) Treatment for AE-ILD should include antibiotics for CAP coverage (specifically including azithromycin), steroids, and respiratory support; consider opportunistic infection if immunosuppressed as well as diuresis as needed for euvolemia HFNC should be favored (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

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

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

The ST elevation in V2-V6 as well as in I and aVL becomes easily recognizable. Resuscitation efforts were undertaken. ECG#3 Resuscitation efforts were ongoing. The patient ultimately did well. The patient was shocked — and then began a long intensive process of resuscitation. Is there OMI? An ICD was placed.

EKG/ECG 129

EKG/ECG Resuscitation Academics EMS 129

Taming the SRU

JANUARY 24, 2024

The case highlights how we as providers can grieve the loss of our patients, as well as the profound relationships with can make with their family members. ETT Depth = ETT size x3 initial defibrillation: 2J/kg (next shock is 4J/kg) Toxicology Quick Hits Fomepizole is the treatment for both polyethylene glycol and methanol toxicity.

Fractures 88

Fractures Leadership Dislocations Resuscitation 88

RebelEM

SEPTEMBER 26, 2022

Patients from both groups are well balanced regarding results from a wide range of coagulation studies. 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

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Background: It’s interesting to see how fluid resuscitation has been debated over the years. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL).

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

Taming the SRU

FEBRUARY 7, 2024

Tillotson and Hinckley Simulation Communication on arrival to a scene is key, both between you and your flight nurse before you enter the ambulance and with the EMS crew Reassessing the potential reasons for shock in a trauma is important to pick up causes that are not initially on your mind initially (blood products for hemorrhage, controlling a significant (..)

Administration 98

Administration PPE Ultrasounds Poisoning 98

EMDocs

NOVEMBER 6, 2023

Use of 20% intravenous lipid emulsion can be efficacious in the resuscitation of life-threatening local anesthetic toxicity, especially from bupivacaine. Venoarterial extracorporeal membrane oxygenation can be lifesaving for patients with cardiogenic shock or dysrhythmias that are refractory to other treatment measure s.

Poisoning 95

Poisoning Hyperthermia / Hypothermia Seizures Administration 95

AED Leader

MAY 27, 2024

This article will discuss the essential features to look for when selecting an AED for schools, ensuring the safety and well-being of students, staff, and visitors. Look for AEDs with clear visual and audio prompts that guide the user through resuscitation. Ease of Use When choosing an AED for schools , ease of use is paramount.

CPR 52

CPR Pediatrics Shock Administration 52

RebelEM

JUNE 26, 2023

4F-PCC contains factors II, VII, IX, X as well as Proteins S and C. Clinical Take Home Point: In adult patients with trauma at risk of massive transfusion, receiving standard trauma resuscitation management, the addition of 4F-PCC did not result in a decrease in blood product consumption over 24 hours compared to placebo.

Administration 145

Administration Outcomes Resuscitation Radiology 145

AED Leader

JUNE 2, 2024

With innovative technology and intelligent algorithms, this AED delivers high-quality, accurate shocks to restore normal heart rhythm. Clear visual and audio prompts guide the user through each step of the resuscitation process, ensuring that anyone can confidently use the AED in an emergency.

CPR 52

CPR Shock Pediatrics Operations 52

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

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

AED Leader

MAY 8, 2024

It features an advanced biphasic waveform, which delivers a highly effective shock to the patient’s heart. The device features clear and concise visual and audio prompts that guide the user through each step of the resuscitation process. The Defibtech DBP 2003 excels with its intuitive and user-friendly design.

Shock 52

Shock CPR Operations Resuscitation 52

AED Leader

JUNE 17, 2024

These devices are designed to analyze the heart rhythm and deliver a potentially life-saving electric shock called defibrillation to restore the heart’s normal rhythm. These devices utilize biphasic waveform technology, which delivers a controlled amount of energy to the heart for a more efficient and effective shock.

CPR 52

CPR Pediatrics Shock Operations 52