Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. How can this situation be rectified or has the use of ultrasound rendered this blind subclavian “trauma line” a thing of the past? One approach to obtaining BCV origin access (fig.1) 2020;35(3):303-321.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Taming the SRU

APRIL 11, 2024

cm is normal Hazard ratio in patients with abnormal TAPSE in normotensive patients is high even though the patient is currently hemodynamically stable Acute vs chronic right heart strain Acute McConnell’s sign: apical hypokinesis with RV free wall hypokinesis Will be present in all causes of increased RV pressure including PE, pulmonary HTN, etc.

Ultrasounds 93

Ultrasounds Pediatrics Hyperthermia / Hypothermia Burns 93

Taming the SRU

FEBRUARY 7, 2024

Ultrasound: Make “windows of access”. The Aircare package to increase DASH-1A airways includes placing patient on AirCare monitor, apneic oxygenation, 3 minutes NRB, bagging after paralytic given, starting only when patient > 97%, push dose pressors if needed for hypotension before paralytic, and make sure to use the checklist!

Administration 97

Administration PPE Ultrasounds Poisoning 97

Broome Docs

MARCH 28, 2024

If you want to see Justin in the video format and his new Youtube series then click here: [link] If you would like to check out my current ultrasound training project then click here: WACHS Ultrasound Otherwise – enjoy the show and see you in a few weeks. Resuscitation. 2023 Dec;193:109991. doi: 10.1016/j.resuscitation.2023.109991.

PPE 107

PPE Ultrasounds Resuscitation Administration 107

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. Place ultrasound machine on the opposite side of the bed to minimize neck strain.

Emergency Department 90

Emergency Department Ultrasounds Administration Burns 90

Core Ultrasound

DECEMBER 30, 2024

In part two of this series on using ultrasound during cardiac arrest, we dive into advanced strategies to further optimize your resuscitation care. Building on the foundation from part one, this video focuses on actionable tips to take your ultrasound skills to the next level during cardiac arrest scenarios.

Ultrasounds 40

Ultrasounds Resuscitation 40

RebelEM

JUNE 26, 2023

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. Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 to 2.10; P = 0.03

Administration 140

Administration Outcomes Resuscitation Radiology 140

EMDocs

JANUARY 16, 2024

Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation. 2,3 If the patient meets criteria for resuscitation, they generally are not declared dead until their core temperature is above 32℃ (“warm and dead”).

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

Dr. Smith's ECG Blog

DECEMBER 16, 2024

And almost all of them could be detected by bedside ultrasound. Conclusion: you may take a few moments to look for dissection with your bedside ultrasound, but when it is a clear STEMI, do NOT waste time with a CT scan. It is not a waste of time to use bedside ultrasound to look for dissection 3. Ultrasound Med.

Ultrasounds 87

Ultrasounds EKG/ECG Operations Emergency Department 87

Ultrasound Gel

JUNE 24, 2019

It is great to see more and more research on ultrasound in cardiac arrest. Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes. link] It is great to see more and more research on ultrasound in cardiac arrest.

Outcomes 52

Outcomes Ultrasounds Resuscitation Research 52

Core Ultrasound

DECEMBER 17, 2024

Ultrasound is a powerful tool that can significantly enhance patient care during cardiac arrest. In Part 1 of this lecture, we break down how ultrasound can be effectively utilized in three key areas: identifying reversible causes, assisting in critical procedures, and guiding resuscitation.

Ultrasounds 40

Ultrasounds Resuscitation 40

EMDocs

JUNE 22, 2023

Remember that while mistakes in resuscitation are often dissected and analyzed, it is equally crucial to acknowledge and celebrate the moments of impeccable execution, where lives are saved and hope is restored. He is on a vasopressin infusion now after the four unit bolus from the initial resuscitation. This guy is an ultrasound guru.

Resuscitation 96

Resuscitation Ultrasounds Critical Access Documentation/Coding 96

Ultrasound Gel

MARCH 18, 2019

TEE has been heralded as the latest and greatest way to monitor a cardiac arrest resuscitation. What we do know is that a few studies have shown that transthoracic ultrasound leads to prolonged pauses in cardiac arrest. link] TEE has been heralded as the latest and greatest way to monitor a cardiac arrest resuscitation.

Resuscitation 52

Resuscitation Ultrasounds 52

PHEM Cast

APRIL 16, 2018

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

Arrival at time 0 ECG 7 min Roomed in hallway at 17 min Moved to room with monitor at 37 min The patient was seen briefly by the physician, who then went to get an ultrasound machine. Resuscitative attempts were initiated quickly. VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc.

EKG/ECG 128

EKG/ECG Resuscitation CPR Emergency Department 128

RebelEM

JUNE 19, 2023

Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7). 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). Demographics were well balanced in the two groups.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

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

Northwestern EM Blog

APRIL 1, 2024

As listed in the above post, symptoms of molar pregnancy can be similar to viable pregnancy and its complications, so it is important to obtain a timely ultrasound in any patient with unknown pregnancy location or if considering molar pregnancy.

OB/GYN 52

OB/GYN Emergency Department Ultrasounds Resuscitation 52

Emergency Medicine News

DECEMBER 31, 2023

An abstract is unavailable.

Resuscitation 59

Resuscitation Ultrasounds Pediatrics 59

EMDocs

APRIL 22, 2024

Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Multiorgan POCUS The diagnostic power of POCUS often resides in combining multiple ultrasound exams. Introduction to Bedside Ultrasound, iBook Ch 2, Basic Cardiac, Pg 27.

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

EMDocs

MAY 15, 2024

Ultrasound Sensitivity 88-100%, specificity 68-94% Positive likelihood ratio of 14.6 (95% Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Look for B lines, consolidation, pleural effusion. CT with IV contrast Higher sensitivity and specificity than x-ray. times maintenance.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

Canadian EM

SEPTEMBER 26, 2023

Traumatic cardiac arrest shares many similarities, yet a few subtle differences from your typical medical resuscitation. Prognostically favourable factors such as shockable rhythm, and organized cardiac activity on ultrasound still exist.

Resuscitation 52

Resuscitation Ultrasounds 52

Taming the SRU

JUNE 26, 2024

TEE can be helpful in guiding resuscitation if available. Factors that improve survival rates include cardiac activity on ultrasound, initial shockable rhythm, witnessed arrest, extremity only trauma, and bystander CPR. Unresponsive patients with undetectable MAP or EtCO2 less than 20 should undergo CPR.

Blood Transfusions 85

Blood Transfusions Sepsis CPR EKG/ECG 85

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. Date: November 21st, 2019 Reference: Daley et al.

Ultrasounds 52

Ultrasounds Emergency Department Academics Outcomes 52

EMDocs

MAY 28, 2024

Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Look for B lines, consolidation, pleural effusion. CT with IV contrast Higher sensitivity and specificity than x-ray. Decreases splinting and improves tidal volumes. times maintenance.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

Critical Care Now

APRIL 26, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. They quickly recognized the underlying condition and began resuscitation and stabilization before transport. Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director.

Resuscitation 52

Resuscitation Fluid Resuscitation EMS Sepsis 52

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 88

CPR Burns Airway Management Wellness 88

EMDocs

APRIL 2, 2024

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

Documentation/Coding 92

Documentation/Coding CPR EKG/ECG Sepsis 92

Taming the SRU

JUNE 24, 2024

Resuscitation , Volume 181,2022,Pages 140-146,ISSN 0300-9572, [link] Scott Weingart, MD FCCM. Available from: [link] Siamak Moayedi, Priya Patel, Nicholas Brady, Michael Witting, Timm-Michael L. Anteroposterior pacer pad position is better than anterolateral for transcutaneous cardiac pacing.” EMCrit 310 – Transvenous Pacemakers. EMCrit Blog.

Advances Cardiac Life Support (ACLS) 88

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 88

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

His primary interests are resuscitation, prehospital critical […] The post SGEM#231: You’re So Vein – IO vs. IV Access for OHCA first appeared on The Skeptics Guide to Emergency Medicine. His primary interests are resuscitation, prehospital critical care, airway management, and point-of-care ultrasound.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

EM Curious

JULY 8, 2015

ULTRASOUND GOODIE BAG ULTRASOUND FOR LATE PREGNANCY [PODCAST]: While not a routine exam we perform other than confirming fetal heart tones, definitely some great pearls on more advanced US topic. Consider an ultrasound guided ulnar nerve block. Part 1 here. US GUIDED ULNAR NERVE BLOCK [BLOG]: Boxer's fracture need a reduction?

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

Dr. Smith's ECG Blog

OCTOBER 24, 2013

He underwent immediate CPR, was found to be in ventricular fibrillation, and was successfully resuscitated. I do not have the post-resuscitation ECG. An emergency cardiac ultrasound could be very useful. The patient went home and, in front of his wife, he collapsed. He underwent coronary stenting (uncertain which artery).

EKG/ECG 52

EKG/ECG Resuscitation CPR Ultrasounds 52

EB Medicine

NOVEMBER 17, 2020

EMplify November 2020 An Evidence-Based Approach to Nonoperative Management of Traumatic Hemorrhagic Shock in the Emergency Department Authors : Christopher Pitotti, MD, FACEP Jason David, MD Topics : The Lethal Triad Prehospital Care Tourniquets - Placement and Pitfalls Stop The Bleed Hemostatic Dressings TXA Temperature Management ED Assessment Shock (..)

Emergency Department 40

Emergency Department Shock Resuscitation CPR 40

JournalFeed

OCTOBER 22, 2022

Peds MTP Spoon Feed: A transfusion threshold of 20 ml/kg of any blood product during the first hour of pediatric trauma resuscitation maximizes sensitivity and specificity for in-hospital mortality, need for intervention, and additional bleeding episodes and may identify children in need of massive transfusion.

Ultrasounds 40

Ultrasounds Resuscitation Pediatrics Hospitals 40

Dr. Smith's ECG Blog

OCTOBER 10, 2022

Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism. Now another, with ultrasound. He was resuscitated — but subsequently had multiple cardiac arrest recurrences, with successful resuscitation each time. Submitted by a Med Student, with Great Commentary on Bias!

EKG/ECG 52

EKG/ECG Resuscitation Ultrasounds CPR 52

EMDocs

DECEMBER 1, 2024

The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus. Curr Opin Infect Dis. 2016 Oct;29(5):433-9. Perera P, Mailhot T, Riley D, Mandavia D.

EMS 82

EMS Infectious Diseases Shock Airway Management 82

PulmCCM

JULY 3, 2023

If those grizzled veterans give you a hard time, remember, they’re also the ones who dispensed attaboys in the pre-ultrasound era like “if you’re not cannulating the carotid artery or dropping lungs, you’re not doing enough central lines!”) (Who themselves would be less experienced at video.) (If

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105