PulmCCM

JANUARY 29, 2024

Epinephrine remains the drug of choice during CPR Epinephrine remains the first-line therapy for cardiac arrest due to non-shockable rhythms (i.e., No new evidence arose to alter the usual schedule of administering 1 mg epinephrine as quickly as possible, then every 3 to 5 minutes while CPR is ongoing. PEA and asystole).

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Emergency Medicine Journal

OCTOBER 26, 2023

The protocol involved patient transport from the emergency site with ongoing mechanical cardiopulmonary resuscitation (CPR) directly to the cardiac catheterisation laboratory where the implementation of extracorporeal membrane oxygenation (ECMO) was considered. All patients received mechanical CPR, epinephrine and/or amiodarone.

Hospitals 75

Hospitals CPR Resuscitation Outcomes 75

The Skeptics' Guide to EM

APRIL 27, 2024

It was a secondary analysis of an observational study which showed an association between decreased favourable neurologic outcomes in the IO group compared to the IV group. This is because of the ease of finding anatomic landmarks and their location away from other procedures like defibrillation, CPR, and airway management.

Resuscitation 87

Resuscitation Airway Management EMS Outcomes 87

The Bottom Line

FEBRUARY 27, 2023

In patients with refractory out-of-hospital cardiac arrest (OHCA) and an initial ventricular arrhythmia, does extracorporeal cardiopulmonary resuscitation (ECPR), as compared with conventional CPR (CCPR), improve survival with a favourable neurologic outcome

CPR 62

CPR Resuscitation Outcomes Hospitals 62

JournalFeed

MARCH 16, 2024

Source: Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis.

CPR 52

CPR Resuscitation Hospitals Outcomes 52

Taming the SRU

MARCH 27, 2024

The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. Secondary outcomes included mean arterial pressure (MAP), heart rate, vasoactive inotropic score (VIS) – a weighted score of different cardiovascular active agents, VIS/MAP, and pulmonary artery catheter (PAC) monitoring. Hill, J.

Resuscitation 87

Resuscitation Outcomes CPR Hospitals 87

Taming the SRU

MAY 10, 2024

r4 Capstone WITH Dr. Stark Learn from your poor patient outcomes. hypovolemia, PTX, and cardiac tamponade are common causes of death in the setting of a traumatic arrest and CPR is unlikely to be beneficial in any of these causes based on available animal studies. who may benefit from CPR in traumatic arrest? Role of epi in TCA?

Leadership 73

Leadership CPR Head Injuries Outcomes 73

AED Leader

APRIL 30, 2024

CPR Coaching and Feedback In addition to delivering a life-saving shock, the Heartsine 350P AED provides real-time CPR coaching and feedback. This feature ensures that CPR is performed correctly, maximizing the chances of a successful resuscitation.

CPR 52

CPR Operations Shock Resuscitation 52

The Skeptics' Guide to EM

MARCH 11, 2023

A fire company is on scene providing high-quality cardiopulmonary resuscitation (CPR) and has defibrillated twice with an automated external defibrillator (AED). Background: Airway management strategies for out of hospital cardiac arrest (OHCA) have been hotly debated since the dawn of CPR. Reference: Smida et al.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

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 133

Outcomes Resuscitation Hospitals CPR 133

RebelEM

AUGUST 21, 2023

This trial aimed to assess whether targeted therapeutic mild hypercapnia (TTMH) applied during the initial 24 hours of mechanical ventilation in the ICU can enhance neurological outcomes at the 6-month mark, as compared to standard care, which involves targeted normocapnia (TN). Paper: Eastwood G, et al.

Hospitals 77

Hospitals Resuscitation Outcomes CPR 77

Don't Forget the Bubbles

JUNE 30, 2023

She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Despite good quality CPR, there is no ROSC. Despite good quality CPR, there is no ROSC. Despite good quality CPR, there is no ROSC. Emergency Medical Services found her apneic and pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Don't Forget the Bubbles

DECEMBER 18, 2023

We might consider how long the child has been in cardiac arrest – the longer the time, particularly if there was any time without CPR, the less likely they are to regain circulation. There are many reasons we may continue resuscitation beyond the period when we hope for a good outcome. Maybe that’s still a form of good outcome?

Resuscitation 131

Resuscitation Outcomes CPR Hospitals 131

The Skeptics' Guide to EM

FEBRUARY 11, 2023

He confirms pulselessness, initiates CPR, gets a colleague to call 911, and intubates the patient on the floor. Comparison: Standard defibrillation with pads placed in anterior-anterior configuration * Outcome: * Primary Outcome: Survival to hospital discharge * Secondary Outcomes: Termination of ventricular fibrillation,

Shock 54

Shock CPR Hyperthermia / Hypothermia Hospitals 54

Stop and Think

JANUARY 10, 2024

One scenario that doctors considered dire enough to use ECLS occurs when CPR does not work to restore circulation. In January, Dutch investigators published results of the INCEPTION trial, in which extracorporeal cardiopulmonary resuscitation (CPR) or conventional CPR (standard advanced cardiac life support) were compared.

CPR 44

CPR Shock Outcomes Resuscitation 44

ED ECMO

FEBRUARY 23, 2021

Make sure to get CPR Certification Cleveland so you can always be prepared in case of any emergency. Zack invited Brian Grunau to discuss these topics as well as a recent ECPR paper out of Norway and study dealing with signs of life during CPR. What strategy gives the most benefit to the most people? Resuscitation. 2021.01.038.

CPR 52

CPR Resuscitation Hospitals Outcomes 52

The Skeptics' Guide to EM

MAY 8, 2021

CPR is initiated and a hospital rapid response team is called. This contrasts with what the public sees watching CPR being done on TV. Improving outcomes for patients with cardiac arrests has been an ongoing challenge in pre-hospital and in hospital medicine. The resuscitation team arrives and ACLS protocols are continued.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

AED Leader

APRIL 24, 2024

It has advanced features that simplify the rescue process and improve outcomes. Some notable features include: Real CPR Help : This feature provides real-time feedback on the depth and rate of chest compressions, ensuring the rescuer administers high-quality CPR.

Shock 52

Shock CPR Pediatrics Documentation/Coding 52

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% Did they get bystander CPR? 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 Control: 9.6% D ECLS: 18.2%

Shock 119

Shock Outcomes Resuscitation Stroke 119

The Skeptics' Guide to EM

DECEMBER 25, 2021

Bystander CPR is being performed. The paramedics performed high-quality CPR and follow their ACLS protocol. CPR is continued while a supraglottic airway is placed successfully. They have a history of hypertension, elevated cholesterol, and smoked cigarettes for 50+ years. The monitor is hooked up.

CPR 52

CPR Administration Outcomes Hospitals 52

EMDocs

JANUARY 16, 2024

Patients can have excellent outcomes despite prolonged resuscitation. 10 The score predicts the probability of survival to hospital discharge using a number of factors including CPR duration, serum potassium, core temperature, age, and suspected mechanism of hypothermia. Hypothermic arrest differs from cardiac arrest from other causes.

Hyperthermia / Hypothermia 83

Hyperthermia / Hypothermia Resuscitation CPR EMS 83

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Your team begins high quality cardiopulmonary resuscitation (CPR). Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Sodium bicarbonate has historically been used during CPR with the goal of alkalizing blood pH and treating metabolic acidosis.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

The Skeptics' Guide to EM

MAY 20, 2023

They started cardiopulmonary resuscitation (CPR) until EMS arrived. Upon arrival at the ED, your team promptly begins high quality CPR and manages to obtain return of spontaneous circulation. He had been having some upper respiratory symptoms in the previous days. Parents found him in bed that morning blue and unresponsive.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. It required multiple attempts which caused several prolonged interruptions in CPR. Key to survival is high-quality CPR and early defibrillation.

Airway Management 52

Airway Management CPR Outcomes Hyperthermia / Hypothermia 52

Taming the SRU

OCTOBER 5, 2023

morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS (..)

Stroke 80

Stroke EKG/ECG Seizures CPR 80

The Skeptics' Guide to EM

JULY 22, 2023

The conclusion from that episode was it’s still uncertain if using etomidate decreases the patient-oriented outcome of survival with good neurologic function in critically ill patients requiring emergent endotracheal intubation. The most recent discussion was about the use of etomidate as an induction agent ( SGEM#405 ).

EMS 98

EMS CPR Ultrasounds Research 98

PulmCCM

JUNE 5, 2023

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. There was no significant difference in survival with a favorable neurologic outcome at 30 days (20% vs 16% nominally favoring the ECMO group, P=0.52) or at 6 months. makes me long for an adequately powered randomized trial. In the U.S.,

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

The Skeptics' Guide to EM

AUGUST 14, 2021

They performed high-quality CPR and shocked the patient twice before giving amiodarone via intraosseous (IO). This has included the classic paper from Legend of EM Dr. Ian Stiell on BLS vs. ACLS ( SGEM#64 ), the use of mechanical CPR ( SGEM#136 ), and pre-hospital hypothermia ( SGEM#183 ).

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

FEBRUARY 3, 2023

The nurses started CPR immediately and place pads before you even arrived. The primary outcome was a good neurologic outcome within six months and occurred in 55% of the hypothermia group and 39% of the normothermia group (p=0.009, RR 1.40, 95% CI 1.08-1.81). The patient is still unconscious. It was also not blinded.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Outcomes Documentation/Coding 52

Ziqitza HealthCare Ltd

MARCH 26, 2024

Whether it’s administering medications, performing CPR, or managing airway obstructions, simulation allows for targeted skill development and feedback. Skill Refinement: Ambulance crews can refine and sharpen their clinical skills through repeated practice in simulation scenarios.

Mass Casualty Incidents 52

Mass Casualty Incidents Ambulance Services Teamwork Basic Life Support 52

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 79

CPR Burns Airway Management Wellness 79

EMDocs

JANUARY 8, 2024

Magnesium does not improve ROSC, survival, or neurologic outcomes, no matter the presenting rhythm (Level 3: no benefit). For patients with OHCA, use of steroids during CPR is of uncertain benefit. COR 2b, LOE B-R. COR 2b, LOE C-LD. Routine administration of calcium for treatment of cardiac arrest is not recommended.

Seizures 80

Seizures Shock CPR Hyperthermia / Hypothermia 80

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Bystander CPR is initiated prior to EMS arrival. However, no randomized trial has compared intravenous access to intraosseous access with a primary outcome of good neurologic function. 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

Ziqitza HealthCare Ltd

MAY 14, 2024

Immediate medical assistance provided at the right time can be life-saving and also help improve patient outcomes. Quick Response: Emergency ambulance services are important in critical medical emergency situations as they provide quick response and help to those in need.

Ambulance Services 52

Ambulance Services Hospitals CPR EKG/ECG 52

Dr. Smith's ECG Blog

APRIL 2, 2024

There was no bystander CPR. The patient awoke and had a good outcome! An elderly man collapsed. Medics found him in ventricular fibrillation. He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD.

EKG/ECG 118

EKG/ECG Shock CPR Stroke 118

RebelEM

SEPTEMBER 28, 2023

neoplasm, aneurysm, intracranial or spinal surgery) or recent trauma to head or cranium (i.e. Primary PCI: 95.7% Stents Placed: Pharmaco-Invasive Treatment: 97.4% Primary PCI: 95.7% ECG Results: Repeat ECG 90min after tenecteplase indicated 70.3% to 1.0mm Median amount of ST deviations declined from 15.0 Primary PCI: 78.4% Primary PCI: 13.3%

EKG/ECG 127

EKG/ECG Allergic Reactions Shock Stroke 127

The Skeptics' Guide to EM

JUNE 24, 2017

By-standard CPR is started and EMS is called. They continue CPR, get intravenous access, give a round of epinephrine and then wonder if they should start rapid cooling en-route to the hospital with some cold saline. The Cochrane Collaboration updated their review on hypothermia for neuroprotection in adults after CPR in 2012.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia CPR Resuscitation Research 40