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 90

Documentation/Coding CPR EKG/ECG Sepsis 90

Don't Forget the Bubbles

AUGUST 23, 2023

These unprocessed emotions can lead to vicarious trauma , especially in resuscitation providers. Rather, immediately after an unsuccessful resuscitation attempt, there should be an opportunity for those involved to partake. 2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Mount Sinai EM

MARCH 20, 2023

Patient codes, no ROSC at first pulse check -> start gathering supplies for C-section. You mostly just need betadine, a 10-blade scalpel, and scissors.

Documentation/Coding 130

Documentation/Coding Resuscitation 130

Don't Forget the Bubbles

MAY 10, 2023

Then you hear the words coming out of the speaker, “ Paediatric code black. Paediatric code black ”. You’ve heard the phrase code black before – it’s a traumatic cardiac arrest. Resuscitation is a team sport. You know a paediatric code black means paediatric traumatic cardiac arrest. …You burst into resus.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

SheMD

DECEMBER 1, 2023

But less physicians talk about the difficult “firsts” like failing your first test, losing your first patient, or being involved in your first code. It means a patient is dying and requires immediate resuscitation. I remember my first code blue like it was yesterday. Thirty minutes after he arrived a code blue was called.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Resuscitation 52

ACEP Now

DECEMBER 10, 2023

You want to respect patient autonomy, but is it legal to let him die without any emergency resuscitation? The answer is no, you cannot allow this patient to die by withholding resuscitative efforts. However, EPs are legally and morally obligated to resuscitate all patients after SA. J Med Ethics. 2008 Sep;34(9):e4.

Resuscitation 52

Resuscitation Hospitals Documentation/Coding EKG/ECG 52

Taming the SRU

DECEMBER 8, 2023

EMS had reported she had coded en route. ED providers should be familiar with several extraction techniques for foreign bodies in the external auditory canal including the use of manual extractors, irrigation, and other methods such as adhesives and acetone. She regained pulses with warming on arrival.

Hyperthermia / Hypothermia 78

Hyperthermia / Hypothermia Resuscitation Head Injuries Documentation/Coding 78

RebelEM

MAY 15, 2023

Frantically look through the assisted care documents for do-not-resuscitate paperwork Place a chest tube on the left side Place a chest tube on the right side Start noninvasive or mechanical ventilation FOR THE RIGHT ANSWER CLICK ON THE ROSH REVIEW LOGO BELOW References: Dixon A.

EMS 82

EMS Documentation/Coding Resuscitation 82

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation Pediatrics 98

Taming the SRU

MAY 11, 2024

Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review.

Administration 81

Administration Resuscitation Research Fluid Resuscitation 81

Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Glucose > 200 mg/dL Moderate or Large Ketonuria The severity of DKA is categorized by the degree of acidosis Mild : venous pH < 7.3 The mortality rate for cerebral edema is 21%–24%.

Fluid Resuscitation 212

Fluid Resuscitation Pediatrics Resuscitation Research 212

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). In contrast, ABG and pH alone are not reliable in determining the clinical futility of resuscitation after major trauma. (14,

Emergency Department 93

Emergency Department Resuscitation COPD Shock 93

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

Dr. Smith's ECG Blog

MARCH 4, 2024

link] Or use the QR code: 10 Cases: Case 1 Do you want to be interrupted to view what the computer calls normal or nonspecific ECGs? He did re-occlude and arrest but was resuscitated. It is not yet available, but this is your way to get on the list. 2 cases at once! RCA Occlusion (OMI), called normal by conventional Veritas algorithm.

EKG/ECG 98

EKG/ECG Documentation/Coding Wellness Resuscitation 98

PulmCCM

JANUARY 29, 2024

Read the document for all the details (it’s not long). In accordance with the fraught ethical and emotional factors surrounding organ donation, this section is the tersest, least explicated section of the document. PulmCCM is not affiliated with the American Heart Association. Here’s PulmCCM’s take on the new changes.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

EM Ottawa

DECEMBER 28, 2023

There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog. Trauma is the leading cause of child and youth mortality globally (1). Pediatric trauma is a high acuity but low frequency event (2).

Pediatrics 81

Pediatrics Documentation/Coding EMS Wellness 81

EMDocs

SEPTEMBER 19, 2023

Airway plan discussed with resuscitation team. Reference: emDOCs – NCSE Journal of Emergency Medicine – Review Case 4: 52-year-0ld male brought in by EMS with “code STEMI” ECG demonstrates ST depressions with rocket like T waves in V2-V4. Cric is progression of the airway plan ; it is not a failure.

Seizures 71

Seizures Documentation/Coding EKG/ECG Emergency Department 71

PulmCCM

JUNE 5, 2023

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. Check out the preliminary program , and use code PULMCCM15 to get 15% off the attendance fees. makes me long for an adequately powered randomized trial. They really go the extra mile in the Netherlands.

Advances Cardiac Life Support (ACLS) 96

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

Mind The Bleep

MAY 1, 2024

Appropriate first line management will help protect and resuscitate the soft tissues and keep the fracture still either to allow healing or until definitive management (operative fixation) is possible. Children’s Injuries – particularly in non-ambulant children, or a suspicious history, consider non-accidental injury.

Fractures 52

Fractures Documentation/Coding Head Injuries Dislocations 52

Stop and Think

NOVEMBER 19, 2023

This was a 20-year survey in which the authors used 4 independent databases to document the incidence and causes of sudden cardiac death in NCAA athletes. The main one I think is the absence of data on resuscitated arrests. In fact, the authors reported a decline in sudden cardiac death during the years 2021-2022.

Documentation/Coding 119

Documentation/Coding Wellness Resuscitation 119

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. Should be here in 5 minutes.”

Resuscitation 95

Resuscitation Ultrasounds Critical Access Documentation/Coding 95

Don't Forget the Bubbles

MAY 6, 2024

of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. The mean time to randomisation was 2 hours, which excludes the initial resuscitation window. Of the 74.9% 1872 children (mean age 2.5

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. Any team member of the resuscitation may lead the hot debrief. No potential resuscitation cases were formally excluded.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Documentation/Coding 40

Documentation/Coding Stroke Emergency Department Shock 40

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Macroscopic T-Wave Alternans: A Red Flag for Code Blue. J Am Coll Cardiol. 2006 Jan 17;47(2):269-81. doi: 10.1016/j.jacc.2005.08.066. 2005.08.066. Epub 2006 Jan 4. PMID: 16412847. Moore PK, Raffel KE, Whitman IR. JAMA Intern Med. 2017 Oct 1;177(10):1520-1522. doi: 10.1001/jamainternmed.2017.3191. 2017.3191.

EKG/ECG 108

EKG/ECG Documentation/Coding Psychiatric EMS 108

PHEM Cast

DECEMBER 12, 2016

pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

FOAMCast Blog

JANUARY 4, 2016

TRAUMA FAST (Focused Assessment using Sonography in Trauma) guided resuscitative – thoracotomy. Bottom Line: If a trauma code comes in and has neither […] We picked the minds of some brilliant Emergency Medicine folk and came up with this short list of important happenings. Recommended by Haney Mallemat, Rob Orman).

Documentation/Coding 40

Documentation/Coding Resuscitation 40

The Skeptics' Guide to EM

MAY 8, 2021

The resuscitation team arrives and ACLS protocols are continued. The issue of whether corticosteroids should be administered is brought up during the code. Crit Care Med Feb 2021 Case: A 58-year-old male has a witnessed cardiac arrest while admitted to the observation unit for a chest pain evaluation.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergency department (ED). Cardiopulmonary resuscitation (CPR) is in progress. The tide now is shifting in resuscitation research to shift our focus from obtaining ROSC to measuring functionality and good neurologic outcomes.

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

All Ohio EM

JULY 15, 2019

By Christy Rukamp DO and Zachary Hampton DO At times, documentation feels like the bane of existence. In residency, we practice resuscitations, rehearse critical procedures, and review in-service test questions; however, we rarely learn key components of documentation. It is more than a record of the patient’s ED timeline.

Documentation/Coding 52

Documentation/Coding Wellness Emergency Department Resuscitation 52

PulmCCM

FEBRUARY 19, 2024

Panelists called this “low certainty evidence from five before-after studies that this intervention may be associated with lower mortality and fewer unsuccessful resuscitation events.” ” But even that watered-down statement is unjustified. Let’s take a closer look. Family-Activated METs in Adults Halves Mortality?

Hospitals 52

Hospitals Resuscitation Burns Research 52

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. Resuscitation. Resuscitation. AAGBI Safer Prehospital Anaesthesia 2017, available here. Positioning From: [link] Recommended Rich Levitan resources Podcast 70 – Airway Management with Rich Levitan Airway axes From: McGuire B, Hodge K.

Airway Management 52

Airway Management Resuscitation Hospitals EMS 52

Emergency Medicine Cases

MAY 23, 2017

This is the first ever video podcast on EM Cases with Jordan Chenkin from EMU Conference 2017 discussing how to optimize three aspects of cardiac arrest care: persistent ventricular fibrillation, optimizing pulse checks and PEA arrest, with code team videos contrasting the ACLS approach to an optimized approach.

Documentation/Coding 52

Documentation/Coding EMS Ultrasounds Resuscitation 52

Sensible Medicine

JUNE 30, 2023

” I documented those words in my progress note that day. KS died during the final one when his inpatient team failed to resuscitate him after a cardiac arrest. He had declined hospice care until the end and would not even accept “do not resuscitate” status. Then, everything changed.

Hospitals 91

Hospitals Hospice Resuscitation COPD 91

The Trauma Pro

MARCH 14, 2024

Next week, I’ll describe my system for quantifying the space in your trauma bay and address the equipment layout in your resuscitation room. Trauma resuscitation rooms vary tremendously. Bottom line: Once again, don’t try to figure out everything from scratch if you are designing new resuscitation rooms.

Resuscitation 162

Resuscitation Documentation/Coding Hospitals 162

Mind The Bleep

FEBRUARY 29, 2024

It is worth looking through previous documentation to see whether the patient’s team or senior intensivists have set any individual cardiovascular targets. Assessing a patient’s cardiovascular status and whether we need to manipulate any aspects of it is disease process-specific and patient-specific.

Documentation/Coding 52

Documentation/Coding Hospitals Wellness Best Practices 52

The Skeptics' Guide to EM

DECEMBER 2, 2017

Case: You are working a regular shift in the emergency department when you hear a code blue called. You are the first physician to respond and you begin to resuscitate the patient. DISCLAIMER: The views and opinions of this podcast do not represent the United States Government or the US Air Force.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40