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Resuscitation

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Simulation olympics: innovations that showcase EM resident resuscitation skills

This post is written by Dr. Damon Dagnone. Dr. Dagnone is an Assistant Professor in the Department of Emergency Medicine and the Faculty Lead of CBME for Postgraduate MedEd at Queen's University. He is the Director of the Queen's Simulation Olympics and is also the Co-Chair of the CAEP Simulation Olympiad. When not in the sim…  
emsimcases.com
about 5 years ago
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Don’t Forget The Bubbles in Print – Don't Forget the Bubbles

At Don’t Forget the Bubbles, a paediatric FOAM online resource, we take evidence-based medicine and put a practical spin on it. Our aim for this series is to do just that. Throughout this series we will focus on paediatric-specific topics relevant to Emergency Medicine practice. Our first article puts the spotlight on paediatric resuscitation.  
dontforgetthebubbles.com
about 5 years ago
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Hands-Only CPR - Nebraska Medicine

Trauma education coordinator Marjorie VanRiper demonstrates how to administer Hands-Only CPR. First, call 911. Then, push hard and fast in the center of the ...  
youtube.com
about 5 years ago
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Critical Care

Goal-directed therapy (GDT) has been shown in numerous studies to decrease perioperative morbidity and mortality. The mechanism of benefit of GDT, however, has not been clearly elucidated. Targeted resuscitation of the vascular endothelium with GDT might alter the postoperative inflammatory response and be responsible for the decreased complications with this therapy.  
ccforum.com
about 5 years ago
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Problems of the neonate and young infant - Pocket Book of Hospital Care for Children - NCBI Bookshelf

This chapter provides guidance on essential newborn care and the management of problems in neonates and young infants, from birth to 2 months of age. It includes neonatal resuscitation, the recognition and management of neonatal sepsis and other bacterial infections, and the management of preterm and low-birth-weight infants. A table giving the doses of commonly used drugs for neonates and young infants is included at the end of this chapter, which also lists the dosages for low-birth-weight and premature infants.  
ncbi.nlm.nih.gov
about 5 years ago
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Dr. Smith's ECG Blog: More Evidence that Inspiratory Threshold Device Improves CPR

Instructive ECGs in Clinical Context ----Archives, Popular Posts, and an Index of all ECGs are down the right-hand side.  
hqmeded-ecg.blogspot.com
about 5 years ago
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Imaging Case of the Week 158

The following supine chest x-rays from a 52 year old patient were obtained in the resuscitation area following presentation post MVA. What radiological sign can be seen?  
emergucate.com
about 5 years ago
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Critical Care

Xu and colleagues evaluated the impact of increasing mean arterial blood pressure levels through norepinephrine administration on systemic hemodynamics, tissue perfusion, and sublingual microcirculation of septic shock patients with chronic hypertension. The authors concluded that, although increasing arterial blood pressure improved sublingual microcirculation parameters, no concomitant improvement in systemic tissue perfusion indicators was found. Here, we discuss why resuscitation targets may need to be individualized, taking into account the patient’s baseline condition, and present directions for future research in this field.  
ccforum.com
about 5 years ago
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A 56 year old woman with syncope, weakness, and refractory hypotension

A 56 year old woman with hypothyroidism after total thyroidectomy presented to the emergency department after an episode of near syncope. When she arrived she had hypotension and atrial fibrillation, with a rapid ventricular response. She reported a history of progressive weakness, weight loss, polyuria, polydipsia, anorexia, and fatigue. Urine analysis was positive for leucocyte esterase and pyuria. She was admitted to the intensive care unit with a diagnosis of severe sepsis of urinary source and atrial fibrillation with a rapid ventricular response. After aggressive fluid resuscitation and the administration of intravenous antibiotics, her heart spontaneously converted to a normal rhythm and she appeared well perfused but remained hypotensive. Review of her medical record showed that her therapeutic thyroxine replacement had recently been decreased because of low thyrotrophin. On perusal of her records from an another facility it was noted that she had undergone pituitary mass resection and irradiation 20 years earlier.  
feeds.bmj.com
about 5 years ago
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A 56 year old woman with syncope, weakness, and refractory hypotension

A 56 year old woman with hypothyroidism after total thyroidectomy presented to the emergency department after an episode of near syncope. When she arrived she had hypotension and atrial fibrillation, with a rapid ventricular response. She reported a history of progressive weakness, weight loss, polyuria, polydipsia, anorexia, and fatigue. Urine analysis was positive for leucocyte esterase and pyuria. She was admitted to the intensive care unit with a diagnosis of severe sepsis of urinary source and atrial fibrillation with a rapid ventricular response. After aggressive fluid resuscitation and the administration of intravenous antibiotics, her heart spontaneously converted to a normal rhythm and she appeared well perfused but remained hypotensive. Review of her medical record showed that her therapeutic thyroxine replacement had recently been decreased because of low thyrotrophin. On perusal of her records from an another facility it was noted that she had undergone pituitary mass resection and irradiation 20 years earlier.  
feeds.bmj.com
about 5 years ago
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E-CPR STRIKES AGAIN

ECMO for cardiac arrest, E-CPR, has been shown several times to increase survival more than any other intervention we have available. Here’s yet another retrospective study to support the findings in previous trials (links at end of post). Survival with good neurological outcome increased from 7.5% to 40% with E-CPR!  
scancrit.com
about 5 years ago
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Lab Case 64 – Interpretation

A 58 year old man with altered mental state, low GCS with tachycardia and hypotension requiring airway control and resuscitation  
emergucate.com
about 5 years ago
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Prolonged lung inflation for neonatal resuscitation | Cochrane

Does the use of sustained (> one second duration) lung inflations compared to standard inflations (≤ one second) improve survival and other important outcomes in newly born infants receiving resuscitation at birth?  
cochrane.org
about 5 years ago
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Routine ultrasound in late pregnancy (after 24 weeks' gestation) to assess the effects on the infant and maternal outcomes | Cochrane

Ultrasound can be used as a clinical diagnostic tool in late pregnancy to assess the baby's condition when there are complications, or to detect problems which may not otherwise be apparent. If such problems are identified this may lead to changes in care and an improved outcome for babies. Carrying out scans on all women is however controversial. Screening all women may mean that the number of interventions is increased without benefit to mothers or babies. Although popular, women may not fully understand the purpose of their scan and may be either falsely reassured, or unprepared for adverse findings. Existing evidence shows that routine ultrasound, after 24 weeks' gestation, in low-risk or unselected women does not provide any benefit for the mother or her baby. Thirteen studies involving 34,980 women who were randomly selected to screening or a control group (no or selective ultrasound, or ultrasound with concealed results) contributed to the review. The quality of trials was satisfactory. There were no differences between groups in the rates of women having additional scans, antenatal admissions, preterm delivery less than 37 weeks, induction of labour, instrumental deliveries or caesarean section. Babies’ birthweight, condition at birth, interventions such as resuscitation, and admission to special care were similar between groups. Infant survival, with or without congenital abnormalities, was no different with and without routine ultrasound screening in late pregnancy. None of the trials reported on the effect of routine ultrasound in late pregnancy on preterm birth less than 34 weeks, maternal psychology or mental development of babies when two years old.  
cochrane.org
about 5 years ago
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Resuscitation guidelines

The Resuscitation Guidelines contain detailed information about basic and advanced life support for adults, paediatrics and the newborn.  
resus.org.uk
about 5 years ago
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Prolonged prehospital tourniquet placement associated with severe complications: a case report

Here is the full report Prolonged prehospital tourniquet placement associated with severe complications: a case report Editor's note: Yes... norepinephrine and crystalloid resuscitation for haemorrhagic shock..not ideal but remote medicine is like this at times! Its easy to blame prolonged tourniquet application for loss of leg but a severed femoral artery is also likely culprit…  
prehospitalmed.com
about 5 years ago
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Twelve lead electrocardiography after collapse

In the percutaneous coronary intervention unit the patient had a heart rate of 45 beats/min and a blood pressure of 70/40 mm Hg, neither of which responded to atropine and fluid resuscitation. …  
feeds.bmj.com
about 5 years ago
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Twelve lead electrocardiography after collapse

In the percutaneous coronary intervention unit the patient had a heart rate of 45 beats/min and a blood pressure of 70/40 mm Hg, neither of which responded to atropine and fluid resuscitation. …  
feeds.bmj.com
about 5 years ago
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paediatric-icu-basic-course-newcastle-nsw

Scared of Paediatric ICU? This could be for you. 17-18th September 2015, John Hunter Hospital, NSW. A 2 day course focusing on post-resuscitation care.  
intensivecarenetwork.com
about 5 years ago
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Beyond ACLS: From CPR to Cath - The New ACC/AHA Cardiac Arrest Algorithm - R.E.B.E.L. EM - Emergency Medicine Blog

Cardiac Arrest: Should we cath all patients with Out-of-hospital cardiac arrest (OHCA) and return of spontaneous circulation (ROSC) who are still comatose?  
rebelem.com
about 5 years ago