Tox Myth-Bust – Prehospital Exposure to Fentanyl Analogs
Alex Chen goes in depth with this toxicology myth-bust on the risk of exposure to fentanyl or fentanyl analogs to prehospital personnel.
January 2019
HOUR – Early Discharge After Opioid OD
The HOUR clinical decision rule can help determine which patients with opioid overdose who have received prehospital naloxone are safe for discharge after one hour of observation. But clinician judgment was just as good, which begs the question of why we need a decision rule.
New IDSA Influenza Guidelines
This is the IDSA influenza guideline, updated from the previous one in 2009. It covers testing, treatment, complications, and more.
Shockingly Ineffective – Double Sequential Defibrillation for Refractory Vfib and Vtach
Prehospital double sequential defibrillation was not associated with improved survival for out-of-hospital cardiac arrest patients with refractory ventricular fibrillation or pulseless ventricular tachycardia.
New Shoulder Reduction – The “Elbow” Technique
The “elbow technique” is a simple and effective way to reduce anterior shoulder dislocations in this study.
Is Routine Pelvic Exam Beneficial for STI Detection?
Pelvic examination added little to clinical judgment when evaluating for sexually transmitted infections in young women.
Does EtCO2 Matter In Pediatric Arrest?
There was no difference in survival to discharge in children with an EtCO2 >20mm Hg during CPR. Focus on high quality CPR and not this number.
Antiarrhythmics In Arrest – New ILCOR Update
The European Resuscitation Council International Liaison Committee on Resuscitation 2018 guideline has made one minor change regarding antiarrhythmic drugs in arrest: lidocaine, in place of amiodarone, is now a viable, equally effective option in patients with VF/pVT refractory to defibrillation.
ETT vs. SGA for OHCA – Metaanalysis Includes AIRWAYS-2 and PART
There was no difference in an endotracheal tube vs supraglottic airway for patients with out-of-hospital cardiac arrest in the outcomes of return of spontaneous circulation, survival to admission, survival to discharge, or survival with good neurological outcome in studies with low risk of bias in this large metaanalysis.
Extracorporeal Life Support in the Emergency Department
This is a review of ECLS, aka ECMO, in the ED. It covers when, why, how, and what might go wrong. If you’re thinking of starting or improving your ED ECLS program, this review will help.