What Defines Pediatric Hypotension?

What Defines Pediatric Hypotension?

The Pediatric Advanced Life Support (PALS)/Advanced Trauma Life Support (ATLS) formula to define hypotension in children (i.e. 5th percentile SBP) seems to be a good compromise between German and U.S. population norms for children. The formula is: Low SBP = <70 + 2(age in years).

Advanced Airway for Pediatric Cardiac Arrest - Should We Just Bag?

Advanced Airway for Pediatric Cardiac Arrest - Should We Just Bag?

There may be a slight advantage for pediatric cardiac arrest patients in survival with good neurological outcome by using simple bag-valve mask ventilation over advanced airway management.

Advanced Airway For Non-Shockable OHCA?

Advanced Airway For Non-Shockable OHCA?

Advanced airway management (AAM) was associated with increased overall survival in out-of-hospital cardiac arrest (OHCA) (though not survival with favorable neurological outcome) in patients with non-shockable initial rhythm. There was no difference in survival with use of AAM in patients with initial shockable rhythm.

ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

Peripheral perfusion guided resuscitation was better than lactate clearance in patients with septic shock in regard to improving organ dysfunction at 72 hours (SOFA score) and barely missed statistical significance in reducing 28-day mortality.

Pediatric Needle Decompression - What Size Needle?

Pediatric Needle Decompression - What Size Needle?

A standard 5cm 14-16 gauge needle for chest decompression was more than twice as long as needed for children < 13 years old based on CT chest wall thickness (CWT).

Shockingly Ineffective - Double Sequential Defibrillation for Refractory Vfib and Vtach

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.

Antiarrhythmics In Arrest - New ILCOR Update

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

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.

Do Antiarrhythmic Drugs Help In Cardiac Arrest?

Do Antiarrhythmic Drugs Help In Cardiac Arrest?

When considering 14 RCTs on use of antiarrhythmic drugs for shockable cardiac arrest, there was no benefit for survival to discharge or survival with good neurological outcome. Lidocaine improved ROSC vs placebo.

Prehospital Airway Management

Prehospital Airway Management

In light of the important prehospital airway management articles that came out this week, I thought it might be helpful to go into more depth on the topic of prehospital airway management.

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