Blog
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Apr 19 2024
How Much Epinephrine Is Too Much in ECPR?
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High-dose epinephrine (>3mg) was associated with unfavorable neurologic outcome when compared to low-dose epinephrine (≤3mg) after extracorporeal cardiopulmonary resuscitation.Source
Cumulative epinephrine dose during cardiac arrest and neurologic outcome after extracorporeal cardiopulmonary resuscitation. Am J Emerg Med. 2024 Mar 15;80:61-66. doi: 10.1016/j.ajem.2024.03.013. Epub ahead of print. PMID: 38507848. -
Apr 18 2024
Higher ETCO2 and Better Outcomes in Pediatric Arrest
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Targeted ETCO2 ≥20 mm Hg during pediatric resuscitation was associated with higher rate of survival in patients with in-hospital cardiac arrest. -
Apr 17 2024
IO for OHCA – Humeral Head or Tibia?
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In subgroup analysis, there may be more successful ROSC in patients with upper extremity IO access compared to lower extremity access in OHCA, but these results should be adopted with caution.Source
Retrospective Comparison of Upper and Lower Extremity Intraosseous Access During Out-of-Hospital Cardiac Arrest Resuscitation. Prehosp Emerg Care. 2024 Mar 26:1-8. doi: 10.1080/10903127.2024.2321285. Epub ahead of print. PMID: 38416867. -
Apr 16 2024
Pediatric EMS VS Ranges to Predict Life-Saving Intervention
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Kids frequently present with abnormal vital signs but seldom require prehospital life-saving interventions (LSI). Based on the occurrence of LSI, age-group vital sign ranges were adjusted to better identify critically ill kids. Abnormal respiratory status (RR, SpO2) was strongly associated with prehospital LSI. -
Apr 15 2024
EMS Vital Signs as Mortality Predictors
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Low and high extremes of prehospital vital signs were associated with higher rates of hospitalization and in-hospital mortality; however, there was not statistically significant improvement in their model when using age adjusted vital signs.Correlation of vital sign centiles with in-hospital outcomes among adults encountered by emergency medical services. Acad Emerg Med. 2024 Mar;31(3):210-219. doi: 10.1111/acem.14821. Epub 2023 Nov 3. PMID: 37845192.
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Apr 12 2024
When “Calm Down” Doesn’t Work…New ACEP Severe Agitation Policy
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This systematic review was conducted to answer the clinical question: Is there a superior parenteral medication or combination of medications for acute management of adult out-of-hospital or emergency department patients with severe agitation? These recommendations do not apply to pediatric, elderly (>65 years), pregnant, or out-of-hospital patients. For these groups, additional studies are needed given unique risk profiles.Source
Clinical Policy: Critical Issues in the Evaluation and Management of Adult Out-of-Hospital or Emergency Department Patients Presenting With Severe Agitation: Approved by the ACEP Board of Directors, October 6, 2023. Ann Emerg Med. 2024 Jan;83(1):e1-e30. doi: 10.1016/j.annemergmed.2023.09.010. PMID: 38105109. -
Apr 11 2024
What Are the New Duke ISCVID Criteria?
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Yesterday, we covered an article demonstrating the superior diagnostic accuracy of the new Duke-International Society for Cardiovascular Infectious Diseases Diagnostic (Duke-ISCVID) criteria. Today, we cover what the new criteria actually are.Source
The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: Updating the Modified Duke Criteria. Clin Infect Dis. 2023 Aug 22;77(4):518-526. doi: 10.1093/cid/ciad271. Erratum in: Clin Infect Dis. 2023 Oct 13;77(8):1222. -
Apr 10 2024
Should We Use New Duke Criteria for Infective Endocarditis?
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This external validation compared the 2023 Duke-International Society for Cardiovascular Infectious Diseases Diagnostic (ISCVID) Criteria against various other criteria for diagnosing infective endocarditis (IE) and found the 2023 Duke-ISCVID Criteria had the best test characteristics. Tomorrow, we'll dive into the new criteria. -
Apr 09 2024
STOP RCT – Duration of Antibiotics for Pediatric Febrile UTI
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The Short-Course Oral Antibiotic Therapy of Acute Pyelonephritis (STOP trial) demonstrated that a 5-day course of amoxicillin-clavulanate was noninferior to the standard 10-day course with regard to recurrence of infection.Source
STOP Trial Group. Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial. Pediatrics. 2024 Jan 1;153(1):e2023062598. doi: 10.1542/peds.2023-062598. -
Apr 08 2024
New AHA Statement on Cardiac Cath Lab Activation After OHCA
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The goal of invasive management in the cardiac catheterization laboratory (CCL) is to identify and treat culprit coronary lesion or additional resuscitative measures (such as mechanical circulatory support (MCS) or interventions for massive pulmonary embolism). This is a scientific statement from the American Heart Association (AHA) which provides an update on the role of CCL in the management of resuscitated patients or those with ongoing cardiac arrest.Source
Cardiac Catheterization Laboratory Management of the Comatose Adult Patient With an Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation. 2024 Jan 30;149(5):e274-e295. doi: 10.1161/CIR.0000000000001199. Epub 2023 Dec 19. PMID: 38112086.