Podcasts about Esmolol

The post Episode 111. Pulse Check! Kyle Stupca's Study on Esmolol & Dose-Capped Epi appeared first on The Pharm So Hard Podcast.

This episode continues the confersation with Andrew Bowman, MSN, BSN, RN, ACNP-BC, ACNP-C, TNS, CEN, CTRN, CPEN, CFRN, TCRN, CBRN, CCRN-CMC, CVRN-I-BC, NRP, FACCN, FAEN about Advance Cardiac Life Support (ACLS ) and take a closer look at the algorithms and medications used in adult resuscitation.   Remember this episode discusses in part research that may not yet be part of the ACLS recommendations.  Always default to your hospital's protocols and guidelines.  Here are a couple of interesting articles for further education: ALPS Study https://www.nejm.org/doi/full/10.1056/nejmoa1514204 Esmolol for refractory V-Fib https://emergencymedicinecases.com/esmolol-refractory-ventricular-fibrillation/ Double sequential external defibrillation for refractory ventricular fibrillation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9907872/ Thrombolysis during Resuscitation for Out-of-Hospital Cardiac Arrest https://emcrit.org/wp-content/hypoarts/2651.pdf Lewis Lead Placement https://litfl.com/lewis-lead-s5-lead/ EKG Lead Placement (incliding R sided) https://litfl.com/ecg-lead-positioning/  Wolff–Parkinson–White Syndrome article by Andrew Bowman https://drive.google.com/file/d/1at6-oMJvvMH9PK5kJCJYbQptj6qdKUSh/view?usp=sharing Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias: Implications of Ultrasound-Guided Technique and Review of the Evidence https://drive.google.com/file/d/1MMImR9r8Cr0QSRkjYJJeAqPkKudn6bdo/view?usp=sharing   The current ACLS Algorithms https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms Follow Andrew on Social https://www.facebook.com/andrew.bowman.925 LinkedIn Www.linkedin.com/in/andrewjbowman1 Twitter @AndrewACNP1  

The ROSC discussion continues and it's a mixed bag including a discussion of the use of Esmolol, refractory VF, and the use of subglottic airways vs. endotracheal intubation.  Being near a tertiary center vs. being in a rural setting is also included.

Welcome all to IS PHARMACOLOGY DIFFICULT Podcast! I am Dr Radhika VijayThis is the festive episode on the DIWALI day (2023) about Beta-1 Selective Antagonistic agents.Wishing everyone a Happy, Healthy, Wealthy Diwali '23 and great new year and season's greetings ahead!!In this episode, I will be describing the major features, Pharmacokinetics, Mechanisms, uses and side effects of Beta-1 Selective drugs like Metoprolol, Atenolol, Esmolol, Acebutolol, Bisoprolol and BetaxololThese would be the whole episode talk and it will be very useful to comprehend the various aspects and applications of these very important drugs.I will be wrapping up the episode with information and latest developments at my end like "Pharmacology Further" E-Newsletter and Podcast:The links for these are at all my websites and specifically:Link for E-Newsletter: https://pharmacologyfurther.substack.com/Link for the E-Newsletter Podcast: https://www.pharmacologyfurther.comFor all the updates and latest episodes of my podcast, please visit www.ispharmacologydifficult.com where you can also sign up for a free monthly newsletter of mine.It actually contains lot of updates about the medical sciences, drug information and my podcast updates also.You can follow me on different social media handles like twitter, insta, facebook and linkedin. They all are with same name "IS PHARMACOLOGY DIFFICULT". If you are listening for the first time, do follow me here, whatever platform you are consuming this episode, stay tuned, do rate and review on ITunes, Apple podcasts, stay safe, stay happy, stay enlightened, Thank you!!Please leave Review on Apple podcasts!My E-Newsletter sign up at Substack!Connect on Twitter & Instagram!My books on Amazon & Goodreads!

Welcome all to IS PHARMACOLOGY DIFFICULT Podcast! I am Dr Radhika VijayThis is the festive episode on the DIWALI day (2023) about Beta-1 Selective Antagonistic agents.Wishing everyone a Happy, Healthy, Wealthy Diwali '23 and great new year and season's greetings ahead!!In this episode, I will be describing the major features, Pharmacokinetics, Mechanisms, uses and side effects of Beta-1 Selective drugs like Metoprolol, Atenolol, Esmolol, Acebutolol, Bisoprolol and Betaxolol These would be the whole episode talk and it will be very useful to comprehend the various aspects and applications of these very important drugs.I will be wrapping up the episode with information and latest developments at my end like "Pharmacology Further" E-Newsletter and Podcast:The links for these are at all my websites and specifically:Link for E-Newsletter: https://pharmacologyfurther.substack.com/Link for the E-Newsletter Podcast: https://www.pharmacologyfurther.comFor all the updates and latest episodes of my podcast, please visit www.ispharmacologydifficult.com where you can also sign up for a free monthly newsletter of mine.It actually contains lot of updates about the medical sciences, drug information and my podcast updates also.You can follow me on different social media handles like twitter, insta, facebook and linkedin. They all are with same name "IS PHARMACOLOGY DIFFICULT". If you are listening for the first time, do follow me here, whatever platform you are consuming this episode, stay tuned, do rate and review on ITunes, Apple podcasts, stay safe, stay happy, stay enlightened, Thank you!! Please leave Review on Apple podcasts! My E-Newsletter sign up at Substack! Connect on Twitter & Instagram! My books on Amazon & Goodreads!

Show notes at pharmacyjoe.com/episode861. In this episode, I’ll discuss a case report of seizures precipitated by esmolol in sterile water formulation. The post 861: When Diluents Attack! A Case Report of Seizure From Esmolol In Sterile Water appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode861. In this episode, I’ll discuss a case report of seizures precipitated by esmolol in sterile water formulation. The post 861: When Diluents Attack! A Case Report of Seizure From Esmolol In Sterile Water appeared first on Pharmacy Joe.

In deze aflevering bespreken we alles over lactaat. Hoe wordt het gevormd, is het schadelijk en wat is het eigenlijk?Veel luisterplezier!We bespreken de volgende onderwerpen:Wat is lactaat?Is lactaat schadelijk?Hoe komt je patiënt aan een hoog lactaat?Waarom zorgen salbutamol, adrenaline en stress voor een hoog lactaat?Wat moeten we doen bij een hoog lactaat?Welke infusievloeistof moeten we gebruiken en welke absoluut niet?Wat is de link tussen lactaat en mortaliteit?Waarom is een hoog lactaat zelden ten gevolge van hypoxie?Waarom zorgt leverfalen voor een verhoogd lactaat?Wat vertellen bergbeklimmers op de Mount Everest ons over lactaatproductie?Waarom hebben septische patiënten een hoog lactaat?Bronnen:https://emcrit.org/pulmcrit/understanding-lactate-in-sepsis-using-it-to-our-advantage/ (Lactaat in sepsis)https://www.oapublishinglondon.com/abstract/431 (Lactaat Daling is een slechte marker)https://pubmed.ncbi.nlm.nih.gov/10465191/ (Lactaat en Hypoxie)https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1419-x (Esmolol en Lactaat + Sepsis)https://pubmed.ncbi.nlm.nih.gov/34856090/ (COVID en Lactaat)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654944/ (Lactaat in de acute zorg)https://eddyjoemd.com/lactic-acid-sepsis/https://escholarship.org/uc/item/5z25r8s8 (Lactaatacidose)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024759/ (Lacto-Bolo-Reflex)https://jamanetwork.com/journals/jama/fullarticle/2724361 (ANDROMEDA Shock Trial)https://academic.oup.com/bjaed/article/6/3/128/375522 (Lactaat fysiologie)Bedankt voor het luisteren!Volg @intensiefdepodcast op InstagramVragen? intensiefdepodcast@gmail.com

Our good friends at Montgomery County Hospital District EMS in suburban Houston brings us a nice feasibility study about the use of esmolol for refractory v-fib. Dr. Jarvis discusses why this is a helpful study. If you like the show, please give us a 5-star rating wherever you get your podcasts. Did you know our podcast is on YouTube, too? Check us out and subscribe on the FlightBridgeED channel. Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvis See omnystudio.com/listener for privacy information.

Trade – BreviblocClass– Beta BlockerMOA– Inhibits the strength of the hearts contractions, as well as heart rate. Indication – ACS, MI, acute HTN, Supraventricular tachyarrhythmiasContraindications – COPD, Acute Bronchospasm, Bradycardia, Advanced Heart blocks, cardiogenic shock, Pulmonary Edema, Side Effects – Hypotension, sinus bradycardia, AV block, Cardiac arrest, nausea/vomiting, hypoglycemia, injection site reactionDosageAdult: 500mcg/kg IV/IO over 1 minute Pedi: 500mcg/kg IV/IO over 1 minute 

Hypertensive Crises (Emergency/Urgency) Special Guest: Deepali Dixit, PharmD, BCPS, BCCCP, FCCM   Show Notes: https://pharmacytodose.files.wordpress.com/2021/02/htn-crises-show-notes.pdf   Reference List: https://pharmacytodose.files.wordpress.com/2021/02/htn-crises-references.pdf    06:50 – Diagnosis; 09:17 – Clinical presentation; 11:14 – Common causes; 13:36 – HTN urgency management; 17:50 – HTN emergency BP goal; 23:26 - IV push v. continuous IV infusions; 28:30 – Aortic dissection/Esmolol; 34:10 – Acute ischemic stroke/Hydralazine; 40:25 – Intracranial hemorrhage/Nicardipine; 44:48 – ACS/Labetalol; 49:20 – ADHF/Nitrates; 56:08 – Miscellaneous medication pearls; 59:33 – Pregnancy treatment; 64:10 – Take-home points   4th Annual Multidisciplinary Tri-State Critical Care Virtual Symposium Details: https://rutgers.cloud-cme.com/course/courseoverview?P=5&EID=8158   PharmacyToDose.Com @PharmacyToDose on Twitter/Instagram PharmacyToDose@Gmail.com

It’s the JournalFeed Podcast for the week of Feb 15-19, 2021. We cover the longstanding controversy around epinephrine for arrest, esmolol for septic shock, TXA for TBI, TXA for SAH, and ECG abnormalities in COVID-19.

Público Alvo: Médicos, Enfermeiros e Farmacêuticos Também estamos no Spotifyhttps://open.spotify.com/episode/4dtIbz5KO4pyZwl2qtxZAN Anchor  https://anchor.fm/pgutipodcast/episodes/COVID-19-Parte-2—Fisiopatologia–Apresentao-Clnica–Evoluo-e-Tratamento-das-Formas-Avanadas-ecv5b1/a-a1vinfk E iTuneshttps://podcasts.apple.com/br/podcast/pacientegraveuti-podcast/id1485110832 Link para o Inova ENF: https://chat.whatsapp.com/HjONMY2DUJL45cze9x7lwa Link da "Playlist" com toda a série: https://soundcloud.com/pacientegraveuti/sets/serie-drogas-vasoativas Sonoplastia https://www.youtube.com/watch?v=kIab29rBHa0 https://www.youtube.com/watch?v=FZwwIMghhPs https://www.youtube.com/watch?v=UMqoNJ_pq70 https://www.youtube.com/watch?v=LqL_HHwHdGU

Público Alvo: Médicos, Enfermeiros e Farmacêuticos Também estamos no Spotify https://open.spotify.com/episode/4dtIbz5KO4pyZwl2qtxZAN Anchor https://anchor.fm/pgutipodcast/episodes/COVID-19-Parte-2—Fisiopatologia–Apresentao-Clnica–Evoluo-e-Tratamento-das-Formas-Avanadas-ecv5b1/a-a1vinfk E iTunes https://podcasts.apple.com/br/podcast/pacientegraveuti-podcast/id1485110832 Link para o Inova ENF: https://chat.whatsapp.com/HjONMY2DUJL45cze9x7lwa Link da "Playlist" com toda a série: https://soundcloud.com/pacientegraveuti/sets/serie-drogas-vasoativas Sonoplastia https://www.youtube.com/watch?v=kIab29rBHa0 https://www.youtube.com/watch?v=FZwwIMghhPs https://www.youtube.com/watch?v=UMqoNJ_pq70 https://www.youtube.com/watch?v=LqL_HHwHdGU

Emergent treatment of rapid atrial fib/flutter with Dr. Dave Zull. Please see below for Evidence based annotated articles Arrigo M. New Onset Atrial Fibrillation in critically ill patients and it’sassociation with mortality. Int J Cardiol 266:95-99, Sept 2018Bosch, NA, et al. Atrial Fibrillation in the ICU CHEST 154:1424-1434. Dec 2018Nice review of A fib in the critically ill patient. Emphasis first on correcting precipitants like sympathomimetics, electrolytes, volume and intercurrent illness. Esmolol implied to be best rate control drugDeSouza IA, et al. Pharmacologic Cardioversion of recent onset Atrial Fibrillation and Flutter in the Emergency Department. Ann Emerg Med 76:14-30. July 2020Looking at 360 patients with acute a fib. Ibutilide converted 50% of A fib and 75% of A flutter patients. Two patients had VT as a complication, but none received Magnesium prophylaxis.Nikki, AHA, et al. Early or Delayed Cardioversion in recent onset Atrial Fibrillation. N Engl J Med 380:1499-1508, Apr 2019Oral H, et al. Facilitating Transthoracic Cardioversion of atrial Fibrillation with Ibutilide pretreatment. N Engl J Med 340:1849, Jun 199972% converted to NSR with electrical cardioversion without pretreatment whereas 100% converted with Ibutilide pretreatment before electicityPatsilinakos S, et al. Effect of high doses of Magnesium on converting Ibutilide to a safe and more effective agent. Am J Cardiol 106:673, Sept 2010Magnesium sulfate 4-5 gm infused over one hour before Ibutilide prevents TorsadesSleeswijk ME, et al. Efficacy of Magnesium-Amiodarone step-up scheme in critically ill patients with new onset atrial fibrillation. J Intensive Care Med 23:61, Jan/Feb 2008Magesium infusion followed by Amiodarone infusion in A fib with RVR in the ICU. Half had acceptable rate or rhythm control with Mag alone. At the end of 24 hours 90% of patients converted to NSR.Stiell, Ian, et al. Electrical vs Pharmacologic cardioversion for emergency department patients with acute Atrial Fibrillation. RAFF2 Lancet 395:339-349, Feb 2020Canada’s aggressive protocol for conversion of acute A fib in the ER. IV Procoinamide infusion converted 50% to NSR. Electrical cardioversion worked in 92%. Only 3% of new A fib patients required admissionTercius AJ, et al. Intravenous Magnesium sulfate enhances the ability of intravenous Ibutilide to successfully convert atrial fibrillation or flutter. Pacing Clin Electrophysiol 30:1331, Nov 2007Vinson DR, et al. Ibutilide effectiveness and safety in the Cardioversion of atrial fibrillation and flutter in the community emergency department. Ann EmergMed71:96, Jan 2018Wyse DG, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation (AFFIRM trial). N Engl J Med 247:1825-33, Dec 2002Internists and cardiologist love to quote the AFFIRM trial as proof that attempts to convert are fruitless and we stick to rate control only. These patient were all in chronic a fib and of course we would never convert these patients unless there is life threat. This study has NO application to acute a fib less than 48 hoursZimetbaum P. Atrial Fibrillation. Annal Intern Med. March 2017Everything you ever wanted to know about atrial fibrillation

Contributor: Ramnik Dhaliwal, MD, JD Educational Pearls: Nitrates Nitroprusside: becomes effective in under a minute, and becomes ineffective 10 minutes after stopping it.  Nitroprusside can metabolize into cyanide leading to toxicity, however this is rare. Nitroglycerin: predominately causes vasodilation but some arterial dilation as well; preferred agent in patients with volume overload/CHF Adrenergic Blocking Agents Labetalol: alpha/beta-blocking agent with a rapid onset of 5 minutes or less given as bolus or intravenous drip Esmolol: cardioselective beta blocker with rapid onset and short duration of action making it easily titratable Hydralazine: direct arterial dilator;  patient dependent response that can be unpredictable. Use with caution in patients with CAD or an aortic dissection because there will be a reflexive increase in heart rate to combat the arteriolar dilation. Calcium Channel Blockers Nicardipine: Given as an IV infusion starting at 5g/hr up to 15g/hr. This drug has a slower onset of action making it difficult to titrate and it has a longer serum elimination half-life (3-6 hours) Clevidipine: rapid onset and short duration of action;  Reduces BP without affecting cardiac filling pressures but can cause reflex tachycardia References )Wani-Parekh P, Blanco-Garcia C, Mendez M, Mukherjee D. Guide of Hypertensive Crisis Pharmacotherapy. Cardiovasc Hematol Disord Drug Targets. 2017;17(1):52-57. doi:10.2174/1871529X16666161220142020 Suneja M, Sanders ML. Hypertensive Emergency. Med Clin North Am. 2017;101(3):465-478. doi:10.1016/j.mcna.2016.12.007 Maloberti A, Cassano G, Capsoni N, et al. Therapeutic Approach to Hypertension Urgencies and Emergencies in the Emergency Room. High Blood Press Cardiovasc Prev. 2018;25(2):177-189. doi:10.1007/s40292-018-0261-4 Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

This week we review a meta-analysis that looked at the use of esmolol in patients in refractory VF/pVT arrest. Will this change your practice? References: Miraglia D, Miguel LA, Alonso W. Esmolol in the management of pre-hospital refractory ventricular fibrillation: a systematic review and meta-analysis. Am J Emerg Med. 2020; 38: 1921-1934Driver BE, Debaty G, Plummer DW, et al. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation. Resuscitation. 2014; 85: 1337-1441Lee, YH, Lee KJ, Min YH, et al. Refractory ventricular fibrillation treated with esmolol. Resuscitation. 2016; 107: 150-155

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Ventricular Fibrillation (VF) is a potentially fatal cardiac arrhythmia; Refractory VF even more so Epinephrine stimulates alpha and beta receptors which increase sympathetic tone, thereby increasing cardiac oxygen demand and myocardial calcium levels which can cause new arrhythmias, particularly a problem during resuscitation Esmolol (or any beta blocker) can be used in VF refractory to defibrillation, epinephrine and amiodarone in a last-ditch effort. Esmolol in the setting of epinephrine can help prevent some of these known effects from repeated beta stimulation Dosing esmolol for refractory VF: 500mcg/kg bolus, followed by drip (max typically 1000 mcg/kg/min) Esmolol is associated with improved mortality in ACLS care in refractory VF References Long DA, Long B, April MD. Does β-Blockade for Treatment of Refractory Ventricular Fibrillation or Pulseless Ventricular Tachycardia Improve Outcomes?. Ann Emerg Med. 2020;76(1):42-45. doi:10.1016/j.annemergmed.2020.01.025 Lee YH, Lee KJ, Min YH, et al. Refractory ventricular fibrillation treated with esmolol. Resuscitation. 2016;107:150-155. doi:10.1016/j.resuscitation.2016.07.243  Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Arrest hastalarımızı acilciler olarak basamaklarını ezbere bildiğimiz ileri kardiyak yaşam desteği algoritmaları ile yönetmeye çalışıyoruz. Bu konuda bilimsel araştırma yapmanın güç olduğunu ve bu nedenle kanıta dayalı önerilerdeki majör değişikliklerin çok uzun zaman gerektirdiğini hepimiz çok iyi biliyoruz. Daha önce de refrakter VF (ventriküler fibrilasyon) ile ilgili başka bir konuyu sizlerle paylaşmıştım. Yaşadığınıza emin olduğum, her ne yaparsak yapalım nabız oluşturan bir ritme dönüş sağlayamadığımız refrakter VF durumlarında, yakın olmasa da gelecek yıllarda alternatif bir çözüm olarak karşımıza çıkabileceğini düşündüğüm bir konuyu sizlerle paylaşmaya çalışacağım. Refrakter VF’de esmolol kullanımı… Önce bazı sorulara beraber yanıt bulmaya çalışalım: Ventriküler Fibrilasyonda Neden β- Bloker Kullanılabilir? Uzayan resüsitasyon sürecinde epinefrin uygulanmasına bağlı olarak sempatik tonusta belirgin bir artış meydana gelmektedir. Kardiyak arrest sırasında epinefrin ile  α-adrenerjik reseptörlerin aktivasyonu, arteriyollerin kasılmasını sağlamakta ve potansiyel olarak kardiyopulmoner resüsitasyon sırasında arteriyel diyastolik basıncı dolayısıyla koroner kan akım hızını ve spontan dolaşımın geri dönüş şansını arttırmaktadır. Epinefrin ile  β- adrenoreseptörlerin aktivasyonu: Koroner kan akımının %40’a kadar azalmasına, Miyokardiyal oksijen tüketimininin 4 kata kadar artmasına,Pozitif kronotropik ve inotropik etkileri ile VF arrest hastalarında miyokardiyal iskemi riskinin artmasına,Resüsitasyon sonrası miyokardiyal disfonksiyonun şiddetinin artmasına, Yeni ritm sorunları ve tekrarlayan kardiyak arrest oluşumuna neden olur. α- adrenerjik stimülasyon ile  platelet aktivasyonuna bağlı olarak mikrovasküler kan akımı bozulur ve bu da resüsitasyon sırasında ve spontan dolaşım sağlandıktan sonra serebral iskemi riskini arttırır. Neden Esmolol ? Esmolol çok düşük lipofiliteye sahip  ve oldukça kardiyoselektif bir ajandır ve hızlı etli etki etmesi yanında oldukça kısa etkili bir β- 1 selektif adrenerjik reseptör blokör aktivitesine sahiptir. İnsanlarda kullanım için onay alan βblokerler arasında en hızlı etki oluşumu süresine (90 saniye) ve en kısa yarılanma ömrüne sahiptir ([t1/2] :9 dakika). Bu nedenle diğer blokerlerle kıyaslandığında, resüsitasyon sırası ve sonrasında aşırı veya uzamış etki gösterme ihtimali daha azdır. Esmolol aynı zamanda kardiyak arrest sırasında kullanılan yüksek dozlardaki epinefrinin neden olduğu VF eşik değerindeki düşüşün azaltılmasına yardımcı olur ki bu durum refrakter VF hastalarında kullanımı için öne sürülen mekanizmalardan biridir. Dirençli VF Nedir? Şoka dirençli VF veya nabızsız VT, bir veya daha fazla şok sonrası devam eden veya tekrarlayan VF veya nabızsız VT anlamına gelmektedir. Kılavuzlar: Kılavuz önerilerine bakıldığında resüsitasyon sonrası ile ilgili β- bloker önerileri bulunmaktadır. 2015 AHA kılavuzunda ''ventriküler fibrilasyon veya nabızsız ventriküler taşikardiye bağlı kardiyak arrest hastalarında, resüsitasyon sonrası erken dönemde oral veya intravenöz β bloker başlanması göz önüne alınmalıdır'' ifadesi yer alamaktadır (Klas IIb, LEO C-LD). 2018 güncellemesinde AHA böyle bir ifadeye yer vermemektedir. Çalışmalarda Kullanılan Esmolol Dozu: Hastane öncesi dirençli VF hasta yönetimi ile ilgili yapılan çalışmalarda esmolol dozu: Bir dakikada  IV, ≤500 mcg/kg/dk yükleme dozu sonrasında,0-100 mcg/kg/dk IV infüzyon olarak karşımıza çıkmaktadır. Ne Zaman Uygulanmalı? Literatüre genel anlamda bakıldığında 3. defibrilasyon girişimi sonrasında başarısız kalındığında uygulandığını görmekteyiz., İşe Yarıyor Mu? Bu sene başında yayımlanan ve hastane öncesi refrakter VF vakalarını değerlendiren bir meta analizde, esmolol kullanımı kullanılmaması ile kıyaslandığında, taburculuğa kadar olan sağkalımın artmış oranı (RR 2.82, 95% CI 1.01– 7.93, p = 0.05) ve daha iyi nörolojik sonlanıma sahip sağ kalımla (RR 3.44, 95% CI 1.

Arrest hastalarımızı acilciler olarak basamaklarını ezbere bildiğimiz ileri kardiyak yaşam desteği algoritmaları ile yönetmeye çalışıyoruz. Bu konuda bilimsel araştırma yapmanın güç olduğunu ve bu nedenle kanıta dayalı önerilerdeki majör değişikliklerin çok uzun zaman gerektirdiğini hepimiz çok iyi biliyoruz. Daha önce de refrakter VF (ventriküler fibrilasyon) ile ilgili başka bir konuyu sizlerle paylaşmıştım. Yaşadığınıza emin olduğum, …

We all love cardiac arrest with VF as the presenting rhythm. These are the ones that walk out of the hospital. But, what happens when you shock, shock, shock and still VF? Today the podcast team addresses refractory ventricular fibrillation/electrical storm and specifically the role of esmolol in this condition. Esmolol is an emerging treatment for refractory VF that makes absolute physiologic sense, however the data is limited. Dr. Patrick addresses the pathophysiology, evidence and MCHD’s approach this in episode 72. REFERENCES 1. Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;32(8):111-21. 2. Lee YH, et al. Refractory ventricular fibrillation treated with esmolol. Resuscitation. 2016;107:150-155. 3. Driver BE, Debaty G, Plummer DW, et al. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular brillation. Resuscitation. 2014;85(10):1337-41.

This week we review a fascinating paper that assesses the direct myocardial effects of IV antiarrhythmic agents upon cardiac muscle function performed by the group at Boston Children's Hospital - Harvard University. We speak with one of the principle authors of this work, Dr. Elizabeth DeWitt, who is an attending electrophysiologist at that large institution about this important work. Which agents were substantial negative inotropes and which had no effects? The answers may be surprising. Dr. DeWitt shares the general approach of the team in Boston when treating arrhythmias that require rapid IV therapies. doi: 10.1177/1074248418810811

This week we review a fascinating paper that assesses the direct myocardial effects of IV antiarrhythmic agents upon cardiac muscle function performed by the group at Boston Children's Hospital - Harvard University. We speak with one of the principle authors of this work, Dr. Elizabeth DeWitt, who is an attending electrophysiologist at that large institution about this important work. Which agents were substantial negative inotropes and which had no effects? The answers may be surprising. Dr. DeWitt shares the general approach of the team in Boston when treating arrhythmias that require rapid IV therapies. doi: 10.1177/1074248418810811

Podcast summary of articles from the March 2019 edition of Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include pediatric joint infections, atrial fibrillation, intranasal ketamine for headache, cannibus induced cardiomyopathy, mercury toxicity, and board review on acute compartment syndrome.  Guest speakers are Dr. Colin Crowe and Dr. Michael Gottlieb.

In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts. References: Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697. Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing … Continue reading "Episode 109: Non-Opioid Adjuncts with Drs. Grant and Bicket part 2"

This week we discuss three recent articles looking at esmolol in refractory VF, c-spine clearance and antibiotics after abscess drainage https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_155_0_Final_Cut.m4a Download Leave a Comment Tags: Cardiac Arrest, Cervical Spine, Esmolol, I+D, Infectious Diseases, Journal Club, MRSA, Refractory VF, Trauma Show Notes Read More REBEL EM: Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses Bryan Hayes at ALiEM: Sulfamethoxazole-Trimethoprim for Skin and Soft Tissue Infections: 1 or 2 Tablets BID? The SGEM: SGEM#164: Cuts Like a Knife Core EM: A...

This week we discuss three recent articles looking at esmolol in refractory VF, c-spine clearance and antibiotics after abscess drainage https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_155_0_Final_Cut.m4a Download Leave a Comment Tags: Cardiac Arrest, Cervical Spine, Esmolol, I+D, Infectious Diseases, Journal Club, MRSA, Refractory VF, Trauma Show Notes Read More REBEL EM: Trimethoprim-Sulfamethoxazole for Uncomplicated Skin Abscesses Bryan Hayes at ALiEM: Sulfamethoxazole-Trimethoprim for Skin and Soft Tissue Infections: 1 or 2 Tablets BID? The SGEM: SGEM#164: Cuts Like a Knife Core EM: Antibiotics in the Treatment of Smaller Abscesse...

In anticipation of EM Cases Episode 112 on Tachydysrhthmias with Amal Mattu and Paul Dorion, Melanie Baimel tells her Best Case Ever of a previously healthy young man who presents in refractory ventricular fibrillation after receiving multiple single shocks, ongoing chest compressions, several rounds of epinephrine, amiodarone and dual sequence defibrillation without ROSC... The post BCE 73 Esmolol in Refractory Ventricular Fibrillation appeared first on Emergency Medicine Cases.

Esmolol intraoperatório reduz a dor pósoperatória e o consumo de opióides

A Fib is the most common arrhythmia that is encountered in the ED. Knowing how to manage it when it is causing problems is important! Join the EM GuideWire Team as they discuss a-fib with RVR management with esteemed Cardiologist (and friend of us in the ED), Dr. Laszlo Littmann.

Editor's Audio Summary by Derek C. Angus, MD, MPH, Associate Editor, the Journal of the American Medical Association, for the October 23/30, 2013 issue

Interesting article published in JAMA about the use of beta-blockade in septic shock patients to improve cardiac dysfunction.