Podcasts about vfib

Contributor: Aaron Lessen, MD Educational Pearls: Quick background info Cardiac arrest is when the heart stops pumping blood for any reason. This is different from a heart attack in which the heart is still working but the muscle itself is starting to die. One cause of cardiac arrest is when the electrical signals are very disrupted in the heart and start following chaotic patterns such as Ventricular tachycardia (VTach) and Ventricular fibrillation (VFib) One of the only ways to save a person whose heart is in VFib or VTach is to jolt the heart with electricity and terminate the dangerous arrhythmia. A recent study in the Netherlands looked at how important the time delay is from when cardiac arrest is first identified to when a defibrillation shock from an Automated External Defibrillator (AED) is actually given. Their main take-away: each minute defibrillation is delayed drops the survival rate by 6%! These findings reinforce the importance of rapid AED deployment and early defibrillation strategies in prehospital cardiac arrest response. References Stieglis, R., Verkaik, B. J., Tan, H. L., Koster, R. W., van Schuppen, H., & van der Werf, C. (2025). Association Between Delay to First Shock and Successful First-Shock Ventricular Fibrillation Termination in Patients With Witnessed Out-of-Hospital Cardiac Arrest. Circulation, 151(3), 235–244. https://doi.org/10.1161/CIRCULATIONAHA.124.069834 Summarized by Jeffrey Olson, MS3 | Edited by Meg Joyce, MS1 & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

This week's podcast is pretty special. Administrative Specialist Denise Krizo is my guest along with Engineer/Paramedic Russ Smith. The podcast marks the first time Denise has seen Russ since Denise suffered a sudden cardiac arrest at CARTA on December 3 while wrapping gifts for Firefighter Angel. Russ was the first face she saw after he administered the shock that converted her heart from VFib to normal sinus rhythm. Denise is the first patient Russ has had to immediately open their eyes and start talking to him over cardioversion. It's rare to get a save and even more rare to have... For the written story, read here >> https://www.signalsaz.com/articles/an-incredible-life-saving-moment-the-chiefs-desk/Check out the CAST11.com Website at: https://CAST11.com Follow the CAST11 Podcast Network on Facebook at: https://Facebook.com/CAST11AZFollow Cast11 Instagram at: https://www.instagram.com/cast11_podcast_network

Today on the podcast is our real life lifesaver.   Karina, the ICU nurse that did life saving CPR on my husband when he went into cardiac arrest 10 months ago at Hoag Hospital.   If it wasn't for Karina showing up and giving everything that she had that day and being so great at what she does… the outcome could have been different.  It's crazy because Craig had the most severe type of cardiac arrest- called VFIB and had no pulse pretty much immediately so he was in the absolute best place he could have been for this to happen.  And it all happened SO FAST.  In this episode, Karina and I talk about that day and what it was like from her perspective.  How she remembers seeing me in the hallway screaming for help and how she was surprised that Craig was so blue in color, so quickly.  I ask her all the questions about what it is like to have such a heavy job and how you can work through the trama that you experience and still go out in the world and be happy.  There were so many incredible doctors and nurses that helped us over this 2 week period through operations and set-backs and organs failing and all the things that come with it.  You just can't express your gratitude in words. But man, I try!  There are so many cool lessons and takeaways from this conversation.  And I'm just honestly so grateful for the opportunity to get to know Karina and spotlight her as the true hero that she is. Key points:  -If someone you love needs your help medically, whether it is an emergency or something urgent or more long term, you have to be tough and think of yourself as their quarterback.   -If there weren't brave people like her - willing to put themselves in this extreme situation to see the most traumatizing things that can happen to humans, over and over, and still show up and go to therapy and work through it so they can keep helping people is amazing. Here are some of the questions that Lindsay asks her…  -First up, I'd love to understand how it works with you and your team. The day you changed our lives, I was holding my husbands hand in the ICU when he went into cardiac arrest.  The nurse that was in the room and I yelled for help before the monitors were going off.  Then I heard CODE BLUE through the hospital speaker. I was like oh my god that's for us.  How do you guys get notified to respond and are you stationed in the ICU? -How do you decide who does what in your team? -Do you have an idea of the medical condition of most patients or are you sort of walking into the crisis and have to be briefed real quick? -What do you remember from the day with Craig?  I know you have such busy days and crazy stories all the time I'm sure.  Just curious as to what his situation was like from your perspective.  -I can't imagine the weight that comes from your job.  You seem to have a happy and full life with family and friends… traveling and doing lots of fun things. Is it hard to get that mental headspace sometimes with the weight of your job?  -How has it changed you?  Does it make you afraid to do things for example because you see accidents or does it make you more emotional or more tough than most people?  -Do you see yourself being in this role or a similar role for a long time?  If not, what else would you like to do? -How often do you get to hear how the good stories turn out? The people that go on and live and thrive because of the work that you do? Do you hear about enough of that to balance out the sadness of what you also must experience?  Ping Lindsay on IG with any questions you have after listening to this episode.  @LindsaysCloud CHEERS TO OUR REAL LIFE LIFESAVER!

Episode 98: Apretude and code blue. Apretude is a new injectable medication for HIV pre-exposure prophylaxis (PrEP), Dr. Yomi presents how to use it. Then, Mandeep, Jon, and.  Introduction: Apretude, a new injectable for HIV PrEP.  By Timiiye Yomi, MD. Moderated by Jennifer Thoene, MD.   What is HIV PrEP? Pre-exposure prophylaxis (or PrEP) consists of taking medication when a patient has a high risk of contracting HIV to lower their chances of getting infected.  Who can take HIV PrEP? Individuals who may benefit from PrEP include but are not limited to: Male who have sex with male (MSM), people with multiple sexual partners with no consistent use of condoms, or people who have been diagnosed with an STD in the past 6 months, IV drug users who share needles, syringes, or other injection equipment. History of HIV PrEP: In 2012, the first medication for HIV PrEP was approved—Truvada® (tenofovir-emtricitabine). Truvada is a once-daily oral prescription drug. Seven years later, in 2019, the next medication for HIV PrEP was approved— Descovy® (tenofovir alafenamide and emtricitabine). It is also a daily PO medication. But today we want to introduce you to the newest medication for HIV PrEP—Apretude® (cabotegravir). On Dec 20, 2021, FDA approved Apretude (cabotegravir), an extended-release injectable for HIV-1 pre-exposure prophylaxis for at-risk adolescents and adults who weigh at least 35 kg (77 lbs). Mechanism of action: Apretude is a long-acting integrase inhibitor that works by binding to the HIV integrase active site and blocking the strand transfer step of retroviral DNA integration. How is it given? Comes as a 600-mg (3-mL) injection. Patients receive 2 initiation injections administered 1 month apart, thereafter every 2 months. Patients can start medication immediately or first take the oral formulation for 4 weeks to assess how well they tolerate the medication before beginning the injection. Trials: The safety and efficacy of Apretude in reducing the risk of contracting HIV-1 were evaluated in two randomized double-blind trials comparing Apretude and Truvada (once-daily oral medication).Trial 1: Participants who took Apretude had a 69% less risk of contracting HIV compared to Truvada.Trial 2: Participants who took Apretude had a 90% less risk of contracting HIV compared to Truvada. Common side effects: Fever, malaise, fatigue, sleep problems, myalgias and arthralgias, headache, rash, red and swollen eyes, edema of face, lips, mouth, tongue; GI discomfort, hepatotoxicity, and depression. Note: Some drug-resistant HIV variants have been identified in people with undiagnosed HIV prior to beginning Apretude. People who test positive for HIV while on Apretude must transition to a complete HIV treatment regimen as Apretude is not approved for HIV treatment.  Requirements to receive Apretude: -Patient must be HIV-1 negative-Patient must remain negative to continue receiving Apretude-Patient must not miss any injections as this increases their risk of contracting the virus Apretude does not protect against other sexually transmitted infections. Patients must be sexually responsible and use other forms of protection such as condoms during sexual intercourse. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________A code blue in clinic.  By Manpreet Singh, MS3; Jon-Ade Holter, MS3; and Sheinnera Gerongay, MS3. Ross University School of Medicine. What is a code blue?Arreaza: Today we will present to you a case to remind you about some principles of cardiopulmonary resuscitation (CPR). The term “code blue” in the United States refers to a situation where a patient is in cardiac arrest, respiratory arrest, unresponsive, or experiencing another medical emergency that requires immediate attention. “Code blue” is commonly used in hospitals and clinics to call a rapid response team to arrive immediately to evaluate the patient. We hope you can benefit from this brief review and feel ready for your next code blue. Of course, you will need more than we provide during these few minutes, but we hope it triggers your curiosity to keep learning or practicing. By the way, “code blue” is not standard for medical emergency in the whole world. For example, in the United Kingdom, they call it “code red”. Case presentation: Mr. DD 56-year-old man with a past medical history of coronary artery disease, recent MI, DM2, and CHF presents today to our clinic for hospital follow. He had an MI 2 weeks ago. He reports that when he was at home working in the yard, he suddenly had 8/10 retrosternal chest pain, pressure-like, accompanied by shortness of breath and diaphoresis. The pain radiated to the left side of his neck/jaw and down his left shoulder and arm. Jon: Nitroglycerin was taken by Mr. DD 3 times without resolution of symptoms. The patient was taken by EMS to Kern Medical ER. In the hospital, there was a 4mm ST elevation on ECG on leads II, III, and aVF. Q waves were also seen in anterior leads V4-V6. Patient was taken to cath lab and stent was placed in the RCA. ECHO showed decreased left ventricle wall motion and dilated left ventricle with an ejection fraction of 28%. Mr. DD was discharged after 5 days in the hospital.M: He is currently on lisinopril, carvedilol, atorvastatin, aspirin, clopidogrel, metformin, and digoxin. He states he is not compliant with all the medications because he forgets to get refills at times. He has a 35-pack year history of smoking and drinks 3-4 4oz drinks every day after work. He states he has used methamphetamine and cocaine intermittently within the last 6 months.J: Today, he lets the MA know that he is having some chest pain at night, shortness of breath with minimal activity for the last week, and at times he feels his heart is beating too fast. He has a follow-up appointment with cardiology in 2 weeks. The MA tells you that the patient vitals today are BP:195/105, HR: 108, RR: 28, and O2% 89% on room air. M: You are reviewing the patient's chart when you hear a loud thud coming from the room, you rush into the room and find the patient on the ground. The patient is unresponsive and is not moving. What is your next action? A. Try to lift the patient off the ground and back onto the chair or bed B. Give the patient nitroglycerin sublingually C. Call and wait for the EMS before proceeding D. Obtain IV accessE. See if the patient is arousable and check pulse and breathing E is the correct answer to this question because before initiating any type of treatment, first, you must assess the patient for alert response and their basic vitals such as their pulse and breathing.J: We do this because we need to know if the cardiopulmonary systems are intact. When they are not intact, regardless of the level of medical training, we must start CPR protocol. M: This patient most likely suffered a tachyarrhythmia, a very common post-MI-complication that causes the highest mortality rates. The most common cause of death are ventricular fibrillation and ventricular tachycardia. J: These are the steps we must take in order to start resuscitation of the cardiopulmonary system in any environment before the patient can be taken to a higher level of care. In this situation, Doctor Holter and Doctor Singh will perform 2-patient CPR. This is only an introduction of basic life support and advanced cardiac life support. You will need additional training to get the BLS and ACLS certificates. M: First, assure your environment is safe before preceding to render care. You want to be able to give the best uninterrupted care to your patient without becoming a patient yourself. Jon: Doctor Holter. Mandeep: Doctor Singh.J - Doctor Holter: I will reach down and check the patient. “Sir, Sir, are you okay” – I am assessing for reactions from visual or verbal cues given by me. When the patient is unresponsive to verbal and visual cues, I will give a painful stimulus to the patient such as a nail bed pinch or sternal rub. Next, it is necessary to assess the pulse and breathing of the patient. Narrator: The reason we check if the patient is alert is to assess the neurologic activity. The lack of response to painful stimuli indicates there is no self-protect response. To assess the carotid pulse, you must palpate the carotid artery by placing the index and middle fingers near the upper neck between the sternomastoid and trachea roughly at the level of the cricoid cartilage. Assess breathing by checking the rise and fall of the chest. Lack of responsiveness, pulse, and breathing indicates that immediate Cardiopulmonary Resuscitation (CPR) needs to be initiated. J - Doctor Holter: Please call 911 and get an AED.M - Doctor Singh: I will call 911 and get an AED.J- Doctor Holter: I will place the person on their back and start single-person CPR until Doctor Singh comes back. Narrator: CPR is performed by placing the patient flat on their back on an even surface. Place the heel of your hand on the center of the person's chest (on the mid sternum) then place the palm of your other hand on top. Press down 5-6 cm (2-2.5 inches) at a rate of 100-120 beats per minute. Compressions should not be interrupted because they serve as an artificial way of contracting the heart and circulating the blood to maintain blood perfusion. For 1 or 2 person CPR on an adult: Give 5 cycles of 30 compressions to 2 breaths.For 1 person CPR on a child: Give 5 cycles of 30 compressions to 2 breaths.For 2 person CPR on a child: Give 5 cycles of 15 compressions to 2 breaths.M - Doctor Singh : Doctor Holter, continue the compressions and I will give rescue breaths and start to place the AED pads on the patient. Let me know if you are tired and we can switch to give high-quality CPR with adequate depth and rate. Narrator: The AED comes with a diagram made on the pads to instruct where to place the pads. Once an AED is positioned correctly on the patient's chest, let it detect if a shockable rhythm is present. Shockable rhythms include ventricular fibrillation and ventricular tachycardia. If there is not a shockable rhythm detected, then continue with CPR until a higher level of care is reached. If a shockable rhythm is detected, the AED will advise the users to step back and verbalize “clear” in order to ensure that everyone is clear of the patient. It will then administer a shock to the patient in the range of 120-200 Joules, based on the device manufacturer's recommendation.M - Doctor Singh: Doctor Holter, stay clear of the patient. The AED advises shocking the patient. I will press the button to administer the shock now.Narrator: After administration of the first shock, ACLS guidelines recommend continuing CPR for 2 minutes without checking for a pulse, as effective cardiac contractility lags behind the restoration of an organized electrical rhythm. After the next 2-minute cycle of CPR, the AED will reanalyze the patient's rhythm to determine if the rhythm is once again shockable. J - Doctor Holter: Doctor Singh , continue high-quality CPR while I initiate ACLS protocol. I will get an IV and start epinephrine. M- Doctor Singh: I will continue CPR in the meantime. Narrator: ACLS starts with again CPR, AED rhythm reading, and shock administration but with a higher level of care (ACLS). You must obtain IV or IO access. Epinephrine is administered every 3-5 minutes during the cycle in doses of 1 mg at a time. After each dose of epinephrine and CPR for 2 minutes the AED should reassess if the rhythm is shockable, and then continue CPR for another 2 minutes. At this time, it is recommended to use amiodarone or lidocaine. CPR will continue but at this time patient will likely be in the ambulance on the way to the hospital, and EMS will be managing the cycles. The cycles will continue until return of spontaneous circulation is obtained.J: Myocardial infarction is the most common cause of shock-refractory ventricular fibrillation, along with coronary artery disease. If CPR does not resume spontaneous circulation within 40-50 minutes, there is a decreased chance of recovery. Spontaneous circulation may be achieved in patients with refractory Vfib with coronary revascularization. Therefore, in addition to traditional CPR, venoarterial ECMO (extracorporeal membrane oxygenation) can be used as an adjunct and can result in much better systemic perfusion. Essentially, this is a technique in which blood is drained from the body and circulated outside through an oxygen and heat exchanger and is then reintroduced into the body. This technique can be used if preparing for coronary revascularization. M: Vfib is a great risk in the acute phase after MI, up to 72 hours after revascularization, due to the recent ischemia and reperfusion. After the first 72 hours and up to a month following, Vfib remains a risk due to the continued remodeling of the heart. This newly remodeled tissue can cause interruptions in the normal electrical signaling of the heart leading to dissociated contractions and subsequent lack of perfusion through the body, which can quickly lead to death within minutes if not recognized and managed immediately with CPR and defibrillation as described.J: Clinicians should be aware of their patients who would be more susceptible to serious events such as this and be on top of their training about management. This may not be a common occurrence in clinics, but it is a very serious event and requires a prompt and appropriate response. Conclusion: Now we conclude our episode number 98 “Apretude and code blue.” Dr. Yomi concisely explained how to use the new injectable medication for HIV Pre-Exposure Prophylaxis (PrEP). Then, Manpreet, Jon, and Sheinnera presented a case that can actually happen in clinic and anywhere. CPR is a life-saving skill that needs to be learned and practiced over and over so we are not taken by surprise. Remember that heart disease continues to be the number 1 killer in the United States. So, make sure you know where your AED is and be ready to use it when needed. Even without trying, every night you go to bed being a little wiser.This week we thank Hector Arreaza, Timiiye Yomi, Jennifer Thoene, Manpreet Singh, Jon-Ade Holter, and Sheinnera Gerongay.Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. Audio edition: Suraj Amrutia. See you next week!_____________________References:American Heart Association 2022 CPR cheat sheet. American Heart CPR Class, BLS, ACLS Ft. Myers all Lee County. (n.d.). Retrieved June 2, 2022, from https://www.cprblspros.com/cpr-cheat-sheet-2022. Algorithms. CPR & First Aid, Emergency Cardiovascular Care, American Heart Association, cpr.heart.org. Retrieved June 2, 2022, from https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms. Bhar-Amato J, Davies W, Agarwal S. Ventricular Arrhythmia after Acute Myocardial Infarction: 'The Perfect Storm'. Arrhythm Electrophysiol Rev. 2017 Aug;6(3):134-139. doi: 10.15420/aer.2017.24.1. PMID: 29018522; PMCID: PMC5610731. Farkas, J. (2021, November 29). Post-mi complications. EMCrit Project. Retrieved June 2, 2022, from https://emcrit.org/ibcc/post-mi-complications/#ventricular_tachycardia. 

Contributor:  Aaron Lessen, MD Educational Pearls: Refractory ventricular fibrillation, defined as 3 defibrillation shocks without resolution, was studied via RCT looking to compare ECMO with cardiac cath vs. typical resuscitation After 30 patients (15 each arm), the trial was stopped because such a significant benefit seen in the ECMO arm 6 patients survived and 3 had good neurological outcomes at 6 months with ECMO This is compared to 1 patient surviving initially and none surviving at 6 months in the typical resuscitation arm References Yannopoulos D, Bartos J, Raveendran G, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. Lancet. 2020;396(10265):1807-1816. doi:10.1016/S0140-6736(20)32338-2 Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD   The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.  Donate to EMM today!

EMS A to Z: Amiodarone Show Notes: From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn Mechanism of Action: Amiodarone is classified as an antiarrhythmic drug. It is a “dirty drug” in that it acts on multiple different receptors including sodium channels, potassium channels, beta-receptors, and calcium channel receptors. Overall, amiodarone prolongs what's called the “refractory period” in which the cardiac musculature is unable to contract or generate another beat. Prolonging this period works to prevent tachyarrhythmias, like Vtach or Vfib. Indications: Amiodarone is indicated for tachyarrhythmias including: Vtach, Vfib, Afib with RVR, depending on the circumstance and patient presentation. We can divide the indications into two major categories: cardiac arrest and non-cardiac arrest. The AHA recommends considering amiodarone or lidocaine in cardiac arrest with a shockable rhythm after the 2nd shock has been delivered. Our AGs allow for administration of amiodarone / lidocaine for refractory VTACH / Vfib not responding to defibrillation.  Administration of amiodarone should not take priority over good cardiac arrest care, like CPR and defibrillation. Side Effects: Rapid administration of amiodarone can cause hypotension. Amiodarone can prolong the QTc interval. What about lidocaine?  Lidocaine also acts on the sodium channel to prolong the refractory period but does not have many of the other effects of amiodarone. A NEJM study of amiodarone vs lidocaine vs placebo in OHCA did not show significant mortality benefit overall to either medication; this is consistent with prior studies as well. Both medications seem to terminate the rhythm and improve survival to admission and did improve survival to discharge in patients with a witnessed arrest. It's possible that the study wasn't large enough to detect a small difference in survival. Fast Facts: Amoidarone can be administered IV or IO, so drill away. The initial dose is 5mg/kg or up to 300mg initially in cardiac arrest with a follow up dose of 2.5mg/kg up to 150mg if a 2nddose is needed.  In patients with a pulse, the dose is 2.5mg/kg up to 150mg given over 10 min.       

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Sudden cardiac death in heart failure has changed as therapies have evolved. We discuss arrhythmic and non arrhythmic sudden death in heart failure, and how we can lower its incidence. Dr Nasrien Ibrahim MD from Massachusetts General Hospital affiliated with Harvard Medical School shares her expertise. Listen, Like, Subscribe, and give us a rating!

Join the EMGuideWire crew as they discuss some tips and pearls on how to skillfully run a medical resuscitation. Pearls Preparation is everything. Get your staff, and get your stuff!  Call out names, be redundant, and say what you are thinking out loud.  Don’t go for the tube! Supraglottic airways are quicker and safer!  High quality compressions are life saving.  V-tach and V-fib are usually ischemic. PEA is usually non-cardiac.  PEA? Is it Wide or Narrow? Narrow - think procedural. Wide - think chemical. Ultrasound is your friend. RV strain, pericardial tamponade, and pneumothorax can all be quickly found! Wide complex (but not V-tach) is hyperkalemia until proven otherwise. Provide Calcium Chloride (not gluconate).  Summarized by Travis Barlock, MD PGY-1

Amy had to go to a class this week and has decided to get dorky so Mitchell and Amy get songs from the Earbuddies about CPR, heart stuff, and generally “stayin’ alive.” There was actual research from Amy that happened on more than one song. Added bonus, Mitchell sings quite a bit on this one.

Want more of this show? Subscribe in iTunes: HERE Subscribe in Google Play: HERE Read our massive post on EKG Interpretation for Nurses here: https://www.nrsng.com/interpret-ekgs-heart-rhythms/ The post EKG08: VTach and VFib (Ventricular Tachycardia and Fibrillation) appeared first on NURSING.com.

This week we discuss the ED management of cardiac arrest with VFib and pulseless VTach. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_62_0_Final_Cut.m4a Download One Comment Tags: Cardiac Arrest, Dual Defibrillation, OHCA, Ventricular Dysrhythmias, Ventricular Fibrillation, Ventricular Tachycardia Show Notes Take Home Points In cardiac arrest, the most important interventions are to deliver electricity quickly when it's indicated and to administer good high-quality compressions with minimal interruptions to maximize your compression fraction. Medications like epinephrine and amiodarone have never been shown to improve good neurologic outcomes in the ACLS recommended doses. Don't focus on them. Consider pre-charging your defibrillator to minimize pauses in CPR and maximize your chance for ROSC Finally, remember that as Emergency Physicians, we are specialists in the resuscitation of cardiac arrests. ACLS is just a starting point. Push your understanding of taking care of these patients so you can deliver the best care possible Additional Reading Core EM:

This week we discuss the ED management of cardiac arrest with VFib and pulseless VTach. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_62_0_Final_Cut.m4a Download One Comment Tags: Cardiac Arrest, Dual Defibrillation, OHCA, Ventricular Dysrhythmias, Ventricular Fibrillation, Ventricular Tachycardia Show Notes Take Home Points In cardiac arrest, the most important interventions are to deliver electricity quickly when it's indicated and to administer good high-quality compressions with minimal interruptions to maximize your compression fraction. Medications like epinephrine and amiodarone have never been shown to improve good neurologic outcomes in the ACLS recommended doses. Don't focus on them. Consider pre-charging your defibrillator to minimize pauses in CPR and maximize your chance for ROSC Finally, remember that as Emergency Physicians, we are specialists in the resuscitation of cardiac arrests. ACLS is just a starting point. Push your understanding of taking care of these patients so you can deliver the best care possible Additional Reading Core EM:

This week we discuss the ED management of cardiac arrest with VFib and pulseless VTach. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_62_0_Final_Cut.m4a Download One Comment Tags: Cardiac Arrest, Dual Defibrillation, OHCA, Ventricular Dysrhythmias, Ventricular Fibrillation, Ventricular Tachycardia Show Notes Take Home Points In cardiac arrest, the most important interventions are to deliver electricity quickly when it’s indicated and to administer good high-quality compressions with minimal interruptions to maximize your compression fraction. Medications like epinephrine and amiodarone have never been shown to improve good neurologic outcomes in the ACLS recommended doses. Don’t focus on them. Consider pre-charging your defibrillator to minimize pauses in CPR and maximize your chance for ROSC Finally, remember that as Emergency Physicians, we are specialists in the resuscitation of cardiac arrests. ACLS is just a starting point. Push your understanding of taking care of these patients so you can deliver the best care possible Additional Reading Core EM:

This episode of EM Basic Essential Evidence will review the two articles that led to the adoption of therapeutic hypothermia as a treatment for survivors of cardiac arrest. This is a simple yet highly effective therapy that improves survival and neurological outcome in survivors of cardiac arrest so it is important that we know and understand these two articles.

In Part 2 of this episode on ACLS Guidelines - Atropine, Adenosine & Therapeutic Hypothermia, Dr. Steven Brooks and Dr. Michael Feldman discuss the removal of Atropine from the PEA/Asystole algorithm, the indications and dangers of Adenosine in wide-complex tachycardias, pressors as a bridge to transvenous pacing in unstable bradycardias, and the key elements of post cardiac arrest care including therapeutic hypothermia and PCI. They answer questions such as: In which arrhythmias can Amiodarone cause more harm than good? Is there any role for transcutaneous pacing for asystole? When should Bicarb be given in the arrest situation? In what situations is Atropine contra-indicated or the dosage need to be adjusted? How has the widespread use of therapeutic hypothermia currently effected our ability to prognosticate post-arrest patients? What are the indications for PCI and thrombolysis in the cardiac arrest patient? Should we be using therapeutic hypothermia in the non-Vfib arrest patient? What is the best method for achieving the target temperature for the patient undergoing therapeutic hypothermia? and many more......

In Part 2 of this episode on ACLS Guidelines - Atropine, Adenosine & Therapeutic Hypothermia, Dr. Steven Brooks and Dr. Michael Feldman discuss the removal of Atropine from the PEA/Asystole algorithm, the indications and dangers of Adenosine in wide-complex tachycardias, pressors as a bridge to transvenous pacing in unstable bradycardias, and the key elements of post cardiac arrest care including therapeutic hypothermia and PCI. They answer questions such as: In which arrhythmias can Amiodarone cause more harm than good? Is there any role for transcutaneous pacing for asystole? When should Bicarb be given in the arrest situation? In what situations is Atropine contra-indicated or the dosage need to be adjusted? How has the widespread use of therapeutic hypothermia currently effected our ability to prognosticate post-arrest patients? What are the indications for PCI and thrombolysis in the cardiac arrest patient? Should we be using therapeutic hypothermia in the non-Vfib arrest patient? What is the best method for achieving the target temperature for the patient undergoing therapeutic hypothermia? and many more...... The post Episode 12 Part 2: ACLS Guidelines – Atropine, Adenosine & Therapeutic Hypothermia appeared first on Emergency Medicine Cases.