Podcasts about vtach

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/  

Contributor: Travis Barlock, MD Educational Pearls: SVT: supraventricular tachycardia Pharmacotherapy for SVT includes drugs that block the AV node, such as adenosine EKG criteria before adenosine administration in SVT Regular rhythm Monomorphic: ​​all QRS complexes are identical If the EKG is polymorphic, with QRS complexes displaying changing morphologies, it is unsafe to administer adenosine  Adenosine can worsen polymorphic VTach and lead to VFib References Ganz, Leonard I., and Peter L. Friedman. “Supraventricular Tachycardia.” New England Journal of Medicine, vol. 332, no. 3, 19 Jan. 1995, pp. 162–173, https://doi.org/10.1056/nejm199501193320307. Smith JR, Goldberger JJ, Kadish AH. Adenosine induced polymorphic ventricular tachycardia in adults without structural heart disease. Pacing Clin Electrophysiol. 1997;20(3 Pt 1):743-745. doi:10.1111/j.1540-8159.1997.tb03897.x Viskin, Sami, et al. “Polymorphic Ventricular Tachycardia: Terminology, Mechanism, Diagnosis, and Emergency Therapy.” Circulation, vol. 144, no. 10, 7 Sept. 2021, pp. 823–839, https://doi.org/10.1161/circulationaha.121.055783. Summarized by Meg Joyce, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS3  

Contributor: Travis Barlock MD Educational Pearls: Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds Wide-complex tachycardia of supraventricular origin is known as SVT with aberrancy Aberrancy is due to bundle branch blocks Mostly benign Treated with adenosine or diltiazem Wide-complex tachycardia of ventricular origin is also known as VTach Originates from ventricular myocytes, which are poor inherent pacemakers Dangerous rhythm that can lead to death Treated with amiodarone or lidocaine 80% of wide-complex tachycardias are VTach 90% likelihood for patients with a history of coronary artery disease In assessing a wide-complex tachycardia, it is best to treat it as a presumed ventricular tachycardia Treating SVT with amiodarone or lidocaine does no harm  However, treating VTach with adenosine or diltiazem may worsen the condition References 1. Littmann L, Olson EG, Gibbs MA. Initial evaluation and management of wide-complex tachycardia: A simplified and practical approach. Am J Emerg Med. 2019;37(7):1340-1345. doi:https://doi.org/10.1016/j.ajem.2019.04.027 2. Viskin S, Chorin E, Viskin D, Hochstadt A, Schwartz AL, Rosso R. Polymorphic Ventricular Tachycardia: Terminology, Mechanism, Diagnosis, and Emergency Therapy. Circulation. 2021;144(10):823-839. doi:10.1161/CIRCULATIONAHA.121.055783 3. Williams SE, O'Neill M, Kotadia ID. Supraventricular tachycardia: An overview of diagnosis and management. Clin Med J R Coll Physicians London. 2020;20(1):43-47. doi:10.7861/clinmed.cme.20.1.3 Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce & Jorge Chalit

We've recently had several challenging, wide-complex tachycardia cases here at MCHD, so the podcast crew decided to bring forth some VT vs. SVT with aberrancy knowledge. Learn the V-Tach FACT, and you'll feel more comfortable with your next wide rhythm at a rate of 185. REFERENCES 1. https://litfl.com/vt-versus-svt-ecg-library/ 2. https://www.youtube.com/watch?v=UXh8PS9dtmo 3. Marill KA, Wolfram S, Desouza IS, Nishijima DK, Kay D, Setnik GS, Stair TO, Ellinor PT. Adenosine for wide-complex tachycardia: efficacy and safety. Crit Care Med. 2009 Sep;37(9):2512-8.

Podcast summary of articles from the May 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include inhaled corticosteroids in asthma, posterior stroke, toxicology, stellate ganglion block, ondansetron in concussion patients, and liver transplant emergencies.  Guest speaker is Dr. Matthew Carvey.

​​Contributor: Travis Barlock MD Educational Pearls The QT interval represents phases 2 and 3 of ventricular plateau and repolarization, respectively. As the QT interval lengthens, more sodium and calcium channels are available and susceptible to action potentials. Prolonged QT interval is more concerning in the setting of bradycardia. This scenario increases the likelihood of R on T phenomenon.  R on T phenomenon occurs due to an early afterdepolarization event in which a premature ventricular contraction (PVC) occurs during the repolarization period (superimposed on the T wave), leading to an aberrant re-entry circuit. The re-entry circuit leads to Torsades de Pointes (polymorphic ventricular tachycardia with prolonged QT) and subsequent ventricular fibrillation. Treatment for Torsades de Pointes is 2g MgSO4. The preferred antiarrhythmic for VTach is IV lidocaine 1.5 mg/kg over 2 minutes. Avoid amiodarone due to risk of further QT prolongation. A heart rate under 80 does not need QT correction Corrected QT interval is used in the setting of tachycardia due to an abnormally small T wave Correction for the QT interval in tachycardia: 472 ms for males vs. 482 ms for females References 1. Banai S, Schuger C, Benhorin J, Tzivoni D. Treatment of torsade de pointes with intravenous magnesium. Am J Cardiol. 1989;63(20):1539-1540. doi:10.1016/0002-9149(89)90033-7 2. Gorgels APM, Van Den Dool A, Hofs A, et al. Comparison of procainamide and lidocaine in terminating sustained monomorphic ventricular tachycardia. Am J Cardiol. 1996;78(1):43-46. doi:10.1016/S0002-9149(96)00224-X 3. Liu MB, Vandersickel N, Panfilov A V., Qu Z. R-From-T as a Common Mechanism of Arrhythmia Initiation in Long QT Syndromes. Circ Arrhythmia Electrophysiol. 2019;12(12):1-15. doi:10.1161/CIRCEP.119.007571 4. Sagie A, Larson MG, Goldberg RJ, Bengtson JR, Levy D. An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol. 1992;70(7):797-801. doi:10.1016/0002-9149(92)90562-D 5. Vandenberk B, Vandael E, Robyns T, et al. Which QT correction formulae to use for QT monitoring? J Am Heart Assoc. 2016;5(6). doi:10.1161/JAHA.116.003264 6. Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death - Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines. Vol 114.; 2006. doi:10.1161/CIRCULATIONAHA.106.178104 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII

Personal one today as I tell some stories about recent calls that went my way, and one that I'm still working out.VTach with a pulse, a head trauma that needed pacing, and a throwback to a few years ago when I wished I had gone to electrician school.Mindfulness is a practice.  Just like yoga or medicine, you just keep working on it and see what days it clicks, and endure the days it doesn't.Support the showSupport the show directly here: https://www.buymeacoffee.com/4thshiftfiEPlease order your favorite products through my affiliate links:Rescue1CBD https://rescue1cbd.com?ref=509Use code TAILBOARD for 15% offAthletic Brewing- Code TTFP10 for 10% off for new customersThen use: https://athletic-brewing-co.sjv.io/c/4029326/889587/12298?campaign=affiliate%20%3Dcontent%3Donline_tracking_link to continue to support the show with your purchases.For topic/guest requests use this form https://www.4thshiftfitness.com/guestformFor all other things, reach out here: https://www.4thshiftfitness.com/contactThank you for listening and let's all keep working to be more capable and durable both on shift and away from it.

Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists.I'm Pradip Kamat coming to you from Children's Healthcare of Atlanta/Emory University School of Medicine and I'm Rahul Damania, from Cleveland Clinic Children's Hospital. We are two Pediatric ICU physicians passionate about all things MED-ED in the PICU. PICU Doc on Call focuses on interesting PICU cases & management in the acute care pediatric setting so let's get into our episode:Welcome to our Episode about a 14-year-old male who collapsed on the baseball field.Here's the case presented by Rahul:A 14-year-old male athlete was playing in a high school baseball tournament when he was hit in the chest with a pitched ball. The impact caused him to collapse on the field. Bystander CPR was begun given his unresponsiveness and emergency medical services were immediately called. The patient was transported to the hospital. Upon arrival, he was unresponsive and had no pulse. An electrocardiogram (ECG) showed ventricular fibrillation, and advanced cardiac life support was initiated. After several shocks and cardiac compressions, the patient regained a pulse and was transferred to the pediatric intensive care unit for further evaluation and management.To summarize key elements from this case, this patient has:Been struck by a high-velocity object in the chestSuffered a cardiac arrest, likely due to an arrhythmia from the blunt chest traumaThe presentation brings up a concern for Commotio Cordis, our topic of discussion today!We wanted to create this educational episode in light of the recent medical event experienced by the Buffalo Bill's safety Damar Hamlin. His blunt chest trauma, which led to cardiac arrest, has been postulated to be due to commotio cordis. At the date of this record, we are glad that Damar Hamlin is on the road to recovery.Absolutely, let's dive in more into this topic, Let's start with a short multiple-choice question:The 14-year-old described in our case suffered cardiac arrest after blunt chest trauma. Based on the working diagnosis of comottio cordis, what is the most likely EKG finding which may be seen in this patient?A. Ventricular fibrillationB. Ventricular tachycardiaC. Complete heart blockD. AsystoleThe correct answer is A. In a study published in JAMA (2002; 287(9):1142-1146) which used data from the US Commotio Cordis registry maintained by the Minneapolis Heart Institute Foundation, reported that the most common arrhythmia out of the 128 confirmed cases, 82 of which had EKGs which could be analyzed was ventricular fibrillation. Three patients had Vtach, 3 had Bradyarrhythmia and 1 had complete heart block. Although 40 patients had asystole, this was unlikely to be the initial rhythm after impact. Interestingly, the majority of these rhythms were recorded at the scene.Rahul, What is the definition of Commotio...

The most concerning type of syncope!  When a patient suddenly passes out from either an arrhythmia or a structural abnormality of the heart... this needs to be investigated and treated... next time they might not wake up from it!If you love learning from other people's mistakes, you will love this episode of when I didn't realize my patient was in V-tach and walked him back to his room!We discuss all of the reasons the heart might cause you to pass out and a little about the challenges of being an ER Triage Nurse in this final episode of the year and the last episode in a 4 part series on syncope.  So make sure you also check out episode #32, #33, and #34 to learn seizure vs syncope, reflex syncope, and orthostatic syncope. If you would like to check out the 1hr, 1 CE course, go to:www.rapidresponseandrescue.comyou can use coupon code: PODCAST22To get $22 off the cost of the course now until the end of 2022

Download the cheat: https://bit.ly/50-meds  View the lesson:     Generic Name procainamide Indication wide variety ventricular and atrial arrhythmias, PAC, PVC, VTach, post cardioversion Action decreases excitability and slows conduction velocity through the heart Therapeutic Class antiarrhythmic (Class IA Na Channel Blocker) Nursing Considerations • may cause ventricular arrhythmias, seizure, asystole, heart block • monitor EKG continuously may cause widening of QRS complex • may cause hypotension keep patient supine • monitor for signs of agranulocytosis monitor CBC frequently • can cause drug induced lupus syndrome

Download the cheat: https://bit.ly/50-meds  View the lesson:     Generic Name ondansetron Trade Name Zofran Indication nausea/vomiting Action blocks effects of serotonin on vagal nerve and CNS Therapeutic Class antiemetic Pharmacologic Class 5-HT3 antagonist Nursing Considerations • administer slowly over 2-5 minutes – fatal QT prolongation and VTach, respiratory arrest • may cause headache, constipation, diarrhea, dry mouth • asses nausea and vomiting • assess for extrapyramidal symptoms • monitor liver function tests

In today's Episode, Janice Brown talks with Fred about surviving having his heart stopped multiple times and learning to advocate for himself. Fred shares his journey to becoming healthy and how he has helped others do the same.   Conversation Highlights: {01:17} Fred's story {05:43} Pushing back when people say “no” {07:17} Traumatic Brain Injury {09:44} When your heart stops {19:55} Life today {22:53} Helping others, moving forward, and getting healthy {38:58} The Six Ps   Resources: https://l.facebook.com/l.php?u=https%3A%2F%2Fwww.instagram.com%2Frepeatedlydf%2F%3Ffbclid%3DIwAR3vhIcnmwexg0hY0E6dcCFO9DUUtS7r4mnNWAoM6VMNMyiD6URpWYC3TFs&h=AT1jHvlI-wgzWFzU90CErt4g6NCde8GrE9SQUQmpLOAsH44Hn_DgGBUA5Mx20Tg0AN5jREs6iz4iZsTBlgXh8gU4y0iu7PDQD9Jacfc07nJ8qZ4LJITyElzFDptslzHoQXD6Ag   betterhealthandrehab.com

My guest for this episode is Dr. Ashkan Ehdaie, an Electrophysiologist at Cedars-Sinai Medical Center in Los Angeles. Dr. Ehdaie is currently an Assistant Professor of Cardiology and Associate Director of the Clinical Cardiac Electrophysiology Fellowship Training Program.I interview Dr. Ehdaie about the different types of Vtach, the risks and outcomes associated with treating each type, and we dig into some of the protocols used for various scenarios where Vtach requires treatment, both medically and surgically. All Things Afib is hosted by me, Dr. Armin Kiankhooy. As a board-certified cardiothoracic surgeon, my focus is on advanced treatments for heart and lung failure and minimally-invasive surgical treatments for atrial fibrillation such as the Hybrid Maze procedure. You can find me on staff at Adventist Health Heart and Vascular Institute in St. Helena California. Discussion points:How is Vtach different from supraventricular tachycardia?What are the different types of Vtach?What is the conversation when a patient is diagnosed with Idiopathic Vtach?Where is the threshold between treating with meds or ablation?Why does malignant Vtach occur?Monomorphic vs. polymorphicThe medications that can cause polymorphic VtachPatient follow up procedures and the LifeVestWe do imaging for Afib at a certain time post-procedure, when do you do it for Vtach?What is the success rate when treating with ablation?How much Vtach is too much?A study focusing on reviving tissue, instead of destroying it with ablationWhat else should our listeners know? “That Vtach is not one-dimensional, it has many presentations and complications.” Resources:Dr. Ashkan Ehdaie Cedars-SinaiDr. Ashkan Ehdaie LinkedInDr. Kiankhooy LinkedInAll Things AFib Website All Things AFib TwitterAll Things AFib YouTube Channel

Welcome to PICU Doc On Call, a podcast dedicated to current and aspiring intensivists. My name is Pradip Kamat. My name is Rahul Damania and we come to you from Children's Healthcare of Atlanta-Emory University School of Medicine. Today's episode Is part two of our pediatric post-cardiac arrest care syndrome If you have not yet listened to part one, I would highly encourage you to visit that episode prior to delving into this one. Part 1 addressed the epidemiology, causes, and pathophysiology of POST CARDIAC ARREST SYNDROME. Part 2 Today will discuss management and complications related to post-cardiac arrest syndrome in the ICU. To revisit our index case we had a: 11 yo previously healthy M who was admitted to the PICU after cardiac arrest. After stabilization: The patient was taken to head CT which showed diffuse cerebral edema and diffusely diminished grey-white differentiation most pronounced in the basal ganglia. He is now 18-24 hours post-cardiac arrest and the team is dealing with hemodynamic changes, arrhythmias, and difficulty with ventilation. The patient's neurological exam still remains poor with fixed 5 mm pupils and upper motor neuron signs in the lower extremities. Let's get right into it: What are some of the principles in management of patients with post cardiac arrest syndrome (PCAS)? Where do we keep the patients blood pressure? Hypotension after ROSC is commonly encountered in children with PCAS. Early hypotension occurred in 27% of children after cardiac arrest is associated with lower survival to hospital discharge and unfavorable neurological outcome. When post-cardiac arrest hypotension is present, it is not clear whether increasing the blood pressure through administration of fluids and inotropes/vasopressors can mitigate harm, despite this 41% of patients under 18 receive vasopressor therapy within the first 6 hours after ROSC. Currently, there is no high-quality evidence to support any single specific strategy for post-cardiac arrest hemodynamic optimization in children. Treatment of post-cardiac arrest hypotension and myocardial dysfunction may be assisted by monitoring and evaluating arterial lactate and central venous oxygen saturation. Parenteral fluids, inotropes, and vasoactive drugs are to be used as needed to maintain a systolic blood pressure greater than the fifth percentile for age. Appropriate vasoactive drug therapies should be tailored to each patient and adjusted as needed. What about cardiac arrhythmia's such as Vtach seen in our patient? The rhythm disturbances observed during the post-cardiac arrest period include premature atrial and ventricular contractions, supraventricular tachycardias, and ventricular tachycardias. Heart block is unusual but can be observed as a manifestation of myocarditis. There is inadequate evidence in adults and no published studies in children to support the routine administration of prophylactic antiarrhythmics after ROSC, but rhythm disturbances during this period may warrant therapy. Treatment depends on the cause and hemodynamic consequences of the arrhythmias. Premature depolarizations, both atrial and ventricular, usually do not require therapy other than maintenance of adequate perfusion and normal fluid and electrolyte balance. Ventricular arrhythmias may signify more serious myocardial dysfunction. QT prolonging agents must be avoided. Many of the vasoactive agents used to support myocardial function can increase myocardial irritability and risk of arrhythmias. Premature atrial or ventricular depolarizations are frequently observed and can be controlled by optimizing the dose of the vasoactive drugs. Bradycardia is frequently seen in TTM and typically requires no therapy. During PCAC, mechanical circulatory support (ECMO) may be considered if significant cardiorespiratory instability persists despite appropriate volume expansion and administration of inotropes, vasopressors, and, if indicated,http://antiarrhythmics.in (...

The most common wide-complex tachycardia, VTach is a must-know for the IM Shelf Exam and wards. Come learn how to pick up this diagnosis on an EKG, and learn how the management of VTach changes based on patient presentation...oh, and some of the many side effects of amiodarone. 

From #CodaZero Live, David Carr chats with Sara Gray about treating recurrent ventricular tachycardia. A 50-year-old male arrives in the emergency room with chest pain. Upon examination, it is clear that he is experiencing recurrent episodes of V-tach. Defibrillation isn't working, so what happens next? Treating recurrent ventricular tachycardia with Dr Sara Gray. For more head to: codachange.org/podcasts

Contributor:  Gretchen Hinson, MD Educational Pearls: Three episodes of ventricular tachycardia within 24 hours or two episodes back-to-back Treat with IV amiodarone and IV beta-blockers initially as well as IV lidocaine Correct underlying causes:  IV magnesium for QT prolongation Replete potassium in hypokalemia Urgent revascularization in ischemia For refractory vtach, urgent radiofrequency ablation or stellate ganglion block can be done Last resort is placing on the patient on ECMO References Muser D, Santangeli P, Liang JJ. Management of ventricular tachycardia storm in patients with structural heart disease. World J Cardiol. 2017;9(6):521-530. doi:10.4330/wjc.v9.i6.521 Eifling M, Razavi M, Massumi A. The evaluation and management of electrical storm. Tex Heart Inst J. 2011;38(2):111-121. Summarized by John Spartz, MS3    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.       

In this episode, Dave talks about VTACH, monomorphic and polymorphic, how to define them and finding the root cause of a rhythm. Also In This Episode Monomorphic VTACH defined  Dave's story - When you're following ACLS but the patient doesn't respond as expected ECG Tracing example - wide tachycardia   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

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!

29. The Piano Man causes Vtach by EM Board Bombs

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

In this episode, I focus on 3 things; ACLS and detailed management of the different ACLS rhythms, HY arrhythmias and their acute management (VTach, Afib, Aflutter, WPW, SVT, etc etc), and the HY cardiac agents that are tested on exams. The material in this podcast is applicable to all the USMLE exams and the ABIM/Medicine … Continue reading Divine Intervention Episode 104 – ACLS, Arrhythmias, and HY Cardiac Pharm

Join the EMGuideWire crew as they learn from the master, Dr. Laszlo Littmann, how to interpret patients' rhythm strips to discern whether there is VTach, SVT, or even artifacts.  

Join the EMGuideWire crew at CMC in Charlotte, NC as they take on the complex and scary topic of Irregular Wide Complex Tachycardia in Part 2 of the 3 part series on the approach to Wide Complex Tachycardia. Dr. Laszlo Littmann's expert advice, once again, saves the day!

This week we review pearls from the EEMCrit conference back in January 2018. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_138_0_Final_Cut.m4a Download Leave a Comment Tags: BRASH, Hyperkalemia, TTP, Ventricular Tachycardia, VTach Show Notes Show Notes Core EM: Procainamide vs Amiodarone in Stable Wide QRS Tachydysrhythmias (PROCAMIO) PulmCrit: Myth-Buesting: Lactated Ringers is Safe in Hyperkalemia, and Is Superior to NS PulmCrit: BRASH Syndrome Read More

This week we review pearls from the EEMCrit conference back in January 2018. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_138_0_Final_Cut.m4a Download Leave a Comment Tags: BRASH, Hyperkalemia, TTP, Ventricular Tachycardia, VTach Show Notes Show Notes Core EM: Procainamide vs Amiodarone in Stable Wide QRS Tachydysrhythmias (PROCAMIO) PulmCrit: Myth-Buesting: Lactated Ringers is Safe in Hyperkalemia, and Is Superior to NS PulmCrit: BRASH Syndrome Read More

Wide Complex Tachycardia will grab everyone's attention. Let's join the crew from EMGuideWire and Dr. Littmann to review a simplified approach to evaluation and management of Wide Complex Tachycardia!

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 review a simplified approach to determining the rhythm on an EKG with a tachydysrhythmia. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_88_0_Final_Cut.m4a Download One Comment Tags: Atrial Fibrillation, AVNRT, SVT, Tachycardias, Tachydysrhythias, Ventricular Tachycardia Show Notes Take Home Points When looking at a tachy rhythm that isn't sinus tach, quickly differentiate by determining if the QRS complexes is narrow or wide and then determine if the rhythm is regular or irregular. This approach quickly drops the rhythm into 1 of 4 boxes and makes rhythm determination much easier Each of those 4 categories has a small set of rhythms included. Narrow and irregular – AF, Aflutter with variable block or MFAT. Narrow and regular – SVT or Aflutter. Wide and irregular – Torsades, VF, AF with aberrancy or a BBB. Wide and regular – VTach, SVT with aberrancy or SVT with a BBB. If you see wide and regular, the top 3 diagnoses are VT, VT and VT. Assuming VT and treating for that will almost never send you astray Read More EM: RAP: Episode 84 – Tachycardia Core EM:

This week, we review a simplified approach to determining the rhythm on an EKG with a tachydysrhythmia. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_88_0_Final_Cut.m4a Download One Comment Tags: Atrial Fibrillation, AVNRT, SVT, Tachycardias, Tachydysrhythias, Ventricular Tachycardia Show Notes Take Home Points When looking at a tachy rhythm that isn’t sinus tach, quickly differentiate by determining if the QRS complexes is narrow or wide and then determine if the rhythm is regular or irregular. This approach quickly drops the rhythm into 1 of 4 boxes and makes rhythm determination much easier Each of those 4 categories has a small set of rhythms included. Narrow and irregular – AF, Aflutter with variable block or MFAT. Narrow and regular – SVT or Aflutter. Wide and irregular – Torsades, VF, AF with aberrancy or a BBB. Wide and regular – VTach, SVT with aberrancy or SVT with a BBB. If you see wide and regular, the top 3 diagnoses are VT, VT and VT. Assuming VT and treating for that will almost never send you astray Read More EM: RAP: Episode 84 – Tachycardia Core EM: A Si...

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:

Mike and Eric talk about the importance of early detection of ventricular rhythms and how to treat tachyarrhythmias. 

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.