St. Emlyn's

JUNE 14, 2024

St.Emlyn's - Emergency Medicine #FOAMed This secondary analysis of the DOSE VF trial highlights double sequential external defibrillation (DSED) as a superior strategy over standard and vector change defibrillation for refractory ventricular fibrillation (RVF) in out-of-hospital cardiac arrest, improving survival rates and neurological outcomes (..)

Defibrillator 103

Defibrillator 103

University of Maryland Department of Emergency Med

NOVEMBER 7, 2022

DOSE VF (DOuble SEquential External Defibrillation for Refractory VF) Trial Background - High quality data regarding the use of. Click to view the rest

Defibrillator 40

Defibrillator 40

The Skeptics' Guide to EM

JANUARY 13, 2024

You continue with compressions and defibrillations and your partner places an advanced airway. The patient is a 54-year-old man who collapsed in front of his family after complaining of chest pain for several hours. On your arrival, first responders from the fire department are performing high-quality basic cardiac life support.

CPR 258

CPR Defibrillator First Responder Life Support 258

ACEP Now

JULY 7, 2023

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. Tips for use of dual sequence defibrillation 11 : Use the same model of defibrillator.

Defibrillator 98

Defibrillator OR ALS Life Support 98

EMDocs

JUNE 29, 2024

Spoon Feed This secondary analysis of the DOSE VF trial found that DSED (dual sequence external defibrillation) was the superior strategy for obtaining ROSC and functional neurologic outcome regardless of whether the patient was in recurrent VF or shock-refractory VF after three standard defibrillation shocks.

Defibrillator 69

Defibrillator Emergency Department ED OR 69

Dr. Smith's ECG Blog

JULY 25, 2024

He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. See these related cases: Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR. This patient was witnessed by bystanders to collapse. They started CPR. EMS arrived and found him in Ventricular Fibrillation (VF).

Defibrillator 79

Defibrillator Coronary Epinephrine ACS 79

St. Emlyn's

JUNE 14, 2024

St.Emlyn's - Emergency Medicine #FOAMed This secondary analysis of the DOSE VF trial highlights double sequential external defibrillation (DSED) as a superior strategy over standard and vector change defibrillation for refractory ventricular fibrillation (RVF) The post Does the outcome from refractory VF differ from recurrent VF in DOSE-VF patients? (..)

Defibrillator 52

Defibrillator 52

Dr. Smith's ECG Blog

MAY 19, 2020

She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). After good ECMO flow was established, she was successfully defibrillated. Here is a case of ECMO defibrillation with near shark fin that was due to proximal LAD occlusion. The K was normal.

Defibrillator 52

Defibrillator CPR Coronary CAD 52

Dr. Smith's ECG Blog

JUNE 9, 2024

We also gave insulin and furosemide (which take much longer to have their effect) After episodes of asystole and VF with defibrillation, she obtained ROSC and this 12-lead was recorded: The monitor around this time was NOT showing a very wide complex What do you think? How would you treat?

Defibrillator 132

Defibrillator Epinephrine OR 132

Dr. Smith's ECG Blog

APRIL 2, 2024

He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. There was no bystander CPR.

Defibrillator 133

Defibrillator Coronary Epinephrine CPR 133

The Skeptics' Guide to EM

OCTOBER 22, 2022

This includes epinephrine for OHCA, target temperature management, mechanical CPR, supraglottic airways, steroids, hands on defibrillation and many more topics. Background: We have covered Out of Hospital Cardiac Arrests (OHCAs) many, many times on the SGEM.

CPR 130

CPR Defibrillator Epinephrine Firefighter 130

Emergency Medicine Cases

NOVEMBER 5, 2019

Sarah Reid on pediatric appendicitis risk calculator, Sheldon Cheskes & Mark Ramzy on double defibrillation for refractory ventricular fibrillation, Hans Rosenberg & Krishan Yadav on cellulitis clinical pearls, Anand Swaminathan on serratus anterior block, Brit Long on recognition of toxic shock syndrome, Justin Morgenstern on tranexamic acid (..)

Defibrillator 130

Defibrillator EMS 130

The Skeptics' Guide to EM

APRIL 27, 2024

This is because of the ease of finding anatomic landmarks and their location away from other procedures like defibrillation, CPR, and airway management. The classic location for IO placement is the tibial plateau.

ICU 217

ICU Defibrillator Paramedic CPR 217

The Skeptics' Guide to EM

OCTOBER 24, 2020

You abandon your coffee order and quickly head next-door, where you are able to start cardiopulmonary resuscitation (CPR) and direct a bystander to find the store’s automated external defibrillator (AED) while waiting for emergency medical services (EMS) to arrive. Unfortunately, most patients don’t receive these crucial interventions.

Emergency Medical Services 130

Emergency Medical Services Defibrillator Advanced Life Support CPR 130

The Skeptics' Guide to EM

MARCH 11, 2023

A fire company is on scene providing high-quality cardiopulmonary resuscitation (CPR) and has defibrillated twice with an automated external defibrillator (AED). Case: A paramedic crew responds to a 54-year-old male in cardiac arrest at a private residence.

CPR 130

CPR Defibrillator BLS Paramedic 130

Medgadget

NOVEMBER 7, 2022

“All of the cells inside the heart get hit at one time, including the pain receptors, and that’s what makes pacing or defibrillation painful,” said Philipp Gutruf, a researcher involved in the study. Moreover, when electrical signals are sent to the heart, every cell receives the shock, often leading to pain and discomfort.

Defibrillator 104

Defibrillator OR 104

Medgadget

MAY 1, 2023

“One of the challenges for current pacemakers and defibrillators is that they are difficult to affix onto the surface of the heart,” said Igor Efimov, one of the creators of the new technology. “Defibrillator electrodes, for example, are essentially coils made of very thick wires.

Defibrillator 111

Defibrillator 111

EMT First Aid

JANUARY 24, 2024

defibrillator is a lifesaving piece of medical equipment which delivers an electrical shock to a cardiac arrest victim. Research has shown that deploying a defibrillator What is an AED and how to use one.A Cardiac arrests can affect anyone at any time. 30,000 occur outside of hospitals across the UK each year.

Defibrillator 40

Defibrillator CPR 40

EMS 12-Lead

MARCH 30, 2024

As this case shows, electrical capture isn't always possible at lower currents, especially with pads placed in a standard anterolateral "defibrillation" position. Escalating directly to TCP requires a certain technical acumen to ensure its efficacy. The anterior-posterior position, however, was 80% more likely to gain capture.

CPR 312

CPR Paramedic Ambulance Defibrillator 312

The Skeptics' Guide to EM

JULY 22, 2023

We should focus more on high-quality CPR and early defibrillation for shockable rhythms and less on type of supraglottic airway device. The SGEM has also covered prehospital intubation using supraglottic devices for out-of-hospital cardiac arrests (OCHAs) with PA Missy Carter ( SGEM#247 and SGEM#396 ).

Emergency Medical Services 234

Emergency Medical Services Defibrillator CPR EMS 234

Dr. Smith's ECG Blog

JULY 21, 2024

He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. Some episodes of PMVT would terminate spontaneously — but on many occasions, the PMVT degenerated to VFib, requiring defibrillation.

Defibrillator 121

Defibrillator Coronary ALS STEMI 121

SSCOR

DECEMBER 21, 2023

The elderly woman had gone into cardiac arrest just minutes before you arrived, but immediate CPR and rapid defibrillation were rewarded with a weak return of pulses. The call is going smoothly. Your IV is flowing and the patient is intubated.

Defibrillator 52

Defibrillator CPR EMS 52

Emergency Medicine Cases

JANUARY 29, 2019

In this CritCases blog Michael Misch takes us through a case of accidental hypothermia and cardiac arrest, reviewing the controversies in management as well as the guidelines for rewarming, the role of ECMO and the alterations to ACLS cardiac arrest medications, CPR and defibrillations.

Defibrillator 130

Defibrillator CPR EMS 130

Dr. Smith's ECG Blog

JUNE 13, 2024

She was successfully defibrillated and taken back to the ED. They also sued both EMTs for allegedly not starting chest compressions and defibrillating quickly enough. The physician documented that she was “improved” and the patient was discharged. The following morning, the patient collapsed in the kitchen in front of her family.

Defibrillator 92

Defibrillator STEMI EMT EMT 92

EMDocs

JANUARY 8, 2024

With respect to timing, for cardiac arrest with a shockable rhythm, it may be reasonable to administer epinephrine after initial defibrillation attempts have failed. Consider administering epinephrine after defibrillation in those with shockable rhythms. COR 2b, LOE C-LD. COR 3, No benefit, LOE B-R. COR 2b, LOE B-R. COR 2b, LOE C-LD.

Epinephrine 82

Epinephrine Defibrillator Coronary CPR 82

Dr. Smith's ECG Blog

JULY 14, 2023

He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated with both with only a fraction of one second separating each defibrillation.

E-9-1-1 94

E-9-1-1 Defibrillator CPR STEMI 94

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc. Then the patient would have been taken to the critical care area with a defibrillator at his side while waiting for the cath lab to be ready. Resuscitative attempts were initiated quickly. Eventually asystole, and the patient died.

Defibrillator 135

Defibrillator Coronary STEMI CPR 135

EMDocs

JANUARY 16, 2024

The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. The patient is moved over to the stretcher and connected to the monitors and defibrillator. What would your next steps be? His point-of-care labs return with a potassium of 3.4

Defibrillator 84

Defibrillator CPR Life Support Epinephrine 84

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

One defibrillation for ventricular fibrillation (VF) is provided but the patient remains in VF. We now know that an emphasis on the basics (high quality chest compressions and defibrillation) are the most important aspects of resuscitation. Case: A 46-year-old man has a cardiac arrest at home, witnessed by family.

BLS 130

BLS Defibrillator Critical Care CPR 130

The Skeptics' Guide to EM

DECEMBER 7, 2018

A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation. Case: A 51-year-old man experiences a cardiac arrest on the street. You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). He is unsuccessfully shocked.

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

Utah's Paramedic and EMS Academy

OCTOBER 23, 2023

Upon arrival, you quickly assess the situation and spring into action, working to save a man's life through CPR and defibrillation. This includes checking monitors, defibrillators, airway management equipment, and other essential tools for stabilizing and transporting critically ill patients.

EMT 52

EMT EMT Emergency Medical Technician Defibrillator 52

EMS 20/20

JULY 28, 2021

Sedation, Intubation, Ventilation, Defibrillation, Exasperation. Sedation, Intubation, Ventilation, Defibrillation, Exasperation. A Paramedic shoulders the weight of a hectic call. all the ations are present in this weeks absolutely epic episode! A Paramedic shoulders the weight of a hectic call.

Defibrillator 40

Defibrillator Paramedic 40

ACEP Now

JULY 7, 2023

Patients with a history of life-threatening or recurrent VT will often undergo radiofrequency catheter ablation and/or placement of a cardioverter defibrillator (implantable or external). Other treatments include electrical cardioversion and the use of antiarrhythmic drugs (e.g., amiodarone or lidocaine). See the original question here.)

Defibrillator 52

Defibrillator ALS OR 52

EMS 20/20

OCTOBER 20, 2021

Can a patients implanted defibrillator shock you? Can a patients implanted defibrillator shock you? Can our hosts offer up some sage advice without making too many Star Trek references? Listen and find out! A patient with a OW troubling and painOWful experience is treated by a OW crew OW that may be jumping to conclusions.

Defibrillator 40

Defibrillator 40

FOAMcast

JANUARY 24, 2023

This story is a reminder of the importance of continuous chest compressions, early defibrillation, and that what we do in emergency and prehospital medicine matters. Billy Frolick , a writer and our patient that day shares his perspective on his case with us.

Defibrillator 52

Defibrillator Emergency Department OR 52

REBEL EM

DECEMBER 19, 2022

Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. N Engl J Med.

Defibrillator 52

Defibrillator Paramedic CPR EMS 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. A team member asks if you want to administer some sodium bicarbonate (1mEq/kg). Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU).

CPR 130

CPR ICU Critical Care Defibrillator 130