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SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

The paramedic is trying to get intravenous (IV) access to give epinephrine per the protocol. Epinephrine has long been a cornerstone in the management of OHCA. Multiple studies have demonstrated how the administration of epinephrine can improve short-term outcomes, such as return of spontaneous circulation (ROSC).

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Symptomatic Bradycardia: The Epinephrine Era Ends

Handtevy

It’s official: the 2025 ILCOR Pediatric Life Support guidelines have removed the recommendation to administer cardiac arrest dose epinephrine for symptomatic bradycardia in children. Hallelujah For years, the use of epinephrine in bradycardic pediatric patients receiving CPR has been embedded in resuscitation algorithms. Resuscitation.

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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

6 Apply direct pressure to the bleeding site with gauze soaked in TXA and epinephrine as a first-line intervention. 7 Epinephrine acts as a local vasoconstrictor, aiding hemostasis, and TXA helps to stabilize clot formation on the exposed tissue and delay hemorrhage progression. Its going to take time to get her to a tertiary center.

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The Future of Autonomous EMS Delivery Systems

JEMS

These unmanned aerial vehicles can rapidly deliver automated external defibrillators (AEDs), naloxone, epinephrine, and other critical supplies to the scene of an emergency, often faster than traditional ambulances. Technological Advancements in Autonomous EMS One of the most significant developments in autonomous EMS is using drones.

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Push-Dose Pressors in the Emergency Department

ACEP Now

Epinephrine (“epi”). Epinephrine has more balanced a 1 and b Because of this, it will give you both peripheral vasoconstriction from the a 1 and an increase in heart rate (chronotropy) and contractility (inotropy) from the b 1. 3 Typical dosing of epinephrine is 10-20 micrograms every three to five minutes.

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Just Culture in EMS

JEMS

Scenario One A paramedic forgets to restock epinephrine 1:1,000 in the medical bag, and the next crew responds to an anaphylaxis call without it. Emergency medical services(EMS) has historically been a punitive system, resulting in people being unforthcoming about issues or concealing minor infractions in hopes of evading discipline.

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The Pediatric EMS Podcast: Prehospital Pediatric Traumatic Cardiac Arrest – Priorities for Care

EMDocs

Navy veteran, he specializes in pediatric trauma care Takehome Points Differentiate Between Traumatic and Medical Cardiac Arrest: The approach to traumatic cardiac arrest is distinct from medical arrest, with hemorrhage control and volume resuscitation taking precedence over standard CPR and epinephrine administration.

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