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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. Early bolus epinephrine administration during pediatric cardiopulmonary resuscitation for bradycardia with poor perfusion: an ICU-resuscitation study.

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Lightning rounds #27: Our favorite FOAM

Critical Care Scenarios

Podcasts * CORE IM * EMcrit * Gobbet ‘o Pus * Simulcast * Intensive Care Network * ACCRAC * Blood Bank Guy Essentials * Traumacast * Maryland Critical Care Project * PulmPEEPS * IBCC podcast * Pharmacy Joe’s Elective Rotation * Trauma ICU Rounds * PulmCast * Jeff Guy’s ICU Rounds * SMACC/CODA * Ultrasound Podcast/Core Ultrasound Blogs/websites (..)

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How Much O2 Is Right in COVID?

REBEL EM

Lower vs higher oxygenation target and days alive without life support in COVID-19. Population: Adult patients ( > 18 years of age) admitted to the ICU with COVID-19 and severe hypoxemia (defined as receiving supplemental O2 with a flow rate of at least 10L/min or receiving mechanical ventilation or non-invasive ventilation.

ICU 68
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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive. For patients who in cardiac arrest standard Advanced Cardiac Life Support (ACLS) should be initiated. Acidemia from hypoventilation or tissue hypoxia will worsen LAST.

E-9-1-1 104
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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

Statements: Early risk stratification is not intended as a tool for triage to withdraw life support and is not used for that purpose (90.5%, 19/21). Digestive Management Takeaway: Start enteral feeds when the patient gets to the ICU. Statements: Initiate EN as soon as possible after ICU admission (100%, 20/20).

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Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

REBEL EM

2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Based on 2019 American Heart Association (AHA) guidelines, amiodarone and digoxin have been suggested as alternative options in controlling ventricular rate refractory to first-line BBs and non-DHP CCBs. 2022 Sep 7.

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The Science on Targeted Temperature Management

ACEP Now

Temperature management after cardiac arrest an advisory statement by the advanced life support task force of the international liaison committee on resuscitation and the American Heart Association emergency cardiovascular care committee and the council on cardiopulmonary, critical care, perioperative and resuscitation. N Engl J Med.