Archive for category: Cardiovascular

Beyond ACLS – POCUS in Cardiac Arrest

20 Aug
August 20, 2015

As we have discussed in previous posts, the care of patients with cardiac arrest is a key skill for Emergency Providers. ACLS provides a foundation for care but is rife with shortcomings including, but not limited to, reliance on outdated data and inability to adapt in the face of improved understanding of cardiac arrest pathophysiology. […]

REBEL Cast Wee: Early Cardiac Catheterization in OHCA Survivors with Non-STEMI

03 Aug
August 3, 2015

Background: We know that cardiac arrest is a devastating disease and that it occurs in approximately 400,000 Americans each year. In the few patients who achieve return of spontaneous circulation (ROSC) and survive past the pre-hospital stage, mortality rates range from 50 – 60% depending on which sources you read. Neurologic injury is the primary […]

Beyond ACLS: CPR, Defibrillation, and Epinephrine

23 Jul
July 23, 2015

Advanced Cardiac Life Support (ACLS) provides a well structured framework for those who resuscitate infrequently. There is room to move beyond the algorithm to potentially provide better care for our patients for those who resuscitate frequently. I will describe some tweaks to the way CPR, defibrillation, and medications are delivered in the arrests I manage.

Beyond ACLS: From CPR to Cath – The New ACC/AHA Cardiac Arrest Algorithm

13 Jul
July 13, 2015

So you are minding your own business when a 60 year old patient comes in after witnessed Out-Of-Hospital Cardiac Arrest (OHCA).  She had a witnessed arrest, good bystander CPR and the prehospital team shocked her out of ventricular fibrillation (vfib), intubated her and brought her in after 25 min of total down time and 15 […]

Journal Update – Beta Blocker vs. Calcium Channel Blocker for Rate Control in Atrial Fibrillation

09 Jul
July 9, 2015

Background: Atrial fibrillation (AF) is a commonly encountered dysrhythmia in the Emergency Department (ED). Atrial flutter is less common but its management is very similar to that of AF. In patients with chronic AF or unknown time of onset and a rapid ventricular response (RVR), rate control and consideration and initiation of anticoagulation therapy are […]

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