Tag Archive for: Resuscitation

Topics in Post-ROSC Care

29 Jan
January 29, 2018

Background: Post-cardiac arrest patients are among the sickest groups of patients seen in the Emergency Department. They are difficult to study, which leads to endless questions about how to best care for them. Below we address the available evidence on four of these controversies: oxygen therapy, hemodynamic management, cardiac catheterization and head CT. We recognize the limitations to the available data and attempt to offer the best recommendations we can. Read more →

REBEL Cast Episode 41: Research From the Past Year – Resuscitation

26 Oct
October 26, 2017

Welcome back to Episode 41 of REBEL Cast. In this episode, we will be discussing some studies from the past year that caught our attention in the area of resuscitation. Again, this 3 part series will be dedicated to discussing current literature and how it can be applied to your clinical practice. Read more →

Can We Agree on Cardiac Standstill?

18 Sep
September 18, 2017

Background: Point of Care Ultrasound (POCUS) has gained wider use in resuscitation of patients presenting with cardiac arrest. POCUS can play an important role in determining the etiology of arrest as well as being used to determine the presence or absence of mechanical activity. The REASON study demonstrated that patients with PEA or asystole without cardiac activity on POCUS are extremely unlikely to survive to hospital discharge though this study did not investigate the more important question of a survival with a good neurologic outcome. (Gaspari 2016). In light of this as well as other evidence, some have proposed that the absence of cardiac activity may be adequate to declare resuscitation futility and stop resuscitative efforts. However, there is a lack of agreement on what defines cardiac activity (see table 1). Due to this, and other factors, the level of agreement between physicians in interpretation of cardiac standstill is unknown. Read more →

The WOMAN Trial: Early TXA in Post-Partum Hemorrhage

22 May
May 22, 2017

Background: Post-partum hemorrhage (PPH) is the leading cause of maternal death worldwide. It is typically defined as > 500 ml of blood loss within 24 hours of giving birth. However, PPH encompasses a broad spectrum of disease from mild oozing over hours to rapid exsanguination and death. The burden of mortality from PPH is shouldered mainly by developing countries thus requiring cost-effective treatment modalities. Tranexamic acid (TXA) is one such possibly modality. TXA works by inhibiting the breakdown of fibrinogen and fibrin by plasmin. In essence, it stabilizes clot that the body naturally forms. TXA has a well established role in reducing death in trauma patients as demonstrated in the CRASH-2 trial (CRASH-2 2010) and is already used by many performing resuscitations in resource strapped locations due to its availability and low cost. Whether early TXA in post-partum hemorrhage reduces mortality while avoiding significant clotting complications (DVT, PE, ACS, CVA) is unknown. Read more →

Baclofen Withdrawal

27 Oct
October 27, 2016

Baclofen WithdrawalDefinition: A dysfunctional condition in which removal of baclofen, an inhibitory neurotransmitter, from the central nervous system (CNS) causes CNS excitation. Read more →

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