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PV Card: Continuous End Tidal CO2 Monitoring in Cardiac Arrest

capnography

For many years, end tidal CO2 monitoring initially was helpful in differentiating tracheal versus esophageal intubations. Now with continuous end tidal capnography, providers have access to so much more information during a cardiac arrest resuscitation, as summarized by the recently released 2015 American Heart Association (AHA) recommendations.1 Thanks to Dr. Abdullah Bakhsh from Emory University for a great PV card to help remind us of these key cardiac resuscitation pearls.

PV Card: Continuous End Tidal CO2 Monitoring in Cardiac Arrest


Adapted from [1-4]

References

  1. Link M, Berkow L, Kudenchuk P, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2):S444-64. [PubMed]
  2. Ahrens T, Schallom L, Bettorf K, et al. End-tidal carbon dioxide measurements as a prognostic indicator of outcome in cardiac arrest. Am J Crit Care. 2001;10(6):391-398. [PubMed]
  3. Silvestri S, Ralls G, Krauss B, et al. The effectiveness of out-of-hospital use of continuous end-tidal carbon dioxide monitoring on the rate of unrecognized misplaced intubation within a regional emergency medical services system. Ann Emerg Med. 2005;45(5):497-503. [PubMed]
  4. Kleinman M, Brennan E, Goldberger Z, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2):S414-35. [PubMed]
By |2021-10-19T19:25:31-07:00Oct 20, 2015|ALiEM Cards, Cardiovascular, Critical Care/ Resus|
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PV Card: Normal Values for Ultrasound Measurements

Ultrasound-PV-Card-sm

As emergency medicine providers become more proficient in using bedside ultrasonography as a diagnostic tool, it can be difficult to remember all of the normal cutoff values. Is it 3 or 5 mm as the cutoff? Thanks to the team at UCSF (Dr. Maria Beylin, Dr. Scott Fischette, and Dr. Nate Teismann) for creating a succinct PV card listing the key numbers to remember. You can download this PV card into your mobile device as a reference guide, or you can even print and attach to each of your ultrasound machines!

 

PV Card: Normal Values for Ultrasound Measurements


Adapted from [1–4]

References

  1. Horrow M. Ultrasound of the extrahepatic bile duct: issues of size. Ultrasound Q. 2010;26(2):67-74. [PubMed]
  2. Beigel R, Cercek B, Luo H, Siegel R. Noninvasive evaluation of right atrial pressure. J Am Soc Echocardiogr. 2013;26(9):1033-1042. [PubMed]
  3. Doubilet P, Benson C, Bourne T, et al. Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med. 2013;369(15):1443-1451. [PubMed]
  4. Adhikari S, Zeger W, Thom C, Fields J. Isolated Deep Venous Thrombosis: Implications for 2-Point Compression Ultrasonography of the Lower Extremity. Ann Emerg Med. 2015;66(3):262-266. [PubMed]
By |2021-10-04T09:56:16-07:00Oct 15, 2015|ALiEM Cards, Ultrasound|
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NEXUS Chest CT Decision Instruments in Blunt Trauma

ct_cat_scanner_angled_400_wht_5332One of the five 2014 American College of Surgeons’ Choosing Wisely recommendations is to avoid routing whole-body CT imaging of trauma patents, also known as the ‘pan-CT’. Until now, no validated decision instrument existed to help guide clinicians decide whether to obtain a chest CT in the setting of blunt trauma. This month, Dr. Robert Rodriguez and the multi-institutional NEXUS Chest CT research team published a paper describing the derivation and validation of 2 decision instruments in PLOS Medicine [1].

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By |2019-01-28T21:43:56-08:00Oct 13, 2015|Radiology, Trauma|
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AIR Series: Cardiology – CHF, PVD, and Others (part 2)

As mentioned last module, the FOAMsphere contains a phenomenal amount of cardiology content. Accordingly, the CORD testing schedule and our cardiology module has been divided into two parts. Below we have listed our selection of the 12 highest quality blog posts within the past 12 months (as of August 2015) related to acute coronary syndromes, curated and approved for residency training by the AIR Series Board. In this module we have 6 AIRs and 6 Honorable Mentions. We strive for comprehensiveness by selecting from a broad spectrum of blogs from the top 50 listing per the Social Media Index.

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By |2017-03-05T14:14:16-08:00Oct 12, 2015|Approved Instructional Resources (AIR series), Cardiovascular|
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ALiEM Bookclub | Dreamland: The True Tale of America’s Opiate Epidemic

51k4NEasuFL._SY344_BO1,204,203,200_They started at once, and went about among the Lotus-eaters, who did them no hurt, but gave them to eat of the lotus, which was so delicious that those who ate of it left off caring about home, and did not even want to go back and say what had happened to them, but were for staying and munching lotus with the Lotus-eaters without thinking further of their return.

— Odyssey IX, translated by Samuel Butler

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By |2016-11-11T19:39:51-08:00Oct 9, 2015|Book Club, Tox & Medications|
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Your Patient In Extremis: THAM To The Rescue?

acid_20base_20balanceOne of the final common denominators dictating the success or failure of any resuscitative effort, be it a trauma or medical code, is the patient’s acid-base status. In the presence of acidosis, many of the tools at your disposal, including vasopressors, become impotent and the patient’s ability to strike a balance between bleeding and clotting or mounting an appropriate inflammatory response become deranged.1–6 So what are the options to tilt the acid-base status in our favor?

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By |2016-11-11T19:39:36-08:00Oct 5, 2015|Critical Care/ Resus, Expert Peer Reviewed (Clinical), Tox & Medications|
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