Mechanical vs Manual CPR Chest Compressions

lucasWhen talking about Out of Hospital Cardiac Arrest (OHCA) there are really only three things that make a true difference on outcomes (i.e. survival and neurologic function):

  • High quality, non-interrupted CPR
  • Early defibrillation
  • Therapeutic hypothermia

The quality of CPR is often under appreciated and performed incorrectly (too slow and/or not hard enough).  With mechanical CPR, chest compressions are delivered uninterrupted and at a predefined depth and rate. In my own practice I have seen these devices being used more and more, but my questions is do these devices impact outcomes?

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By |2019-09-10T13:35:31-07:00Oct 23, 2013|Cardiovascular, Critical Care/ Resus|

P-Video: Rule of 15 in anion gap metabolic acidosis

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You have a patient with an anion gap of 30 and bicarbonate of 10 mEq/L. You also determine on VBG that the patient’s pCO2 is 25 mmHg. What trick of the trade can you use to quickly determine whether this low pCO2 is an appropriate compensation of the primary metabolic acidosis? Dr. Jeremy Faust and Dr. Corey Slovis explains the quick “Rule of 15”.

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By |2019-01-28T21:53:37-08:00Oct 22, 2013|Endocrine-Metabolic, Tricks of the Trade|

P-Video: Sources for pediatric and adult fevers

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Dr. Jeremy Faust is back with another P-video, which stands for Paucis Videos (paucis means “few” or “brief” in Latin) much like the Paucis Verbis cards. These P-videos are short video-based educational pearls for the practicing physician with a focus on Emergency Medicine and Critical Care. Here Jeremy shares two mnemonics, LUCAS and FEBRILE, to help you remember the common causes for fevers in pediatric and adult patients, respectively.

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By |2019-01-28T21:53:48-08:00Oct 17, 2013|Infectious Disease, P-videos, Pediatrics|

Confessions of an Emergency Department Kid Helper

FrightenedChildAs I was rounding the corner from the adult area of the emergency department to the pediatric area I heard a child screaming at the top of his lungs, “I DON’T WANT A SHOT”. I knew at that moment I was being summoned. I walked into the room and I saw a mother with her 5 year old son in a full headlock, while a new intern was trying to look in his ears. I made eye contact with the intern said “maybe I can help” then turned my attention to mom and son.

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By |2016-11-20T07:15:20-08:00Oct 14, 2013|Pediatrics|

Treating Ischemic Stroke with tPA in the ED: Time is Brain

Ischemic stroke is an emergent and devastating neurologic disorder, and is a leading cause of both death and disability in the United States. With each minute of brain ischemia, two million neurons are irreversibly damaged. Total ischemic time is linked to functional outcome, and therefore, the role of the Emergency Department is paramount in the management of these patients. Fibrinolytic therapy has become a mainstay of therapy for acute stroke, but guidelines for the use of tPA are dynamic, and often even controversial. When you identify someone with symptoms of stroke, what is your approach to determining if a patient should receive tPA?

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