Mechanical vs Manual CPR Chest Compressions

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

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

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

P-Video: Sources for pediatric and adult fevers

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 Michelle Lin, MD|2019-01-28T21:53:48-08:00Oct 17, 2013|Infectious Disease, P-videos, 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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By Todd A. Seigel, MD|2016-11-11T19:04:15-08:00Oct 10, 2013|Critical Care/ Resus, Expert Peer Reviewed (Clinical), Neurology|

Acute Pulmonary Embolism: Size does matter and ECG can give us clues

Acute pulmonary embolism (PE) is a common condition that can be both severe and difficult to diagnose. Half of all acute PE cases are diagnosed in the emergency department, and acute PE follows acute coronary syndrome as the second most common cause of sudden unexpected death in outpatients. Also, right ventricular dysfunction is a consequence of massive/submassive acute pulmonary embolism and correlates with a poor prognosis and high mortality rate. Although an ECG lacks both sensitivity and specificity for acute PE, there are some clues that can help in determining the size of an acute PE.

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By Salim Rezaie, MD|2019-09-10T13:35:37-07:00Oct 8, 2013|Cardiovascular, ECG, Pulmonary|

Diagnosing hyperthyroidism: Answers to 7 common questions

The prevalence of hyperthyroidism in the general population is about 1-2%, and is ten times more likely in women than men. The spectrum of hyperthyroidism ranges from asymptomatic or subclinical disease to thyroid storm. So how do we diagnose various presentations of hyperthyroidism in the Emergency Department? Below are answers to 7 common questions that commonly arise.
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By Terrance Lee, MD|2016-11-11T19:03:57-08:00Oct 7, 2013|Endocrine-Metabolic, Expert Peer Reviewed (Clinical)|

The Ultimate Consult Service: Emergency Pharmacists

Imagine a consult service located IN the ED. The consultants are some of the friendliest people you’ve met and are there to help you. They tirelessly go out of their way to guide you through hospital protocols, help you with treatments, keep a close eye on your work, and ensure that you and your patients stay out of trouble. Not only are these consultants helpful to you, but also your residents, mid-levels, nurses, and the admitting teams. Everything they know, they teach you – and some are very active in FOAMed and emergency medicine research.

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By Zlatan Coralic, PharmD|2018-03-12T19:56:03-07:00Oct 3, 2013|Tox & Medications|