Med Inspired

Resuscitation sequenced intubation!! Great podcast/vodcast.

https://m.youtube.com/watch?fbclid=IwAR2hUYpXjB0QeUCo3ojxDKIA0C46YrEayxHDGUUjcFkVdrgialPbvLGr0zE_aem_ATsE0CAAn1jCZmQa3fd7sbJbN5Foh3fyOaNfsGv1KcSzKxSMu42O9zP3r_w7y8zLQp8&v=qI9dRp9Hb5k&feature=youtu.be

Resuscitation Sequenced Intubation In this Episode of the PCHD EMS Podcast we discuss Resuscitation focused, Sequenced Intubation, and delayed movement of sick patients. Supervisor Jeff McNew ...

Beware of the patient with right ventricular failure!

Identifying right ventricular failure POCUS, ECG and assessment findings to look for to avoid the RV spiral of death

VL improves view at laryngoscopy but also the efficacy & effectiveness of tracheal intubation.

This is no longer usefully debatable

https://www.cochranelibrary.com/web/cochrane/content?templateType=full&urlTitle=/cdsr/doi/10.1002/14651858.CD011136.pub2&doi=10.1002/14651858.CD011136.pub2&type=cdsr&contentLanguage=

Thoughts?

Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest Little is known about the impact of tidal volumes delivered by emergency medical services (EMS) to adult patients with out-of-hospital cardiac arrest …

Fantastic study on key performance issues in emergency intubation. We should be structuring our training around mitigating these errors!

https://m.facebook.com/story.php?story_fbid=824835952977286&id=100063526660051

EMCrit 360 - A Taxonomy of Key Performance Errors for Emergency Intubation (Primer) We categorized intubation errors and published a paper about it...

https://www.sciencedirect.com/science/article/pii/S1067991X23002195?dgcid=coauthor

Ketamine Efficacy for Management of Status Epilepticus: Considerations for Prehospital Clinicians Current first-line therapies for seizure management recommend benzodiazepines, which target gamma-aminobutyric acid type A channels to stop the seizur…

Hyper acute T-waves in early diagnosis if AMI.

Neither sensitive nor specific because of lack of exact definition.

Very subjective

You should worry if significant T:QRS disproportion is present! AKA: you can fit T wave into QRS.

👇🏻 study below!

Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction - PubMed Hyperacute T waves, when defined as increased T-wave amplitude exceeding the 95th percentile, did not provide useful information in diagnosing myocardial infarction in this sample.

🥊 battle of the vasopressers! 🥊

Which is better post ROSC?

https://www.facebook.com/100009858604961/posts/2040265129645421/?mibextid=cr9u03

✅ Which is better post-ROSC for OHCA.... Epinephrine or Norepinephrine?

A recent study titled "Prehospital Administration of Norepinephrine and Epinephrine for Shock after Resuscitation from Cardiac Arrest" was conducted by Emma R. Wender and team from Seattle. Here are the key takeaways:

🔹 Study Overview:
‣ The research included OHCA cases in Seattle, WA from 2014-2021.
‣ Out of 451 OHCA patients with return of spontaneous circulation (ROSC) followed by vasopressor infusion:
◘ 253 (56%) received norepinephrine
◘ 198 (44%) received epinephrine

🔹 Key Findings:
‣ Patients on epinephrine were more likely to rearrest in the prehospital setting: 55% vs 25% for those on norepinephrine.
‣ After adjustment for various factors, the odds of rearrest for epinephrine patients were 3.28 times higher.
‣ The odds of having pulses upon hospital arrival were lower for the epinephrine group (OR 0.52).
‣ Overall survival to hospital discharge was 14%, with 10% having a favorable neurological outcome.
‣ No significant difference was found between the two groups in terms of survival or neurological outcome.

🔹 Conclusion:
Epinephrine infusion was associated with higher odds of prehospital rearrest compared to norepinephrine yet there was no difference in neuro-intact survival. The findings emphasize the need for further randomized controlled trials on this topic.

For a deeper dive into the research and its implications, check out the full study: https://ow.ly/E5hg50PIBiK

Stay informed and stay safe!

Ultrasound for the lungs.

A comprehensive review encompassing 222 studies of more than 26,000 participants undergoing tracheal intubation further supported the superiority of video laryngoscopy.

Video Laryngoscopy for the Win: The DEVICE trial was... : Emergency Medicine News An abstract is unavailable.

https://www.dropbox.com/scl/fi/fnw650cnek3p0txaixbeo/The-Association-of-Combined-Prehospital-Hypotension-and-Hypoxia-With-Outcomes-Following-Out-of-Hospital-Cardiac-Arrest-Resuscitation.pdf?rlkey=ljx5teapfa91pm2vf6een8wwu&dl=0

The Association of Combined Prehospital Hypotension and Hypoxia With Outcomes Following Out of Hospital Cardiac Arrest Resuscitation.pdf Shared with Dropbox

Announcement!! Med Inspired LLC is proud to announce a new medical director! So happy to have Dr. Root on board and will help take Med Inspired to the next level of medical education!! And he likes breakfast burritos! Who doesent! 👇🏻

Chris Root is an emergency medicine physician, flight physician and a former New York City paramedic. His career in EMS has spanned urban and rural, 911 and interfacility, clinical practice and education, and critical care transport by ground and by air. He earned his medical degree from the Icahn School of Medicine at Mount Sinai in New York City. He completed his emergency medicine residency at the University of New Mexico in sunny Albuquerque. He is currently completing a fellowship in EMS at UNM and working as a flight physician for UNM Lifeguard Air Emergency Services. His research interests include prehospital airway management, education, ultrasound, cardiac arrest management and also breakfast burritos.