Author Archives: SWORBHP

Why do the pandemic guidelines allow for the administration of 2 doses of epinephrine (<50y) in bronchoconstriction (asthma exacerbation) vs the ALS PCS allowing only a single dose (without age guideline)?

TOTW:2020 AHA Guidelines Recommends Early administration of Epinephrine (ACP-Scope)

TOTW:2020 AHA Guidelines Recommends Early administration of Epinephrine (ACP-Scope)
Posted on: Sepetmeber 10th, 2021

TOTW:2020 AHA Guidelines Recommends Early administration of Epinephrine (ACP-Scope)

New to the 2020 AHA guidelines is a recommendation for epinephrine administration as early as possible in non-shockable cardiac arrest for both adult and pediatric postulations.

A systematic review and met analysis showed increased ROSC and survival to hospital discharge in those given epinephrine. Observational data suggest there are better outcomes when epinephrine is given sooner.

For more great evidence based recommendations, check out your 2021 MCME Precourse module on the AHA Guidelines Update!

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Can we just wear a surgical mask and goggles for all AGMPS and optional gown if we want to? Shouldn't there be an update for our PPE as well and not just our screening tool, now that we know a little bit more about COVID? Thank you!

TOTW: 2020 AHA Guidelines Recommends IV Over IO (ACP-Scope)

TOTW: 2020 AHA Guidelines Recommends IV Over IO (ACP-Scope)
Posted on: February 17th, 2021

2020 AHA Guidelines Recommends IV Over IO (ACP-Scope)

New to the 2020 AHA guidelines is the preference for IV medication administration during ACLS, over IO administration.

A recent systematic review found better clinical outcome in patients that received ACLS drug administration via IV vs IO.

 

Consistent with the current ALS-PCS treatment, they state IO access is acceptable if IV access is unavailable.

For more great evidence based recommendations, check out your 2021 MCME Precourse module on the AHA Guidelines Update!

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2020 AHA Guidelines Recommends Resuscitation Debriefing

TOTW: 2020 AHA Guidelines Recommends Resuscitation Debriefing
Posted on: February 17th, 2021

2020 AHA Guidelines Recommends Resuscitation Debriefing

New to the 2020 AHA guidelines is that recommendation for performance-focused debriefing after resuscitation.

Post event debriefing = a discussion between 2 or more individuals in which aspects of performance are analyzed, with the goal of improving care.

There is evidence that shows these debrief sessions (formal and informal) resulted in improved quality of resuscitation (i.e. Increased chest compression fraction, reduced pause) in future resuscitations.

See more great evidence based recommendations in your  2021 MCME Precourse AHA update module!

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Given that rapid atrial fibrillation and other tachydysrhythmias can result from myocardial ischemia; is it wise to provide ASA to these patients as a precaution. I am a PCP, and we don’t have a defined treatment for pulsed tachycardia.

In regards to an IV that you have established are other medical professionals allowed to use it to give drugs on way to hospital? Back story, picked up a female patient who had just given birth with significant post partum hemorrhage. Midwife onscene was unable to establish a line but you subsequently start one. Midwife wants to push oxytocin through the IV that you have established is this OK?

I had a patient who met the criteria for Nitro administration under the ACPE directive. The initial BP was 104/72, with no previous Nitro use, and unable to obtain IV access. The pt’s blood pressure in the back went up to 143/88 while in the back of the ambulance... can nitro be given now that the blood pressure has increased, even if the pt started <140 SBP?

I was just curious to see if there has ever been talk about the idea of reducing fractures in the field, rather then just femur fx's? Obviously following all of the same protocols as the sager. Not that I have done much research, but could the possibility that some sort of equipment be readily available? We have done so many of those calls that could have gone much smoother and at more of a comfort for the patient in the long run.

For the IV bolus directive when one of the contraindications is “fluid overload”, if a patient has CHF and is presenting hypotensive, and is not experiencing SOB but has chronic edema in his/her feet/legs is that technically a contraindication to not bolus? Considering that would fall under “fluid overload” ? What are the signs and symptoms of fluid overload you guys are wanting us to look out for and be aware of?

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