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Adenosine for wide-complex tachycardia – diagnostic?
- Adenosine is a drug that wears off very quickly, so that its side effect of asystole is not really a problem. The metabolism of adenosine takes place in the cells. If you remember the Krebs cycle,...
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The assessment of the hemodynamic disturbances in patients in the early...
- There is not much research on the goal of postresuscitation care, other than recognition that leaving the hospital with a functioning brain is the goal. This abstract looks at some of the early...
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What is the basis for post-resuscitation treatment recommendations?
- We spend a lot of time worrying about how to get a pulse back. We spend so much time on getting that pulse back, that some of us think that producing a pulse is what matters. Once we have a pulse...
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Is a half a bottle of nitro too much for a single dose?
In what I last wrote about the emergency treatment of CHF (Congestive Heart Failure) and furosemide (Lasix – frusemide in Commonwealth countries) being a bad drug,[1] I also mentioned what Peter...
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Is Digoxin a Killer?
From the London Science Museum – Bottle of digoxin tablets, ‘Tabloid’ brand, London, England, 1884-1924. Digoxin (Lanoxin) is an antiarrhythmic drug, which means that it is also a proarrhythmic...
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Should the AHA reintroduce the ‘Indeterminate’ class of ACLS recommendations?
In 2005 the AHA (American Heart Association) used more categories for their drug recommendations. The recent very poor showing of epinephrine in resuscitation studies, and the lack of evidence of...
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How do we measure the QT segment when there are prominent U waves?
This ECG has large T waves, U waves, and P waves, but where does one end and the other begin? When measuring the QT segment, where do we measure the end of the QT segment and why? Click on the image...
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Woman with Risks for Torsades de Pointes Dying within Hours of Leaving the...
I don’t expect to see this as a headline anywhere, but this possible cause of death something we should be aware of. Abdominal pain in a patient with many comorbidities. She is given medication and...
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Worst test question ever! – Maybe
Thank you to David Baumrind of EMS 12 Lead for linking to this here. It probably is not the worst test question ever, but it is very bad. Read the question, figure out what your response would be,...
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Another Sinus Tachycardia that F&B Medics Want to Shock
In Worst test question ever! – Maybe, I pointed out some of the problems with the way we “educate” people in EMS. The following question was provided with the rhythm above. You are dispatched...
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What Does a Moon Landing ECG Look Like?
Some interesting ECG from the first people to land on the Moon. During landing, they were running low on fuel and Buzz Aldrin appears to be showing signs of stress. Click on images to make them...
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Examples of Ventricular Tachycardia Caused by Amiodarone – Part I
How much worse could the patient get if we give amiodarone? But amiodarone doesn’t cause V Tach (Ventricular Tachycardia). Amiodarone stops V Tach. Right? If amiodarone can cause V Tach, shouldn’t...
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Epinephrine for V Tach – Instant Death or Effective Treatment?
The patient has V Tach (Ventricular Tachycardia) with a pulse. After amiodarone is given the patient’s blood pressure drops and the patient becomes unstable. The patient is still awake, so...
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Why Did We Remove Atropine From ACLS? Part II
Continuing from Part I. The AHA (American Heart Association) stopped recommendeding use of atropine for the treatment of PEA (Pulseless Electrical Activity) or asystole in the 2010 ACLS (Advanced...
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Is Earlier Better for Therapeutic Hypothermia? Part I
When is the right time to begin TH (Therapeutic Hypothermia) to produce the best outcomes? In the ICU (Intensive Care Unit)? In the ED (Emergency Department)? In the ambulance? While the patient is...
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A Recalled AED is Better Than No AED
Cardiac arrest. CPR in progress. Do not use the AED, because it has been recalled! Wrong. HeartStart automated external defibrillators from Philips Healthcare have been recalled. What does the...
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Who Needs a 12 Lead ECG?
Do we do too many 12 lead ECGs on patients who do not have chest pain? This is something that some people worry about. Save the electrodes! Those poor little electrodes are being abused! Are...
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Valsalva the SVT or Shock the Monkey?
The Skeptics’ Guide to Emergency Medicine should be on your podcast list. The podcasts are short, so there is not much reason to avoid them. This one is 13 minutes. Valsalva for SVT...
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Why are we making the heart work harder in heart failure?
– Is the harm from furosemide (Lasix – frusemide in Commonwealth countries) anything new? This study is looking at the effects of furosemide in patients with chronic CHF (Congestive Heart Failure),...
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Blood Type, Heart Attacks, and Bad Research
– The major media love to present information out of context in order to increase viewers. Fortunately, there are some sources of accurate information. Science Friday covered this today with Dr. Eric...
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