2018 AHA PALS Update – Nothing New


The optimal sequence of PALS interventions, including administration of antiarrhythmic drugs during resuscitation, and the preferred manner and timing of drug administration in relation to shock delivery are still not known. One study reported a statistically significant improvement in return of spontaneous circulation when lidocaine administration was compared with amiodarone for pediatric ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. However, no difference in survival to hospital discharge was observed among patients who received amiodarone, lidocaine, or no antiarrhythmic medication.

Top 10 Posts of 2017

Mistakes that Kill during Cardiopulmonary Resuscitation

  • Too Slow or Too Fast Chest Compressions
  • Too Shallow or Too Deep Chest Compressions
  • Too Many or Too Slow Breaths
  • Leaning on the Chest
  • Too Many Interruptions
  • Giving Up Too Soon
  • Too Slow Adaptation


 

Oxygen Bubble Bottles or Bacteria Swimming Pools?

Humidified oxygen is widely administered in hospitals and EMS vehicles and this is presumed to alleviate nasal and oral discomfort in the non-intubated patient. Humidification of supplemental oxygen is commonly delivered by bubbling oxygen through either cold or warm sterile water before it reaches the patient. However, the effect on patient comfort is negligible. Bubble humidifiers may, however, represent an infection hazard and should not be used.

 


 

Anaesthesia, Trauma & Critical Care

 

 


 

WHO Emergency and Trauma Care e-Learning Training Course

A modular e-learning course that can easily be accessed by medical providers in an effort to improve emergency trauma care. Give it a try.

 


 

Guillain Barré Syndrome (GBS)


 

Surviving Sepsis Guidelines 2016: Recommendations and Best Practice Statements

 

 

 

Treatment of Helicobacter pylori Infection

 

 


 

2017 American Diabetes Association Standards of Medical Care in Diabetes

 

 


 

I am an Emergency Department doctor…I make mistakes

 

 


 

The Health Act 2017 – Emergency Care

 


 

Thank you for all the support in 2017. We look forward to providing you with even greater emergency care content in 2018. From all of us at the Emergency Medicine Kenya Foundation, HAPPY NEW YEAR!

And don’t’ forget…

 

The Health Act 2017 – Emergency Care

 

American Heart Association Guidelines for CPR & Emergency Cardiovascular Care 2017

 

These highlights summarize the key issues and changes in the adult and pediatric basic life support (BLS) 2017 focused updates to the American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC).

 

Hands-Only CPR

Hands-Only CPR is CPR without mouth-to-mouth breaths. It is recommended for use by people who see a teen or adult suddenly collapse in an “out-of-hospital” setting (such as at home, at work or in a park). It consists of two easy steps:

 

 

Did you know Adrenaline doesn’t work for Cardiac Arrest?

Adrenaline may improve return of spontaneous circulation, but it does not improve survival to discharge or neurologic outcome. The timing of epinephrine may affect patient outcome, but Basic Life Support measures are the most important aspect of resuscitation and patient survival.

 

Adrenaline: It’s just a suggestion

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Epinephrine and other ACLS drugs lead to more patients with ROSC but no increase in the number of patients with good neurologic outcomes after OHCA.

Something that’s very interesting is the actual 2015 ACLS recommendation for epinephrine. It reads, “it is reasonable to consider administering a 1 mg dose of IV/IO epinephrine every 3 to 5 minutes during adult cardiac arrest.” This actually leaves room to not give the medication if the physician thinks it should be withheld.

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