atropine Archives - Emergency Medicine Cases

Ep 155 Treatment of Bradycardia and Bradydysrhythmias

In Part 1 of our 2-part series on bradycardia and bradydysrhythmias we discussed a practical approach with electrophysiologist Paul Dorian and EM doc Tarlan Hedayati. In this, part 2, we discuss details of treatment. We answer questions such as: When should pacing be prioritized over medications and vice versa? What are the latest recommendations about dosing of atropine and when is atropine likely to be detrimental? How is the treatment of bradycardia different in the patient with hypothermia? Cardiac ischemia? Myxedema coma? AV nodal blocker overdose? What are the most common pitfalls in utilizing transcutaneous and transvenous pacing? and many more...

By Anton Helman|2023-02-06T12:44:08-05:00April 20th, 2021|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: atropine, dopamine, epinephrine, isoproterenol, transvenous pacer, transvenous pacing|2 Comments

Episode 93 – PALS Guidelines

I remember when I started practicing emergency medicine a decade and a half ago it seemed that any kid who came to our ED in cardiac arrest died. I know, depressing thought. But, over the past 15 years, survival to discharge from pediatric cardiac arrest has markedly improved, at least for in-hospital arrests. This is probably mostly due to an emphasis on high-quality CPR and advances in post-resuscitation care; nonetheless the more comfortable, knowledgeable and prepared we are for the always scary critically ill pediatric patient, the more likely we will be able to resuscitate them successfully - which is always a huge save.

By Anton Helman|2022-12-06T07:28:41-05:00March 14th, 2017|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Pediatrics, Resuscitation|Tags: amiodarone, atropine, cardiac arrest, chest compressions, CPR, ECMO, fluid management, lidocaine, septic shock, TTM|3 Comments

Episode 12 Part 2: ACLS Guidelines – Atropine, Adenosine & Therapeutic Hypothermia

In Part 2 of this episode on ACLS Guidelines - Atropine, Adenosine & Therapeutic Hypothermia, Dr. Steven Brooks and Dr. Michael Feldman discuss the removal of Atropine from the PEA/Asystole algorithm, the indications and dangers of Adenosine in wide-complex tachycardias, pressors as a bridge to transvenous pacing in unstable bradycardias, and the key elements of post cardiac arrest care including therapeutic hypothermia and PCI. They answer questions such as: In which arrhythmias can Amiodarone cause more harm than good? Is there any role for transcutaneous pacing for asystole? When should Bicarb be given in the arrest situation? In what situations is Atropine contra-indicated or the dosage need to be adjusted? How has the widespread use of therapeutic hypothermia currently effected our ability to prognosticate post-arrest patients? What are the indications for PCI and thrombolysis in the cardiac arrest patient? Should we be using therapeutic hypothermia in the non-Vfib arrest patient? What is the best method for achieving the target temperature for the patient undergoing therapeutic hypothermia? and many more......

By Anton Helman|2023-02-06T13:06:09-05:00March 9th, 2011|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Resuscitation|Tags: adenosine, atropine, capnography, cardiac arrest, cardiocerebral resuscitation, CPR, Michael Fledman, post arrest care, Steven Brooks|0 Comments

Episode 12 Part 1: ACLS Guidelines – What’s New & Controversial

In Part 1 of this episode on the latest ACLS Guidelines, Dr. Steven Brooks and Dr. Michael Feldman review and debate what's new and what's controversial in the the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Within the frameworks of Cardiocerebral Rescusitation and the 3 phase model of rescucitation (electrical, circulatory and metabolic), they discuss the importance of high quality CPR, the de-emphasis on early ventilation and the utility of continuous quantitative waveform capnography. Dr. Brooks and Dr. Feldman answer questions such as: of all the therapeutic manoeuvres we do for the cardiac arrest patient, which ones have been shown to improve survival to hospital discharge? What is the evidence for chest compression machines? What is the utility of bedside ultrasound in the cardiac arrest patient? Why is cardiac arrest survival to discharge in Seattle the best in the world? Should we be performing 'hands-on defibrillation'? and many more.....

By Anton Helman|2021-06-24T22:53:37-04:00March 9th, 2011|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Resuscitation|Tags: atropine, capnography, cardiocerebral resuscitation, CPR, Michael Fledman, post arrest care, Steven Brooks|0 Comments