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Now displaying: May, 2016
May 20, 2016

Ep #21 Ketamine Induced Rapid Sequence Intubation with Faizan H. Arshad, MD @emscritcare

Happy #EMSWeek #EMSStrong #EMSNation

 

SKEPTIC = Safety & Efficacy of Ketamine in Emergent Prehospital Tracheal Intubation – a Case Series

 

Brand new paper from Sydney HEMS on Ketamine and Shock Index in Annals of EM!

http://www.annemergmed.com/article/S0196-0644(16)30002-6/abstract

 

Additional References:

  1. Carlson JN, Karns C, Mann NC, et al. Procedures performed by emergency medical services in the united states.Prehosp Emerg Care. 2015.
  2. Jacobs PE, Grabinsky A. Advances in prehospital airway management.International Journal of Critical Illness & Injury Science. 2014;4:57-64.
  3. Prekker ME, Kwok H, Shin J, Carlbom D, Grabinsky A, Rea TD. The process of prehospital airway management: Challenges and solutions during paramedic endotracheal intubation.Crit Care Med. 2014;42:1372-1378.
  4. Wang HE, Kupas DF, Greenwood MJ, et al. An algorithmic approach to prehospital airway management.Prehospital Emergency Care. 2005;9:145-155.
  5. Mace SE. Challenges and advances in intubation: Airway evaluation and controversies with intubation.Emerg Med Clin North Am. 2008;26:977-1000.
  6. Combes X, Jabre P, Jbeili C, et al. Prehospital standardization of medical airway management: Incidence and risk factors of difficult airway.Acad Emerg Med. 2006;13:828-834.
  7. Drummond GB. Comparison of sedation with midazolam and ketamine: effects on airway muscle activity. Br J Anaesth. 1996;76:663-667.
  8. Jackson APF, Dhadphale PR, callaghan ML, Alseri S. Haemodynamic studies during induction of anaesthesia for open-heart surgery using diazepam and ketamine. Br J Anaesth. 1978;50:375-378.
  9. Price B, Arthur AO, Brunko M, et al. Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting. Am J Emerg Med. 2013;31:1124-1132.
  10. Scherzer D, Leder M, Tobias JD. Pro-Con Debate: Etomidate or Ketamine for Rapid Sequence Intubation in Pediatric Patients. J Pediatr Pharmacol Ther. 2012;17:142-149.
  11. Bruder Eric A, Ball Ian M, Ridi S, Pickett W, Hohl C. Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients.Cochrane Database of Systematic Reviews. 2015
  12. Thompson Bastin ML, Baker SN, Weant KA. Effects of Etomidate on Adrenal Suppression: A Review of Intubated Septic Patients.Hospital Pharmacy. 2014;49:177-183.
  13. Arnold C. The promise and perils of ketamine research Ketamine began its life as an anaesthetic , but has enjoyed a recent renaissance as a potential. Lancet Neurol. 2013;12:940-941.
  14. Craven R. Ketamine. Anaesthesia. 2007;62:48-53.
  15. Perkins ZB, Gunning M, Crilly J, Lockey D, O’Brien B. The haemodynamic response to pre-hospital RSI in injured patients. Injury. 2013;44:618-623.
  16. Aroni F, Iacovidou N, Dontas I, Pourzitaki C, Xanthos T. Pharmacological Aspects and Potential New Clinical Applications of Ketamine: Reevaluation of an Old Drug. J Clin Pharmacol. 2009;49:957-964.
  17. Manthous CA. Avoiding circulatory complications during endotracheal intubation and initiation of positive pressure ventilation.J Emerg Med. 2010;38:622-631.
  18. Kohrs R, Durieux ME. Ketamine. Anesth Analg. 1998;87:1186-1193.
  19. Moy RJ, Clerc S Le. Trends in Anaesthesia and Critical Care Ketamine in prehospital analgesia and anaesthesia. Trends Anaesth Crit Care. 2011;1:243-245.
  20. Reich DL, Silvay G. Ketamine: an update on the first twenty-five years of clinical experience. Can J Anaesth. 1989;36(2):186-197.
  21. Porter K. Ketamine in prehospital care. Emerg Med J. 2004;21:351-354.
  22. Svenson JE, Abernathy MK. Ketamine for prehospital use: new look at an old drug. Am J Emerg Med. 2007;25:977-980.
  23. Johansson J, Sjöberg J, Nordgren M, Sandström E, Sjöberg F, Zetterström H. Prehospital analgesia using nasal administration of S-ketamine--a case series. Scand J Trauma Resusc Emerg Med. 2013;21:38.
  24. Filanovsky Y, Miller P, Kao J. Myth: Ketamine should not be used as an induction agent for intubation in patients with head injury. Can J Emerg Med. 2010;12:154-201.
  25. Himmelseher S, Durieux ME. Revising a Dogma: Ketamine for Patients with Neurological Injury? Anesth Analg. 2005;101:524-534.
  26. Kropf J a., Grossman MD, Genzlinger M a., Stoltzfus J, Stehly CD. 328 Ketamine versus Etomidate for Rapid Sequence Intubation in Traumatically Injured Patients: An Exploratory Study. Ann Emerg Med. 2012;60:S117.
  27. Angus DC, van dP. Severe sepsis and septic shock.N Engl J Med. 2013;369:840-851.
  28. Jabre P, Avenel A, Combes X, et al. Morbidity related to emergency endotracheal intubation-A substudy of the KETAmine SEDation trial. Resuscitation. 2011;82:517-522.
  29. Shafi S, Gentilello L. Pre-Hospital Endotracheal Intubation and Positive Pressure Ventilation Is Associated with Hypotension and Decreased Survival in Hypovolemic Trauma Patients: An Analysis of the National Trauma Data Bank. The Journal of Trauma: Injury, Infection, and Critical Care. 2005;59:1140–1147.
  30. Seymour CW, Band RA, Cooke CR, et al. Out-of-hospital characteristics and care of patients with severe sepsis: A cohort study.J Crit Care. 2010;25:553-562.
  31. Williams E, Arthur a., Price B, Banister NJ, Goodloe JM, Thomas SH. 175 Ketamine versus Etomidate for Use in Helicopter Emergency Medical Services Endotracheal Intubation. Ann Emerg Med. 2012;60:S63-S64
  32. Bruns, B, Gentilello, L, Elliott, A, Shafi, S. Prehospital Hypotension Redefined. The Journal of Trauma: Injury, Infection, and Critical Care. 2008;65:1217–1221.
  33. Seymour, CW, Cooke, CR, Heckbert, SR, et al. Prehospital Systolic Blood Pressure Thresholds: A Community-based Outcomes Study. Acad Emerg Med Academic Emergency Medicine. 2013;20:597–604.
  34. Kristensen AKB, Holler JG, Mikkelsen S, Hallas J, Lassen A. Systolic blood pressure and short-term mortality in the emergency department and prehospital setting: a hospital-based cohort study.Critical Care. 2015;1:158.
  35. Heffner AC, Swords DS, Neale MN, Jones AE. Incidence and factors associated with cardiac arrest complicating emergency airway management. Resuscitation. 2013;84:1500-1504.
  36. Salt PJ, Baranes PK, Beswick FJ. Inhibition of neuronal and extraneuronal uptake of noradrenaline by ketamine in the isolated perfused rat heart. Br J Anaesth. 1979;51:835-838.
  37. Sprung J, Schuetz SM, Stewart RW, Moravec CS. Effects of Ketamine on the Contractility of Failing and Nonfailing Human Heart Muscles in Vitro. Surv Anesthesiol. 1999;43:230-231.
  38. Kunst G, Martin E, Graf BM, Hagl S, Vahl CF. Actions of Ketamine and Its Isomers on Contractility and Calcium Transients in Human Myocardium. Anesthesiology. 1999;90:1363-1371.
  39. Lundy PM, Lockwood PA, Thompson G, Frew R. Differential Effects of Ketamine Isomers on Neuronal and Extraneuronal Catecholamine Uptake Mechanisms. Anesthesiology. 1986;64:359-363.
  40. Selde W. Push dose epinephrine. A temporizing measure for drugs that have the side-effect of hypotension.JEMS. 2014;39:62-63.

 

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May 19, 2016

Ep #20 Designing High Performing Systems of Prehospital CPR w/ Tom Bouthillet @tbouthillet

Happy #EMSWeek #EMSStrong #EMSNation

 

Tom Bouthillet

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EMS 12-Lead

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ECG Medical Training

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ACLS Medical Training

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Adult Pit Crew CPR – The Explicit Details

http://www.ems12lead.com/2014/06/20/pit-crew-cpr-the-explicit-details/

 

The Science of CPR with Peter Kudenchuk, M.D.

https://www.youtube.com/watch?v=irHXrNqRbcY

 

 

Sponsored by @PerfectCPR

Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery

PerfectCPR.com

 

 

Query us on Twitter:

www.twitter.com/EMS_Nation

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Wishing Everyone a safe tour!

~Faizan H. Arshad, MD @emscritcare

www.emsnation.org

 

May 18, 2016

Ep #19 Equanimity, Puni & Parachuting: Evolving Concepts in Optimizing Resuscitation Performance w/ Mike Lauria @ResusPadawan

Happy #EMSWeek #EMSStrong #EMSNation

 

AMPA – Air Medical Physicians Association

https://www.ampa.org/

#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference

http://www.iafccp.org/events/EventDetails.aspx?id=177507

4/10/2017 to 4/12/2017

When:

April 10 - 12, 2017

Where:

Map this event »
Wyndam River Walk Hotel
111 E. Pecan St.
San Antonio, Texas  78205
United States

Contact:

Pat Petersen
ppeter1111@aol.com

 

 

Sponsored by @PerfectCPR

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PerfectCPR.com

 

 

Query us on Twitter:

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Wishing Everyone a safe tour!

~Faizan H. Arshad, MD @emscritcare

www.emsnation.org

 

May 17, 2016

Ep #18 The Resuscitation Workshop - Designing High Performance Teams @LaerdalMedical

Happy #EMSWeek #EMSStrong #EMSNation

 

Laerdal Medical:

http://www.laerdal.com/us/

Resucitation Workshop:

http://www.laerdal.com/us/News/49290950/Building-High-Performance-Teams-to-Tackle-Sudden-Cardiac-Arrest-Are-you-Providing

 

Sponsored by @PerfectCPR

Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery

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May 16, 2016

Ep #17 A Primer on Intrathoracic Pressure Regulation & The Physiology of CPR with Dr. Keith Lurie Happy #EMSWeek #EMSStrong #EMSNation

 

Sponsored by @PerfectCPR

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Dr. Keith Lurie is a practicing cardiac electrophysiologist and resuscitation scientist who, over the past 25 years, has devoted himself to study novel ways to resuscitate patients experiencing sudden cardiac arrest.  Dr. Lurie earned his bachelors degree at Yale University and his medical degree at Stanford University. He studied cardiovascular medicine at the University of California in San Francisco and later joined the faculty there.  He has been on the faculty at the University of Minnesota since 1991. As one of the leading innovators in the field, he has helped to develop new devices and methods that optimize cardio-pulmonary resuscitation (CPR) and, in turn, improve survival chances following cardiac arrest. In addition, he has become a respected thought leader in developing and implementing a systems-based approach to managing and treating sudden cardiac death events. Some of his most notable contributions include the development and assessment of various resuscitative techniques such as the impedance threshold device (ITD), active compression-decompression (ACD) CPR and the use of intra-thoracic pressure regulation to modulate cerebral and systemic circulation in states of severe hypotension and head injury. He has also helped to develop devices to treat heart failure and abnormal heart rhythms. He has mentored scores of research and clinical fellows over the past 30 years and he actively collaborates with multiple scientist colleagues worldwide. A professor of Emergency Medicine and Internal Medicine at the University of Minnesota, Dr. Lurie also directs an NIH-funded research laboratory at Hennepin County Medical Center in Minneapolis and he is a consultant for Zoll Medical.

 

Selected Peer-Reviewed Publications (Selected from over 200 publications):

 

  1. Lurie KG, Nemergut EC, Yannopoulos D, Sweeney M. The physiology of cardiopulmonary resuscitation. Anesth Analg. 11/2015
  2. Kwon Y, Debaty G, Puertas L, Metzger A, Rees J, McKnite S, Yannopoulos D, Lurie K. Effect of regulating airway pressure on intrathoracic pressure and vital organ perfusion pressure during cardiopulmonary resuscitation: A non-randomized interventional cross-over study. Scandinavian journal of trauma, resuscitation and emergency medicine. 2015;23:83
  3. Debaty G, Metzger A, Lurie K. Evaluation of zoll medical's resqcpr system for cardiopulmonary resuscitation. Expert review of medical devices. 2015;12:505-516
  4. Smith G, Dwork N, O'Connor D, Sikora U, Lurie K, Pauly J, Ellerbee A. Automated, depth resolved estimation of the attenuation coefficient from optical coherence tomography data. IEEE transactions on medical imaging. 2015
  5. Lurie KL, Gurjarpadhye AA, Seibel EJ, Ellerbee AK. Rapid scanning catheterscope for expanded forward-view volumetric imaging with optical coherence tomography. Optics letters. 2015;40:3165-3168
  6. Debaty G, Metzger A, Rees J, McKnite S, Puertas L, Yannopoulos D, Lurie K. Enhanced perfusion during advanced life support improves survival with favorable neurologic function in a porcine model of refractory cardiac arrest. Crit Care Med. 2015;43:1087-1095
  7. Salzman JG, Frascone RJ, Burkhart N, Holcomb R, Wewerka SS, Swor RA, Mahoney BD, Wayne MA, Domeier RM, Olinger ML, Aufderheide TP, Lurie KG. The association of health status and providing consent to continued participation in an out-of-hospital cardiac arrest trial performed under exception from informed consent. Acad Emerg Med. 2015;22:347-353
  8. Metzger A, Rees J, Kwon Y, Matsuura T, McKnite S, Lurie KG. Intrathoracic pressure regulation improves cerebral perfusion and cerebral blood flow in a porcine model of brain injury. Shock. 2015;44 Suppl 1:96-102
  9. Debaty G, Shin SD, Metzger A, Kim T, Ryu HH, Rees J, McKnite S, Matsuura T, Lick M, Yannopoulos D, Lurie K. Tilting for perfusion: Head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest. Resuscitation. 2015;87:38-43
  10. Bartos JA, Matsuura TR, Sarraf M, Youngquist ST, McKnite SH, Rees JN, Sloper DT, Bates FS, Segal N, Debaty G, Lurie KG, Neumar RW, Metzger JM, Riess ML, Yannopoulos D. Bundled postconditioning therapies improve hemodynamics and neurologic recovery after 17 min of untreated cardiac arrest. Resuscitation. 2015;87:7-13
  11. Gold B, Puertas L, Davis SP, et al. Awakening after cardiac arrest and post resuscitation hypothermia: are we pulling the plug too early? Resuscitation. Feb 2014;85(2):211-214.
  12. Metzger A, Rees J, Segal N, et al. "Fluidless" resuscitation with permissive hypotension via impedance threshold device therapy compared with normal saline resuscitation in a porcine model of severe hemorrhage. The journal of trauma and acute care surgery. Aug 2013;75(2 Suppl 2):S203-209.
  13. Frascone RJ, Wayne MA, Swor RA, et al. Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device. Sep 2013;84(9):1214-1222.
  14. Yannopoulos D, Segal N, Matsuura T, et al. Ischemic post-conditioning and vasodilator therapy during standard cardiopulmonary resuscitation to reduce cardiac and brain injury after prolonged untreated ventricular fibrillation. Aug 2013;84(8):1143-1149.
  15. Sarraf M, Sharma A, Caldwell E, McKnite S, Aufderheide T, Lurie K, Neumar R, Riess M, Yannopoulos D. Postconditioning with inhaled sevoflurane at the initiation of cpr improves hemodynamics and mitigates post-cardiac arrest myocardial injury after 15 min of untreated ventricular fibrillation. Crit Care Med. 2012;40:1-328
  16. Yannopoulos D, Segal N, McKnite S, Aufderheide TP, Lurie KG. Controlled pauses at the initiation of sodium nitroprusside-enhanced cardiopulmonary resuscitation facilitate neurological and cardiac recovery after 15 mins of untreated ventricular fibrillation. Crit Care Med. 2012;40:1562-1569
  17. Segal N, Matsuura T, Caldwell E, Sarraf M, McKnite S, Zviman M, Aufderheide TP, Halperin HR, Lurie KG, Yannopoulos D. Ischemic postconditioning at the initiation of cardiopulmonary resuscitation facilitates functional cardiac and cerebral recovery after prolonged untreated ventricular fibrillation. Resuscitation. 2012;83:1397-1403
  18. Convertino VA, Parquette B, Zeihr J, Traynor K, Baia D, Baumblatt M, Vartanian L, Suresh M, Metzger A, Gerhardt RT, Lurie KG, Lindstrom D. Use of respiratory impedance in prehospital care of hypotensive patients associated with hemorrhage and trauma: A case series. The journal of trauma and acute care surgery. 2012;73:S54-59
  19. Yannopoulos D, Matsuura T, Schultz J, et al. Sodium nitroprusside enhanced cardiopulmonary resuscitation improves survival with good neurological function in a porcine model of prolonged cardiac arrest. Crit Care Med. Jun 2011;39(6):1269-1274.
  20. Yannopoulos D, Kotsifas K, Lurie KG. Advances in cardiopulmonary resuscitation. Heart Fail Clin. Apr 2011;7(2):251-268, ix.
  21. Lurie KG, Coffeen P, Shultz J, McKnite S, Detloff B, Mulligan K. Improving active compression-decompression cardiopulmonary resuscitation with an inspiratory impedance valve. Circulation 1995;91(6):1629-32.
  22. Plaisance P, Lurie KG, Vicaut E, Adnet F, Petit JL, Epain D, Ecollan P, Gruat R, Cavagna P, Biens J and others. A comparison of standard cardiopulmonary resuscitation and active compression-decompression resuscitation for out-of-hospital cardiac arrest. French Active Compression-Decompression Cardiopulmonary Resuscitation Study Group. N Engl J Med 1999;341(8):569-75.
  23. Lurie KG, Voelckel WG, Zielinski T, McKnite S, Lindstrom P, Peterson C, Wenzel V, Lindner KH, Samniah N, Benditt D. Improving standard cardiopulmonary resuscitation with an inspiratory impedance threshold valve in a porcine model of cardiac arrest. Anesth Analg 2001;93(3):649-55.
  24. Lurie KG, Zielinski T, McKnite S, Aufderheide T, Voelckel W. Use of an inspiratory impedance valve improves neurologically intact survival in a porcine model of ventricular fibrillation. Circulation 2002;105(1):124-9.
  25. Aufderheide TA, Sigurdsson G, Pirrallo RG, Yannopoulos D, McKnite S, van Briesen C, Sparks C, Conrad CJ, Provo CA, Lurie KG. Hyperventilation-induced hypotension during CPR. 2004;109:1960-65.
  26. Aufderheide TP, Pirrallo RG, Provo TA, Lurie KG. Clinical evaluation of an inspiratory impedance threshold device during standard cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest. Critical Care Medicine. 2005, Apr;33(4):734-40.
  27. Pirrallo RG, Aufderheide TP, Provo TA, Lurie KG. Effect of an inspiratory impedance threshold device on hemodynamics during conventional manual cardiopulmonary resuscitation. 2005 Jul;66(1):13-20.
  28. Aufderheide T, Alexander C, Lick C, Myers B, Romig L, Vartanian L, Stothert J, S. M, Matsuura T, Yannopoulos D and others. From laboratory science to six emergency medical services systems: New understanding of the physiology of cardiopulmonary resuscitation increases survival rates after cardiac arrest. Crit Care Med 2008;36(Suppl):S397-S404.
  29. Lurie KG, Yannopoulos D, McKnite SH, Herman ML, Idris AH, Nadkarni VM, Tang W, Gabrielli A, Barnes TA, Metzger AK. Comparison of a 10-breaths-per-minute versus a 2-breaths-per-minute strategy during cardiopulmonary resuscitation in a porcine model of cardiac arrest. Respir Care 2008;53(7):862-70.
  30. Metzger A, Yannopoulos D, Lurie KG. Instrumental Management of CPR. Severe Acute Heart Failure Syndromes:  A Practical Approach for Physicians. Mebazaa, A., Gheorghiade, M., Zannad, F., Parrillo, J.E. (eds.). Springer-Verlag, London Ltd. 2008, pp. 43-51.
  31. Metzger A, Lurie K. Harnessing Cardiopulmonary Interactions to Improve Circulation and Outcomes After Cardiac Arrest and Other States of Low Blood Pressure. In: Iaizzo PA, editor. Handbook of Cardiac Anatomy, Physiology, and Devices: Springer Science; 2009. p 583-604.
  32. Nichol G, Aufderheide TP, Eigel B, Neumar RW, Lurie KG, Bufalino VJ, Callaway CW, Menon V, Bass RR, Abella BS and others. Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association. Circulation;121(5):709-29.
  33. Yannopoulos D, Matsuura T, McKnite S, Goodman N, Idris A, Tang W, Aufderheide TP, Lurie KG. No assisted ventilation cardiopulmonary resuscitation and 24-hour neurological outcomes in a porcine model of cardiac arrest. Crit Care Med;38(1):254-60.

 

 

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Wishing Everyone a safe tour!

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