Tag Archives: POCUS
Follow MEDEST on Twitter
- Decline of the Physical Exam: Clinical Tragedy or Good Riddance? fb.me/3QbaQKouK 22 minutes ago
- fb.me/1f7dvoEHR 39 minutes ago
- LUNGus v’s CXR fb.me/1Aajke9m2 3 hours ago
- Life in the eFAST Lane: Sonography for Trauma (Part 3) fb.me/5TRFbUQn4 3 hours ago
- RT @SIMEU_EM: L'esperienza toscana x l'applicazione di protocolli infermieristici in Emergenza in sede pre-ospedaliera https://t.co/wieH3Kv… 8 hours ago
Articoli Recenti
- AIRWAY MANAGEMENT. DECISION MAKING, STRATEGIES AND CLINICAL OPTIONS 20 luglio 2017
- Prehospital Emergency Procedures: Scalpel, Finger, Bougie. That’s all you need! 13 luglio 2017
- Prehospital POCUS: Why I love it! Real Clinical Scenario. 10 luglio 2017
- The case of a misleading EKG trace 24 giugno 2017
- HEMS vs GEMS: by ground or by air, which is the best way to take care of traumatized patients 25 aprile 2017
- Yes We Can 4 marzo 2017
- Quality, education, clinical competence and other amenities about Emergency Medicine 17 febbraio 2017
Archivi
MyTweet
- Decline of the Physical Exam: Clinical Tragedy or Good Riddance? fb.me/3QbaQKouK 22 minutes ago
- fb.me/1f7dvoEHR 39 minutes ago
- LUNGus v’s CXR fb.me/1Aajke9m2 3 hours ago
- Life in the eFAST Lane: Sonography for Trauma (Part 3) fb.me/5TRFbUQn4 3 hours ago
- RT @SIMEU_EM: L'esperienza toscana x l'applicazione di protocolli infermieristici in Emergenza in sede pre-ospedaliera https://t.co/wieH3Kv… 8 hours ago
- fb.me/DJz331rw 8 hours ago
Favourites FOAMED Blogs
- urgentcareultrasound
- My CPD
- MariaLuisaRuberto.com
- Critical Care Northampton
- OHCA research
- SonoStuff
- phemcast
- First10EM
- Songs or Stories
- airwayNautics
- resusNautics
- EMSPOCUS
- LITFL: Life in the Fast Lane Medical Blog
- emDOCs.net - Emergency Medicine Education
- The Collective
- Dave on Airways
- FOAMcast
- Broome Docs
- St.Emlyn's
- BoringEM
- "CardioOnline"Basic and Advanced Cardiovascular medicine" Cariology" concepts and Review -Dr.Nabil Paktin,MD.FACC.دکتـور نبــــیل "پاکطــــین
- DOWNSTAIRS CARE OUT THERE BLOG
- EmergencyPedia
- Little Medic
- Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds
- Prehospital Emergency Medicine Blog
- Italy Customized Travel Blog
- GoogleFOAM
- EM Lyceum
- Pediatric EM Morsels
- Academic Life in Emergency Medicine
- EM Pills
- AmboFOAM
- FOAM4GP
- Rural Doctors Net
- Auckland HEMS
- ECHOARTE
- MEDEST
- ruralflyingdoc
- EM Basic
- KI Doc
- Emergency Live
- AMP EM
- ERCAST Emergency Medicine Podcasts
- www.podcastingformedicalprofessionals.com
- Academic Life in Emergency Medicine
- www.thennt.com/welcome/feed
- Greater Sydney Area HEMS
Scrivi a MEDEST
Prehospital POCUS: Why I love it! Real Clinical Scenario.
10 Lug73 yrs old male found unconscious by his wife. CPR started by a neighbour with pre arrival CPR instructions provided by dispatcher. We found him in asystolic cardiac arrest. Established mechanical chest compressions (MCC), ventilated through an 8.0 ET tube, placed an intraosseus access, 10 min of ALS and 2 mg of epinephrine later, on the monitor appears an organised rhythm at 40 bpm (narrow junctional shape), NO CENTRAL PULSE. After 2 min (CPR still going) same rhythm stil NO CENTRAL PULSE but this time, during the MCC pause, a subcostal view of the heart was obtained (sorry for the quality of the images but were recorded during the code and I’m not an expert but just an ultrasound user)
As you can see the heart is moving and the right ventricle is almost the double of the left one. Due also to the clinical history of a recent surgical knee replacement the most probable origine of the cardiac arrest is PE. We decided to continue chest compressions, but to stop epinephrine at 1 mg dose, starting push doses of 0,1 mg till the return of a central pulse. After 5 min a strong carotid pulse appeared and this is the ultrasound view of the heart at that moment
The patient arrived to the hospital sedated and paralysed in assisted pressure control ventilation. You can see on the monitor the rest of vital signs.
No follow up yet.
You can read more about PEA and Pseudo-PEA on MEDEST
Forget ACLS guidelines if you are dealing with Pulseless Electric Activity. Part 1.
Forget ALS Guidelines when dealing with PEA. Part 2.
Condividi:
Mi piace:
Tag:ACLS, Advanced Cardiac Life Support, arresto cardiaco, cardiac arrest, ecografia, emergency medicine, medicina d'urgenza, PEA, POCUS, point of care ultrasound, pulseless electric activity