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(Pulseless electrical activity PEA )
231 results
  • Digoxin use in systemic light-chain (AL) amyloidosis: contra-indicated or cautious use? [Journal Article]
  • AAmyloid 2018 Mar 12; :1-7
  • Muchtar E, Gertz MA, … Grogan M
  • CONCLUSIONS: Digoxin may be cautiously utilized in AL amyloidosis patients. We suggest its use in lower doses and frequent drug concentration monitoring along with close monitoring of electrolytes and renal function. Nonetheless, toxicity at low serum concentration cannot be excluded due to potential for toxic concentration at the tissue level and should be taken under consideration when prescribing digoxin for these patients. Studies with higher-level evidence are needed to confirm these findings.
  • The dead and the dying - a difficult part of EMS transport: A Swiss cross-sectional study. [Journal Article]
  • PlosPLoS One 2018; 13(2):e0191879
  • Hasler RM, Stucky S, … Neff F
  • CONCLUSIONS: The low ED mortality rate of 0.9% shows that only a few dying patients are transported to hospital. However, transport to hospital has to be carefully evaluated, especially for elderly patients with asystole or PEA due to medical conditions. The low CPR rate from bystanders demonstrates that public CPR training should be promoted further. The use of Lucas™2 did not reduce the operating time on site. For further investigations, comparison with survivors would be needed.
  • Echocardiography in cardiac arrest: An emergency medicine review. [Review]
  • AJAm J Emerg Med 2018; 36(3):488-493
  • Long B, Alerhand S, … Koyfman A
  • CONCLUSIONS: Cardiac arrest can be distinguished between shockable and non-shockable rhythms, with management varying based on the rhythm. POCUS provides a diagnostic and prognostic tool in the emergency department (ED), which may improve accuracy in clinical decision-making. Several protocols incorporate POCUS based on different cardiac views. TTE includes parasternal long axis, parasternal short axis, apical 4-chamber, and subxiphoid views, which may be used in cardiac arrest for diagnosis of underlying cause and potential prognostication. TEE is conducted by inserting the probe into the esophagus of intubated patients, with several studies evaluating its use in cardiac arrest. It is associated with few adverse effects, while allowing continued compressions (and evaluation of those compressions) and not interrupting resuscitation efforts.POCUS is a valuable diagnostic and prognostic tool in cardiac arrest, with recent literature supporting its diagnostic ability. TTE can guide resuscitation efforts dependent on the rhythm, though TTE should not interrupt other resuscitation measures. TEE can be useful during arrest, but further studies based in the ED are needed.
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