Emergency Department Resuscitation, An Issue of Emergency Medicine Clinics of North America

1st Edition, Volume 38-4 - October 9, 2020
Editors: Michael E. Winters, Susan R. Wilcox
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 6 1 0 7 - 9
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 6 1 0 8 - 6

This issue of Emergency Medicine Clinics, guest edited by Mike Winters and Susan R. Wilcox, focuses on Emergency Department Resuscitation. This issue is one of four selected each… Read more

Emergency Department Resuscitation, An Issue of Emergency Medicine Clinics of North America

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This issue of Emergency Medicine Clinics, guest edited by Mike Winters and Susan R. Wilcox, focuses on Emergency Department Resuscitation. This issue is one of four selected each year by series Consulting Editor, Dr. Amal Mattu. Topics include: Mindset of the Resuscitationist; Updates in Cardiac Arrest Resuscitation; Post-Arrest Interventions That Save Lives; Current Concepts and Controversies in Fluid Resuscitation; Emergency Transfusions; Updates in Sepsis Resuscitation; Pediatric Cardiac Arrest Resuscitation; The Crashing Toxicology Patient; The Crashing Obese Patient; Massive GI Hemorrhage; Updates in Traumatic Cardiac Arrest; Resuscitating the Crashing Pregnant Patient; Pearls & Pitfalls in the Crashing Geriatric Patient; Current Controversies in Caring for the Critically Ill PE Patient; and ECMO in the ED.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Erratum
Foreword
Preface
The Mindset of the Resuscitationist
Key points
Introduction
Case scenario
Before the crisis occurs
Case scenario
During the resuscitation
Case scenario
After the crisis has ended
Case resolution
Summary
Updates in Cardiac Arrest Resuscitation
Key points
Introduction
Airway management during cardiac arrest
Mechanical cardiopulmonary resuscitation
Intravenous versus intraosseous drug administration during cardiac arrest
Role of vasopressors
Role of antiarrhythmic medications
Hemodynamic-directed resuscitation
Prehospital and intracardiac arrest hypothermia
Double sequential external defibrillation for refractory ventricular fibrillation
Utility of point-of-care echocardiography during cardiac arrest
Summary
Postarrest Interventions that Save Lives
Key points
Introduction
Summary
Fluid Resuscitation: History, Physiology, and Modern Fluid Resuscitation Strategies
Key points
Introduction
The great fluid debate
The forgotten physiology of venous return
The clinical reality of a fluid bolus
A modern-day resuscitative strategy
Summary
Emergency Transfusions
Key points
Introduction
Considerations in emergent transfusion
Obtaining access
Permissive hypotension
Massive transfusion and critical administration threshold
Fixed ratio resuscitation
Viscoelastic assay goal-directed therapy
Transfusion considerations and adjuncts
Complications of massive transfusions
Special considerations
Endpoints of resuscitation
Summary
Updates in Sepsis Resuscitation
Key points
Introduction
Early goal-directed therapy and the Surviving Sepsis Campaign
Current controversies
Key components of emergency department sepsis management
Monitoring the septic emergency department patient
Hemodynamic support for the septic emergency department patient
Immunomodulation in Sepsis: Corticosteroid Use
Septic cardiomyopathy
Nutritional and metabolic support
Summary
Pediatric Cardiac Arrest Resuscitation
Key points
Introduction
Epidemiology
Cause
Initial assessment
Precardiac arrest states
Cardiac arrest
Special circumstances
Postresuscitation management
Treatment of underlying cause
Parental presence during resuscitation
Termination of resuscitation
Summary
The Crashing Toxicology Patient
Key points
Introduction
Neurologic toxicity
Respiratory failure
Cardiovascular toxicity
Cardiogenic and vasodilatory shock
Summary
The Crashing Obese Patient
Key points
Introduction
Access and monitoring
Airway anatomy
Respiratory pathophysiology
Approach to the obese airway
Respiratory support
Pharmacology
Condition-specific considerations
Summary
Massive Gastrointestinal Hemorrhage
Key points
Introduction
Does this patient have a massive gastrointestinal hemorrhage?
Identifying the location of hemorrhage
Emergency department resuscitation of the patient with massive gastrointestinal bleed
Summary
Updates in Traumatic Cardiac Arrest
Key points
Introduction
Withholding and termination of resuscitation
Etiology of traumatic cardiac arrest
Key components of emergency medical management of traumatic cardiac arrest
Pediatric patients
Novel advances
Summary
Resuscitating the Crashing Pregnant Patient
Key points
Introduction
Physiologic changes of pregnancy
Uteroplacental physiology
Initial steps
Management of critical illness
Critical illness specific to pregnancy
Summary
Pearls and Pitfalls in the Crashing Geriatric Patient
Key points
Introduction
Geriatric patients are not just old adults: physiologic changes in the geriatric population
Age is just a number: beyond chronologic age
Danger drugs: critical care pharmacology in the geriatric patient
Do not resuscitate/do not intubate does not mean do not provide critical care: establishing goals of care and triaging critical care interventions
Fate far worse than death: navigating end-of-life and goals-of-care discussions
Phone a friend: roles of geriatrics and palliative care consultation
Summary
Current Controversies in Caring for the Critically Ill Pulmonary Embolism Patient
Key points
Introduction
Pulmonary embolism pathophysiology
Pulmonary embolism classification
Initial evaluation and testing
Advanced imaging in the patient with pulmonary embolism
Initial resuscitation
Anticoagulation, thrombolysis, and thromboembolectomy
Summary
Extracorporeal Membrane Oxygenation in the Emergency Department
Key points
Introduction
Extracorporeal membrane oxygenation modes and circuit configuration
Patient selection
Running an extracorporeal cardiopulmonary resuscitation code
Extracorporeal cardiopulmonary resuscitation cannulation procedure
Post extracorporeal membrane oxygenation initiation management in the emergency department
Summary
Supplementary data

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Michael E. Winters

Susan R. Wilcox