RCP de Alto Desempa ño – ¡Rendimiento sobre Protocolo!
Esta entrada es un complemento a Pit-Crew CPR en Adultos y Pit-Crew CPR Pediátrica.
En concreto, esta es la forma en la que hemos modificado nuestro proceso de formación tras asistir a la Resuscitation Academy en Seattle / King County.
Durante el re-entrenamiento, cada rescatador debe experimentar cada posición al menos dos veces. Dicho de otro modo: se ejecuta el ejercicio, parar y cambiar, ejecutar el ejercicio, parar y cambiar. ¡Esta práctica es muy bien recibida por los técnicos de emergencias médicas y paramédicos! Resulta divertido ver como el rendimiento mejora con el tiempo.
Eso es lo que se trata todo esto...
Source: EMS 12-Lead - June 14, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: Uncategorized RCP de Alto Desempaño Reanimación Cardiopulmonar Source Type: research
RCP de Alto Desempaño – ¡Rendimiento sobre Protocolo!
Esta entrada es un complemento a Pit-Crew CPR en Adultos y Pit-Crew CPR Pediátrica.
En concreto, esta es la forma en la que hemos modificado nuestro proceso de formación tras asistir a la Resuscitation Academy en Seattle / King County.
Durante el re-entrenamiento, cada rescatador debe experimentar cada posición al menos dos veces. Dicho de otro modo: se ejecuta el ejercicio, parar y cambiar, ejecutar el ejercicio, parar y cambiar. ¡Esta práctica es muy bien recibida por los técnicos de emergencias médicas y paramédicos! Resulta divertido ver como el rendimiento mejora con el tiempo.
Eso es lo que se trata todo esto...
Source: EMS 12-Lead - June 14, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: Uncategorized RCP de Alto Desempaño Reanimación Cardiopulmonar Source Type: research
High Performance CPR – Performance Not Protocol!
This is a supplement to Adult Pit Crew CPR and Pediatric Pit Crew CPR.
Specifically, this is how we have modified our training process since attending the Resuscitation Academy in Seattle / King County.
Each rescuer should experience each position at least twice. In other words, you run the drill, stop and switch, run the drill, stop and switch. This drill is very well received by EMTs and paramedics! It’s fun to watch the performance improve over time.
That’s what it’s all about — perfecting resuscitation!
In a perfect world you would use an instrumented manikin to measure rate, depth, recoil; ...
Source: EMS 12-Lead - June 14, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management High Performance CPR Pit Crew CPR resuscitation Resuscitation Academy Simulation Source Type: research
High Performance CPR – Performance Not Protocol!
This is a supplement to Adult Pit Crew CPR and Pediatric Pit Crew CPR.
Specifically, this is how we have modified our training process since attending the Resuscitation Academy in Seattle / King County.
Each rescuer should experience each position at least twice. In other words, you run the drill, stop and switch, run the drill, stop and switch. This drill is very well received by EMTs and paramedics! It’s fun to watch the performance improve over time.
That’s what it’s all about — perfecting resuscitation!
In a perfect world you would use an instrumented manikin to measure rate, depth, recoil; ...
Source: EMS 12-Lead - June 14, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management High Performance CPR Pit Crew CPR resuscitation Resuscitation Academy Simulation Source Type: research
Pit Crew / High Performance CPR on the EMS Nation Podcast
Editor-in-Chief Tom Bouthillet (@tbouthillet) was on the EMS Nation podcast (@EMS_Nation) for EMS Week. The topic was Pit Crew / High Performance CPR and Systems of Care.
Click HERE to open in iTunes.
Click HERE to open in Libsyn (with built-in media player).
Referenced in this podcast
Adult Pit Crew CPR – The Explicit Details
Continuous chest compressions vs. 30:2. Does it matter? Depends on the quality!
Resuscitation Academy
The Science of CPR with Peter Kudenchuk, M.D.
(Source: EMS 12-Lead)
Source: EMS 12-Lead - May 20, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: Uncategorized EMS Nation podcast Faizan H. Arshad Tom Bouthillet Source Type: research
Cardiac arrest and deep T wave inversions
The paramedic swung the stretcher into the resus bay, and started giving report. As the team of RNs, techs, and residents swung into action, I noted that the young adult patient didn’t look very sick at all. Confused, yes, and perhaps a bit anxious, but this seemed like an over-triage.
“Paramedic Battistelli,” I called out, “why is this 38 year-old female patient here, instead of in fast track?”
“Hey Dr. Walsh! We were called for a seizure, but she looked fine when we got to the house. She denied any problems, but family said she was just lying on the bed, no warning, when she started convulsing. Vitals and sug...
Source: EMS 12-Lead - April 4, 2016 Category: Cardiology Authors: Brooks Walsh MD Tags: Uncategorized Source Type: research
Continuous Chest Compressions vs. 30:2. Does It Matter? Depends On the Quality!
Seattle Fire Department Engine 2. The rescuer on the left has just placed a metronome on the ground.
I will eventually get around to composing a more thoughtful blog post about my experiences at the Resuscitation Academy but in the interim I wanted to share something about the ventilation strategy in King County, Washington.
There isn’t much controversy in the fact that ventilations are probably unnecessary in the first 4 minutes of sudden cardiac arrest. The idea is that the arterial system is full of fresh, oxygenated blood at the time of collapse. However, after that time period has elapsed things get a bit murky...
Source: EMS 12-Lead - March 25, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: Cardiac Arrest Resuscitation Academy Source Type: research
Continuous Chest Compressions vs. 30:2 – Does It Matter? Depends On the Quality!
Seattle Fire Department Engine 2. The rescuer on the left has just placed a metronome on the ground.
I will eventually get around to composing a more thoughtful blog post about my experiences at the Resuscitation Academy but in the interim I wanted to share something about the ventilation strategy in King County, Washington.
There isn’t much controversy in the fact that ventilations are probably unnecessary in the first 4 minutes of sudden cardiac arrest. The idea is that the arterial system is full of fresh, oxygenated blood at the time of collapse. However, after that time period has elapsed things get a bit murky...
Source: EMS 12-Lead - March 25, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: Cardiac Arrest Resuscitation Academy Source Type: research
The 12 Rhythms of Christmas: Paroxysmal AV-Block
This article is the ninth in our latest series, The 12 Rhythms of Christmas, where we examine a different rhythm disorder with each new post. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. And, just like last year’s series, I’m rather late getting the final articles out, but the end is in sight.
Hope you had a good Valentine’s Day—let’s talk about some heart stuff. Today I want to discuss a form of AV-block that many providers don’t even realize is its own unique entity:
Paroxysmal AV-Block
What differentiates this arrhythmia from the other AV-blocks is that ...
Source: EMS 12-Lead - February 15, 2016 Category: Cardiology Authors: Vince DiGiulio Tags: 12-Leads of Christmas Vince DiGiulio Source Type: research
70s male with “ seizures ” proves to be incessant arrhythmias with multiple ICD shocks
EMS is called to the residence of a 71 year old male for “seizures.”
On arrival the patient’s spouse meets the ambulance outside and hurries the paramedics along saying “Come quickly! Please help him!”
The paramedics arrive at the patient’s side just in time to see him receive an ICD shock.
They ask how long this had been going on.
“That was my 15th shock!”
The patient states that he “felt himself going faint” just prior to the first shock.
The cardiac monitor is attached and the following rhythm strips are recorded.
The patient appears anxious. His skin is pink, warm, and moist.
Numerous skin...
Source: EMS 12-Lead - February 6, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management donut magnet ICD Implantable Cardioverter-Defibrillator pacemaker ring magnet Seizures Source Type: research
70s male with “seizures” proves to be incessant arrhythmias with multiple ICD shocks
EMS is called to the residence of a 71 year old male for “seizures.”
On arrival the patient’s spouse meets the ambulance outside and hurries the paramedics along saying “Come quickly! Please help him!”
The paramedics arrive at the patient’s side just in time to see him receive an ICD shock.
They ask how long this had been going on.
“That was my 15th shock!”
The patient states that he “felt himself going faint” just prior to the first shock.
The cardiac monitor is attached and the following rhythm strips are recorded.
The patient appears anxious. His skin is pink, warm, and moist.
Numerous skin...
Source: EMS 12-Lead - February 6, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management donut magnet ICD Implantable Cardioverter-Defibrillator pacemaker ring magnet Seizures Source Type: research
71 year old male with “seizures” that prove to be ICD shocks
EMS is called to the residence of a 71 year old male for “seizures.”
On arrival the patient’s spouse meets the ambulance outside and hurries the paramedics along saying “Come quickly! Please help him!”
The paramedics arrive at the patient’s side just in time to see him receive an ICD shock.
They ask how long this had been going on.
“That was my 15th shock!”
The patient states that he “felt himself going faint” just prior to the first shock.
The cardiac monitor is attached and the following rhythm strips are recorded.
The patient appears anxious. His skin is pink, warm, and moist.
Numerous skin...
Source: EMS 12-Lead - February 6, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management donut magnet ICD Implantable Cardioverter-Defibrillator pacemaker ring magnet Seizures Source Type: research
90 year old female with abdominal pain and wide complex tachycardia
EMS is called to the residence of a 90 year old female who awoke to an “uncontrolled bowel movement” that corresponded with sudden onset abdominal pain.
On EMS arrival, the patient is alert and oriented to person, place, time, and event. She has a grimace on her face and appears acutely ill.
When asked the exact location of her pain she points to the epigastric area.
Past medical history: “Cardiac problems”
Medications: Numerous (but list unavailable)
Vital signs are assessed.
RR: 18 shallow
HR: Too rapid to count
NIBP: 118/60
SpO2: 96% on room air
The cardiac monitor is attached.
A wide complex...
Source: EMS 12-Lead - January 30, 2016 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics synchronized cardioversion ventricular tachycardia wellens' criteria Source Type: research
The 12 Rhythms of Christmas: High-Grade AV-Block
This article is the eighth in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas.
In our recent articles we’ve discussed three different types of AV-block that cause dropped P-waves: type I, type II, and 2:1 AV-block. Consider the prototypical tracings from each article:
Figure 1. Type I AV-block.
Figure 2. Type II AV-block.
Figure 3. 2:1 AV-block of uncertain mechanism.
Each shows different conduction ratios—ranging from 2:1 to 3:2 to 4:3—but they don’t demonstrate something like 3:1 ...
Source: EMS 12-Lead - January 14, 2016 Category: Cardiology Authors: Vince DiGiulio Tags: 12 Rhythms of Christmas Vince DiGiulio Source Type: research
The 12 Rhythms of Christmas: 2:1 AV-Block
This article is the seventh in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas.
Our last two posts have examined type I and type II AV-block, so it’s only fitting that we continue our theme with a topic that combines the two:
2:1 AV-Block
While most everyone has heard of first degree, type I, type II, and complete AV-block, comparatively few people recognize 2:1 AV-block as a valid rhythm diagnosis in its own right. That’s a shame, because 2:1 AV-block is a rather interesting finding. T...
Source: EMS 12-Lead - January 5, 2016 Category: Cardiology Authors: Vince DiGiulio Tags: 12 Rhythms of Christmas Vince DiGiulio Source Type: research
