A 34-year-old male presents to the emergency department from his urologist’s office after exhibiting word-finding difficulty and confusion during an elective surgery. He had previously been feeling well and is otherwise healthy. Per discussion with his urologist, the patient reported continued discomfort during the procedure, so he was given additional lidocaine until his pain was sufficiently managed. He developed symptoms that progressed from dizziness to word-finding difficulty and confusion. It was subsequently noticed that he had accidentally been treated with 2% lidocaine without epinephrine instead of 1% lidocaine without epinephrine, thus doubling the intended dose…

Toxicology, ResuscitationSean ReidMay 6, 2022Toxicology, AnestheticsComment

Pediatric Submersions

The overhead announcement goes off: “Team B to the trauma room”. The report: EMS is bringing a 2-year-old female that was found unresponsive in the family swimming pool by her mother after being alerted by an older sibling. Unknown downtime. The patient is being bagged by bag-valve mask (BVM) and has slow, but palpable, femoral pulses, she is unresponsive, ETA 2 minutes…

Critical Care, Pediatrics, Resuscitation, TraumaSean BilodeauApril 29, 2022Drowning, PediatricsComment

Volume Assessment Using POCUS in the Emergency Department

An 83-year-old male with a history of HFrEF (40%), CAD, hypertension, and hyperlipidemia presented to the ED with generalized weakness and fatigue. His vitals were remarkable for hypotension with a MAP of 58. On physical exam, the patient appeared non-toxic and was able to answer questions appropriately. He did not appear frankly fluid overloaded, other than mild, chronic peripheral edema. Additional laboratory studies and chest x-ray were performed. A fluid bolus was given to treat his hypotension, however there was minimal response. Given his heart failure, there was concern that aggressive fluid resuscitation would result in pulmonary edema. Additionally, inserting a central line and starting vasopressors is not without risk. Fortunately, this clinical team knows how to use ultrasound to do a proper volume assessment to manage this patient appropriately…

Ultrasound, ResuscitationJoshua NimsApril 11, 2022POCUS, ShockComment

The History of Resuscitation

“Since the dawn of humanity, medical procedures have been used and are one of our species’ defining characteristics. …Various procedures and tinctures were used to ameliorate a wide range of pains and suffering, so it is no wonder that early medicine was also applied to resuscitating the dead.”

Resuscitation, Conference RecapsAustin QuinnFebruary 25, 2022resuscitation, history of resuscitation, health humanitiesComment

Hypothermic Cardiac Arrest

An unknown age male, estimated 30 years old, is brought into the emergency department by emergency medical services in cardiac arrest. He was found unresponsive on a park bench outside on a cold night. When EMS arrived he was noted to be very cold with no palpable pulse, spontaneous respirations, or response to sternal rub. A supraglottic airway was placed but they were unable to establish IV access. They performed 30 minutes of chest compressions and brought him to the emergency department on a LUCAS device…

Critical Care, ResuscitationFred VaroneJuly 30, 2021Hypothermia, Cardiac ArrestComment

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