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Airway Management of the Cardiac Arrest Victim
This article will review both current data and guidelines for airway management in cardiac arrest, a stepwise approach to airway management, the utility o f various airway adjuncts, and best practices for oxygenation and ventilation in the peri-arrest period. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 18, 2023 Category: Emergency Medicine Authors: Anthony Chase Palisch Source Type: research

Cardiopulmonary Resuscitation
Cardiac arrest is the loss of organized cardiac activity. Unfortunately, survival to hospital discharge is poor, despite recent scientific advances. The goals of cardiopulmonary resuscitation (CPR) are to restore circulation and identify and correct an underlying etiology. High-quality compressions remain the foundation of CPR, optimizing coronary and cerebral perfusion pressure. High-quality compressions must be performed at the appropriate rate and depth. Interruptions in compressions are detrimental to management. Mechanical compression devices are not associated with improved outcomes but can assist in several situatio...
Source: Emergency Medicine Clinics of North America - April 14, 2023 Category: Emergency Medicine Authors: Brit Long, Michael Gottlieb Source Type: research

Prognosis of Cardiac Arrest —Peri-arrest and Post-arrest Considerations
There has been only a small improvement in survival and neurologic outcomes in patients with cardiac arrest in recent decades. Type of arrest, length of total arrest time, and location of arrest alter the trajectory of survival and neurologic outcome. In the post-arrest phase, clinical markers such as blood markers, pupillary light response, corneal reflex, myoclonic jerking, somatosensory evoked potential, and electroencephalography testing can be used to help guide neurological prognostication. Most of the testing should be performed 72  hours post-arrest with special considerations for longer observation periods in pat...
Source: Emergency Medicine Clinics of North America - April 14, 2023 Category: Emergency Medicine Authors: Brian D. Sumner, Christopher W. Hahn Source Type: research

Out-of-Hospital Cardiac Arrest
This article focuses on the management of OHCA by EMS providers. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 10, 2023 Category: Emergency Medicine Authors: Ryan B. Gerecht, Jose V. Nable Source Type: research

Defibrillation in the Cardiac Arrest Patient
Defibrillation is one of the few interventions known to favorably impact survival in cardiac arrest. In witnessed arrest, survival improves with defibrillation as early as possible, whereas it may improve outcomes to administer high-quality chest compressions for 90  seconds before defibrillation in unwitnessed arrest. Minimizing pre-, peri-, and post-shock pauses has been shown to have mortality benefits. Refractory ventricular fibrillation has high mortality rates, and there is ongoing research into promising adjunctive treatment modalities. There remains no consensus on optimal pad positioning and defibrillation energy...
Source: Emergency Medicine Clinics of North America - April 10, 2023 Category: Emergency Medicine Authors: Andrea Dreyfuss, Greta Kreider Carlson Source Type: research

Post-Cardiac Arrest Care
This article summarizes the current understanding of the hemodynamic, neurologic, and metabolic abnormalities encountered in postarrest patients. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 10, 2023 Category: Emergency Medicine Authors: Amandeep Singh, Jamal Jefferson Source Type: research

Pre-Arrival Care of the Out-of-Hospital Cardiac Arrest Victim
Lay rescuers play a pivotal role in the recognition and initial management of out-of-hospital cardiac arrest. The provision of timely pre-arrival care by lay responders, including cardiopulmonary resuscitation and the use of automated external defibrillator before emergency medical service arrival, is important link in the chain of survival and has been shown to improve outcomes from cardiac arrest. Although physicians are not directly involved in bystander response to cardiac arrest, they play a key role in emphasizing the importance of bystander interventions. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 7, 2023 Category: Emergency Medicine Authors: Jillian Horning, Daniel Griffith, Corey Slovis, William Brady Source Type: research

In-Hospital Cardiac Arrest
This article reviews the epidemiology and management of in-hospital cardiac arrest. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 7, 2023 Category: Emergency Medicine Authors: Andrew Julio Barros, Kyle B. Enfield Source Type: research

Pediatric Cardiac Arrest and Resuscitation
This article focuses on both prevention of arrest and the key elements of pediatric resuscitation that have been shown to improve outcomes for children in cardiac arrest. Finally, we review changes to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care that were published in 2020. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 7, 2023 Category: Emergency Medicine Authors: Steven Garbin, Joshua Easter Source Type: research

Trauma in Pregnancy
Trauma is the leading cause of nonobstetric maternal death. Pregnant patients have a similar spectrum of traumatic injuries with a noted increase in interpersonal violence. A structured approach to trauma evaluation and management is recommended with several guidelines expanding on ATLS principles; however, evidence is limited. Optimal management requires understanding of physiologic changes in pregnancy, a team-based approach, and preparation for interventions that may including neonatal resuscitation. The principles of trauma management are the same in pregnancy with a systematic approach and initial maternal focused res...
Source: Emergency Medicine Clinics of North America - April 5, 2023 Category: Emergency Medicine Authors: Jessica Downing, Lucas Sjeklocha Source Type: research

Spontaneous and Complicated Therapeutic Abortion in the Emergency Department
Pregnancy-related emergency department visits are common in the United States. Although typically managed safely in the outpatient setting, patients with spontaneous abortion may also present with life-threatening hemorrhage or infection. Management strategies for spontaneous abortion are similarly wide-ranging from expectant management to emergent surgical intervention. Surgical management of complicated therapeutic abortion is similar to that of spontaneous abortion. The dramatic changes in the legal status of abortion in the United States may have significant influence on the incidence of complicated therapeutic abortio...
Source: Emergency Medicine Clinics of North America - April 5, 2023 Category: Emergency Medicine Authors: Sara Manning, Diane Kuhn Source Type: research

Emergency Medicine Considerations in the Transgender Patient
Transgender patients are at high risk for poor health outcomes and many harbor fear of healthcare settings secondary to prior discrimination, perceived sensationalism, clinician unfamiliarity, and unwanted exams. It is essential to approach transgender patients without judgement and with empathy. Asking open ended questions with explanation as to why your questions are pertinent to their specific care will help create rapport and trust. Through a basic working knowledge of terminology, types of hormone therapy, non-surgical techniques, garments, and surgical procedures typically encountered by such patients, and their resp...
Source: Emergency Medicine Clinics of North America - April 5, 2023 Category: Emergency Medicine Authors: Benito Nikolas Pascua, Pamela L. Dyne Source Type: research

Emergency Gynecologic Considerations in the Older Woman
As women mature through menopause, they will experience normal physiologic changes that can contribute to emergency complaints specific to this patient population. Reviewing the expected physiologic changes of menopause and correlating these normal processes to the development of specific pathologic conditions offers a framework for emergency physicians and practitioners to use when evaluating older women for breast, genitourinary, and gynecologic symptoms. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 5, 2023 Category: Emergency Medicine Authors: Nicole Cimino-Fiallos, Pamela L. Dyne Source Type: research

The Emergency Department Safety Net for Obstetric/Gynecologic Emergencies
Despite advances in modern medicine, access to obstetric and gynecologic care has declined in many areas across the United States and North America. As a result, we are experiencing a rise in the frequency of obstetric and gynecologic issues requiring attention in the Emergency Department (ED). This important and timely issue of the Emergency Medicine Clinics of North America covers cutting-edge literature and updates on gynecologic and obstetric emergencies for which emergency physicians must be prepared to manage. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 5, 2023 Category: Emergency Medicine Authors: Brittany Guest, Sarah B. Dubbs Tags: Preface Source Type: research

Updates in Obstetric and Gynecologic Emergencies
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 5, 2023 Category: Emergency Medicine Authors: Brittany Guest, Sarah B. Dubbs Source Type: research