Podcast 588: Esmolol for Refractory Ventricular Fibrillation

Podcast 588: Esmolol for Refractory Ventricular Fibrillation

Contributor: Ricky Dhaliwal, MD, JD

Educational Pearls:

  • Ventricular Fibrillation (VF) is a potentially fatal cardiac arrhythmia; Refractory VF even more so
  • Epinephrine stimulates alpha and beta receptors which increase sympathetic tone, thereby increasing cardiac oxygen demand and myocardial calcium levels which can cause new arrhythmias, particularly a problem during resuscitation
  • Esmolol (or any beta blocker) can be used in VF refractory to defibrillation, epinephrine and amiodarone in a last-ditch effort.
  • Esmolol in the setting of epinephrine can help prevent some of these known effects from repeated beta stimulation
  • Dosing esmolol for refractory VF: 500mcg/kg bolus, followed by drip (max typically 1000 mcg/kg/min)
  • Esmolol is associated with improved mortality in ACLS care in refractory VF

References

Long DA, Long B, April MD. Does β-Blockade for Treatment of Refractory Ventricular Fibrillation or Pulseless Ventricular Tachycardia Improve Outcomes?. Ann Emerg Med. 2020;76(1):42-45. doi:10.1016/j.annemergmed.2020.01.025

Lee YH, Lee KJ, Min YH, et al. Refractory ventricular fibrillation treated with esmolol. Resuscitation. 2016;107:150-155. doi:10.1016/j.resuscitation.2016.07.243

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD



Episoder(1146)

Podcast 731: Fluid Resuscitation in Burns

Podcast 731: Fluid Resuscitation in Burns

Contributor: Chris Holmes, MD Educational Pearls: Parkland Formula: 4 mL x [Total Body Surface Area Burned (%)] x [body weight (kg)] given in 24 hours 50% given over 8 hours and 50% given over the ...

22 Nov 20214min

Podcast 730: Alternative Treatment for Gonorrhea

Podcast 730: Alternative Treatment for Gonorrhea

Educational Pearls: Recent updates to treatment guidelines increased the 250 mg ceftriaxone IM dose to 500 mg ceftriaxone IM IM dosing can be very painful, so other methods of administration can help...

16 Nov 20213min

Podcast 729: Molnupiravir for COVID

Podcast 729: Molnupiravir for COVID

Contributor: Jared Scott, MD Educational Pearls: A press release from Merck introduced Molnupiravir for treatment of mild to moderate COVID-19 The yet to be published study is a randomized control tr...

15 Nov 20215min

Podcast 728: Angiography for Out-of-Hospital Cardiac Arrest without ST Elevation

Podcast 728: Angiography for Out-of-Hospital Cardiac Arrest without ST Elevation

Contributor: Nick Tsipis, MD Educational Pearls: Meaningful survival under 10% for out of hospital cardiac arrest The most common cause of out-of-hospital cardiac arrest is due to cardiac ischemia St...

9 Nov 20215min

Podcast 727: Antibiotics for Diverticulitis

Podcast 727: Antibiotics for Diverticulitis

Contributor: Aaron Lessen, MD Educational Pearls: Classically, diverticulitis is diagnosed via CT scan and patients are discharged home on antibiotics if they are without complication The DINAMO stud...

8 Nov 20213min

Podcast 726: Ophthalmia Neonatorum

Podcast 726: Ophthalmia Neonatorum

Contributor: Peter Bakes, MD Educational Pearls: Ophthalmia Neonatorum encompasses any conjunctivitis that presents within the first 28 days of life Neonates often receive prophylactic silver nitrate...

2 Nov 20214min

Podcast 725: Hypothermia in Preterm Deliveries

Podcast 725: Hypothermia in Preterm Deliveries

Contributor: Aaron Lessen, MD Educational Pearls: Preterm deliveries in the ED can be complex and preventing hypothermia is essential to the health of the baby Recent meta-analysis examined methods f...

1 Nov 20213min

Podcast 724: Ivermectin Overdose

Podcast 724: Ivermectin Overdose

Contributor: Don Stader, MD Educational Pearls: Ivermectin is a Nobel-Prize winning antiparasitic  used to treat filariasis and onchocerciasis Ivermectin is receiving press due to a scientific study ...

26 Okt 20214min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
nevropodden
diagnose
smart-forklart
nordnorsk-historie
abid-nadia-skyld-og-skam
rss-overskuddsliv
dekodet-2
tidlose-historier