Podcast 675: CHF like it's 1966

Podcast 675: CHF like it's 1966

Contributor: Chris Holmes, MD

Educational Pearls:

  • Medicine is cyclical and practice is always evolving
  • A description of recommended treatment for CHF from 1966
    • Give oxygen
    • Give one dose morphine then switch to demerol
    • Decrease venous return and start PPV
    • Immediately apply tourniquet to 3 extremities rotating tourniquets every 20 minutes
    • Phlebotomy of 350-500 cc blood into a donor bag and draw off plasma as RBCs settle down
    • Give aminophylline (make sure it is warmed)
    • Induce hypotension with nitroglycerin and trimethoprim camphorsulfonate (infused at 10 drips/minute)
    • Start digitalis
    • Don't use any diuretics as they are ineffective
    • If in shock, release tourniquets and hang the phlebotomized blood
    • Isoproterenol might be beneficial

References

Messer JV. Management of emergencies. 13. Acute cardiac decompensation. N Engl J Med. 1966;274(26):1491-1493. doi:10.1056/NEJM196606302742608

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Donate to EMM today!

Photo Credit: Photo presented without modification courtesy of Kipp Teague , CC license

Episoder(1146)

Podcast 604: Baclofen Withdrawal

Podcast 604: Baclofen Withdrawal

Contributor: Erik Verzemnieks, MD Educational Pearls: Baclofen is used to treat muscle spasms or spasticity. Baclofen comes in two forms: oral and intrathecal Withdrawal is much more common with thos...

13 Okt 20202min

Podcast 603: Don't Sedate. Block.

Podcast 603: Don't Sedate. Block.

Contributor: Don Stader, MD Educational Pearls: Fractures and dislocations that require reduction do not necessarily require sedation Nerve blocks are an effective alternative that can provide analg...

12 Okt 20203min

Podcast 602: Post-Narcan Observation

Podcast 602: Post-Narcan Observation

Contributor: Donald Stader, MD Educational Pearls: Not uncommon for patients presenting after opiate overdose and narcan administration to be observed for 4-6 hours This has been based more on tradit...

6 Okt 20204min

Podcast 601: Droperidol

Podcast 601: Droperidol

Contributor: Sam Killian, MD Educational Pearls: Droperidol (Inapsine) is an antipsychotic drug with efficacy for nausea, vomiting, headaches, and treating agitation In the early 2000's, Droperidol ...

5 Okt 20204min

Pediatric Emergencies Brewcast: Pediatric Fever

Pediatric Emergencies Brewcast: Pediatric Fever

Emergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies geared towards mid-level providers at a local Denver brewery for our latest...

30 Sep 202013min

Podcast 600: Penicillin Allergy?

Podcast 600: Penicillin Allergy?

Contributor: Aaron Lessen, MD Educational Pearls: True allergies to penicillin compared to reported allergies from patients ranges around 10% Recent study took patients undergoing sensitivity tests a...

29 Sep 20202min

Podcast 599: Facial Blocks for the Win

Podcast 599: Facial Blocks for the Win

Contributor: Don Stader, MD Educational Pearls: Local anesthetics injected directly into wounds can cause distortion - especially important in facial lacerations Several blocks can be helpful to help...

28 Sep 20205min

UnfilterED #10: Debi Smith

UnfilterED #10: Debi Smith

General Counsel attorney, Debi Smith, joins Dr. Nick Tsipis to discuss the ins and outs of healthcare law. Many people forget that a subpoena only compels attendance to a court date, it does not compe...

23 Sep 202024min

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