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



Avsnitt(1146)

Podcast 754: Balanced Fluids vs. Normal Saline, The Battle Continues

Podcast 754: Balanced Fluids vs. Normal Saline, The Battle Continues

Contributor: Aaron Lessen, MD Educational Pearls: Normal saline is thought to interfere with renal function and cause an acidosis and balanced fluids (like lactated ringers) are a better option The S...

8 Feb 20223min

Podcast 753: Ring Cutting Raptors

Podcast 753: Ring Cutting Raptors

Contributor: Aaron Lessen, MD Educational Pearls: Techniques regarding ring removal in the ED were evaluated in a recent study which looked at using trauma shears versus the motorized ring cutters A ...

7 Feb 20222min

Podcast 752: Budesonide for COVID

Podcast 752: Budesonide for COVID

Contributor: Aaron Lessen, MD Educational Pearls: Recent study evaluated budesonide for outpatient COVID-19 infection treatment to see if there was a decrease in length of illness or hospitalization ...

1 Feb 20222min

Podcast 751: The Bougie Trial

Podcast 751: The Bougie Trial

Contributor: Aaron Lessen, MD Educational Pearls: An endotracheal tube introducer or bougie are often used as a rescue device during difficult intubations as they are small and can be placed blindly ...

31 Jan 20223min

Mental Health Monthly #9: Suicide Assessment in the ED: Using the ICAR2E Tool

Mental Health Monthly #9: Suicide Assessment in the ED: Using the ICAR2E Tool

Dr. Kim Nordstrom discusses a valuable bedside tool for evidence-based assessment in patients that visit the ED and are at risk for suicidality. Dr. Nordstrom is a practicing emergency psychiatrist an...

26 Jan 20228min

Podcast 750: Take Home Naloxone

Podcast 750: Take Home Naloxone

Contributor: Aaron Lessen, MD Educational Pearls: Think about giving take home naloxone kits for anyone on long-term opioids as well as anyone with an opioid use disorder, those in opioid withdrawal,...

25 Jan 20222min

Podcast 749: PCC for Me?

Podcast 749: PCC for Me?

Contributor: Nick Tsipis, MD Educational Pearls: Prothrombin complex concentrate (Kcentra)  and Vitamin K are used to reverse life-threatening bleeds in patients on warfarin (Coumadin) Factors II, VI...

24 Jan 20224min

Podcast 748: Botulism

Podcast 748: Botulism

Contributor: Nick Hatch, MD Educational Pearls: Botulism requires a prompt clinical diagnosis as lab results can take about 5 days to return Whale blubber, honey, home fermented foods, homemade wine ...

18 Jan 20228min

Populärt inom Vetenskap

dumma-manniskor
svd-nyhetsartiklar
p3-dystopia
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-ufo-bortom-rimligt-tvivel
rss-vetenskapsradion
pojkmottagningen
sexet
rss-vetenskapsradion-2
dumforklarat
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
halsorevolutionen
bildningspodden
rss-experimentet
rss-spraket
hacka-livet
vetenskapsradion