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

Avsnitt(1145)

Podcast 746: Elderly Head Trauma on Anticoagulation

Podcast 746: Elderly Head Trauma on Anticoagulation

Contributor: Aaron Lessen, MD Educational Pearls: Biggest study to date examined new protocol for repeat head CT in anticoagulated elderly patients with head trauma and an initial negative head CT ...

11 Jan 20223min

Podcast 745: Nitrous-Induced B12 Deficiency

Podcast 745: Nitrous-Induced B12 Deficiency

Contributor: Alicia Oberle, MD Educational Pearls: Nitrous oxide (N2O) can cause a vitamin B12 deficiency in patients after regular use N2O is used in procedural sedation but also as a popular recrea...

10 Jan 20222min

Podcast 744: Glucagon for Beta Blocker Toxicity

Podcast 744: Glucagon for Beta Blocker Toxicity

Educational Pearls: Glucagon can be used to treat hypoglycemia and esophageal foreign body, but it can also be used in beta-blocker toxicity to bypass cardiac beta-blockade The superior option for tr...

4 Jan 20222min

Podcast 743: Rust Rings

Podcast 743: Rust Rings

Contributor: Jared Scott, MD Educational Pearls: A rust ring can occur after a metallic foreign body is left in the eye for a prolonged period of time Issues occur when the rust ring is left as it ca...

3 Jan 20225min

Podcast 742: Pulse Check During CPR

Podcast 742: Pulse Check During CPR

Contributor: Aaron Lessen, MD Educational Pearls: Pulse checks are necessary during CPR to check for return of spontaneous circulation (ROSC) Previous studies have shown that assessing ROSC with palp...

29 Dec 20213min

Podcast 741: Calcium for Cardiac Arrest

Podcast 741: Calcium for Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Study of nearly 400 patients evaluating giving calcium during cardiac arrest with the endpoint as return of spontaneous circulation (ROSC) Compared g...

28 Dec 20212min

Podcast 740: Placenta Previa

Podcast 740: Placenta Previa

Contributor: Peter Bakes, MD Educational Pearls: High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa In placenta previa, the placenta ...

21 Dec 20213min

Podcast 739: Perceptions of Dress

Podcast 739: Perceptions of Dress

Contributor: Aaron Lessen, MD Educational Pearls: Study examined patient perceptions of providers wearing traditional white coats,  fleece coats and soft-shell jackets Found that white coats were see...

20 Dec 20213min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion-2
rss-vetenskapsradion
sexet
halsorevolutionen
rss-ufo-bortom-rimligt-tvivel
rss-spraket
rss-experimentet
vetenskapsradion
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
bildningspodden
4health-med-anna-sparre