Respiratory Monitoring In The Emergency Department - $30.00
This issue includes 3 AMA PRA Category 1 CreditsTM; 3 ACEP category 1; 3 AAFP Prescribed credits; and 3 AOA Category 2B CME credits.
Chad M. Meyers, MD
Director of Emergency Critical Care, Department of Emergency Medicine, Bellevue Hospital, New York, NY; Assistant Professor of Clinical Emergency Medicine, NYU School of Medicine, New York, NY
Scott Weingart, MD, FACEP
Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY; Director of Emergency Critical Care, Elmhurst Hospital Center, New York, NY
Andy Jagoda, MD, FACEP
Professor and Chair, Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY; Medical Director, Mount Sinai Hospital, New York, NY
Publication Date: June 1, 2011; Volume 1, Number 1
Excerpt from the issue...
An EMS notification of prehospital cardiac arrest is received by your community ED. Per the paramedic crew, the patient is a 62-year-old man initially complaining of chest tightness who became unresponsive and apneic during transport approximately 3 minutes prior to arrival. The rhythm was noted initially to be ventricular fibrillation; after a single biphasic countershock, his rhythm became organized, but he remained pulseless. He was intubated en route and is now being wheeled into your critical care area receiving active chest compressions.
You glance at the EMS monitor and note a slow narrow complex rhythm; chest compressions are continued, and his prehospital capnography tubing is connected to the ED monitor. The characteristic waveform reassures you of proper ETT placement, and the ETCO2 is 14 mm Hg. You obtain central access, and a round of ACLS drugs is administered. At the following rhythm check, you note ventricular fibrillation; he receives another shock, and chest compressions continue. You now note an ETCO2 of 36 mm Hg, a central pulse is appreciated, and his plethysmographic waveform becomes clearly defined. Hypothermia is induced, and the patient is admitted to the cardiac critical care unit.