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Unstable Bradycardia Resolves Following Atropine and Attempted Transcutaneous Pacing (TCP)

Unstable Bradycardia Resolves Following Atropine and Attempted Transcutaneous Pacing (TCP)

A  75 year old male experienced a syncopal episode. The event was witnessed by family members who contacted 9-1-1. On arrival of EMS personnel the patient appears acutely ill. He is pale, diaphoretic and cool to touch. He states that he is feeling lightheaded and weak.

Medical History

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Mixed Overdose and Na-Channel Blockade

Mixed Overdose and Na-Channel Blockade

It’s 06:30 when EMS is called to an inner-city apartment for an 18-year-old male having a seizure. After gaining entry into the building, Paramedics and First Responders trudge up two flights of stairs and down a narrow, dimly lit hallway, until they find an open door into a dark two-bedroom apartment.

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Acute Inferior STEMI with Right Ventricular Infarction and Cardiac Arrest

Acute Inferior STEMI with Right Ventricular Infarction and Cardiac Arrest

EMS (with physician on board) is dispatched to a 42-year-old male with a chief complaint of chest pain and “possible heart attack.”

The patient is found lying on the couch. He appears to be reasonably comfortable and indicates that “the pain has eased a bit” since EMS was contacted.

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CPR First? Or Defibrillation First?

CPR First? Or Defibrillation First?

Ventricular Fibrillation is considered the most favorable cardiac arrest rhythm, and if treated promptly can result in ROSC with a favorable neurological outcome. Most survival rates are reported using witnessed arrest with a shockable rhythm as opposed to asystole or PEA, as the outcomes of these rhythms are comparatively very poor.

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Naxolone

Is there an Irrational Fear of Naloxone?

In the U.S. there has been a 286% increase in heroin-related overdose deaths since 2002. In 2014, a total of 47,055 drug overdose deaths occurred. Our EMS systems and emergency departments have felt the surge, along with a corresponding increase in the use of the drug naloxone.
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