A necrotic arm with a palpable pulse

2021 ◽  
Author(s):  
Lamiaa Hamie ◽  
Mazen Kurban ◽  
Ossama Abbas ◽  
Amir Ibrahim ◽  
Shukrallah Zaynoun
Keyword(s):  
Palpable Pulse

scholarly journals Frontal EEG Changes with the Recovery of Carotid Blood Flow in a Cardiac Arrest Swine Model

Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3052
Author(s):  
Heejin Kim ◽  
Ki Hong Kim ◽  
Ki Jeong Hong ◽  
Yunseo Ku ◽  
Sang Do Shin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Circulation ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Swine Model ◽  
Carotid Blood Flow ◽  
Non Invasive ◽  
Entropy Measures ◽  
Palpable Pulse ◽  
Eeg Changes

Monitoring cerebral circulation during cardiopulmonary resuscitation (CPR) is essential to improve patients’ prognosis and quality of life. We assessed the feasibility of non-invasive electroencephalography (EEG) parameters as predictive factors of cerebral resuscitation in a ventricular fibrillation (VF) swine model. After 1 min untreated VF, four cycles of basic life support were performed and the first defibrillation was administered. Sustained return of spontaneous circulation (ROSC) was confirmed if a palpable pulse persisted for 20 min. Otherwise, one cycle of advanced cardiovascular life support (ACLS) and defibrillation were administered immediately. Successfully defibrillated animals were continuously monitored. If sustained ROSC was not achieved, another cycle of ACLS was administered. Non-ROSC was confirmed when sustained ROSC did not occur after 10 ACLS cycles. EEG and hemodynamic parameters were measured during experiments. Data measured for approximately 3 s right before the defibrillation attempts were analyzed to investigate the relationship between the recovery of carotid blood flow (CBF) and non-invasive EEG parameters, including time- and frequency-domain parameters and entropy indices. We found that time-domain magnitude and entropy measures of EEG correlated with the change of CBF. Further studies are warranted to evaluate these EEG parameters as potential markers of cerebral circulation during CPR.

scholarly journals Just the Facts: Protected code blue – Cardiopulmonary resuscitation in the emergency department during the coronavirus disease 2019 pandemic

CJEM ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 431-434 ◽  
Author(s):  
Sarah McIsaac ◽  
Randy S. Wax ◽  
Brit Long ◽  
Christopher Hicks ◽  
Christian Vaillancourt ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Negative Pressure ◽  
Shortness Of Breath ◽  
Code Blue ◽  
Palpable Pulse ◽  
History Of

Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?

scholarly journals The Value of Focused Echocardiography During Cardiac Arrest

2019 ◽  
Vol 35 (6) ◽  
pp. 484-490
Author(s):  
Julie White
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Medical Condition ◽  
Advanced Cardiac Life Support ◽  
The United States ◽  
Area Of Interest ◽  
Palpable Pulse ◽  
Life Threatening ◽  
Developing Area ◽  
Focused Echocardiography

Cardiac arrest is the absence of a centrally palpable pulse and no respiratory effort in an unresponsive patient. This often-lethal medical condition affects hundreds of thousands of people in the United States alone every year. Immediate intervention is crucial to provide the patient with any chance of survival. Advanced cardiac life support (ACLS) is the cornerstone therapy for cardiac arrest. Increased awareness and proper identification of life-threatening arrhythmias is critical, as it may lead to prompt medical treatment and improved mortality. The use of focused echocardiography, during a cardiac arrest, has been a developing area of interest over the past several years. The specific aim of this literature review was to emphasize the role of a focused echocardiogram and the valuable information that can be provided during a cardiac arrest.

Abstract 335: Predicting Pulse Status From the ECG Signal Without Interrupting CPR

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Heemun Kwok ◽  
Shiv Bhandari ◽  
Jennifer E Blackwood ◽  
Jason Coult ◽  
Peter Kudenchuk ◽  
...  
Keyword(s):  
Wavelet Analysis ◽  
Real Time ◽  
Cardiac Rhythm ◽  
Logistic Model ◽  
Direct Care ◽  
Study Cohort ◽  
Palpable Pulse ◽  
Validation Set ◽  
The Individual ◽  
Pulse Check

Objective: Currently, cardiac arrest resuscitation requires interruptions in CPR every 2 minutes to assess cardiac rhythm and pulse. A method which analyzed the ECG during CPR to predict whether or not an organized rhythm generated a pulse could help to direct care and limit CPR interruptions. We evaluated a real-time method to predict pulse status from organized rhythm ECG segments with and without CPR. Methods: The study cohort received attempted resuscitation by a metropolitan EMS system following out-of-hospital ventricular fibrillation arrest. Two-minute rhythm/pulse checks on the continuous defibrillator recordings were annotated for CPR, rhythm, and pulse status using the ECG, impedance, and accelerometer signals, the audio recording, and EMS record. Pulse was defined by the presence of a palpable pulse by EMS. Paired ECG segments with and without CPR were extracted at each rhythm/pulse check. Using organized rhythm segments from one-third of cases for training, we developed four ECG features using wavelet analysis (median power values in three frequency bands and QRS rate) and a logistic model to predict pulse status. Predictive performances of each ECG feature and the logistic model were measured by AUC in the remaining validation cases with and without CPR. Results: There were 238 cases and 911 paired segments with a median of 3 (IQR 2,5) paired segments per case. Among 319 organized rhythm segments in the validation set, AUC for pulse prediction ranged from 0.67 to 0.79 for the individual ECG features (Figure). The logistic model was more predictive than any individual feature (AUC 0.84, 95% CI 0.80-0.89, p < 0.05 for each comparison). The model predicted pulse similarly regardless of CPR activity (p = 0.2). Conclusion: ECG features extracted by wavelet analysis were predictive of pulse status among organized rhythm segments with and without ongoing CPR. Further study is required to understand how pulse prediction could guide rescuer actions in real-time.

scholarly journals Dedo Azul Não-Isquémico Espontâneo: Um Fenómeno Raro e Benigno

2015 ◽  
Vol 28 (4) ◽  
pp. 528
Author(s):  
Daniela Franco ◽  
Daniela Alves ◽  
Ana Cristina Almeida ◽  
Carlos Costa Almeida ◽  
Cecília Moreno ◽  
...  
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Complete Resolution ◽  
Signs And Symptoms ◽  
Early Assessment ◽  
Temperature Changes ◽  
Palpable Pulse ◽  
Fast Resolution ◽  
The Right ◽  
Finger Tip

The spontaneous non-ischaemic blue finger is a rare and benign disorder, characterized by purple discoloration of a finger, with complete resolution. This article reports the case of a woman of 88 years, which after a few hours of stay in the emergency department developed without associated trauma, a purplish color of the 3rd finger of the right hand, with a palpable pulse and without temperature changes or pain. The etiological investigation was negative. The patient was assessed one week after the event and showed complete<br />resolution. There are several diseases that share the same signs and symptoms, as such the diagnosis is based on the spontaneous violaceous color sparing the finger tip, and fast resolution without treatment. Though being a harmless phenomenon, it requires early assessment for timely differential diagnosis with severe pathologies.

scholarly journals Liver Dysfunction in Severe Sepsis from Respiratory Syncytial Virus

2017 ◽  
Vol 07 (02) ◽  
pp. 110-114 ◽  
Author(s):  
Ilirjana Bakalli
Keyword(s):  
Severe Sepsis ◽  
Respiratory Syncytial Virus ◽  
Liver Dysfunction ◽  
Supportive Therapy ◽  
Pediatric Intensive Care ◽  
Assessment Scores ◽  
Severe Hypotension ◽  
Palpable Pulse ◽  
Rapid Restoration ◽  
Syncytial Virus

AbstractA 1-month-old child was admitted at our pediatric intensive care unit (PICU) in a very critical state with generalized cyanosis, grunting, high fever, tachypnea, tachycardia, severe hypotension with capillary refill time > 5 seconds, and no palpable pulse. The child was apparently doing well until a few hours before admission. On admission to PICU, his clinical diagnosis was consistent with severe sepsis with his sequential organ failure assessment scores of 7 to 8 points. We started rapid restoration of circulation with aggressive volume replacement and empiric antimicrobial therapy. Despite optimal supportive therapy, the patient showed severe liver injury leading to liver failure, making the treatment more challenging. His simplex real-time reverse transcriptase polymerase chain reaction assay and enzyme linked immune sorbent assay documented respiratory syncytial virus (RSV) infection. Through our case report we would like to highlight the extrapulmonary manifestations of RSV infections and the importance of liver dysfunction during sepsis.

The “Dead Digit, Palpable Pulse” Syndrome: A Preliminary Study of the Value of Antiplatelet Drugs in This Disorder

1979 ◽  
Author(s):  
W Morris-Jones ◽  
F Preston
Keyword(s):  
Platelet Aggregation ◽  
Antiplatelet Drugs ◽  
Controlled Clinical Trials ◽  
Therapeutic Value ◽  
Palpable Pulse ◽  
Platelet Aggregate ◽  
The Mean ◽  
Preliminary Study ◽  
The Dead ◽  
Spontaneous Platelet Aggregation

We report here the results of a pilot study to investigate the value of antiplatelet drugs in patients with pregangrene of one or both feet associated with palpable peripheral pulses but without clinical or laboratory evidence of a myeloproliferative disorder in diabetes mellitus. 32 patients were studied. For each patient pregangrene of one or both feet had been present for a minimum period of six weeks. All patients had failed to respond to medical therapy. Platelet aggregation, using ADP, collagen and adrenaline was assessed before therapy. PRP was also tested for spontaneous platelet aggregation (SPA). BTG assays and platelet aggregate ratios were also performed. Aspirin, 325mgs t.d.s. and persantin 100mgs t.d.s. produced significant and maintained clinical improvement in 5 of the 7 patients with SPA- 7 of 12 patients with hypersensitive platelets and 3 of 13 patients with normo-or hyposensitive platelets. Sympathectomy was performed in patients who failed to respond to drug therapy. The mean PAR was 0.94 for the non-responder group and 0.78 for the responder group. The mean BTG for non-responders was 44ng/ml (normal 50). The mean BTG for the responder group was 59.1ng/ml. The results suggest that antiplatelet drugs may be of therapeutic value in patients with the “dead-digit palpable pulse” syndrome arid that controlled clinical trials are indicated.

A Palpable Pulse does Not Exclude Radial Artery Occlusion in Patients with Previous Arterial Cannulation

2011 ◽  
Vol 13 (2) ◽  
pp. 263-264
Author(s):  
Georges Khoueiry ◽  
Fady Geha ◽  
Mustafain Meghani ◽  
Nidal Abi Rafeh ◽  
Basem Azab ◽  
...  
Keyword(s):  
Radial Artery ◽  
Artery Occlusion ◽  
Arterial Cannulation ◽  
Palpable Pulse ◽  
Radial Artery Occlusion
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