Safety of prehospital intravenous bolus dose nitroglycerin in patients with acute pulmonary edema: A 4-year review.

Background: Intravenous nitrates are a primary therapy for hypertensive congestive heart failure (CHF) with acute pulmonary edema (APE) in the hospital setting. Historically, sublingual nitrates are the mainstay of emergency medical services (EMS) pharmacologic therapy for these patients. We aimed to evaluate the safety of prehospital bolus dose intravenous nitroglycerin in patients with APE.

Treatment of Presumed Hyperkalemia in the Prehospital Setting.

Introduction: Hyperkalemia (HK) is common and potentially a life-threatening condition. If untreated, HK can progress to ventricular arrhythmia and cardiac arrest. Early treatment reduces mortality in HK.

Feasibility of prehospital esmolol for refractory ventricular fibrillation.

Background: Esmolol may increase survival for patients with refractory ventricular fibrillation (RVF); however, information related to esmolol use in the prehospital environment is limited. We aimed to assess the feasibility of prehospital bolus dose esmolol for patients with RVF treated by a high-volume, ground-based emergency medical services (EMS) agency.

Methods:  Esmolol (0.

Prehospital Sinus Node Dysfunction and Asystole in a Previously Healthy Patient with COVID-19.

We report a case of a previously healthy 47-year-old female with syncope due to multiple episodes of nodal dysfunction and asystole. During these brief episodes, she was hypoxic in the mid-80's as a result of COVID-19 pneumonia. The patient was admitted and treated for viral pneumonia and found to have normal electrocardiograms (ECG's), normal troponin levels and a normal echocardiogram during her hospital stay.

Prehospital Efficacy and Adverse Events Associated with Bolus Dose Epinephrine in Hypotensive Patients During Ground-Based EMS Transport.

Background: The utility and efficacy of bolus dose vasopressors in hemodynamically unstable patients is well-established in the fields of general anesthesia and obstetrics. However, in the prehospital setting, minimal evidence for bolus dose vasopressor use exists and is primarily limited to critical care transport use. Hypotensive episodes, whether traumatic, peri-intubation-related, or septic, increase patient mortality.

Feasibility, Effectiveness and Safety of Prehospital Intravenous Bolus Dose Nitroglycerin in Patients with Acute Pulmonary Edema.

The necessity of rapid preload and afterload reduction in patients with decompensated congestive heart failure (CHF) and acute pulmonary edema (APE) is well established. In the hospital setting, intravenous (IV) nitroglycerin demonstrates improved patient morbidity and mortality. However, prehospital treatment is typically limited to sublingual nitroglycerin at doses that often do not affect afterload.

Motor vehicle crash fatalities among Hispanics in rural North Carolina.

Objectives: Deaths from motor vehicle crashes (MVCs) have decreased significantly over the past three decades. Unfortunately, few data have been collected regarding death rates for MVCs in minority populations. The purpose of this study was to compare the death rate of whites versus Hispanics for MVCs in a rural environment.