ALiEM

MAY 19, 2023

The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Apply traction to the tube by tying a roller bandage to the end of it and then the other end to a 1 L bag of IV fluids. Pearl 1: Check the units of pressure being used. The conversion rate is: 1 cmH2O = 0.74 1950 May;131(5):781-9.

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E-9-1-1 Emergency Department ICU OR 245

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al.

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E-9-1-1 Plasma ALS OR 145

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. ECG 1 What do you think? Grines, C.

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Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. For clarity in Figure-1 — I've reproduced the initial ECG in today's case.

E-9-1-1 113

E-9-1-1 ALS Defibrillator OR 113

Don't Forget the Bubbles

NOVEMBER 29, 2023

Intensive Care Research , 1 (3-4), pp.60-64. A 2012 study on paediatric patients showed that approximately 42% were intubated without medications, and 2% were intubated with paralysis only in the ED. Pediatric Emergency Care 28(11): p 1129-1131, November 2012. | Epub 2014 Sep 9. 2013 Jan;31(1):222-6. Burgart, A.M.

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E-9-1-1 Emergency Department ED CPR 135

REBEL EM

SEPTEMBER 13, 2023

Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation. Both conditions can range in severity from benign to life threatening (Wilkerson 2012).

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

Dr. Smith's ECG Blog

JULY 22, 2023

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year incidence of SCD in this cohort [1].

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EMDocs

SEPTEMBER 23, 2023

Answer : Brugada Syndrome Epidemiology and Etiology Rare genetic disorder that affects approximately 1 in 5,000 individuals worldwide 1. More common in males than females, with a male-to-female ratio of approximately 8:1 1. Type 1 “Brugada sign” The only type that is considered diagnostic.

E-9-1-1 105

E-9-1-1 EMS ALS Defibrillator 105

REBEL EM

AUGUST 30, 2023

Epidemiology 1 to 2.4 cases per 100,000 people ( Zimmerli 2010 ) More common in males with M:F of 3:1 Rate is also increasing due to increased number of spinal procedures Typically affects adults, with most cases occurring in patients over 50 years old. Other pathogens include: E. Often used interchangeably with osteomyelitis.

E-9-1-1 100

E-9-1-1 ALS ED OR 100

Don't Forget the Bubbles

JANUARY 17, 2024

Around 80% of those reported pass spontaneously, with another 10-20% requiring endoscopic removal and only 1% requiring surgical intervention. Mirza and Sheikh reported perhaps the first unfortunate case in 2012. In 2012, one brand of SAP beads – Water Balz – was recalled by the U.S. 2012 Jan;3(1):6.

E-9-1-1 111

E-9-1-1 ALS Emergency Department OR 111

This Podcast Will Kill You

JANUARY 16, 2024

2012): 865-872. Manaresi, E. Pt 9 (2008): 2280. 2012): e1002666. Adeno-associated virus 2 infection in children with non-A–E hepatitis. ” Parvoviruses 1 (2006): 5-14. History Biology Allison, Andrew B., ” Journal of virology 86.2 Heegaard, E.D. and Brown, K.E., Human parvovirus B19. Kabir, M.H.

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EMDocs

SEPTEMBER 7, 2024

1 Risk Factors: 1-4 Spontaneous Anticoagulants (Apixaban, Rivaroxaban, etc.) Older Age (median age of 70 years) 1 Abnormal vasculature/neoplasm of the kidney (e.g., 5 Clinical Presentation: 1-3 Variable presentation but may present with dropping hemoglobin/hematocrit without other findings in spontaneous cases.

EMS 97

EMS E-9-1-1 Operating Room OR 97

EMDocs

JULY 13, 2024

1997 Mar;11(1):203-22. 2012 May;27(5):1368-74. Epub 2012 Mar 14. 1985 Dec 1;153(7):737-9. 1985 Dec 1;153(7):737-9. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. 2024, [link] Mackeen AD, Packard RE, Ota E, Speer L. Infect Dis Obstet Gynecol. 2000;8(2):77-82. PMID: 10805361; PMCID: PMC1784665.

EMS 89

EMS E-9-1-1 Plasma OR 89

EMDocs

JANUARY 17, 2024

1) There are a limited number of antitussives on the US market which include benzonatate, codeine, dextromethorphan, diphenhydramine, and hydrocodone. 9) The safety announcement highlighted the mortality risk of exploratory ingestions in children under 10 years. 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

E-9-1-1 89

E-9-1-1 Overdose Emergency Medical Services Life Support 89

EMDocs

MAY 11, 2024

CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis? Updated November 9, 2023. Epub 2019 Dec 9. On exam, the patient opens eyes to voice, has extraocular movements intact, is unable to speak, and has 0/5 strength in all extremities. Available from: [link] Guy-Evans, Olivia.

EMS 110

EMS E-9-1-1 ALS OR 110

FOAMfrat

MAY 19, 2024

While transporting to the emergency department, the patient’s mother informed me that PDCD affects less than 1 in 50,000 individuals and is more common in males than females. The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. 2012 Jan.

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E-9-1-1 ALS Emergency Department EMT 98

EMDocs

FEBRUARY 7, 2024

Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. 2023 October 9. 2012 Feb 1;4(1):127-57. Essex R, Weldon SM, Thompson T, Kalocsányiová E, McCrone P, Deb S. 2013 Dec;14:1-0. 2022 Nov 9. January 23, 2024. Retrieved from: [link] Fischer S.

E-9-1-1 98

E-9-1-1 Ambulance OR 98

Don't Forget the Bubbles

DECEMBER 16, 2024

Coverage of the 6-in-1 vaccine measured at 12 months of age in England for Q4 2023 to 2024 Source: ONS under the Open Government License v3.0 Young infants and immunosuppressed individuals are particularly at risk of severe disease, resulting in significant morbidity and associated mortality rates of 1-3 per 1,000 cases.

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E-9-1-1 OR ALS Emergency Department 59

Don't Forget the Bubbles

MARCH 18, 2024

The Royal Children’s Hospital in Melbourne summarises them in an easy-to-follow flow diagram (figure 1). Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. Blood tests Urine Stool Full blood count with blood film Urinalysis Stool MC&S Coagulation Urine MC&S E.

E-9-1-1 59

E-9-1-1 ALS OR 59

This Podcast Will Kill You

OCTOBER 24, 2023

2005): 1-6. Bulletin of Science, Technology & Society , 25 (1), pp.37-45. “Insecticide toxicology, mammalian toxicity of 1-naphthyl-N-methylcarbamate (Sevin insecticide).” Stewart, Nelson E., “Acute toxicity of the insecticide Sevin® and its hydrolytic product 1-naphthol to some marine organisms.”

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E-9-1-1 ED ALS 52

ACEP Now

FEBRUARY 13, 2024

A radiograph is shown (see figure 1). LEARN MORE The most common nerve blocks in this study are shown in Table 1. 1–4 Emergency physicians commonly prescribe opioid pain medications, and there is significant variability among prescribing patterns. 2023 Sep 2;15(9):e44583. 2024 Jan;83(1):14-21. 2016;129(2):221.e21–221.e30.

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E-9-1-1 Emergency Department ED ALS 52

Don't Forget the Bubbles

MAY 29, 2023

A study of teams over a 1-year period highlights that people witnessing incivility are also affected, which could lead to individuals feeling unsupported in their teams. 2021:36:1–2, NP448–NP473 Available at. Review of Cultivating Communities of Practice: A Guide to Managing Knowledge, by Wenger E, McDermott R, Snyder WM].

Critical Care 98

Critical Care E-9-1-1 Paramedicine Paramedicine 98

EMDocs

AUGUST 22, 2024

1 However, we recognize that many patients prefer to speak a language other than English regardless of their English proficiency, and this does not indicate a deficiency. 9 Less likely to be satisfied with their care and have a lower understanding of their discharge instructions. Karliner L, Jacobs E, et al. Lion KC, et al.

Emergency Department 104

Emergency Department ALS E-9-1-1 ED 104

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

To me, it was clearly atrial flutter with 1:1 conduction. Continue Eliquis 5mg BID, should be continued for 3 months == MY Comment , by K EN G RAUER, MD ( 9/18 /2024 ): == I found the following aspects of today's case of special interest. Why did Dr. Smith immediately say the rhythm was AFlutter with 1:1 AV conduction?

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E-9-1-1 ALS OR ED 64

Dr. Smith's ECG Blog

JANUARY 30, 2019

The pattern of STE and STD reminded us of Brugada Type 1 morphology. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year incidence of SCD in this cohort [1].

E-9-1-1 52

E-9-1-1 CAD STEMI OR 52

FOAMfrat

OCTOBER 20, 2023

As reported within the 6th edition Manual of Emergency Airway Management, there are cardiac arrest rates between 1% and 4%, with other complications (mostly hypoxemia and hypotension) as high as 30% in patients with first-pass success [1, pg 29; 4-10]. Recommendations : 1. Why is Physiologic Optimization Important?

E-9-1-1 52

E-9-1-1 ALS ACS OR 52

This Podcast Will Kill You

NOVEMBER 7, 2023

New England Journal of Medicine, 355(1), pp.51-65. Nature reviews Disease primers, 1(1), pp.1-20. Craythorne, E. 2012): 114. International journal of dermatology, 49(9), pp.978-986. Public Health Research & Practice, 32(1). Drissi, Madeeha, Emily Carr, and Chad Housewright. Miller, A.J.

E-9-1-1 52

E-9-1-1 ALS ED OR 52

NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. 1] Table from Hamam et al. 9] Figure from Clemency et al. 1] References 1. Fowler R, Gallagher JV, Isaacs SM, Ossman E, Pepe P, Wayne M. Resuscitation.

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E-9-1-1 Advanced Life Support Epinephrine Life Support 52

FOAMfrat

JULY 1, 2023

In fact, Herbstritt 2012, identified that there was "no significant difference to time to intubate, intubating conditions, or intubating success rate when using 1 to 1.2 mg/kg Rocuronium versus 1 to 1.5 mg/kg Rocuronium versus 1 to 1.5 E1, March 01, 2012. 2012 Mar;29(3):256-8. 2012 Mar;59(3):165-75.e1.

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E-9-1-1 Emergency Department OR ALS 52

ECG & Echo Learning

OCTOBER 2, 2022

Most agents exhibit both vasopressor and inotropic effects (Figure 1). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 mg (max 1 mg) Safe for peripheral use ++ + N/A Beta-effect more pronounced at low doses. De Backer D, Creteur J, Silva E, Vincent JL. Kill C, Wranze E, Wulf H.

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E-9-1-1 ALS Coronary Epinephrine 52

Don't Forget the Bubbles

MARCH 11, 2024

New York, USA: The International Society for Pediatric Neurosurgery, 2024 (Accessed January 9, 2024). link] Mitchell, E. Pediatric Annals, 52(1), e10–e17. References The ISPN Guide to Pediatric Neurosurgery (USA): Positional Plagiocephaly in Children Homepage. Bialocerkowski, A. Vladusic, S. L., & Wei Ng, C. Vollman, A.

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E-9-1-1 OR ED 59

NAEMSP

APRIL 19, 2023

This CI does include 1; and further and further analysis of the data showed that the likelihood that calcium has a beneficial effect (e.g. The overall conclusion was that as less than 1% of cardiac arrest etiologies fall into a group that would potentially benefit from calcium, that routine use should be avoided (Padrao, et.

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E-9-1-1 Advanced Life Support Overdose CPR 52

AAEM RSA

AUGUST 27, 2020

1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Kirkegaard H, Soreide E, de Haas, I et al. De Fazio C, Skrifvars MB, Soreide E et al. 2019;23(1):1–9.

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

There are two main etiologies of ischemic ST-depression: 1) subendocardial ischemia 2) reciprocal to ST-elevation in an opposite wall Here there are distinct R-waves with marked ST-depression throughout most of the precordium. Tips for recognizing Acute Posterior STEMI: 1. References: 1. This can help in confirmation.

STEMI 52

STEMI E-9-1-1 Coronary ALS 52

REBEL EM

JANUARY 19, 2023

Patients were randomly assigned 1:1 to treatment with either an ambulatory device or standard guideline-based management (aspiration, standard chest tube insertion, or both). Patients were observed for 1-2 hours for clinical stability, and placement was confirmed with a chest x-ray. 2013 Jul;68(7):664-9. Epub 2013 Mar 20.

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E-9-1-1 OR ALS EMS 52

REBEL EM

DECEMBER 28, 2022

Conducted at 2 US Veterans Affairs medical centers from 2012–2019. Approx 1 in 4 (23%) patients with a urine culture had no bacterial growth, which may dilute any effect of treatment duration or choice of agent. Approx 1 in 4 patients (23%) with a urine culture had no growth. 2016;57(9):485-490. 2017;15(1):70.

E-9-1-1 52

E-9-1-1 ALS OR EMS 52

REBEL EM

MARCH 13, 2023

The search contained terms for (1) prehospital cardiac arrest or prehospital advanced life support, and (2) injuries and trauma. Grasner 2011; Zwingmann 2012) Their data pools overlap considerably with previous studies; it would have been concerning if the data differed significantly. 2012 Jul 6;16(4):R117. A systematic review.

Advanced Life Support 52

Advanced Life Support Life Support E-9-1-1 EMS 52