Pediatric EM Morsels

OCTOBER 27, 2023

Rosenburg 2010] B-L system is designed for 12yo and younger, patients up to 80 lbs, height 46-143 cm [Meguerdichian 2012] Estimates the 50%ile weight for height (Length vs Ideal Body Weight). Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. x exp[0.02

E-9-1-1 268

E-9-1-1 Emergency Medical Services Life Support ALS 268

ALiEM

SEPTEMBER 27, 2023

2012 Jul;64(3):520-39. Disulfiram-like reaction with ethanol consumption Coprinus atramentarius or Ink Cap mushroom is well known to cause a disulfiram-like reaction when it is consumed prior to ethanol. This results in significant nausea and vomiting and can lead to tachycardia and hypotension. In: Goldfrank’ s Toxicologic Emergencies.

ALS 169

ALS OR ED 169

REBEL EM

JANUARY 24, 2024

You will notice the squeeze will cause no motion if there is a full rupture/tear, and diminished motion if there is a partial tear Performance Characteristics ( Garras 2012 ) Sensitivity Specificity (+) LR (-) LR 96-100% 93-100% 13.7 Take Home Points Achilles tendon rupture is a clinical diagnosis. Weakness with plantar flexion.

ALS 103

ALS ED OR EMS 103

EMDocs

AUGUST 22, 2024

6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. One cohort study in a public ED found that 84.5%

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

The Skeptics' Guide to EM

APRIL 8, 2023

John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. This is an SGEM Xtra episode.

Emergency Department 139

Emergency Department ED Ambulance ALS 139

The Skeptics' Guide to EM

AUGUST 17, 2019

ED physicians are among the most frequent prescribers of opioids. Pain 2012). ACEP has a clinical policy regarding prescribing of opioids for adult ED patients that was published in 2012 ( Cantrill et al ). Volkow et al. JAMA 2011). Platts-Mills TF, et al.

Emergency Department 130

Emergency Department ALS ED OR 130

Core EM

JULY 23, 2024

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. 10-Hour Flight: 0.03

ALS 130

ALS OR Emergency Department ED 130

Core EM

MARCH 12, 2024

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. 10-Hour Flight: 0.03

ALS 130

ALS OR Emergency Department ED 130

The Skeptics' Guide to EM

JANUARY 14, 2018

Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. One issue that has been to use CT or ultrasound for the diagnosis.

Emergency Department 130

Emergency Department ALS ED OR 130

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

Don't Forget the Bubbles

AUGUST 23, 2023

Very rarely are the ED team allowed to stand, in silence, with a purpose. 2012) “Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue”. 2012) “Implementation of a Rapid Post-Code Debrief Quality Improvement Project in a Community Emergency Department Setting”. Or exhausted from it.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

EMDocs

NOVEMBER 7, 2023

For more on the ED evaluation of diverticulitis, please see Part 1. 2012 Apr;99(4):532-9. Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we discuss the controversy of antibiotics for patients with uncomplicated diverticulitis. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br  Br J Surg.

ACPE 88

ACPE ALS OR ED 88

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. On ED presentation, he was experiencing 10 out of 10 pain level. Trends in opioid prescriptions among part D medicare recipients from 2007 to 2012. A radiograph is shown (see figure 1). Problem How should his pain be managed? Goodwin J.

E-9-1-1 52

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

REBEL EM

AUGUST 30, 2023

REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Classified as either acute (days), subacute (weeks) or chronic (months) Spondylodiscitis: a term encompassing osteomyelitis, spondylitis and discitis.

E-9-1-1 102

E-9-1-1 ALS ED OR 102

REBEL EM

JULY 20, 2022

Take Home Points SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation. The rate of concurrent DVT and PE in patients with SVT is 25% and 5%, respectively. REBEL Core Cast 85.0 – Superficial Venous Thrombosis Click here for Direct Download of the Podcast Definition: The presence of a clot in a superficial vein.

ALS 52

ALS OR ED EMS 52

REBEL EM

FEBRUARY 8, 2023

Surv Ophthalmol 2012; 57(5):448-462. Epidemiology: Most frequent cause of corneal blindness in the United States Most common source of infectious blindness in the Western world. However, the American Academy of Ophthalmology recommends treatment of epithelial keratitis to prevent recurrence and progression to stromal or endothelial keratitis.

ALS 52

ALS OR EMS ED 52

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission. The Emergency Medical Treatment and Labor Act (EMTALA) mandates examination, treatment, and stabilization of anyone who comes to the ED.

Emergency Department 52

Emergency Department ED ALS OR 52

EMDocs

SEPTEMBER 7, 2024

A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank.

EMS 75

EMS E-9-1-1 Operating Room OR 75

EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Because the RT responsible for drawing arterial blood gases is busy caring for these patients, ABGs will be delayed.

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

The Overrun Podcast

JULY 21, 2019

Ed, Mike and Dan get nerdy again talking about IV fluids and vasopressors! What works, why, and what do you need to know about the stuff we put into patients…and why it may be hurting more than helping! per cent salt solution is neither “normal” nor physiological. per cent salt solution is neither “normal” nor physiological.

ED 52

ED OR 52

EMS 12-Lead

JUNE 20, 2022

Here is the final ECG just prior to ED transfer. Attached below is the initial ED tracing upon hospital arrival, approximately 25 minutes after the prehospital ECG. CASE 1 A 45 y/o Male called 911 for new onset central chest discomfort, non-radiating, 5/10 pain scale, and without any vomiting, diaphoresis, or pallor.

ACS 130

ACS Coronary STEMI CAD 130

Don't Forget the Bubbles

JANUARY 17, 2024

” ( Ed. 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. Roy was less than impressed when young Kendall tried to eat his Orbeez. Alharbi and Dabbour report a similar case to our fictitious one.

E-9-1-1 111

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

EMDocs

OCTOBER 5, 2024

4 The incidence of ESBL-E identified in bacterial cultures in the United States increased by 53% from 2012 to 2017. They are found primarily in hospital specimens but are increasing in frequency in samples from the community. Increased incidence is largely due to increasing community spread. IV fluid resuscitation as needed.

E-9-1-1 74

E-9-1-1 EMS ALS OR 74

REBEL EM

MARCH 8, 2023

et al, Emergency Medicine Clinical Essentials ed 2. Eye Emergencies, in Tintinalli J et al (eds): Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, Seventh Edition New York City: McGraw-Hill 2016 (Ch) 241 Guluma K, Lee JE. Ophthalmology, in Marx J et al (eds): Rosens Emergency Medicine: Concepts and Practice, ed 9.

Emergency Department 52

Emergency Department ALS ED OR 52

Don't Forget the Bubbles

SEPTEMBER 27, 2023

Jamie is admitted to the Paediatric Ward, and the paediatric trainee calls the ED to ask if a viral respiratory panel was obtained. SpO2 is 88%. Jamie does not improve after receiving nebulized salbutamol and low-flow O2 via mask. What do the guidelines say? What is the evidence for avoiding respiratory viral panels (RVP)? cystic fibrosis).

Emergency Department 84

Emergency Department ALS ED OR 84

EMDocs

SEPTEMBER 9, 2023

He presents to the ED with profound difficulty extending his middle and ring finger. Examination reveals the following: What is the diagnosis?

EMS 78

EMS ED ALS Emergency Department 78

ACEP Now

MARCH 15, 2024

A 20-year-old man presents to the emergency department (ED) directly from the scene of a fall from a bicycle, where he lost balance and landed on his outstretched hand. 6 A missed DRUJ injury may lead to chronic wrist supination deficit and pain, which can be prevented with surgery in some cases, so early diagnosis in the ED is important.

ALS 52

ALS ED OR EMS 52

EMDocs

MAY 11, 2024

A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. We’ll keep it short, while you keep that EM brain sharp. Vital signs include BP 168/89, HR 96, T 98.3,

EMS 89

EMS E-9-1-1 ALS OR 89

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Imagine you just started your ED shift. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician. It's a busy Friday afternoon. All of the patients presented with chest pain , and they are all in triage. See these multiple cases. There is SR.

ED 103

ED Coronary OR 103

EMDocs

JANUARY 17, 2024

She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). Upon ED arrival, she had a heart rate (HR) of 160 and blood pressure (BP) of 80s/40s. 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

E-9-1-1 67

E-9-1-1 Overdose Emergency Medical Services Life Support 67

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

He was brought to the ED. Appropriately, the medics electrically cardioverted immediately. They did not feel they had time to sedate. He cardioverted to sinus rhythm, and a 12-lead was obtained. What is the diagnosis from the above rhythm strip? To me, it was clearly atrial flutter with 1:1 conduction.

E-9-1-1 66

E-9-1-1 ALS OR ED 66

Don't Forget the Bubbles

MARCH 11, 2024

A 4-month-old boy presents to the paediatric ED. His parents are concerned about the appearance and shape of his head. They ask how this can be fixed. Before we get into the clinical case, let’s consider some anatomy and background. Terminology Plagios is ancient Greek for oblique or slanting Cephal is Latin for head or skull.

E-9-1-1 59

E-9-1-1 OR ED 59

Dr. Smith's ECG Blog

MAY 21, 2023

Here is the first ED ECG: COMPUTER INTERPRETATION: Electronic Atrial Pacemaker. An elderly patient had a fall from probable syncope, and could not get up. He complained of weakness and shortness of breath, but no CP. Vital signs were normal. Marked ST Elevation, ACUTE MI What do you think? First, the QRS is incredibly wide!

ALS 68

ALS OR ED 68

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." Smith comment: But the tests (ECG and troponin) are extremely specific and so the post test probability is nearly 100%. Repeat cTnI drawn at around 8 AM was 3.910 ng/mL. This patient was not one of the lucky 6.4%

E-9-1-1 111

E-9-1-1 OR Coronary ACS 111

AAEM RSA

DECEMBER 1, 2020

Most emergency departments (EDs) already have disaster plans outlining how they will respond to a sudden influx of critically ill patients. Yet, we must also be cognizant that the surge preparedness of other units will affect the ability of the ED to operate efficiently. Updated February 14, 2012. into temporary treatment areas.

ED 52

ED Emergency Department ALS OR 52

ACEP Now

OCTOBER 9, 2023

Clinical Case Your next patient is a Spanish-speaking 24-year-old female who begins by telling you that she is embarazada. Census Bureau, 60.6 million Americans (approximately 20.8 1,2 Medical interpreters (as opposed to translators who work with the written word), are essential to bridging the language gap. emergencies, patient’s request).

Emergency Department 64

Emergency Department E-9-1-1 ALS OR 64

Dr. Smith's ECG Blog

MAY 8, 2023

Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. I cannot be anything else.

STEMI 52

STEMI Coronary ED ACS 52