EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Case A 25-year-old-female presented to the ED in cardiac arrest. Summary This case exemplifies the value of POCUS in cardiac arrest patients in the ED. 2014 May;145(5):950-957.

ED 82

ED NARCAN ALS OR 82

EMDocs

OCTOBER 21, 2023

Median time from ED arrival to diagnosis was 8 hours 24 min in one study, with only 19% being diagnosed within the 4.5-hour All patients who receive thrombolytics for ischemic stroke should be admitted to a neurosurgical, neurologic, or medical ICU for management and monitoring, as this is shown to decrease mortality and length of stay.

EMS 74

EMS ALS OR ACS 74

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. To date, ketamine has been the agent of choice (12).

ED 65

ED Emergency Department ALS OR 65

REBEL EM

JANUARY 9, 2024

Bottom Line Up Top: In patients with infectious processes that are stable for discharge home, there is no role for giving a first dose of antibiotics IV in the ED. BMJ (Clinical research ed.). 2014; PMID: 25066627 Li HK et al. 2014; 32(10):1195-9. Her vitals are: HR 115, BP 120/80, Temp 102.8, O2 Sat 99% on RA, RR 18.

ALS 99

ALS ED ICU OR 99

Dr. Smith's ECG Blog

MARCH 11, 2019

The patient was managed in the ICU and had serial troponins. Here is data from a study we published in 2014 for type II NonSTEMI: Sandoval Y. He had no more ECGs recorded. Here is the patient's troponin I profile: These were interpreted as due to demand ischemia, or type II MI. First was 2.9 ng/mL and subsequentle dropped to 1.5

OR 52

OR ACS ICU STEMI 52

REBEL EM

JANUARY 25, 2023

3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 Louis, Mosby, Inc., 2010, (Ch) 92: p 1216-1227. References Taylor MR, Lalani N.

ED 52

ED ALS OR ICU 52

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. 2014 Jun 26;23(12):653-9. The Fearless Organization. British journal of nursing. 2015 May;30:656-74.

E-9-1-1 105

E-9-1-1 Critical Care CPR ICU 105

Don't Forget the Bubbles

JUNE 30, 2023

All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The ODP is caught up leaving theatres and has not yet made it down to ED. They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

EMDocs

JANUARY 6, 2024

A 64-year-old male presents by EMS to the ED with shortness of breath. You review his chart and note that he had a heart transplant in 2014 but has not followed up with a cardiologist for at least 3 years. 3,14 Always ensure that drugs administered in the ED do not interact with the patient’s transplant medications.

EMS 63

EMS E-9-1-1 ACS Coronary 63

Don't Forget the Bubbles

JANUARY 4, 2024

In 2014, the Royal College of Radiologists (RCR) Paediatric Trauma Protocols were published, recommending that CT chest imaging be appropriately limited to children in specific high-risk groups. Have the UK Pediatric Trauma Protocols resulted in a reduction in chest computed tomography imaging for children presenting with major blunt trauma?

ED 128

ED ICU ALS OR 128

Don't Forget the Bubbles

MAY 3, 2023

This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergency department (ED). During a 6-month period, paediatric patients (< 18 years old) who underwent tracheal intubation in their ED were included in the study.

CPR 52

CPR Emergency Department ALS ICU 52

AAEM RSA

APRIL 1, 2021

The authors excluded those with devastating injuries (expected to die within one hour of admission), need for thoracotomy prior to receiving blood products, significant burns (>20% total body surface area), inhalation injuries, or receiving over five minutes of cardiopulmonary resuscitation prior to arrival or in the ED. 248(3):447-58.

E-9-1-1 52

E-9-1-1 Plasma ACS ALS 52

Dr. Smith's ECG Blog

MARCH 6, 2019

She was asymptomatic at the time of this ECG recorded on arrival to our ED: What do you think? If for some reason the angiogram is delayed, they should receive maximal medical therapy in an ICU setting with continuous 12-lead ST segment monitoring under the close attention of a practitioner with advanced ECG interpretation training.

STEMI 52

STEMI ALS ACS OR 52

Don't Forget the Bubbles

JULY 5, 2023

Haematology specialist clinics are key to manage the chronic side of the disease, while ED doctors should be able to act rapidly on the common acute emergencies. with thanks A 15-month-old Kenyan boy presents to ED with right hand swelling. A 10-year-old boy with known SCA presents to ED due to severe pain in the legs.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

EMDocs

DECEMBER 18, 2023

On arrival to the ED, her blood pressure is 84/36 mmHg with a heart rate of 110 beats per minute. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. 8,9 Recently, monocyte distribution width (MDW) has shown promise in a large meta-analysis as a useful screening tool in the ED.

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65