Core EM

OCTOBER 16, 2024

Philadelphia, PA: Elsevier; 2014:75-80. Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3%

Allergic Reaction 145

Allergic Reaction Plasma ED Epinephrine 145

EMDocs

APRIL 2, 2024

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

CPR 92

CPR STEMI Epinephrine ICU 92

Core EM

OCTOBER 2, 2024

Philadelphia, PA: Elsevier; 2014:75-80. Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3%

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

The Skeptics' Guide to EM

DECEMBER 16, 2017

He is now stabilized, fosphenytoin is being infused, you are getting ready to ship him to the neuro-ICU and wonder if cooling him down would help. His oxygen saturation begins to drop and you decide to intubate and mechanically ventilate. Background: We have covered hypothermia a number of times on the SGEM.

ALS 100

ALS ICU Emergency Department Paramedic 100

EMDocs

JUNE 27, 2024

2014 Feb;69(2):144-51. May substitute levofloxacin if allergic to cephalosporin Anti-viral medications if indicated Oseltamivir for influenza Patients >14 days old Remdesivir for COVID Patients >28 days old and at least 7lbs (3.2 Epub 2013 Aug 7. PMID: 23925645 Davila J, O’Brien SH, Mitchell WB, Manwani D.

E-9-1-1 75

E-9-1-1 ICU ACS EMS 75

Pediatric EM Morsels

MARCH 17, 2023

In the US, the venomous snakes include rattlesnakes , copperheads, cottonmouths/water moccasins , and coral snakes [ CDC, 2021 ] Rattlesnakes live all across the United State s Copperheads inhabit the eastern U.S. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S.

Frozen Plasma 130

Frozen Plasma Plasma First Aid OR 130

EMDocs

JUNE 7, 2023

Disposition is often admission to an intensive care unit (ICU) setting. Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Iran Red Crescent Med J 16: e5072, 2014. Airway management should not be delayed. BMC Res Notes. 2013; 6:524.

E-9-1-1 83

E-9-1-1 ICU Emergency Department ED 83

Don't Forget the Bubbles

JUNE 17, 2024

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. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. How do you manage this situation? The Fearless Organization.

E-9-1-1 105

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

EMDocs

NOVEMBER 1, 2023

Disposition : Admission to ICU with potential GI, IR, and/or surgical management. McGraw-Hill Education; 2014. May not be an option. If there will be a delay in definitive management and there is evidence of intra-thoracic gastric contents, consider chest tube placement. Esophageal Perforation. Accessed September 30, 2023.

Critical Care 66

Critical Care ED EMS OR 66

REBEL EM

JANUARY 25, 2023

Emery Med J 2014; 31(3): 248-9. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

ED 52

ED ALS OR ICU 52

EMDocs

OCTOBER 21, 2023

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. link] Published January 2014. Epub 2014 Dec 4. 2012;43(6):1484-1489. doi:10.1161/STROKEAHA.111.646414 ResearchGate.

EMS 73

EMS ALS OR ACS 73

AAEM RSA

AUGUST 27, 2020

The 48-hour group had a significantly longer length of stay in the ICU and time on mechanical ventilation amongst survivors, both of which were expected since they were kept at target temperature for longer, requiring more resources. The trial was conducted in 25 ICUs in France between 2014 and 2018. C to a goal of 36.5

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

EMDocs

APRIL 22, 2024

2014 May;145(5):950-957. Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., Accuracy of point-of-care multiorgan ultrasonography for the diagnosis of pulmonary embolism. doi: 10.1378/chest.13-1087. PMID: 24092475. Marino, P. Tintinalli, J.E.

ED 81

ED NARCAN ALS OR 81

Don't Forget the Bubbles

JUNE 30, 2023

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. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. 2014 Sep;45(9):1287-95.

E-9-1-1 139

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

EMDocs

SEPTEMBER 25, 2023

Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19). PLoS One 2014; 9(11): e112779. Epub 2014 Feb 17. Resuscitation 2013; 84(11): 1500 – 4. PMID: 23911630 Kim WY et al. J Intensive Care Med.

ED 65

ED Emergency Department ALS Paramedic 65

Don't Forget the Bubbles

JULY 5, 2023

They should be admitted to hospital in case of clinical deterioration to receive ICU treatment. This treatment is usually done in the ICU setting. Blood transfusions are indicated in major surgical procedures, acute priapism > 3 hours not responsive to treatment, severe acute chest syndrome with hypoxia requiring ICU.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

AAEM RSA

APRIL 1, 2021

There was no difference in the secondary outcomes of time to hemostasis, ventilator-free days, ICU-free days, disposition at 30 days, incidence of primary surgical procedures, and functional status at hospital discharge (measured as Glasgow Outcome Scale-Extended Score). link] Published October 2014. vs. 78.1%, p=0.006). 248(3):447-58.

E-9-1-1 52

E-9-1-1 Plasma ACS ALS 52

ECG & Echo Learning

OCTOBER 2, 2022

Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). J Cardiovasc Pharmacol Therap (2014). Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome. Circulation 2011. Jentzer et al. Vasopressors for shock.

E-9-1-1 52

E-9-1-1 ALS Coronary Epinephrine 52

EMDocs

FEBRUARY 12, 2024

In this situation, an ABG should be obtained periodically for correlation, though this is more relevant for the intensive care unit (ICU) setting than in routine ED care (5, 9). 2014 Feb;19(2):168-175. Epub 2014 Jan 3. 2014 Apr;21(2):81-8. 2014 Jul;20(4):236-40. A systematic review and meta-analysis. Respirology.

Emergency Department 93

Emergency Department E-9-1-1 ED ICU 93

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

Dr. Smith's ECG Blog

MARCH 6, 2019

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. J of National Association of EMS Physicians 2014. Meisel et al.

STEMI 52

STEMI ALS ACS OR 52

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 129

ED ICU ALS OR 129

AAEM RSA

SEPTEMBER 17, 2020

All treatments were given for the assigned time frame or until ICU discharge, whichever came first. In the control group, patients treated for severe sepsis or septic shock in the year prior to the initiation of triple therapy, hydrocortisone was used at the discretion of the intensive care unit (ICU) attending.

ICU 52

ICU E-9-1-1 ALS OR 52

Don't Forget the Bubbles

MAY 3, 2023

This explorative review described insertion success rates, time to first insertion, and duration of IO function (time from insertion to IO failure, IV access insertion, transfer to ICU, or death). Garabon et al. demonstrated a first-attempt success rate of 71% in all ages and an overall success rate in 83% of cases. Why does it matter?

CPR 52

CPR Emergency Department ALS ICU 52

EMDocs

JANUARY 6, 2024

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. Cardiogenic shock in the setting of acute rejection would warrant inotropic agents and ICU admission (C) , but these would not be indicated in cases of mild rejection, such as in this patient.

EMS 63

EMS E-9-1-1 ACS Coronary 63

EMDocs

DECEMBER 18, 2023

Disposition The SSC guidelines suggest that patients with septic shock or critical illness be moved to the intensive care unit (ICU) within six hours of presentation to the ED. Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009–2014. Restriction of Intravenous Fluid in ICU Patients with Septic Shock.

E-9-1-1 65

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

REBEL EM

NOVEMBER 11, 2024

What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. Imbalances Between Treatment Groups : ICU Admissions : Higher in piperacillin-tazobactam (33% vs. 30%). Sex : More males in piperacillin-tazobactam (57.1%

E-9-1-1 84

E-9-1-1 ALS ICU Critical Care 84