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. Most common organism is Staph Aureus (36-67% of cases) ( Boody 2015 ).

E-9-1-1 103

E-9-1-1 ALS ED OR 103

This Podcast Will Kill You

JULY 23, 2024

Official journal of the American College of Gastroenterology| ACG , 118 (1), pp.59-76. Annals of internal medicine , 172 (1), pp.ITC1-ITC16. ” BMC medicine 17 (2019): 1-20. . ” BMC medicine 17 (2019): 1-20. 2015): 6900-6923. Gastroenterology , 160 (1), pp.63-75. Burki, Talha Khan. 2019): 100.

E-9-1-1 98

E-9-1-1 ALS OR 98

Pediatric EM Morsels

AUGUST 18, 2023

Myth #1: Musculoskeletal Adverse Events (MAE) This concern is likely the most common reason fluoroquinolones are rarely used in children. Binz 2015) Remember, dogs grow 18 times as fast an infant in the first year of life. Binz 2015) Remember, dogs grow 18 times as fast an infant in the first year of life.

E-9-1-1 130

E-9-1-1 OR ACS ALS 130

Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. Challenge QUESTION: The relative change in T-QRS-D is not the only thing that changes during period of time that passed between recording of the 2 ECGs shown in Figure-1.

E-9-1-1 123

E-9-1-1 Coronary ACS BLS 123

EMDocs

MARCH 2, 2024

Answer : Pneumocephalus 1-21 Background: Pneumocephalus is defined by the presence of air within the cranial cavity. 1-3] The most common location is the frontal region, followed by the occipital and temporal regions. [4] 1-3] The most common location is the frontal region, followed by the occipital and temporal regions. [4]

EMS 114

EMS E-9-1-1 OR ED 114

EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? Other lung fields unremarkable. C or 100.4 mg/kg, max 0.4

E-9-1-1 75

E-9-1-1 ICU ACS EMS 75

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. Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. What is typical HUS?

E-9-1-1 59

E-9-1-1 ALS OR 59

EMDocs

MAY 11, 2024

CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis? On exam, the patient opens eyes to voice, has extraocular movements intact, is unable to speak, and has 0/5 strength in all extremities. The patient was intubated for acute hypercapnic and hypoxic respiratory failure and airway protection.

EMS 89

EMS E-9-1-1 ALS OR 89

Don't Forget the Bubbles

JANUARY 17, 2024

2015 But we all know that what happens in the lab does not always mirror what happens in real life. Around 80% of those reported pass spontaneously, with another 10-20% requiring endoscopic removal and only 1% requiring surgical intervention. Roy was less than impressed when young Kendall tried to eat his Orbeez. ” ( Ed.

E-9-1-1 111

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

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. 2015 Nov 25;351. Author: Ryan Leone, MSc, Medical Student at Columbia University // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) What’s the issue?

E-9-1-1 77

E-9-1-1 Ambulance OR 77

Don't Forget the Bubbles

FEBRUARY 26, 2024

Add in PEFR <33% and SpO2 <92% Management of acute asthma* * as per BTS guidelines Acute asthma is managed in a stepwise fashion using the following guidelines. Intubation, however, can be a significant challenge in these patients.

E-9-1-1 72

E-9-1-1 Critical Care OR ALS 72

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. 2015): 83-92. Craythorne, E. International journal of dermatology, 49(9), pp.978-986. History Biology Heckman, Carolyn J., and Sharon L. Manne, eds. Shedding light on indoor tanning. Linares, M.A., Zakaria, A.

E-9-1-1 52

E-9-1-1 ALS ED OR 52

Broome Docs

JANUARY 30, 2023

PMID: 33933300 Khan A, Saleem MS, Willner KD, Sullivan L, Yu E, Mahmoud O, Alsaid A, Matsumura ME. 2022 Sep 1;5(9):e2235575. 2015 Apr;72(4):668-73. Epub 2015 Jan 23. doi: 10.1007/s00381-022-05455-1. 2015 Dec;21(6):1244-6. Epub 2015 Dec 29. N Engl J Med. 2017 Dec 7;377(23):2240-2252. Am J Emerg Med.

E-9-1-1 52

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

Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures Without Pyuria. 2024;24(1):111-118. Acad Pediatr. doi:10.1016/j.acap.2023.06.023

E-9-1-1 75

E-9-1-1 Emergency Department OR ALS 75

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. Knowledge is power.

E-9-1-1 98

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

Dr. Smith's ECG Blog

NOVEMBER 14, 2019

I’ve taken th e l ead V 3 examples in Figure-1 from previous cases posted on Dr. Smith’s ECG Blog : T OP in Figure-1 — Despite marked ST elevation in this lead V3 — this is not T-QRS-D, because there is well-defined J-point notching ( BLUE arrow ). Although simple to define — this finding may be subtle!

E-9-1-1 52

E-9-1-1 OR ED 52

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. have limited English proficiency according to the 2015 U.S. The United States does not have an official language, though English is most commonly spoken.

Emergency Department 82

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

EMDocs

JULY 3, 2023

Presentation Traumatic SAH occurs following a direct or indirect traumatic mechanism leading to TBI that allows for bleeding into the subarachnoid space. 3 Common associated injuries may include skull fractures, intracerebral contusion, cervical spine injuries, and vascular injuries of the head and neck.

ED 85

ED E-9-1-1 ALS OR 85

NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. The AHA further specifies that IV access is the preferred route; however, IO access is acceptable if unable to obtain IV access. [2] Or in other words, is IO access inferior to IV access?

E-9-1-1 52

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

Don't Forget the Bubbles

MARCH 11, 2024

Terminology Plagios is ancient Greek for oblique or slanting Cephal is Latin for head or skull. When put together as ‘plagiocephaly’, the term broadly means cranial asymmetry. Deformational plagiocephaly is due to external forces causing constraint or twisting. Possible causes include twin pregnancy, intra-uterine constraint, or sleeping position.

E-9-1-1 59

E-9-1-1 OR ED 59

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. link] Isn’t it just ‘part of the job?’ Unfortunately, incivility may be familiar in your workplace. Incivility doesn’t just affect the person on the receiving end of it.

Critical Care 97

Critical Care E-9-1-1 Paramedicine Paramedicine 97

Don't Forget the Bubbles

JANUARY 10, 2024

The study asked TWO questions: 1. Transfusion guidelines in LMICs in sub-Saharan Africa differ significantly from the Western world. However, these recommendations are only based on expert opinion and have not been systematically evaluated. Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes.

E-9-1-1 78

E-9-1-1 ALS OR Critical Care 78

ALiEM

MARCH 7, 2024

Ultrasound probes from left to right: linear (nenoates), phased array (infants/younger children), and curvilinear (older children/adolescents) Pro tips for performing renal/bladder POCUS on a child [1] Addressing potential anxiety leads to a more efficient and comfortable examination. Pre-warmed ultrasound gel is helpful when available.

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

Dr. Smith's ECG Blog

MARCH 9, 2023

He had episodes of chest pain off and on all night, until about 1 hour prior to arrival when the pain became constant, crushing, 10/10 chest pain that radiated to both arms. Proven STEMI has an open artery in 19% to 36% of cases, depending on whether it is TIMI −1, −2, or −3 flow. 25] Stone et al found that 72% have TIMI 0 or 1 flow.

E-9-1-1 52

E-9-1-1 STEMI Coronary ALS 52

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.

E-9-1-1 120

E-9-1-1 OR Coronary ACS 120

REBEL EM

MAY 27, 2024

Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). Duration of Antiarrhythmic Effect: MVM group: 35.44 seconds (SD = 7.73) Adenosine group: 24.24

OR 137

OR E-9-1-1 ED ALS 137

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

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.

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

Pediatric EM Morsels

AUGUST 4, 2023

Record, 2015) Normal aortomesenteric angle ranges from 28 o to 65 o and the normal distance from 10 to 34 mm. Oka, 2023) A systematic review linked SMA syndrome to the immediate post-operative period after surgery for scoliosis in pediatric patients, and found the mean days to onset of symptoms was 9. Record, 2015).

E-9-1-1 246

E-9-1-1 ED OR EMS 246

Don't Forget the Bubbles

JUNE 17, 2024

Riskin (2015) showed that rudeness accounted for a 12% reduction in diagnostic and procedural performance in a simulated resuscitation. Here are ten things to think about: 1. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J. cognitive rehearsal techniques ). Organizational dynamics.

E-9-1-1 105

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

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

ECG Medical Training

DECEMBER 4, 2016

Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. I’m your host Tom Bouthillet. In today’s episode I’d like to talk about mechanical CPR, which is a frequent topic of conversation in the Resuscitation group on Facebook and the #FOAMed community on Twitter.

CPR 52

CPR E-9-1-1 Defibrillator Ambulance 52

Pediatric EM Morsels

NOVEMBER 17, 2023

Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. 1994 Jul;125(1):57-62. 2019 Sep;74(9):1186-1190. 2016 Feb;30(1):3-11. Epub 2015 Aug 22. Cuffed Endotracheal Tubes: Evolution of Thought and Technology Why did we historically use uncuffed endotracheal tubes in kids younger than 8?

E-9-1-1 183

E-9-1-1 Operating Room Emergency Department ALS 183

Don't Forget the Bubbles

JUNE 30, 2023

He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. She calls out her findings: A – OK B – 1 puncture mark to the anterior left chest wall, covered with a three-sided dressing. RR 25-30. Actively oozing.

E-9-1-1 139

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

REBEL EM

FEBRUARY 5, 2024

Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Recurrence of pneumothorax within 1 year. Population: Inclusion: Patients between 18–50 years of age. Symptomatic with chest pain and/or dyspnea for < 48 hours.

E-9-1-1 104

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

Don't Forget the Bubbles

SEPTEMBER 18, 2023

However, symptoms may also be non-specific, including irritability, headache, poor feeding, vomiting, or diarrhoea. The diagnosis is clinical and can be made by directly visualising erythema or bulging of the tympanic membrane. Treatment is mainly symptomatic with analgesia. A throat culture is the gold standard for confirming a bacterial infection.

Emergency Department 142

Emergency Department E-9-1-1 ALS OR 142

EMDocs

JULY 13, 2024

Evaluate for retained products of conception as etiology Diagnosis Diagnosis of endometritis with at least two of the following: 8 Fever >100.4F Evaluate for retained products of conception as etiology Diagnosis Diagnosis of endometritis with at least two of the following: 8 Fever >100.4F

EMS 64

EMS E-9-1-1 Plasma OR 64