2016 - Paramedicine Now

2016

EM Cases Best of 2016 Top Ten

Emergency Medicine Cases

JANUARY 3, 2017

The year 2016 was one of the most productive one in the entire 7 year history of EM Cases with a total of 29 podcast releases, the introduction of the CritCases blog, the Q & A Pearl of the Week, Just The Nuggets emails, BEEM Cases, the expansion of the Waiting to Be Seen blog, the second EM Cases Digest ebook and the first ever EM Cases Course.

EMS

EMS Overdose

Congenital Pulmonary Airway Malformation (CPAM)

Pediatric EM Morsels

JUNE 30, 2023

Prenatal and Postanatal Management of Congenital Pulmonary Airway Malformation. Neonatology. Apr 110 (2): 101-15. PMID: 27070354 Mehta AA, Viswanathan N, Vasudevan AK, Paulose, R, Abraham, M. Congential Cystic Adenomatoid Malformation: A Teritriay Care Hospital Experience. J Clin Diagn Res. Nov: 10 (11): SC01-SC04.

E-9-1-1

E-9-1-1 ED EMS OR

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Trending Sources

Podcast 186.0: Hypocalcemia

Core EM

JANUARY 25, 2024

2016, January 27). Pfenning CL, Slovis CM: Electrolyte Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Louis, Mosby, Inc., 2014, (Ch) 125: p 1636-53. Swaminathan, A. Hypocalcemia. Retrieved April 29, 2022, from [link] Vantour L, Goltzman D.

Critical Care

Critical Care ED ALS OR

Imported Malaria

Pediatric EM Morsels

NOVEMBER 3, 2023

2016 Apr; 32(4): 227–231. Worldwide, children <5 years old account for 76% of deaths related to malaria, but these are predominantly in Sub-Saharan Africa (WHO 2022) P. vivax , P. malariae , and the less common P. knowlesi and P. simium (Forgie 2022) P. vivax and P. falciparum parasitemia , and no other defined cause of AMS (WHO 2023).

ALS

ALS Critical Care EMS OR

Morel-Lavallée Lesion in Children

Pediatric EM Morsels

JUNE 16, 2023

Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Overdose

Overdose OR Critical Care ALS

Acute Transverse Myelitis in Children

Pediatric EM Morsels

JUNE 14, 2024

(Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g.

Plasma

Plasma ALS OR EMS

Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Pediatric EM Morsels

AUGUST 4, 2023

Reece, 2016) There is multiple cases of sudden death from undiagnosed SMA syndrome in the literature attributed to a variety of causes at autopsy. 2016: 7809281. Ganss, 2018) At least one case of abdominal compartment syndrome noted in the literature. The Oschner Journal. 15(1):74-78. PMID: 25829884 Reece K, Day R, Welch J.

E-9-1-1

E-9-1-1 ED OR EMS

Traveling Ticks: Tickborne Illnesses and International Travel

Pediatric EM Morsels

APRIL 5, 2024

Climate change and changes in land usage have contributed to an expanded range of ticks (Beard 2016). 2016 Apr 26;315(16):1767-77. Traveling Ticks are more than just ticking off a checklist before you get ready to travel! There are species of ticks found on every continent and carrying a variety of vectors capable of infecting humans.

E-9-1-1

E-9-1-1 ALS OR EMS

SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess

The Skeptics' Guide to EM

OCTOBER 21, 2023

Population: Adults attending at continuously-staffed EDs in a health network covering 15 states, 2016-19. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023.

Emergency Department

Emergency Department ALS ED OR

Winter event season 2016-17

Paramedics Unlimited

MAY 14, 2017

Wow, we’ve had a wild and fun winter event season. We’ve so enjoyed delivering top notch medical standby at a variety of events throughout the valley, and beyond our valley! This season has seen so many different kinds of events, from medical standby at rappeling to conference and dinner functions.

Fluoroquinolone Use In Children

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) Ciprofloxacin was the first fluoroquinolone approved by the FDA in the 1980’s as a broad-spectrum antibiotic. Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs. 2016 138(5):e20162706.

E-9-1-1

E-9-1-1 ACS OR ALS

SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

The Skeptics' Guide to EM

JUNE 4, 2017

Lancet August 2016. Lancet August 2016. Lancet August 2016. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial.

OR ALS CPR ICU

SGEM#182: Platelet Transfusions for Intracerebral Hemorrhage (PATCH) – Don’t Do It.

The Skeptics' Guide to EM

JUNE 11, 2017

Lancet 2016. Lancet 2016. Lancet 2016. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. first appeared on The Skeptics Guide to Emergency Medicine.

ALS

ALS OR EMS

The Broselow-Luten System

Pediatric EM Morsels

OCTOBER 27, 2023

Bowen 2016] Moral of the Morsel: Weight Matters! [Khouli 2015] In South Sudan, the Broselow system overestimated weight by 26.6% in malnourished children and by 16.6% in non-malnourished children. The authors recommended alternate methods to estimate weights and doses of medications in low to middle income countries. x exp[0.02 x exp[0.02

E-9-1-1

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

5 Min Sono – Pericardiocentesis (2024)

Core Ultrasound

APRIL 1, 2024

Pericardial effusion Old 5MS vid (2016) Pericardial Tamponade Courses The post 5 Min Sono – Pericardiocentesis (2024) first appeared on Core Ultrasound.

SGEM#194: Highway to the Dexamethasone – For Pediatric Asthma Exacerbations

The Skeptics' Guide to EM

NOVEMBER 11, 2017

Ann Emerg Med 2016 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine provider who works at Harlem Hospital Center in New York and Children’s […] The post SGEM#194: Highway to the Dexamethasone – For Pediatric Asthma Exacerbations first appeared on The Skeptics Guide to Emergency Medicine. Intervention Dexamethasone (DEX) 0.3

Emergency Department

Emergency Department ALS OR

Glasgow Coma Scale in Children

Pediatric EM Morsels

JULY 21, 2023

2016 Aug;23(8):878-84. Epub 2016 Aug 1. Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Acad Emerg Med. doi: 10.1111/acem.13014. PMID: 27197686. Holmes, James F et al. 2005): 814–819.

Critical Care

Critical Care ALS OR Life Support

Elbow Dislocations

REBEL EM

NOVEMBER 6, 2024

2016 Jan 6;17:6-11. 2016 Jul;24(7):413-23. Multiple Concomitant Injuries in One Upper Extremity: A Case Report. Am J Case Rep. doi: 10.12659/ajcr.894984. PMID: 26732673 Akhondi H, Varacallo M. Anterior Interosseous Syndrome. 2023 Aug 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Shoulder Elbow.

E-9-1-1

E-9-1-1 ACS OR Emergency Department

ACMT Toxicology Visual Pearl: Salt, not Shock

ALiEM

FEBRUARY 20, 2024

2016 Mar;12(1):121-9. Acute Card Care. 2013 Dec;15(4):90-2. doi: 10.3109/17482941.2013.841949. Epub 2013 Nov 7. PMID: 24200150. Bruccoleri RE, Burns MM. A Literature Review of the Use of Sodium Bicarbonate for the Treatment of QRS Widening. J Med Toxicol. doi: 10.1007/s13181-015-0483-y. PMID: 26159649 ; PMCID: PMC4781799.

Life Support

Life Support Overdose ED

EM Notes – Adult Cardiac Arrest

EMergucate

MAY 30, 2016

ANZCOR Cardiac Arrest Flowchart Reviewed: 16 August, 2016

EMS

PEM POCUS Series: Soft Tissue Ultrasound

ALiEM

MAY 13, 2024

Acad Emerg Med 2016 [7] 800 Systematic review of adult and pediatric (patients from birth – 21yrs) studies 97% (94-98%) 83% (75-88%) POCUS may assist physicians in distinguishing cellulitis versus abscess. 2016 Nov;23(11):1298-1306. Epub 2016 Nov 1. 2016 Feb;169:122-7.e1. Lam et al., 94.7%) 80% (70.0-87.4%)

E-9-1-1

E-9-1-1 ALS Emergency Department OR

Imaging Case of the Week 202

EMergucate

APRIL 24, 2016

Answer will be posted on 27/04/2016. A 79 year old with bloody diarrhoea has the following abdominal x-ray. What can be noted?

EMS

Low dose rivaroxaban plus aspirin reduce mortality and morbidity in cardiovascular high risk pt

EMergucate

SEPTEMBER 21, 2021

Compass trial Design– double-blind trial involving placebo medication vs study medication, March 2013 to May 2016. Rivaroxaban (2.5mg bd) + … Continue reading →

SGEM#199: Therapeutic Hypothermia – What is it Good For?

The Skeptics' Guide to EM

DECEMBER 16, 2017

NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. [display_podcast] Date: November 27th, 2017 Reference: Legriel et al.

ALS

ALS ICU Emergency Department Paramedic

Sickle Cell Disease and Stroke

Pediatric EM Morsels

APRIL 7, 2023

Epub 2016 Oct 17. 2016 Dec 2;2016(1):625-631. Impact of the New American Heart Association/American Stroke Association Definition of Stroke on the Results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial. J Stroke Cerebrovasc Dis. 2017 Jan;26(1):108-115. 2016.08.038.

ALS

ALS OR EMS Critical Care

SGEM Xtra: On the Edge of Burnout ACEM18

The Skeptics' Guide to EM

NOVEMBER 24, 2018

One of the most common reasons cited for burnout is the electronic medical record (EMR) (Shanafelt et al 2016). West et al 2016 published a SRMA in the Lancet on interventions to prevent and reduce physician burnout. The highest prevalence of burnout (70%) was reported by emergency physicians (Shanafelt et al 2015).

EMR

EMR ALS Emergency Department OR

SGEM Xtra: Strange BRUE

The Skeptics' Guide to EM

DECEMBER 7, 2019

The change in name took place in 2016. The subcommittee on ALTEs in the AAP published a practice guideline renaming ALTEs to brief resolved unexplained events ( BRUEs ) in 2016. If even the folks who are really expert in the topic are not applying the definition consistently, then perhaps it’s time for a new definition.

CPR

CPR ALS OR

Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

Pediatric EM Morsels

MAY 12, 2023

However clinical judgement was more specific in this same group (54% vs 92%) [ Atabaki, 2016 ]. 2016 May;23(5):566-75. Epub 2016 Apr 20. When we discussed this topic previously , we concluded with “Clinical Guidelines are never perfect, but this one is pretty good”. Acad Emerg Med. doi: 10.1111/acem.12923. PMID: 26825755.

OR EMS

SGEM#414: The SQuID Protocol

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

However, over the past 20 years, there is burgeoning evidence that fast-acting subcutaneous insulin analogs could be a potential treatment option for mild to moderate severity DKA including a 2016 Cochrane SRMA [4].

ICU

ICU ED Critical Care ALS

SGEM#190: Wee are the Champions of Pediatric Urine Samples

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

In 2016, the American Academy of Pediatrics (AAP) reaffirmed their clinical practice guidelines for the diagnosis and management of UTIs. This two-step process can decrease the rate of catheterization by over 30% without missing UTIs or increasing length of stay in the pediatric emergency department (Lavelle et al Pediatrics 2016 ).

Emergency Department

Emergency Department ALS OR

SGEM#332: Think Outside the Cardiac Box

The Skeptics' Guide to EM

MAY 29, 2021

Date: May 20th, 2021 Guest Skeptic: Dr. Robert Edmonds is an emergency medicine physician in the Air Force in Dayton, Ohio, and a University of Missouri-Kansas City residency alumni from 2016. Reference: Jhunjhunwala et al. Reference: Jhunjhunwala et al. Journal of Trauma and Acute Care Surgery.

Emergency Medical Services

Emergency Medical Services ACS ALS Emergency Department

SGEM#191: No Time for Physio – Roll With It

The Skeptics' Guide to EM

OCTOBER 7, 2017

BMJ Nov 2016. BMJ Nov 2016. BMJ Nov 2016. [display_podcast] Date: October 5th, 2017 Reference: Brison et al. Effect of early supervised physiotherapy on recovery from acute ankle sprain: randomised controlled trial. Guest Skeptic: Dr. Steve Joseph. display_podcast] Date: October 5th, 2017 Reference: Brison et al.

Emergency Department

Emergency Department ALS OR

SAEM Clinical Images Series: An Unusual Foreign Body

ALiEM

SEPTEMBER 9, 2024

2016 Dec 28;7(Suppl 44):S1150-S1153. Bales J, Morton RP, Airhart N, Flum D, Avellino AM. Transanal presentation of a distal ventriculoperitoneal shunt catheter: Management of bowel perforation without laparotomy. Surg Neurol Int. doi: 10.4103/2152-7806.196930. PMID: 28194303; PMCID: PMC5299151.

Emergency Department

Emergency Department ED OR

Trick of Trade: Inflating the Esophageal Balloon of a Blakemore/Minnesota Tube without a Manometer

ALiEM

MAY 19, 2023

Published May 4, 2016. Placement of a Blakemore Tube for Bleeding Varices. EM:RAP HD Videos. Accessed December 17, 2021. PulmCrit Wee: Ultrasound-guided blakemore tube placement. EMCrit Project. Accessed April 6, 2023. Roohollahi A, Suleiman Bilal Rana H, Hadique S. Blakemore Tube Insertion – BAVLS. American Thoracic Society.

E-9-1-1

E-9-1-1 Emergency Department ICU OR

Pediatric Cervical Spine Injury Risk Stratification: Rebaked Morsel

Pediatric EM Morsels

JULY 5, 2024

2016; Published June 20, 2016. J Spinal Disord Tech. 2015;28(7). PMID: 26165728. Cui LW, Probst MA, Hoffman JR, Mower WR. Sensitivity of plain radiography for pediatric cervical spine injury. Emerg Radiol. doi:10.1007/s10140-016-1417-y. Easter JS, Barkin R, Rosen CL, Ban K.

ALS

ALS OR ED Emergency Department

SAEM Clinical Images Series: A Lethal Combination of Skin and Lung Findings

ALiEM

JANUARY 8, 2024

2016 May;68(5):689-94. Anti-Melanoma Differentiation-Associated Gene 5 Is Associated With Rapidly Progressive Lung Disease and Poor Survival in US Patients With Amyopathic and Myopathic Dermatomyositis. Arthritis Care Res (Hoboken). doi: 10.1002/acr.22728. PMID: 26414240; PMCID: PMC4864500.

ED OR

Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

JANUARY 25, 2024

doi:10.1182/blood-2016-10-709857. J Clin Med. 2022 Feb 19;11(4):1103. doi: 10.3390/jcm11041103. Joly BS, Coppo P, Veyradier A. Thrombotic thrombocytopenic purpura. 2017;129(21):2836-2846. Kappler S, Ronan-Bentle S, Graham A. Thrombotic Microangiopathies (TTP, HUS, HELLP). Hematol Oncol Clin North Am. 2017;31(6):1081-1103.

Plasma

Plasma Frozen Plasma Emergency Department FFP

SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

The Skeptics' Guide to EM

AUGUST 28, 2021

They include: Cognitive Behavioural Therapy and mindfulness ( Cherkin et al JAMA 2016), chiropractic ( Paige et al JAMA 2017), physical therapy ( Paolucci et al J Pain Research 2018) and acupuncture (Colquhoun and Novella Anesthesia and Analgesia 2013 ). None of these other treatments has high-quality evidence supporting their use.

ED Emergency Department ALS OR

SAEM Clinical Images Series: A Man with Blurry Vision

ALiEM

AUGUST 18, 2023

2016 May-Aug;9(2):80-6. Semin Neurol. 2000;20(1):55-74. doi: 10.1055/s-2000-6833. PMID: 10874777. Singh A, Bahuguna C, Nagpal R, Kumar B. Surgical management of third nerve palsy. Oman J Ophthalmol. doi: 10.4103/0974-620X.184509. PMID: 27433033; PMCID: PMC4932800.

Emergency Department

Emergency Department OR

SGEM#193: Stop, In the Name of Love

The Skeptics' Guide to EM

OCTOBER 28, 2017

Stevens and colleagues updated their review in 2016 and concluded “sucrose is effective for reducing procedural pain” and “no serious side effects or harms have been documented with this intervention”. That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015.

ALS

ALS Emergency Department OR ED

SGEM#246: I Start the Line – But Will It Make a Difference?

The Skeptics' Guide to EM

FEBRUARY 23, 2019

The Surviving Sepsis Campaign makes a number of recommendations in their 2016 guideline. The bottom line from that episode pre-hospital antibiotics in the ambulance do not appear to have a mortality benefit in patients with varying degrees of sepsis in an optimized EMS system.

Paramedic

Paramedic ALS Ambulance EMS

SGEM#327: MAGNUM PA – Nebulized Magnesium for Pediatric Asthma

The Skeptics' Guide to EM

APRIL 17, 2021

For children with severe asthma, IV magnesium has been shown to significantly decrease hospitalization rates though practically these children are rarely sent home after this IV treatment ( Cheuk et al 2005 , Griffith et al 2016 ,

Emergency Department

Emergency Department ALS ED

SGEM#378: Keepin’ It REaL when Treating Pediatric Migraine Patients

The Skeptics' Guide to EM

OCTOBER 1, 2022

Population: All patients treated in a single pediatric ED with at least one migraine-relevant medication using an ED migraine pathway from pathway inception (October 14, 2016) through February 28, 2020. AEM September 2022. Excluded: Repeat encounters * Intervention: Intravenous (IV) medications +/- oral (.

Emergency Department

Emergency Department ALS ED OR

SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens?

The Skeptics' Guide to EM

MAY 2, 2020

July 2019 * Population: All dispatches of a transport-capable ground EMS vehicle to a 911 emergency scene from the 2016 National EMS Information System, both the response to the scene and the transport from the scene. Yes Results: The 2016 NEMSIS database contained 20.4 Annals of Emergency Medicine.

ED Ambulance Medical Transportation EMS

EM Cases Best of 2016 Top Ten

Congenital Pulmonary Airway Malformation (CPAM)

Trending Sources

Podcast 186.0: Hypocalcemia

Imported Malaria

Morel-Lavallée Lesion in Children

Acute Transverse Myelitis in Children

Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Traveling Ticks: Tickborne Illnesses and International Travel

SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess

Winter event season 2016-17

Fluoroquinolone Use In Children

SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

SGEM#182: Platelet Transfusions for Intracerebral Hemorrhage (PATCH) – Don’t Do It.

The Broselow-Luten System

5 Min Sono – Pericardiocentesis (2024)

SGEM#194: Highway to the Dexamethasone – For Pediatric Asthma Exacerbations

Glasgow Coma Scale in Children

Elbow Dislocations

ACMT Toxicology Visual Pearl: Salt, not Shock

EM Notes – Adult Cardiac Arrest

PEM POCUS Series: Soft Tissue Ultrasound

Imaging Case of the Week 202

Low dose rivaroxaban plus aspirin reduce mortality and morbidity in cardiovascular high risk pt

SGEM#199: Therapeutic Hypothermia – What is it Good For?

Sickle Cell Disease and Stroke

SGEM Xtra: On the Edge of Burnout ACEM18

SGEM Xtra: Strange BRUE

Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

SGEM#414: The SQuID Protocol

SGEM#190: Wee are the Champions of Pediatric Urine Samples

SGEM#332: Think Outside the Cardiac Box

SGEM#191: No Time for Physio – Roll With It

SAEM Clinical Images Series: An Unusual Foreign Body

Trick of Trade: Inflating the Esophageal Balloon of a Blakemore/Minnesota Tube without a Manometer

Pediatric Cervical Spine Injury Risk Stratification: Rebaked Morsel

SAEM Clinical Images Series: A Lethal Combination of Skin and Lung Findings

Thrombotic Thrombocytopenic Purpura (TTP)

SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

SAEM Clinical Images Series: A Man with Blurry Vision

SGEM#193: Stop, In the Name of Love

SGEM#246: I Start the Line – But Will It Make a Difference?

SGEM#327: MAGNUM PA – Nebulized Magnesium for Pediatric Asthma

SGEM#378: Keepin’ It REaL when Treating Pediatric Migraine Patients

SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens?

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