2016, ACS and E-9-1-1 - Paramedicine Now

Elbow Dislocations

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

E-9-1-1

E-9-1-1 ACS OR Emergency Department

Occlusion myocardial infarction is a clinical diagnosis

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Moreover , the patient has ongoing symptoms and has an unexplained elevated troponin, so she is having an MI and the only question is whether it is type 1 or type 2 due to hypertension. Case continued She was loaded with aspirin 325 mg, and repeat troponin drawn around the time of EKG 1 resulted at 267 ng/L. Peterson, E.

E-9-1-1

E-9-1-1 ACS Coronary STEMI

Concerning EKG with a Non-obstructive angiogram. What happened?

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

E-9-1-1 Coronary ACS BLS

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. Which is a risk of 1 event for 62.5

E-9-1-1

E-9-1-1 ACS OR ALS

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

REBEL EM

NOVEMBER 30, 2023

Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis [published online ahead of print, 2023 Aug 9]. References: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM.

E-9-1-1

E-9-1-1 ALS ACS ICU

Penetrating chest trauma

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. Actively oozing.

E-9-1-1

E-9-1-1 FFP Plasma Emergency Department

Steroids in preschool wheeze

Don't Forget the Bubbles

JULY 22, 2024

study from 200 9. The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. Castro-Rodriguez JA, Beckhaus AA, Forno E. 2016 Aug;51(8):868–76. 2016 May;67(5):593-601.e3.

E-9-1-1

E-9-1-1 ALS ACS ED

emDOCs Revamp – Acute Chest Syndrome

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? 2022 Jul 5;328(1):57-68. C or 100.4 mg/kg, max 0.4

E-9-1-1

E-9-1-1 ICU ACS EMS

Are these Wellens' waves?

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

Some providers were worried about ACS because of this ECG. My answer alleviated their concern for ACS and no further workup was done for ACS. 4 important features that indicate acute right hear strain: 1. looked at consecutive patients with PE, ACS, or neither. Tachycardia (or nearly) 2. Poor R-wave progression 4.

E-9-1-1

E-9-1-1 ACS ALS OR

Resident Journal Review: Massive Transfusion Protocols (MTPs) in Traumatic Hemorrhage

AAEM RSA

APRIL 1, 2021

1 The American College of Surgeons’ (ACS) Trauma Quality Improvement Program (TQIP) Massive Transfusion in Trauma Guidelines leave a good amount of flexibility for hospitals regarding transfusion protocols, focusing more on systems-level aspects of designing and implementing MTPs.2,3 in the 1:1:1 group vs. 17.0%

E-9-1-1

E-9-1-1 Plasma ACS ALS

Inotropes and Vasopressors: Doses, indications, contraindications and effects

ECG & Echo Learning

OCTOBER 2, 2022

Most agents exhibit both vasopressor and inotropic effects (Figure 1). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 mg (max 1 mg) Safe for peripheral use ++ + N/A Beta-effect more pronounced at low doses. De Backer D, Creteur J, Silva E, Vincent JL. Kill C, Wranze E, Wulf H.

E-9-1-1

E-9-1-1 ALS Coronary Epinephrine

Right precordial ST depression in a patient with chest pain

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

STEMI E-9-1-1 Coronary ALS

ABG Versus VBG in the Emergency Department

EMDocs

FEBRUARY 12, 2024

Introduction Arterial blood gas (ABG) or venous blood gas (VBG) testing is used to assess the pH and systemic carbon dioxide tension in patients, and, therefore, provide a more complete picture of their acid-base status than an isolated basic metabolic panel (BMP) (1). However, ABGs have many drawbacks compared to VBGs.

Emergency Department

Emergency Department E-9-1-1 ED ICU

Antibiotics in the paediatric emergency department

Don't Forget the Bubbles

SEPTEMBER 18, 2023

Davidson L, Foley DA, Clifford P, Blyth CC, Bowen AC, Hazelton B, et al. Community-acquired pneumonia Addo-Yobo E, Anh DD, El-Sayed HF, Fox LM, Fox MP, MacLeod W, et al. Addo-Yobo E, Chisaka N, Hassan M, Hibberd P, Lozano JM, Jeena P, et al. 2007 Feb 1;24(2):128–9. 2011 Jan;25(1):21–9. 2018 Jul;110:123–9.

Emergency Department

Emergency Department E-9-1-1 ALS OR

EM@3AM: Cardiac Transplant Complications

EMDocs

JANUARY 6, 2024

Answer : Cardiac Transplant Complications Epidemiology: There were over 3,000 heart transplants in North America in 2016. 1 There are over 50,000 visits related to heart transplant in the United States each year and over half of these patients are admitted to the hospital from the ED. What is most likely the cause for his symptoms?

EMS

EMS E-9-1-1 ACS Coronary

What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

ACEP Now

NOVEMBER 7, 2023

1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). 2018;13(9):e0204169. Margey R, Browne L, Murphy E, et al. Emmerson AC, Whitbread M, Fothergill RT. 20(S1):S67.

Defibrillator

Defibrillator E-9-1-1 ALS Epinephrine

Pain Management of Common Chief Complaints in the ED

EMDocs

NOVEMBER 4, 2024

1 The ED is a fast-paced environment where patient stability and life-and-limb-threatening conditions are prioritized. The pain began abruptly 1 hour ago, described as a stabbing sensation, and has occurred daily at the same time for the past week, each episode lasting about 45 minutes. Pain can be improved or exacerbated with meals.

ED

ED E-9-1-1 Emergency Department ALS

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. Palpitations preceding syncope (highest value on EGSYS score) 9. Abnormal ECG – looks for cardiac syncope. Syncope without a prodrome, no precipitating factors (EGSYS) 5. Hemoglobin less than 10 (SF rule) 6.

Emergency Department

Emergency Department E-9-1-1 ED ALS

Paramedicine Now

Elbow Dislocations

Occlusion myocardial infarction is a clinical diagnosis

Trending Sources

Concerning EKG with a Non-obstructive angiogram. What happened?

Fluoroquinolone Use In Children

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

Penetrating chest trauma

Steroids in preschool wheeze

emDOCs Revamp – Acute Chest Syndrome

Are these Wellens' waves?

Resident Journal Review: Massive Transfusion Protocols (MTPs) in Traumatic Hemorrhage

Inotropes and Vasopressors: Doses, indications, contraindications and effects

Right precordial ST depression in a patient with chest pain

ABG Versus VBG in the Emergency Department

Antibiotics in the paediatric emergency department

EM@3AM: Cardiac Transplant Complications

What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

Pain Management of Common Chief Complaints in the ED

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

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