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

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

ALiEM

MAY 19, 2023

The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Apply traction to the tube by tying a roller bandage to the end of it and then the other end to a 1 L bag of IV fluids. Pearl 1: Check the units of pressure being used. The conversion rate is: 1 cmH2O = 0.74 1950 May;131(5):781-9.

E-9-1-1

E-9-1-1 Emergency Department ICU OR

emDOCs Revamp: Alcohol Withdrawal

EMDocs

DECEMBER 18, 2024

Initial vital signs: HR 136 BPM, BP 172/82 mmHg, RR 24, T 37.2C, SpO2 97% RA Physical examination: General: restless, mildly agitated CV: tachycardic, regularly regular, diaphoretic, Abdomen: Soft, NT, ND, intermittently dry heaving Neuro: tremulous in bilateral arms and hands, tongue fasciculations What do you suspect as the diagnosis?

E-9-1-1

E-9-1-1 Emergency Department ICU ED

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

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? C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

E-9-1-1

E-9-1-1 ICU ACS EMS

ToxCard: Iron

EMDocs

DECEMBER 6, 2024

1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Commercially available formulations of iron have varying elemental components. 1 Table 1: Iron content of various preparations. 1 Obtain a single view abdominal x-ray.

E-9-1-1

E-9-1-1 Frozen Plasma Plasma Overdose

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

REBEL EM

SEPTEMBER 26, 2022

2020;71(1):235-246. What They Did Single-center randomized controlled study design performed by the Department of Hepatology & Liver transplantation in New Delhi Study participants, investigator clinicians, data collectors, and data analysts were blinded Investigators recruited participants from February 27, 2016 – March 3, 2018.

FFP

FFP E-9-1-1 ICU ALS

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). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 De Backer D, Creteur J, Silva E, Vincent JL.

E-9-1-1

E-9-1-1 ALS Coronary Epinephrine

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

Sepsis Updates Relevant to the Emergency Physician

EMDocs

DECEMBER 18, 2023

This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1). 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

E-9-1-1

E-9-1-1 ALS Emergency Department Plasma

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

Resident Journal Review: Do Adjunctive Therapies Beyond Infection Control and Appropriate Fluid Resuscitation Change Outcomes in Sepsis and Septic Shock?

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. 2016:316(17);1775-85.

ICU

ICU E-9-1-1 ALS OR

The Things We Do -- Interview w/ Matt Hoffman @PulmCCM

FOAMfrat

NOVEMBER 28, 2024

." When a critical care team transports a patient from an outlying ER to your ICU, do you automatically set your own ventilator settings, or do you ever use the vent settings the critical care transport team had dialed in for transport? "That’s We don’t seem to see Ketamine infusions in the ICU often. Henderson, E.

E-9-1-1

E-9-1-1 Critical Care ICU EMS

Paramedicine Now

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

emDOCs Revamp: Alcohol Withdrawal

Trending Sources

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

Penetrating chest trauma

emDOCs Revamp – Acute Chest Syndrome

ToxCard: Iron

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

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

Inotropes and Vasopressors: Doses, indications, contraindications and effects

ABG Versus VBG in the Emergency Department

Sepsis Updates Relevant to the Emergency Physician

EM@3AM: Cardiac Transplant Complications

Resident Journal Review: Do Adjunctive Therapies Beyond Infection Control and Appropriate Fluid Resuscitation Change Outcomes in Sepsis and Septic Shock?

The Things We Do -- Interview w/ Matt Hoffman @PulmCCM

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