ALiEM

MAY 13, 2024

Her symptoms started 1 week ago as a scratch which progressively got more red and painful. Pediatric Soft Tissue POCUS Ultrasound Technique Figure 1. Cellulitis with cobblestoning Video 1. Abscess with irregular borders and surrounding cellulitis E. Superficial abscess with well-circumscribed borders Table 1.

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E-9-1-1 ALS Emergency Department OR 161

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 (..)

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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.

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EMDocs

DECEMBER 1, 2024

typhi infection if treatment is refractory to supportive measures or conventional community-acquired pneumonia antibiotics Treat with atypical bacterial coverage (doxycycline, azithromycin, chloramphenicol, or fluoroquinolones) A 32-year-old woman presents to the ED with a fever and rash after returning from a trip to Southeast Asia. .:

EMS 82

EMS E-9-1-1 OR ED 82

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. For clarity in Figure-1 — I've reproduced the initial ECG in today's case.

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E-9-1-1 ALS Defibrillator OR 111

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. Gastroenterology , 160 (1), pp.63-75. Burki, Talha Khan. 2019): 100. Rubin, J.E. and Crowe, S.E.,

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Dr. Smith's ECG Blog

AUGUST 14, 2024

R waves 6 through 9 have no preceding P waves and are suspiciously regularly spaced. Impulses E, F, G, H, and I were blocked. Progress in Biophysics and Molecular Biology , 120 (1–3), 164–178. Science Translational Medicine , 9 (400). link] Li, N., Hansen, B. Ignozzi, A. Zakharkin, S. Kalyanasundaram, A., Biesiadecki, B.

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EMS 12-Lead

APRIL 28, 2022

Initial vital signs include: NIBP 99/58 HR 150-160 (trend) RR 10 (spontaneous, but shallow) SpO2 86 (RA) BBS CTA The initial rhythm strip is attached: Figure 1 There is a wide complex tachycardia of varying morphology, amplitude, and R-R cycle length. A prominent vertical scar, however, is noted at the sternum.

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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.

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Don't Forget the Bubbles

NOVEMBER 29, 2023

Intensive Care Research , 1 (3-4), pp.60-64. Journal of Neurosurgical Anesthesiology 29(2): p 161-167, April 2017. | Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This article is based on: Mayberry, H., Burgart, A.M. and Kanaris, C., W hat is the problem? DOI: 10.1097/ANA.0000000000000275

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E-9-1-1 Emergency Department ED CPR 135

EMS 12-Lead

AUGUST 22, 2022

Question 1: What is the rhythm? Beat 1 : Sinus, narrow QRS complex. The assumption is that a premature complex discharged prior to Beat 1, which prolonged its respective refractory period in the same manner as Beat 5. A 12 Lead ECG was recorded secondary to bizarre telemetry findings at bedside. Said differently, it’s a mess.

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E-9-1-1 Coronary ALS ICU 130

Dr. Smith's ECG Blog

JULY 22, 2023

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% He denied chest pain or shortness of breath.

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EMDocs

APRIL 10, 2024

1-5] Since then, many more medications have been developed and deployed. 1-5] This post focuses on the identification and management of Local Anesthetic Systemic Toxicity (LAST). 3-5,7] Symptom onset is usually within 1 minute of intravascular injection but can be delayed if multiple injections or continuous infusion. [5]

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Don't Forget the Bubbles

JULY 17, 2023

You will find the list is broken down into four sections: 1.Reviews Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. 2023 Jun 1. 2023 Jun 9. Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Sethi SK, et al. Pediatr Nephrol. 2023 Jun;38(6):1733-1751. 2023 Jun 15.

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E-9-1-1 ALS Emergency Department Emergency Medical Services 98

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. They concluded that more research of higher quality is needed to strengthen the evidence in favor of one technique over the other.

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EMDocs

JULY 17, 2023

1 While less common than small bowel obstruction (SBO), obstruction of the large bowel is more likely to be a surgical emergency and is often associated with a serious underlying condition. 1 The most common causes of non-cancer-related LBO are cecal and sigmoid volvulus.

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E-9-1-1 ED ALS Operating Room 77

REBEL EM

SEPTEMBER 13, 2023

Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation. of people who take NSAIDs ( Nzeako 2010 ). of people who take NSAIDs ( Nzeako 2010 ).

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

Dr. Smith's ECG Blog

JANUARY 13, 2024

Spikes 2, 3, 4, 5, 7, 8, and 9 all occur either during or immediately after P waves which should never happen. He had routine follow up for the mitral valve clip approximately 1 month after the procedure, and the note indicated recognition of atrial lead dislodgement on the CT scan from the hospitalization a few weeks prior.

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E-9-1-1 OR Emergency Department 109

ACEP Now

FEBRUARY 13, 2024

A radiograph is shown (see figure 1). LEARN MORE The most common nerve blocks in this study are shown in Table 1. 1–4 Emergency physicians commonly prescribe opioid pain medications, and there is significant variability among prescribing patterns. 2023 Sep 2;15(9):e44583. 2017 Feb 16;376(7):663-673. N Engl J Med.

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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.

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Don't Forget the Bubbles

JULY 5, 2023

Figure 1: Clinical manifestations and long-term consequences of sickle cell disease Training and education on sickle cell disease: Training and education are crucial to improve morbidity and mortality. Investigations : Bloods show Hb of 8 g/L, White cell count 13x 10 9 /L, Platelets 570 x10 9 /L, CRP 35mg/L.

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EMDocs

MARCH 30, 2024

Comprehensive physical exam is unremarkable, but she does have pain at the T-12/L-1 region of her back. Her patellar reflexes are 1+ bilaterally, no ankle clonus is noted, and she denies any saddle anesthesia or bowel/bladder incontinence. CT of lower spine is ordered and shows the following: 1 What is the diagnosis?

EMS 90

EMS E-9-1-1 Emergency Department Ambulance 90

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

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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

This Podcast Will Kill You

DECEMBER 10, 2024

Nature Reviews Gastroenterology & Hepatology , 20 (9), pp.615-624. 2016): 1-9. Conficconi, E., BioMed research international , 2017 (1), p.9784565. 2017): 39-57. Thieme, E. Surgeons performed appendectomies like it was spring cleaning – when in doubt, cut it out. Harnoss, J.C.,

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EMDocs

MARCH 4, 2024

A wide variety of conditions can result in either type of cholestasis (Figure 1). 1 Extrahepatic obstruction is due to mechanical obstruction occurring downstream of the hepatic ducts such as pancreatic disease, gallstone obstruction of the common bile duct, and cancer. 9 How are cholestatic labs defined?

Emergency Department 87

Emergency Department E-9-1-1 ALS OR 87

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 98

Critical Care E-9-1-1 Paramedicine Paramedicine 98

This Podcast Will Kill You

JANUARY 2, 2024

2002): 1-7. 2017): 128-129. Nature Reviews Endocrinology , 7 (9), pp.540-557. Endocrine reviews , 43 (1), pp.61-90. Molecular and Cellular Pediatrics , 7 (1), pp.1-9. Sochett, E. Annual review of biochemistry , 78 , pp.929-958. ” Annals of Anatomy-Anatomischer Anzeiger 184.1 and Glorieux, F.H.,

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Dr. Smith's ECG Blog

JANUARY 30, 2019

The pattern of STE and STD reminded us of Brugada Type 1 morphology. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% The article is edited by Smith. F (rectal).

E-9-1-1 52

E-9-1-1 CAD STEMI OR 52

AAEM RSA

NOVEMBER 23, 2020

Moreno, MD MS MSCR FAAEM FIFEM Originally published: Common Sense May/June 2017 The number of women enrolled in medical schools has risen from less than 25% in the 1970s to over 47% today. Image credit: Pexels Authors: Eveline Hitti, MD MBA FAAEM Lisa A. Shollen et al. 6 Jolly et al. hours more per week on domestic activities.

OR 52

OR E-9-1-1 ALS 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

To me, it was clearly atrial flutter with 1:1 conduction. Continue Eliquis 5mg BID, should be continued for 3 months == MY Comment , by K EN G RAUER, MD ( 9/18 /2024 ): == I found the following aspects of today's case of special interest. Why did Dr. Smith immediately say the rhythm was AFlutter with 1:1 AV conduction?

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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?

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EMDocs

JUNE 1, 2023

Bradycardia: 18.8% Average ventilator days (8.3 Take Aways: The data do not suggest that targeted hypothermia improves neurological function, reduces death, or reduces hospital length of stay as compared to normothermia. Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8%

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E-9-1-1 Emergency Medical Services Emergency Department OR 61

This Podcast Will Kill You

OCTOBER 1, 2024

Medical journal of Australia , 190 (9). 2017): e301-e301. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1, 3-galactose. Ronmark, E. ” Parasites & vectors 12 (2019): 1-5. 2013): 1-11. Rindsjö, E.

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EMDocs

SEPTEMBER 7, 2023

1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity? Toxicity typically evolves through three phases: 2,3,7,8,9 Phase 1: Gastrointestinal symptoms (e.g., Upon review of the history, several of the patients had been exposed to a liquid acetaminophen-based teething medication.

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E-9-1-1 ALS Emergency Department Plasma 66

REBEL EM

FEBRUARY 21, 2024

The ceiling pain relief dose for ketorolac is 15 mg IV ( Motov 2017 ). Read More REBEL EM: The Ketorolac Analgesic Ceiling References Irizarry E et al. Can J Emerg Med 2007; 9(1): 30-2. Ann Emerg Med 2017; 70(2): 177-84. You contemplate analgesic options and decide that a NSAID makes sense.

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E-9-1-1 Emergency Department ALS ED 63

Don't Forget the Bubbles

JANUARY 10, 2024

The study asked TWO questions: 1. 3,950 children were recruited between September 2014 to May 2017. 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.

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