2019, E-9-1-1 and ICU - Paramedicine Now

The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

REBEL EM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. 4, 8 Paper: Dahyot-Fizelier, C.,

E-9-1-1

E-9-1-1 ICU OR ALS

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

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

The ‘Hidden C’

Don't Forget the Bubbles

JUNE 17, 2024

The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. Here are ten things to think about: 1. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J. 2014 Jun 26;23(12):653-9. 2020 Jan 1;35(1):70-6. 2019 May 31:bmjqs-2019.

E-9-1-1

E-9-1-1 Critical Care CPR ICU

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: Local Anesthetic Systemic Toxicity

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]

E-9-1-1

E-9-1-1 Plasma Epinephrine Life Support

ToxCard: Acute Organophosphate Toxicity

EMDocs

JUNE 7, 2023

1-5 Farmers also treat sheep for parasites using OPs and may become symptomatic after exposure, an illness called Dipper’s Flu. 8 Intermediate syndrome Occurs 1 to 5 days after acute exposure in up to 40% on individuals. 7, 9 Often have absence of excessive cholinergic stimulation. 7 May lead to respiratory failure.

E-9-1-1

E-9-1-1 ICU Emergency Department ED

What Lies Beneath

EMS 12-Lead

AUGUST 22, 2022

A 65 y/o Female was admitted to the ICU for septic shock. 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.

E-9-1-1

E-9-1-1 Coronary ALS ICU

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

REBEL EM

SEPTEMBER 26, 2022

2020;71(1):235-246. Article: Kumar M et al. Thromboelastography-Guided Blood Component Use in Patients With Cirrhosis With Nonvariceal Bleeding: A Randomized Controlled Trial. Hepatology. Significant coagulopathy: INR > 1.8 Significant coagulopathy: INR > 1.8 Significant coagulopathy: INR > 1.8

FFP

FFP E-9-1-1 ICU ALS

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

"Pericarditis" strikes again

Dr. Smith's ECG Blog

DECEMBER 13, 2019

On review of systems the patient reported back pain for approximately 1 week which he was treating with NSAIDs with minimal relief. in the ICU but survived with excellent function. 15-9/6/2017 ). Figure-1: Excerpt from ESC review on acute pericarditis ( See text ).

E-9-1-1

E-9-1-1 ACS Coronary CAD

Sickle Cell Disease Module

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.

E-9-1-1

E-9-1-1 ACS OR ICU

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

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

Is Pip-Tazo Harming Sepsis Patients?

REBEL EM

NOVEMBER 11, 2024

What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. Imbalances Between Treatment Groups : ICU Admissions : Higher in piperacillin-tazobactam (33% vs. 30%). 9 Instrumental Variable Analysis? vs. 52.2%).

E-9-1-1

E-9-1-1 ALS ICU Critical Care

Paramedicine Now

The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

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

Trending Sources

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

The ‘Hidden C’

emDOCs Revamp – Acute Chest Syndrome

ToxCard: Local Anesthetic Systemic Toxicity

ToxCard: Acute Organophosphate Toxicity

What Lies Beneath

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

Penetrating chest trauma

"Pericarditis" strikes again

Sickle Cell Disease Module

ABG Versus VBG in the Emergency Department

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

Is Pip-Tazo Harming Sepsis Patients?

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