2019, Emergency Department and ICU

Post-Intubation Sedation and Analgesia

Core EM

JANUARY 25, 2024

The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients. It was found that patients exposed to deep sedation in the ED had an independent higher incidence of continued deep sedation on ICU day one ( Fuller, 2019 ).

ICU

ICU Emergency Department Critical Care ALS

Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department

Emergency Department ICU Critical Care EMR

Brazilian Butt Lift Procedure Can Result in Emergency Department Visits

ACEP Now

MAY 9, 2024

When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. The post Brazilian Butt Lift Procedure Can Result in Emergency Department Visits appeared first on ACEP Now.

Emergency Department

Emergency Department Operating Room Critical Care ICU

SGEM#268: Vitamin C Not Ready for Graduation to Routine Use

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Date: September 11th, 2019 Reference: Putzu et al. Guest Skeptics: Dr. Erin Willard is a PGY-3 Emergency Medicine Resident, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Date: September 11th, 2019 Reference: Putzu et al. You are ready to call the ICU and get her admitted.

ICU

ICU Critical Care ALS Emergency Department

Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Am J Emerg Med. Am J Emerg Med.

Emergency Department

Emergency Department ALS Critical Care ED

The Pause- a recognition of a life

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ 23 (2), pp.

Emergency Department

Emergency Department ICU ALS Critical Care

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

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

E-9-1-1

E-9-1-1 Emergency Department ICU OR

SGEM#294: Blood Pressure – Do Better, Keep Rising with NorEpi

The Skeptics' Guide to EM

JUNE 6, 2020

Respir Crit Care Med 2019. Guest Skeptic: Dr. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Respir Crit Care Med 2019. Max is then going to Georgetown to be an attending in both EM and ICU.

EMR

EMR ALS ICU Emergency Department

SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Date: November 6th, 2019 Reference: Lascarrou et al. NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Reference: Lascarrou et al.

ALS

ALS CPR ICU EMS

The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Epub 2019 Jul 3. Am J Emerg Med. J Med Toxicol.

Epinephrine

Epinephrine Emergency Department ALS Critical Care

First10EM Journal Club: November 2024

Broome Docs

NOVEMBER 17, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. J Emerg Med. Epub 2019 Dec 13. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4. 2019.10.034.

Epinephrine

Epinephrine Emergency Department Critical Care 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. Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). 2019 May 31:bmjqs-2019.

E-9-1-1

E-9-1-1 Critical Care CPR ICU

52 in 52 – #36: Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus

EMDocs

MAY 25, 2023

2019; 381(22): 2103-2113. DOI: 10.1056/NEJMoa1905795 The post 52 in 52 – #36: Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus appeared first on emDOCs.net - Emergency Medicine Education. Reference: Kapur J, Elm J, Chamberlain JM, et al. N Engl J Med.

Emergency Department

Emergency Department ICU OR ALS

ABG Versus VBG in the Emergency Department

EMDocs

FEBRUARY 12, 2024

In this situation, an ABG should be obtained periodically for correlation, though this is more relevant for the intensive care unit (ICU) setting than in routine ED care (5, 9). Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension-an emergency department-based cross-sectional study.

Emergency Department

Emergency Department E-9-1-1 ED ICU

ToxCard: Acute Organophosphate Toxicity

EMDocs

JUNE 7, 2023

Disposition is often admission to an intensive care unit (ICU) setting. Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Parenteral organophosphorus poisoning in a rural emergency department: a case report. Airway management should not be delayed.

E-9-1-1

E-9-1-1 ICU Emergency Department ED

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

2019 Jan 24;14:263-292. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Predictors of impending acute chest syndrome in patients with sickle cell anaemia. 2020 Feb 12;10(1):2470.

E-9-1-1

E-9-1-1 ICU ACS EMS

EM/IM Combined Residency: What up with that?

AAEM RSA

JUNE 30, 2021

This path involves seventy-two months split between emergency medicine and internal medicine with additional experience in the critical care setting.[3] Combined Residency Programs in Emergency Medicine. The Journal of Emergency Medicine. Published online August 31, 2019. 2018; 15(3):431. link] Winters M.

EMS

EMS Critical Care ICU Emergency Department

Palliative and Hospice Care in the Prehospital Setting

NAEMSP

FEBRUARY 15, 2023

Sometimes they may benefit from transport to an emergency department if it is consistent with their care plan/wishes. The patient was dying while intubated in the ICU but was awake enough to engage in discussions with providers through writing about her wishes. Prehosp Emerg Care. 2019 Aug;58(2):355-359.

Emergency Medical Services

Emergency Medical Services EMS CPR Paramedic

Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

SEPTEMBER 25, 2023

Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19). actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department.

ED

ED Emergency Department ALS Paramedic

Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Am J Emerg Med. doi.org/10.1016/j.resuscitation.2018.11.004

Defibrillator

Defibrillator CPR Epinephrine Life Support

A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

OCTOBER 25, 2023

A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store. Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc. He did not have chest pain.

Overdose

Overdose OR ACS ICU

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment. She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia.

Coronary

Coronary ACS ED OR

Penetrating chest trauma

Don't Forget the Bubbles

JUNE 30, 2023

They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. Emerg Med Australas. Emerg Med Australas.

E-9-1-1

E-9-1-1 FFP Plasma Emergency Department

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. They should be admitted to hospital in case of clinical deterioration to receive ICU treatment. This treatment is usually done in the ICU setting. 2019, 3 rd edition. What is the role of hydroxycarbamide?

E-9-1-1

E-9-1-1 ACS OR ICU

POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2019 Oct-Dec;29(4):169-171.

ED

ED NARCAN ALS OR

The 77th Bubble Wrap x Chelsea and Westminster Paediatric ED

Don't Forget the Bubbles

JANUARY 4, 2024

We have teamed up with the team from Chelsea and Westminster Paediatric Emergency Department to give you 5 reviews of recent studies. Records of all children (defined age 0-16) on the TARN database who fulfilled the TARN criteria (had been admitted for longer than 72 hours, admitted to an ICU, or died in hospital) were included.

ED

ED ICU ALS OR

Evaluating Chronic Obstructive Pulmonary Disease

ACEP Now

JUNE 14, 2024

In 2019, the global prevalence of COPD was estimated to be 10.3 4 Acute exacerbations of COPD (AECOPD) are a common presentation in emergency medicine. And, finally, patients with a history of COPD frequently present to the emergency department with dyspnea. Ann Emerg Med. 8 Bronchodilators Albuterol 2.5-5

ALS

ALS Coronary OR Emergency Department

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%). 2019 Jul;3(7):520-531. vs. 52.2%).

E-9-1-1

E-9-1-1 ALS ICU Critical Care

Paramedicine Now

Post-Intubation Sedation and Analgesia

Impact of Emergency Department Crowding on Lung Protective Ventilation

Trending Sources

Brazilian Butt Lift Procedure Can Result in Emergency Department Visits

SGEM#268: Vitamin C Not Ready for Graduation to Routine Use

Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

The Pause- a recognition of a life

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

SGEM#294: Blood Pressure – Do Better, Keep Rising with NorEpi

SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest

The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

First10EM Journal Club: November 2024

The ‘Hidden C’

52 in 52 – #36: Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus

ABG Versus VBG in the Emergency Department

ToxCard: Acute Organophosphate Toxicity

emDOCs Revamp – Acute Chest Syndrome

EM/IM Combined Residency: What up with that?

Palliative and Hospice Care in the Prehospital Setting

Beyond Ketamine: When to use Facilitated Intubation in the ED

Hypothermic Cardiac Arrest: Pearls and Pitfalls

A man in his 60s with syncope and ST depression. What does the ECG mean?

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Penetrating chest trauma

Sickle Cell Disease Module

POCUS findings of hemodynamically unstable PE with cardiac arrest

The 77th Bubble Wrap x Chelsea and Westminster Paediatric ED

Evaluating Chronic Obstructive Pulmonary Disease

Is Pip-Tazo Harming Sepsis Patients?

Stay Connected