ALiEM

AUGUST 26, 2024

His vision slowly improved though it never normalized. He continued to have pain, so he presented for evaluation. He also reported seeing floaters and denied pain with eye movement, increased light sensitivity, or eye discharge. Additional Images Physical Exam Eyes : Lids without injury. Visual acuity was 20/50 OD, 20/30 OS. References Knoop, K.

Emergency Department 177

Emergency Department OR 177

Core EM

JANUARY 25, 2024

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 ). The authors found that deep early sedation within the first four hours was an independent predictor for delayed extubation and increased mortality. Short acting.

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

Core EM

MARCH 1, 2024

Epub 2019 Apr 17. 2019 Jul;42(4):673-685. Epub 2019 Jan 28. McGraw-Hill Education; 2019. Significance of the Inverted V Sign : This MRI sign is pathognomonic for subacute combined degeneration, indicating it is a distinct marker for this condition. PMID: 27293327; PMCID: PMC4888679. Transverse Myelitis. 2020:952–9.

Emergency Department 162

Emergency Department ED OR ALS 162

Pediatric EM Morsels

APRIL 5, 2024

Silva-Ramos 2021) Majority of cases arise from travel to South Africa. (Frean 2019) The classic triad described is fever, eschar and rash. Ricardi 2019) Tick-Borne Encephalitis has a biphasic pattern of symptoms. Ricardi 2019) Initial symptoms are nonspecific and include fever, malaise, headache, nausea, vomting and myalgias.

E-9-1-1 161

E-9-1-1 ALS OR EMS 161

Pediatric EM Morsels

JULY 7, 2023

Horan, 2006 ] Anatomy of the PTF Joint [ Cunningham, 2019 ] The PTF joint is a synovial joint between the lateral condyle of the tibia and the head of the fibula. Cunningham, 2019 ] Treatment [ Horan, 2006 ] 1st option for Subluxation and Anterolateral Dislocation is Manual Reduction ( similar to reducing that Nursemaid’s Elbow ).

OR 141

OR EMS 141

Pediatric EM Morsels

JUNE 30, 2023

Fetal Congenital Cystic Adenomatoid Malformation (CCAM): Pathogenesis, Diagnosis, and Clinical Management: A Case Report. Clinical and Experimental Obstetrics & Gynecology. Dec 46 (6) 999–1002, [link]. Leblanc C, Baron M, Desselas, E, Phan, MH, Rybak A, Thouvenin G, Lauby C, Irtan S.

E-9-1-1 258

E-9-1-1 ED EMS OR 258

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019.

Emergency Department 130

Emergency Department ALS ED EMS 130

Core EM

JANUARY 25, 2024

link] Published October 28, 2019. EVALUATION: Scan the affected and contralateral body part for comparison with a sterile cover (or Tegaderm) overlying a high frequency linear probe. REFERENCES: Castleberg E, Jenson N, Dinh VA. Diagnosis of necrotizing faciitis with bedside ultrasound: The staff exam. Western Journal of Emergency Medicine.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

The Good, The Bad & The Ugly Paramedic

NOVEMBER 15, 2020

By the time we add reduced empathy levels, increased judgmental responses and less overall joy in life to the mix, it becomes clear to see that a negative spiral can occur, either gradually or suddenly, with every aspect further impacting on each other. So why would we want to do this to ourselves?

OR 52

OR EMS Paramedic Emergency Medical Services 52

Pediatric EM Morsels

OCTOBER 27, 2023

2019 Jan;22(1):147-156. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. Krug 2007] What If the Child is Obese or Emaciated? of children; PAWPER predicted within 10% for 89.2% x exp[0.02

E-9-1-1 268

E-9-1-1 Emergency Medical Services Life Support ALS 268

Pediatric EM Morsels

SEPTEMBER 22, 2023

McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. Spinal shock is a phenomenon of transient, physiologic (rather than anatomic) complete loss of spinal cord function inferior to an injury. It may, however, be seen preceding or concurrently with neurogenic shock.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

Pediatric EM Morsels

JULY 26, 2024

Epub 2019 Dec 19. While it is important for us to maintain a safe work environment for our patients and our team, managing the agitated patient requires more of us than administering Droperidol or Ketamine. Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! The prevalence ranges from 12.5%-61%

Plasma 265

Plasma OR ED Critical Care 265

Pediatric EM Morsels

JUNE 21, 2024

Chaganti 2019] Other studies have not shown a difference in infection rates between silver-containing creams and antimicrobial ointments. Or maybe you have the adventurous adolescent who was a little too aggressive with the lighter fluid before igniting the campfire.

ALS 169

ALS OR EMS 169

Paramedics World

JANUARY 25, 2024

The NHTSA reports that out of 5,114 motorcycles in 2019, 2,811 (or 55%) were involved in… The post 7 Surefire Tips to Prevent Motorcycle Accidents appeared first on Paramedics World. Are you worried about your safety while riding a motorcycle? Well, you’re not alone.

Paramedic 98

Paramedic OR 98

Pediatric EM Morsels

JUNE 9, 2023

Specific Therapies for Variceal Hemorrhage : [ Luoto, 2020 ; Castillo, 2019; Garcia-Tsao, 2007 ] Antibiotic prophylaxis (usually for 7 days) Ceftriaxone is reasonable 1st choice. Castillo, 2019 ] Somatostatin (or its analogues, like Octreotide) Guidelines do recommend this… There is great variability in its administration, though.

OR 152

OR Critical Care EMS 152

ALiEM

JANUARY 5, 2024

2019 Dec 9;21(1):96-101. What does the Electronic Residency Application Service (ERAS) preliminary data show just far for the 2024 residency application season? Has the program signaling option been working? Have there been any surprises or changes during interview season? What should students think about in the post-interview stage?

EMS 177

EMS ALS OR 177

ALiEM

APRIL 12, 2024

The Cochrane database of systematic reviews, 2019(10), CD002312. Obstruction may also occur from clotted blood [9] or pleural effusion loculations [12, 13] within the catheter lumen. The pigtail catheter for pleural drainage: a less invasive alternative to tube thoracostomy. Br J Radiol. 2000;73(871):786-790. doi: [link] Altmann, E.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

Pediatric EM Morsels

OCTOBER 6, 2023

Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective. Lancet Infect Dis.

OR 161

OR EMS ED 161

Pediatric EM Morsels

MARCH 17, 2023

Since we all inhabit the same beautiful world , and sometimes we humans overtake previous habitats of animals, we inevitably will cross paths with an animal that bites us. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ). Sometimes it’s a beloved pet who gets surprised or has an “off” day ( Dog Bites and PTSD ).

Frozen Plasma 130

Frozen Plasma First Aid Plasma OR 130

NAEMSP

FEBRUARY 1, 2023

2019): 364-376. Article Summary by James Li, MD Sinclair, Julie E., “Characteristics, prehospital management, and outcomes in patients assessed for hypoglycemia: repeat access to prehospital or emergency care.” ” Prehospital Emergency Care 23.3 Background: Diabetes is a common chronic medical condition. were admitted.

OR 52

OR Emergency Department Emergency Medical Services Paramedic 52

The Skeptics' Guide to EM

SEPTEMBER 21, 2019

Date: September 18th, 2019 Reference: Scheuermeyer et al. AEM Sept 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary. Date: September 18th, 2019 Reference: Scheuermeyer et al. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.

Emergency Department 130

Emergency Department ALS OR 130

Core EM

JANUARY 25, 2024

2007;33(11):2019-2024. McGraw-Hill Education, New York, 11th edition, 2019. Supplement additional dextrose prn, if hypoglycemia occurs do not stop the insulin, increase the rate of the dextrose drip. Potassium Shifted intracellularly by insulin, total body potassium is normal Replete to goal 3-3.5 Intensive Care Med.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

Pediatric EM Morsels

MAY 5, 2023

2019 Oct;26(7):442-450. Epub 2019 Oct 12. Supplementation is key! Key nutrients and vitamins are not always found in specialized diets (or picky children) and adherence to multivitamins is a must! Look out for nutritional deficiencies ! References: Alexy U, Fischer M, Weder S, Längler A, Michalsen A, Sputtek A, Keller M. Arch Pediatr.

E-9-1-1 130

E-9-1-1 OR EMS 130

EMDocs

AUGUST 22, 2024

You may be more familiar with the term “limited English proficiency” (LEP), defined as: someone who does not speak English as their primary language and has a limited ability to read, speak, write, or understand English. For instance, displaying posters in multiple languages that explain the language services patients are entitled to.

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

The Skeptics' Guide to EM

DECEMBER 7, 2019

Date: October 2nd, 2019 Reference: Ramgopal et al. Pediatrics 2019 Guest Skeptic: Dr. Katie Noorbakhsh is a pediatric emergency physician at the Children’s Hospital of Pittsburgh. Date: October 2nd, 2019 Reference: Ramgopal et al. Changes in the Management of Children With Brief Resolved Unexplained Events (BRUEs).

CPR 130

CPR ALS OR 130

The Skeptics' Guide to EM

DECEMBER 14, 2019

Date: December 13th, 2019 Reference: Belisle et al. AEM December 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: December 13th, 2019 Reference: Belisle et al. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Belisle et al.

ALS 130

ALS Emergency Department OR 130

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Date: November 21st, 2019 Reference: Daley et al. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: November 21st, 2019 Reference: Daley et al. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

APRIL 14, 2019

Date: April 11th, 2019 Reference: Brucker et al. AEM April 2019 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com WARNING: This SGEM episode discusses suicide. Date: April 11th, 2019 Reference: Brucker et al. Reference: Brucker et al.

ED 130

ED Emergency Department ALS OR 130

ALiEM

NOVEMBER 1, 2023

McGraw-Hill Education; 2019 Madiwale T, Liebelt E. As ferrioxamine is excreted, the patient’s urine becomes an orange or brown rusty hue, classically referred to as vin rosé urine [1,2]. For iron toxicity, what are the indications for deferoxamine? 1, 3, 5] Vin rosé urine is simply indicates the excretion of ferrioxamine and is not harmful.

E-9-1-1 161

E-9-1-1 ALS OR ED 161

The Skeptics' Guide to EM

OCTOBER 14, 2019

Date: October 14th, 2019 Reference: CRASH-3 Trial Collaborators. The Lancet October 2019 Guest Skeptic: Dr. Salim Rezaie currently works as a community emergency physician at Greater San Antonio Emergency Physicians […] The post SGEM#270: CRASH-3 TXA for Traumatic Head Bleeds? first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department EMS ALS OR 130

Pediatric EM Morsels

AUGUST 9, 2024

2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). Neonates presenting to the Emergency Department often cause a lot of uncertainty. Is this scalp swelling normal? Is this bloody stool concerning? Are this odd movements part of normal development? Is that umbilical area ok or concerning?

E-9-1-1 152

E-9-1-1 Emergency Department Plasma OR 152

The Skeptics' Guide to EM

JUNE 6, 2019

Date: May 15th, 2019 Guest Skeptic: Dr. Dara Kass is an Assistant Professor, Emergency Medicine, Columbia University Medical Center. This is an SGEM Xtra that was recorded at the Society of Academic Emergency Medicine 2019 (SAEM) annual meeting. All of the SAEM 2019 winners can be found at this LINK.

OR 130

OR 130

The Skeptics' Guide to EM

AUGUST 17, 2019

Date: August 9th, 2019 Reference: Daoust et al. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: August 9th, 2019 Reference: Daoust et al. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Daoust et al.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 26, 2019

Date: October 22nd, 2019 Reference: Iyengar R et al. AEM October 2019. Date: October 22nd, 2019 Reference: Iyengar R et al. AEM October 2019. AEM October 2019. The Effect of Financial Incentives on Patient Decisions to Undergo Low-value Head Computed Tomography Scans. He had no pain, nausea, or neurologic symptoms.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

FEBRUARY 9, 2019

Date: February 7th, 2019 Reference: Bouida et al. AEM February 2019. Date: February 7th, 2019 Reference: Bouida et al. AEM February 2019. AEM February 2019. LOw dose MAGnesium sulfate versus HIgh dose in the early management of rapid atrial fibrillation: randomised controlled double-blind study.

Emergency Department 130

Emergency Department ALS ED OR 130

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

He had been smoking an opiate and suddenly collapsed. He was ventilated with BVM on arrival. He awoke with naloxone. This EKG was recorded as part of a standing order for critical care. He denied any CP or SOB. An EKG was repeated at 5 minutes The T-wave is less hyperacute. Maybe there is some spontaneous reperfusion? It does not radiate.

Overdose 52

Overdose OR Coronary ACS 52

REBEL EM

DECEMBER 13, 2023

Goldfrank’s Toxicology 2019) Carboxyhemoglobin levels > 25% or >15% in pregnant patients are indications for hyperbarics, independent of signs/symptoms There is evidence that hyperbaric oxygenation reduces the risk of cognitive sequelae after acute carbon monoxide poisoning. Toxicity is mediated through multiple mechanisms.

OR 102

OR EMS ED 102