The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Date: September 16th, 2020 Guest Skeptics: Dr. Robert Goulden and Dr. Audrey Marcotte are Chief Residents from the Royal College of Emergency Medicine Program at McGill University. Outside of medicine, Audrey likes […] The post SGEM#301: You Can’t Stop GI Bleeds with TXA first appeared on The Skeptics Guide to Emergency Medicine.

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The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? Date: January 5th, 2021 Reference: Grunau et al.

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Core EM

JANUARY 25, 2024

Written by: Sadakat Chowdhury MD Edited by: Mak Sarich MD, Jay Lin MD, Jonathan Kobles MD Background: Ultrasound (US) guided nerve blocks offer an applicable option for achieving analgesia in the emergency department. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians.

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The Skeptics' Guide to EM

FEBRUARY 25, 2023

Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. 1] The SGEM has covered the use of epinephrine, vasopressin, methylprednisolone, and calcium for cardiac arrest in SGEM#238 , SGEM#350 , and SGEM#353. Pediatric Crit Care Med.

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Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion. The below ECG (ECG #4) was recorded.

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REBEL EM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Ong MEH, Chan YH, Oh JJ, et al.

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ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Adult cardiac arrest in the emergency department – A Swedish cohort study.

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ACEP Now

NOVEMBER 6, 2024

A gravid woman presents to your emergency department (ED). mg/kg IV epinephrine, or 0.05–0.1 Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Before you can obtain any history, she gives birth in your waiting room.

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Broome Docs

NOVEMBER 17, 2024

PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest. 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.

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ACEP Now

DECEMBER 6, 2024

Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. N Engl J Med. 1992;326(22):1451-1455. Circulation.

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NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. However, evidence emerged in the 1980’s demonstrating that calcium chloride had no effect on return of spontaneous circulation (ROSC) rates, and in fact could be detrimental (Landry, Foran, & Koyfman, 2014). 2020, Sep 4).

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REBEL EM

JANUARY 23, 2023

Ann Emerg Med 2020. Multicenter study of emergency department visits for insect sting allergies. Multicenter study of emergency department visits for food allergies. Patients were randomized in a 1:1 ratio. A contraindication, known allergy, or suspected intolerability to the study medication. Ledford, D.

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FOAMfrat

OCTOBER 20, 2023

Epinephrine should be considered as the vasopressor of choice in patients with decreased myocardial function. Peri-intubation cardiac arrest in the Emergency Department: A National Emergency Airway Registry (NEAR) study. Intern Emerg Med. Acad Emerg Med. 2020 Fall;20(3):97-102. Epub 2020 May 8.

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Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury.

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ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med. 13,14 The typical regimen is 500 mg three times daily. References Deshwal H, Sinha A, Mehta AC.

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AAEM RSA

AUGUST 27, 2020

Douglas, MD; Taylor Conrad, MD, MS; Theodore Segarra, MD; Christianna Sim, MD, MPH Editors: Kelly Maurelus MD FAAEM, Kami Hu MD FAAEM Originally published: Common Sense July/August 2020 Introduction The ability to obtain good neurological outcomes after cardiac arrest is often limited.

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FOAMfrat

SEPTEMBER 19, 2024

These side effects do not contraindicate antivenom administration and can be treated with antihistamines and epinephrine. Hypotension and anaphylaxis should be treated with epinephrine following your local guidelines. Rattlesnake Envenomation Treatment & Management: Prehospital Care, Emergency Department Care, Consultations.”

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EMDocs

JANUARY 4, 2024

In 2020, bupropion was the 18 th most-prescribed medication in the USA. Other Norepinephrine or epinephrine are preferred vasopressors when needed. Case Follow-up: The patient required a dose of lorazepam in the emergency department. References: The Top 200 Drugs of 2020. Accessed 12/18/2022.

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EMDocs

JANUARY 20, 2024

Takotsubo syndrome is often exceedingly difficult to distinguish from acute myocardial infarction in the emergency department, as there is significant overlap in many clinical and diagnostic features. 2020 Apr;7(2):400-406. 2020 Jan 3;12(1):e6556. Vital signs show T of 99.0°F ESC Heart Fail. J Med Life. 2020;13(1):3-7.

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REBEL EM

DECEMBER 19, 2022

That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here. The fragility index of these findings found to be 1 for VC and 9 for DED Obtaining a second defibrillator in the emergency department or intensive care unit can be very easy to do. N Engl J Med. 2022 Nov 6 PMID: 36342151 Cheskes S, et al.

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