The Skeptics' Guide to EM

MAY 25, 2024

Reference: Borgundvaag et al. AEM May 2024 Date: May 22, 2024 Dr. Bjug Borgundvaag Guest Skeptic: Dr. Bjug Borgundvaag is the Founding Director of the Schwartz/Reisman Emergency Medicine Institute (SREMI), at Sinai Health System.

ED 193

ED Emergency Department ICU ALS 193

REBEL EM

FEBRUARY 8, 2024

Paper: Haber, EN et al. J Intensive Care Med 2024. PMID: 38215002 Clinical Question: In critically ill adults in the ICU is noninvasive blood pressure (NIBP) monitoring similar (≤10% difference) to invasive arterial blood pressure (IABP) monitoring? References: Haber, EN et al. J Intensive Care Med 2024.

MICU 126

MICU ICU ALS EMS 126

REBEL EM

FEBRUARY 19, 2024

Paper: Yerke JR et al. CHEST 2024. PMID: 37611862 Clinical Question: In patients treated in the ICU, can a protocol of peripheral IV catheter vasopressors safely reduce the number of days of CVC use and frequency of placement? References: Yerke JR et al. CHEST 2024. PMID: 37611862 Evans L et al.

ICU 137

ICU EMS ALS OR 137

FOAMfrat

NOVEMBER 21, 2024

Today, increased mortality rates, higher transfusion requirements, and lengthened ICU stays are recognized as proximate effects of the Trauma Triad. PubMed , StatPearls Publishing, 5 May 2024, www.ncbi.nlm.nih.gov/books/NBK603758/. Jessica Dawkins Mills BSN, et al. EMS Tactical Paramedic Lethal Triad.” Accessed 10 Oct.

ICU 111

ICU Emergency Department OR Ambulance 111

Core EM

JANUARY 25, 2024

Disposition to ICU. References: Yuan TH, Kerns WP, Tomaszewski CA, et al. von Lewinski D, Bruns S, Walther S, et al. Cole JB, Corcoran JN, Engebretsen KM, et al. Holger JS, Engebretsen KM, Fritzlar SJ, et al. Kerns W, Schroeder D, Williams C, et al. Kline JA, Tomaszewski CA, Schroeder JD, et al.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

REBEL EM

FEBRUARY 29, 2024

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. Mimoz (2024). The low incidence could be a result of the systematic implementation of bundles known to decrease VAP incidence in the ICU. Lasocki, T.

E-9-1-1 126

E-9-1-1 ICU OR ALS 126

REBEL EM

AUGUST 12, 2024

The authors of this study sought to test the hypothesis that intravenous amino acid therapy would lead to a lower occurrence of postoperative AKI when compared to placebo. Paper: Landoni G. Intravenous amino acid therapy for kidney protection in cardiac surgery a protocol for a multi-centre randomized blinded placebo controlled clinical trial.

ICU 81

ICU Critical Care Operating Room ALS 81

ACEP Now

JULY 7, 2024

Neurology consultation should be initiated, and the patient should be admitted to the ICU. References Brophy GM, Bell R, Claassen J, et al. Zehtabchi S, Abdel Baki SG, Omurtag A, et al. Towne AR, Waterhouse EJ, Boggs JG, et al. Huff JS, Melnick ER, Tomaszewski CA, et al. Paliwal P, Wakerley BR, Yeo LLL, et al.

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

REBEL EM

APRIL 22, 2024

Paper: Nielsen FM et al. Population: Adult patients ( > 18 years of age) admitted to the ICU with COVID-19 and severe hypoxemia (defined as receiving supplemental O2 with a flow rate of at least 10L/min or receiving mechanical ventilation or non-invasive ventilation. The HOT-COVID Randomized Controlled Trial.

Life Support 75

Life Support ICU EMS OR 75

EMDocs

JUNE 27, 2024

Alkindi S, Al-Busaidi I, Al-Salami B, Raniga S, Pathare A, Ballas SK. Alghamdi FA, Al-Kasim F, Alshhada F, Ghareeb E, Azmet FR, Almudaibigh A, Baitalmal L, Alnawfal B, Alluqmani R. 2024 Mar 12;14(1):5978. 2024 Jul;71(7):e31002. Epub 2024 Apr 21. 2024 Apr 5. 2020 Feb 12;10(1):2470. Epub 2018 Oct 17.

E-9-1-1 75

E-9-1-1 ICU ACS EMS 75

Dr. Smith's ECG Blog

JUNE 17, 2024

The patient was upgraded to the ICU for closer monitoring. In fact, Kosuge et al. Accessed May 28, 2024. Stein et al. This is a paper worth reading : Marchik et al. Kosuge et al. Witting et al. This does not contradict the conclusions of Kosuge et al. It is nearly pathognomonic for PE.

E-9-1-1 137

E-9-1-1 ACS Emergency Department Coronary 137

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

His temperature was brought back to normal over time in the ICU. Altered Mental Status, Bradycardia == MY Comment , by K EN G RAUER, MD ( 2/2 /2024 ): == Dr. Meyers began today’s case with the clinical challenge of asking you to identify the underlying cause of ECG #2. Rituparna et al — as well as Chauhan and Brahma ( Int.

ICU 132

ICU OR ALS ED 132

ACEP Now

MAY 9, 2024

Taking a different approach than the authors of the AHRQ report, Auerbach et al used a “look back” approach to perform both qualitative and quantitative evaluations of the types and frequencies of errors occurring in hospital settings. After developing encephalopathy and hypoxemic respiratory failure, the patient was transferred to the ICU.

Emergency Department 52

Emergency Department ICU ALS ACS 52

ACEP Now

MAY 9, 2024

Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission. Accessed March 6, 2024. Accessed February 19, 2024. Al Jazeera. Accessed March 6, 2024. Mofid MM, Teitelbaum S, Suissa D, et al. units per patient. Healing Is No Joke.

Emergency Department 52

Emergency Department Operating Room Critical Care ALS 52

ACEP Now

APRIL 3, 2024

Several recent studies yield insights into this hypothesis: In a single site retrospective cohort study, Callaway et al demonstrated that TTM efficacy may be impacted by arrest severity.10 In a multisite retrospective cohort study, a study by Nishikimi, et al., Group W, Nolan JP, et al. Nielsen N, Wetterslev J, et al.

Advanced Life Support 40

Advanced Life Support ALS Life Support CPR 40

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. Frich JC, Brewster AL, Cherlin EJ, Bradley EH. InHealthcare 2024 Jan 22 (Vol. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Future Healthc J.

E-9-1-1 105

E-9-1-1 Critical Care CPR ICU 105

EMDocs

APRIL 22, 2024

Alerhand et al described ten individual echocardiographic findings of RV strain that suggest PE. Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., VUMC Emergency Medicine, “RV Strain & TAPSE” YouTube Video [link] Farcy et al. Available from: [link] Meneveau, Nicolas, et al.

ED 81

ED NARCAN ALS OR 81

ALiEM

OCTOBER 30, 2024

We have certainly seen patients who have pain which is controlled and still have psychomotor agitation and sympathetic activation, leading some to require ICU admission for dexmedetomidine and/or ketamine infusion. Multimodal medication options for fentanyl-xylazine withdrawal management in London et al. 2024 study [16].

E-9-1-1 161

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

ACEP Now

JUNE 14, 2024

4,6,11 Antibiotics Antibiotic use for AECOPD patients remains a contentious topic; however, data suggests AECOPD patients requiring admission, particularly to the ICU, should receive antibiotics. Adeloye D, Song P, Zhu Y, et al. Canut A, Martín-Herrero JE, Labora A, et al. Accessed May 19, 2024. 5 mg plus ipratropium 0.5

ALS 52

ALS Coronary OR Emergency Department 52

REBEL EM

NOVEMBER 11, 2024

Article: Chanderraj R, Admon AJ, He Y, et al. Imbalances Between Treatment Groups : ICU Admissions : Higher in piperacillin-tazobactam (33% vs. 30%). For example, in this analysis, 33% of patients receiving piperacillin-tazobactam were admitted to the ICU, compared to 30% of those receiving cefepime. 2024 Jul 1;184(7):769-777.

E-9-1-1 84

E-9-1-1 ALS ICU Critical Care 84