Broome Docs

SEPTEMBER 3, 2024

2024 Mar 25:S0196-0644(24)00099-4. 2024 Jun;26(6):381-385. Epub 2024 Apr 9. PMID: 38592662 Bottom line: Would you be happy if you kid follow-ed your footsteps into emergency medicine? 2024 Jul;81:75-81. Epub 2024 Apr 23. 2024 Mar;27(1):26-29. 2024 Apr;165(4):847-857. 2024 Jul 4;391(1):9-20.

E-9-1-1 95

E-9-1-1 Emergency Department ICU ALS 95

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. AEM August 2024. Case: It’s another day, another dollar in the emergency department (ED). You wonder if she could have an allergy challenge dose of ceftriaxone in the ED. Emergency Physicians frequently encounter ED patients with self-reported penicillin allergies.

ICU 141

ICU Emergency Department ALS ED 141

Broome Docs

MAY 31, 2024

Welcome to the June edition of the Journal Club for 2024. Do we need to intubate French drunkards in ED? 2024 Apr 1:e240167. Welcome to the June edition of the Journal Club for 2024. Articles linked below and podcast available on your favourite player or YouTube over at the First10EM channel. JAMA Pediatr.

E-9-1-1 82

E-9-1-1 ED Critical Care ICU 82

EMDocs

JUNE 15, 2024

Non-rebreather Mask Spoon Feed Noninvasive ventilation (NIV) was superior to a standard non-rebreather (NRB) oxygen mask for preoxygenation of critically ill ED or ICU patients requiring intubation, with a NNT of 11 to prevent 1 episode of hypoxemia <85%. 2024 Jun 13. #2: 2024 Mar 25:S0196-0644(24)00099-4.

ICU 98

ICU Emergency Department ED OR 98

EMDocs

SEPTEMBER 7, 2024

A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank.

EMS 98

EMS E-9-1-1 Operating Room OR 98

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

He was intubated on arrival at the ED for mental status and airway protection due to vomiting. His temperature was brought back to normal over time in the ICU. There is also large T wave inversion and long QT. Clinical context: A man in his 50s was found down outside in the cold, unresponsive but with intact vital signs.

ICU 137

ICU OR ALS ED 137

Dr. Smith's ECG Blog

OCTOBER 8, 2024

A temporary pacemaker was implanted, and she was admitted to the ICU with cardiogenic shock. Available from: [link] Click here to sign up for Queen of Hearts Access == MY Comment , by K EN G RAUER, MD ( 10/8 /2024 ): == It’s always easier to look back at a case from the comfort of one’s home — and to criticize decisions that were made.

OR 122

OR STEMI ICU Coronary 122

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). 2 A study of routine EEG in the ED in 2013 found that five percent of ED patients with altered mental status had nonconvulsive seizures (of whom 75 percent were in nonconvulsive status epilepticus). Am J Emerg Med.

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment. This patient presented to the ED “after a couple of days of chest discomfort”. Remember that this patient presented to the ED “after a couple of days of chest discomfort”.

Coronary 119

Coronary ACS ED OR 119

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. InHealthcare 2024 Jan 22 (Vol. Future Healthc J. 2023 Mar 13. Luca CE, Sartorio A, Bonetti L, Bianchi M.

E-9-1-1 105

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

Broome Docs

MARCH 28, 2024

2024 Jan 22;41(2):96-102. 2024 Jan 2;53(1):afad255. Although I miss performing the procedure, these days I almost always leave the central line until the patient is stabilized and settled into their ICU bed. 2024 Jan 29:jme-2023-109651. Emerg Med J. doi: 10.1136/emermed-2023-213285. Age Ageing. Is pregnancy a disease?

E-9-1-1 96

E-9-1-1 ICU Emergency Department ALS 96

EMDocs

OCTOBER 19, 2024

A 6-year-old girl presents to the ED with 1 day of fevers up to 104.1°F Accessed August 11, 2024. Published 2024. Accessed August 11, 2024. Patients with true cephalosporin allergy may be treated with vancomycin or clindamycin + levofloxacin or ciprofloxacin. [2][3][9] Georgiaemsacademy.com. Published 2023.

EMS 111

EMS E-9-1-1 Epinephrine OR 111

Dr. Smith's ECG Blog

JUNE 17, 2024

The patient was upgraded to the ICU for closer monitoring. Accessed May 28, 2024. Supporting Kosuge, Ferrari found that anterior T-wave inversions were the most common ECG finding in massive PE. == MY Comment , by K EN G RAUER, MD ( 6/17 /2024 ): == Today's case by Drs. It is nearly pathognomonic for PE.

E-9-1-1 138

E-9-1-1 ACS Emergency Department Coronary 138

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. Case A 25-year-old-female presented to the ED in cardiac arrest. Summary This case exemplifies the value of POCUS in cardiac arrest patients in the ED. EKG RV strain. 2014 May;145(5):950-957.

ED 98

ED NARCAN ALS OR 98

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). percent of ED visits resulted in preventable death as result of diagnostic error. Further diagnostic testing in the ICU identified salicylate toxicity.

Emergency Department 52

Emergency Department ICU ALS ACS 52

ACEP Now

MAY 9, 2024

JHS’ chart review project, which identified 163 patients presenting to the ED with gluteal AFT complications in a 30-month period between 2020 and 2023, provides one of the most comprehensive and informative datasets on the breadth of AFT complications as they are currently being performed. Accessed March 6, 2024. units per patient.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

ACEP Now

JUNE 14, 2024

4,11 Oral corticosteroids are as effective as intravenous steroids, but a one-time dose of intravenous methylprednisolone 125 mg in the ED is useful for patients who obviously cannot tolerate oral medications. Accessed May 19, 2024. Tintinalli JE, Stapczynski JS, Ma OJ, et al, eds. 8 Bronchodilators Albuterol 2.5-5 Updated Feb.

ALS 52

ALS Coronary OR ED 52

REBEL EM

NOVEMBER 11, 2024

They analyzed the electronic health records of patients presenting to the ED who met modified Center for Disease Control and Prevention (CDC) sepsis surveillance criteria and received empiric treatment with either vancomycin/piperacillin-tazobactam or vancomycin/cefepime. Comorbidity Index : Higher in the cefepime group (median 2 vs. 1).

E-9-1-1 108

E-9-1-1 ALS ICU Critical Care 108

Broome Docs

NOVEMBER 17, 2024

2024 Aug;201:110266. Epub 2024 Jun 9. 2024 Jul;8(7):482-490. Epub 2024 Jun 4. 2024 May-Jun;22(3):230-232. 2024 Jun 22:S0196-0644(24)00232-4. 2024 Sep 16:e2415815. 2024 Jun 4;5(3):e13210. 2024 Sep 26;391(12):1108-1118. 2024 Aug;201:110266. Epub 2024 Jun 9. Resuscitation.

Epinephrine 61

Epinephrine Emergency Department Critical Care ICU 61

EMDocs

JANUARY 14, 2025

For the presentation and ED evaluation of GBS, please see Part 1. Episode 112: Guillain-Barr Syndrome Part 2 ED treatment: IVIG and plasma exchange are the main treatment modalities. 2024 Jan;75:90-97. Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the management of Guillain-Barr syndrome. Am J Emerg Med.

Plasma 98

Plasma Epinephrine ICU ED 98

REBEL EM

DECEMBER 23, 2024

Both these physiologic principles and recent preclinical evidence have called into question whether NS is the best resuscitation fluid for patients experiencing VOE due to concerns its tonicity and tendency to induce acidosis may promote sickling ( Carden 2017a , Carden 2017b , Alwang 2024 ). Sickle Cell Disease in the ED.

ALS 128

ALS ED ACS EMR 128

REBEL EM

NOVEMBER 25, 2024

2024 Feb 83(2):132-144. Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Duration of intubation: Nine of thirteen studies reported slightly longer intubation times with a bougie, with a maximum average increase of 13 seconds in ED–based studies. 2024 Feb 83(2):132-144.

Operating Room 104

Operating Room Emergency Department ICU ALS 104

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has received 20ml/kg in 5 to 10ml/kg aliquots in the ED, as his blood pressure keeps dropping, and the ED team is concerned about possible sepsis. Approximately 20% of adults with septic shock in the ICU exhibit venous congestion, with significant implications for prognosis and treatment.[3] Can J Anaesth, 2024.

Critical Care 78

Critical Care ALS OR ICU 78

EMDocs

JANUARY 20, 2025

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. For links to FOAM-ED ultrasound content, see the section after take-home points.) 11 A study by Stephan et al. Tullo et al.

ED 75

ED ALS Emergency Department Critical Care 75

EMDocs

FEBRUARY 8, 2025

A 65-year-old male with a past medical history of chronic obstructive pulmonary disease on 2 liters per minute (LPM) nasal cannula at baseline, hypertension, hyperlipidemia, and polypectomy presents to the ED with 2 days of worsening shortness of breath, pleuritic chest pain, persistent fevers, and productive coughs with occasional hemoptysis.

ED 73

ED E-9-1-1 EMS ICU 73

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. 2024 Mar 12;14(1):5978. Acute chest syndrome in sickle cell disease.

E-9-1-1 98

E-9-1-1 ICU ACS EMS 98

FOAMfrat

NOVEMBER 21, 2024

Today, increased mortality rates, higher transfusion requirements, and lengthened ICU stays are recognized as proximate effects of the Trauma Triad. upon ED arrival incur mortality rates of up to 3-5x that of patients without coagulopathy. PubMed , StatPearls Publishing, 5 May 2024, www.ncbi.nlm.nih.gov/books/NBK603758/.

ICU 119

ICU Emergency Department OR ED 119

Don't Forget the Bubbles

MARCH 3, 2025

This month, the team from Royal Manchester Childrens ED highlights the diversity of current paediatric literature, ranging from air pollution, wheeze, trauma, surgery, to sadly but inevitably, child death. This month, the team from ED highlights the diversity of current paediatric literature to reflect the versatility of RMCH ED.

Emergency Department 88

Emergency Department ED OR ALS 88

EMDocs

JANUARY 16, 2025

2024 Jun 26:S0140-6736(24)00495-1. 2024 Feb 27;331(8):675-686. but PPV ranges from 25.1-39.5% years Internal validation cohort: 43,400 patients with mean age 3.7 years External validation cohort: 45,855 patients with mean age 2.6 0.38 (95% CI 0.20-0.39) 0.39) AUROC of 0.71-0.92 0.92 (95% CI 0.70-0.92) and PPV of 5.3-7.1% and PPV of 5.3-7.1%

ALS 95

ALS Critical Care ICU Emergency Department 95

Core EM

JANUARY 16, 2025

While this guide isnt exhaustive, its designed by residents, for residents, to provide practical tips and foundational knowledge thats crucial in the fast-paced, high-stakes environment of the ED. Introduction Airway management is a critical ED skill to master. Want an even more powerful option? Pre-oxygenate with BiPAP (Farkas 2015).

E-9-1-1 130

E-9-1-1 EMS ALS OR 130

EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. Labs Laboratory workup in the ED is notable for a leukocytosis of 41,000/L, hemoglobin of 6.5 She is sent to the medical ward after three days in the ED with the diagnoses of resolving septic shock, severe malaria, and AKI.

ED 75

ED E-9-1-1 ALS Emergency Department 75