EMS 12-Lead

MARCH 30, 2024

Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the first installment of a blog series showing how transcutaneous pacing (TCP) can be difficult, and how you can improve your skills. On ED arrival ROSC is achieved. They are unable to feel a pulse and resume CPR.

CPR 312

CPR Paramedic Ambulance Defibrillator 312

ALiEM

OCTOBER 14, 2023

6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. Reference Lin M, Phipps M, Chan TM, et al. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. Ann Emerg Med. 2023;82(1):55-65.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

EMOttawa

JANUARY 22, 2024

5 Usefulness: 4/5 Friedman BW, et al. Question and Methods: This double-blinded RCT of 209 patients presenting to the ED with moderate to severe migraines compared high- to low- dose dexamethasone (16 mg vs 4 mg) on sustained headache relief 48 hours post discharge. Methodology: 3.5/5 2023 Oct 3;101(14):e1448-e1454.

ALS 107

ALS ED 107

REBEL EM

JULY 17, 2023

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED? Click here for Direct Download of the Podcast Paper: Knack SKS et al. PMID: Clinical Question: Does a single dose of ketamine or etomidate used for rapid sequence intubation (RSI) of critically adults in the ED impact the SOFA score within 3 days of hospitalization?

ED 98

ED ICU Emergency Department Overdose 98

REBEL EM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Available at: HERE Branch KHR et al. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Resus 2023.

CPR 145

CPR ICU EMS ALS 145

The Skeptics' Guide to EM

JANUARY 20, 2018

[display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, […] The post SGEM#203: Let Me Clear My Sore Throat with a Corticosteroid first appeared on The Skeptics Guide to Emergency Medicine. Reference: Sadeghirad B, et al.

Emergency Department 130

Emergency Department ALS EMS ED 130

The Skeptics' Guide to EM

APRIL 12, 2019

He is an ED intensivist from New York City and runs the popular EMCrit blog and podcast. He is an ED intensivist from New York City and runs the popular EMCrit blog and podcast. Date: April 10th, 2019 Guest Skeptic: Dr. Scott Weingart. Scott is attempting to bring upstairs care, downstairs one podcast at a time.

ALS 130

ALS ED EMS OR 130

REBEL EM

JUNE 5, 2023

These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The benefit of accessibility, availability, and safety of buprenorphine compared to methadone makes it a viable option for opioid use disorder treatment initiation in the ED. PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

EMOttawa

MAY 13, 2024

Methodology: 4/5 Usefulness: 3/5 von Hellmann R, et al. 95%CI 1.06 […] The post Effect of Bougie Use on First-Attempt Success in Tracheal Intubations: A Systematic Review and Meta-Analysis appeared first on EMOttawa Blog. Ann Emerg Med. 2024 Feb;83(2):132-144.

ALS 110

ALS ED 110

The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. Date: November 30th, 2022 Reference: Johnson et al. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY. He’s got a big job coming up in a couple of months and can’t work with a cast.

Emergency Department 130

Emergency Department ALS ED OR 130

REBEL EM

FEBRUARY 15, 2024

Background: Patients with decreased level of consciousness due to alcohol, drugs, or medications commonly present to the ED. Paper: Freund Y et al. References: Freund Y et al. It is unclear, though, if the risks of intubation (including ventilator associated pneumonia) outweighs the benefits.

ICU 141

ICU ALS ED OR 141

The Skeptics' Guide to EM

JULY 25, 2020

Emlyn’s blog and podcast. Emlyn’s blog and podcast. Reference: Carley et al. The bottom line from that episode on skin glue for peripheral intravenous lines was: “Skin glue does appear to decrease the failure rate of IVs in patients admitted to hospital from the ED at 48 hours.

ED 130

ED ALS OR 130

The Skeptics' Guide to EM

JANUARY 16, 2021

Date: January 5th, 2021 Reference: Shipman et al. Date: January 5th, 2021 Reference: Shipman et al. In the emergency department (ED), tetracaine drops are applied prior to slit lamp examination and the pain is completely resolved. He tried some over-the-counter red eye drops that did not seem to work.

ALS 130

ALS Emergency Department EMS ED 130

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Date: November 10th, 2022 Reference: de-Madaria E et al. Date: November 10th, 2022 Reference: de-Madaria E et al. Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice.

ALS 130

ALS Emergency Department OR EMS 130

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. See our other blog posts of hypothermia and Osborn waves -- Massive Osborn Waves of Severe Hypothermia (23.6 Rituparna et al — as well as Chauhan and Brahma ( Int. There is also large T wave inversion and long QT.

ICU 132

ICU OR ALS ED 132

REBEL EM

NOVEMBER 15, 2023

However, data is limited in ED patients. The ED AWARENESS study found a 2.6% “The ED-AWARENESS study: A prospective, observational cohort study of awareness with paralysis in mechanically ventilated patients admitted from the emergency department.” References Pappal, Ryan D., ” Annals of emergency medicine 77.5

Emergency Department 105

Emergency Department ED EMS ALS 105

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. Richards JE et al. NEJM 1994. [2]

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

The Skeptics' Guide to EM

SEPTEMBER 1, 2018

[display_podcast] Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. display_podcast] Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. He writes a blog called Broken Toy covering topics such as his experience with burnout, medical education and looking after each other. Pediatrics.

ALS 130

ALS Emergency Department OR EMS 130

The Skeptics' Guide to EM

APRIL 16, 2022

Date: April 16th, 2022 Reference: Blom et al. Disclaimer: The views and opinions of this blog […] The post SGEM#365: Stop! Date: April 16th, 2022 Reference: Blom et al. Disclaimer: The views and opinions of this blog and podcast do not represent the United States Government or the US Military. Tricoci et al.

Emergency Department 100

Emergency Department ALS OR ED 100

EMS 12-Lead

APRIL 21, 2022

The ECG’s were sent to the PCI center, and the providers in the respective ED identified the T wave characteristics mentioned above. From Smith ECG Blog LCx occlusion There is aVR STE with broad STD, appreciable in both Leads II and V5. STEMI was activated and the patient went to Cath on arrival. link] [1] Mirand, D. 2] Aslanger, E.,

Coronary 130

Coronary ALS OR ACS 130

Dr. Smith's ECG Blog

JANUARY 20, 2024

Cardiology refused to be the admitting physician because it was "NSTEMI", and forced the ED physician to admit the patient to the hospitalist. Of course, there was terrible boarding and the patient was considered non-emergent (NSTEMI), and so could not leave the ED for some time. de Winter et al in N Engl J Med 359:2071-2073, 2008.

STEMI 115

STEMI CAD ED ALS 115

Dr. Smith's ECG Blog

OCTOBER 3, 2024

Not OMI with High Confidence Click here to sign up for Queen of Hearts Access We showed that the Queen of Hearts decreases false positive cath lab activations: 1) Published recently in Prehospital Emergency Care Baker PO et al. 2) To be presented at AHA conference in Chicago in 2 weeks: Sharkey SW et al. Full text ! 27 post ).

E-9-1-1 111

E-9-1-1 Coronary ALS ED 111

REBEL EM

JANUARY 9, 2024

Bottom Line Up Top: In patients with infectious processes that are stable for discharge home, there is no role for giving a first dose of antibiotics IV in the ED. PMID: 9114201 Siegel RE et al. BMJ (Clinical research ed.). PMID: 17090560 Castro-Guardiola A et al. PMID: 1664833 Addo-Yobo E, et al. Pneumonia 2017.

ALS 99

ALS ICU ED OR 99

REBEL EM

SEPTEMBER 21, 2023

Type 2 MI is common in the ED and can result from vigorous exercise (common in athletes after marathons), sepsis, trauma and tachydysrhythmias including SVT. Read More EMRAP: Cardiology Corner: Troponins in SVT CoreP: Tachydysrhythmias References Gabrielli M et al. appeared first on REBEL EM - Emergency Medicine Blog.

Coronary 143

Coronary ACS ED OR 143

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. He arrived to the ED at around 6:45am, and stated the pain has persisted. Here is his ED ECG at triage: Obvious high lateral OMI that does not quite meet STEMI criteria. The pain radiated to both shoulders.

Coronary 116

Coronary ACS OR EMR 116

Dr. Smith's ECG Blog

JUNE 17, 2024

In fact, Kosuge et al. 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. found normal ECGs in only 3 of 50 patients with massive PE, and 9 of 40 with submassive PE. of patients with PE and 3.3% of controls.

E-9-1-1 138

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

REBEL EM

OCTOBER 2, 2023

One solution to decrease ICU admission is to treat these patients in the ED until their anion gap is closed and the patient can be transitioned from IV insulin infusion to SQ insulin. Paper: Griffey RT et al. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. tests/hr (0.8

ICU 105

ICU ED ALS OR 105

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Additionally, they host selected guests for special episodes, and publish blogs dedicated to more advanced medical questions or topics. Reference: Ruberto et al. Case: A 32-year-old male patient presents to your emergency department (ED) with severe nausea, vomiting and abdominal pain. Reference: Ruberto et al.

ALS 100

ALS Emergency Department Paramedic OR 100

Dr. Smith's ECG Blog

MARCH 4, 2024

Algorithm: Marquette 12 SL (GE) The Queen gets it right Case 9 (prehospital and ED ECGs). The Queen gets it right First ED ECG: Hyperacute T-waves persist. Echocardiography, even (or especially) with Speckle Tracking, can get you in trouble. The ECG told the story. 30 yo woman with trapezius pain. HEART Pathway = 0.

STEMI 110

STEMI OR ED ALS 110

REBEL EM

SEPTEMBER 13, 2023

Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. PMID 25629740 Hassen GW et al. PMID 23062323 Kostis JB et al. PMID 16043683 McCormick M et al. PMID 20954277 Sinnert R et al. Zuraw et al. In: UptoDate, Feldweg AM (ed.) N Engl J Med.

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

EMS 12-Lead

APRIL 28, 2022

Grauer on the Smith ECG Blog: [link] Take a deep dive into the management of TdP versus PVT with Dr. Smith: [link] [1] Callans, D. Josephson’s Clinical Cardiac Electrophysiology: Techniques and Interpretations (6th ed). Chou’s Electrocardiography in Clinical Practice (6th ed). Marriott’s Practical Electrocardiography (13th ed).

E-9-1-1 130

E-9-1-1 ALS Coronary EMS 130

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. This is beyond the scope of this blog post. After all these considerations and thinking about receptors, you feel that Ed is most likely to have a problem with low vascular tone. After 40ml/kg of IV 0.9%

Advanced Life Support 143

Advanced Life Support ED ALS OR 143

REBEL EM

JUNE 22, 2023

Article: Bramante CT et al. Had a very precise four-part definition of severe COVID-19 (Hypoxemia at home, ED Visit, Hospitalization, death) 95% of participants completed at least 9 months of follow-up Patient had to receive diagnosis of long-COVID from a medical professional (not simply based on symptom reporting).

ALS 145

ALS OR EMS ED 145

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Consider the following: We become attuned to looking for acute coronary occlusion in patients who present with acute symptoms to the ED ( E mergency D epartment ). More than just RBBB — the qR pattern in lead V1 is an ECG indicator of pulmonary hypertension in today's case ( See My Comment in the March 28, 2022 post in Dr. Smith's ECG Blog ).

E-9-1-1 115

E-9-1-1 Coronary STEMI ALS 115

Dr. Smith's ECG Blog

APRIL 22, 2024

It was present on arrival at triage but then resolved before bed placement in the ED. This is a demonstration of how Wellens' is transient OMI : First ED ECG is Wellens' (pain free). Lemkes JS, et al. It is a ssociated with mild dyspnea on exertion. At times the pain does go to his left neck. Eur Heart J [Internet].

Coronary 119

Coronary STEMI ED OR 119

REBEL EM

APRIL 17, 2023

Article: Kim DJ et al. The neck and thyroid are particularly vulnerable to radiation (Tipnis et al.). Additionally, potential increases in resource utilization, healthcare expense, and ED length of stay are also essential considerations. Podcast Blog. appeared first on REBEL EM - Emergency Medicine Blog.

OR 129

OR ALS ED EMS 129

The Skeptics' Guide to EM

JULY 16, 2022

Date: July 16th, 2022 Reference: Lamontagne F et al. Date: July 16th, 2022 Reference: Lamontagne F et al. Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice.

ICU 100

ICU ALS Critical Care Emergency Department 100