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

Broome Docs

JANUARY 27, 2025

Full blog post here. 100% seems too good to be true Morello et al., European Journal of Internal Medicine , [link] You can listen to my 27-minute rant on Youtube here: [link] This multinational trial looked at a three-pronged diagnostic protocol in the ED for adults with suspected acute aortic syndromes.

ED 101

ED OR ACS Critical Care 101

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

FEBRUARY 8, 2020

Date: January 29th, 2020 Reference: Perry et al. He also has this amazing #FOAMed blog called EM Nerd. Date: January 29th, 2020 Reference: Perry et al. He also has this amazing #FOAMed blog called EM Nerd. Reference: Perry et al.

Emergency Department 130

Emergency Department Critical Care ALS EMS 130

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 110

ALS ED 110

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 97

Naloxone ED Overdose Emergency Department 97

The Skeptics' Guide to EM

AUGUST 18, 2018

[display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. Chris also has his own #FOAMed blog called Standing on the Corner Minding My Own Business ( SOCMOB ). Reference: Hohl C et al. AEM Aug 2018. AEM Aug 2018. AEM Aug 2018.

Emergency Department 130

Emergency Department Overdose ED ALS 130

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 113

ALS ED 113

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

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

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

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

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-9-1-1 123

E-9-1-1 Coronary ALS ED 123

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

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 137

ICU OR ALS ED 137

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

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 121

Coronary ACS OR EMR 121

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

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 120

STEMI CAD ED ALS 120

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-9-1-1 127

E-9-1-1 Coronary STEMI ALS 127

REBEL EM

JANUARY 24, 2024

Wallace 2011 ) If addressed early and appropriately, most patients have good self-reported long-term outcomes regardless of the treatment modality Links Orthobullets: Achilles Tendon Rupture Resources: Sheth U et al. PMID: 9519398 Kayser R et al. PMID: 16244194 Margetic P et al. PMID: 17598414 Garras DN et al.

ALS 101

ALS ED OR EMS 101

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 127

STEMI OR ED ALS 127

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 104

ICU ED ALS OR 104

Dr. Smith's ECG Blog

OCTOBER 30, 2023

Here is the first prehospital ECG (time 0, after one hour of pain): I do not see evidence of OMI, and neither did the Queen of Hearts Here is the 2nd prehospital ECG (time 10 minutes, after 70 minutes of pain): No change On arrival, the first ED ECG was recorded 20 minutes after the last one (90 minutes after pain onset): What do you think?

STEMI 123

STEMI ED ALS OR 123

Dr. Smith's ECG Blog

JUNE 2, 2023

Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED. They are rare and hard to find in normal practice in the ED. She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think? Cardiac MRI will tell you if ARVC is or is not present.

ED 96

ED OR ALS CAD 96

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

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 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