EMS 12-Lead

MAY 15, 2024

TCP in the ROSC Patient: False Electrical Capture at 75mA Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the second installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. Pacing was continued in the ED, with identical settings.

Epinephrine 331

Epinephrine Paramedic CPR ED 331

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

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 106

ALS ED 106

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

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

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 108

ALS ED 108

The Skeptics' Guide to EM

NOVEMBER 18, 2017

[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Outside his family and work, Jesse pours […] The post SGEM#195: Some Like It Hot – ED Temperature and ICU Survival first appeared on The Skeptics Guide to Emergency Medicine. display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al.

ICU 130

ICU ED Emergency Department Critical Care 130

REBEL EM

MAY 20, 2024

A 67-year-old woman with a history of atrial fibrillation on apixaban presents to the ED for epistaxis that began 30 minutes ago. Post TW, ed. In: Tintinalli JE, Ma OJ, Yealy DM, et al., In: Tintinalli JE, Ma OJ, Yealy DM, et al., Her vital signs are within normal limits. How should this patient’s apixaban be managed?

ALS 59

ALS ED EMS 59

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

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

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

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

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 23, 2023

Article: Abella BS et al. Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 Anecdotally, the persistence of urticaria often has little influence on the decision to discharge a patient from the ED.

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

REBEL EM

MARCH 11, 2024

In: Tintinalli JE, Ma OJ, Yealy DM, et al., Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review MyEMCert Question appeared first on REBEL EM - Emergency Medicine Blog. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. McGraw-Hill; 2020:(Ch) 89.

Emergency Department 59

Emergency Department ED ALS EMS 59

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

REBEL EM

JANUARY 22, 2024

In: Walls RM, Hockberger RS, Gausche-Hill M, et al., Roy PM, Penaloza A, Hugli O, et al. Stevens SM, Woller SC, Kreuziger LB, et al. Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review MyEMCert Question appeared first on REBEL EM - Emergency Medicine Blog. Rosen’s Emergency Medicine: Concepts and Clinical Practice.

ALS 59

ALS ED EMS OR 59

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 115

Coronary ACS OR EMR 115

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

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

DECEMBER 18, 2023

Post TW, ed. In: Tintinalli JE, Ma OJ, Yealy DM, et al., Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. Peritoneal catheter exit-site and tunnel infections in peritoneal dialysis in adults. UpToDate Inc. Accessed September 28, 2023.

EMS 59

EMS ED ALS 59

EMOttawa

MARCH 25, 2024

Methodology: 3/5 Usefulness: 3/5 Bandyopadhyay A, et al. They report […] The post Peri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial appeared first on EMOttawa Blog. Anesth Analg. 2023 May 1;136(5):913-919.

ALS 56

ALS Critical Care ED 56

REBEL EM

SEPTEMBER 23, 2024

What The Evidence Says: Etomidate has long been the favored induction agent for ED RSI in the US. PMID: 21373823 Cohen L et al. PMID: 25064742 Kotani Y et al. J Crit Care 2023;77: PMID: 37127020 Koroki T, Kotani Y, Yaguchi T, et al. appeared first on REBEL EM - Emergency Medicine Blog. Intensive Care Med.

ALS 75

ALS EMS ED OR 75

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

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

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 100

ALS ICU ED OR 100

REBEL EM

FEBRUARY 21, 2024

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Read More REBEL EM: The Ketorolac Analgesic Ceiling References Irizarry E et al. PMID: 34133820 Arora S et al. Arch Surg 1998;133:432-7.

E-9-1-1 64

E-9-1-1 Emergency Department ALS ED 64

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-9-1-1 110

E-9-1-1 Coronary STEMI ALS 110

REBEL EM

AUGUST 17, 2023

In: Walls RM, Hockberger RS, Gausche-Hill M, et al., Post TW, ed. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. Femur and hip injuries. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Elsevier; 2023:(Ch) 47. Von Fange TJ.

EMS 52

EMS Emergency Department ED ALS 52

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

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

SEPTEMBER 18, 2024

He was brought to the ED. As discussed often in Dr. Smith's ECG Blog — quick determination of heart rate often provides an important clue to the etiology of certain regular SVT ( S upra V entricular T achycardia ) rhythms ( See My Comment in the July 19, 2023 post , among others ). They did not feel they had time to sedate.

E-9-1-1 64

E-9-1-1 ALS OR ED 64

REBEL EM

OCTOBER 23, 2023

His parent noticed a dental problem and immediately brought the patient to the ED. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. The patient was walking his dog when it ran after a squirrel. The physical exam is shown below. Dent Traumatol.

EMS 59

EMS ACS ALS ED 59

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

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 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