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Reference: Snelling et al. New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and criticalcare. Reference: Snelling et al. Reference: Snelling et al.
Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , CriticalCare , Resuscitation Show Notes Coagulation Cascade: Algorithm for Anticoagulated Bleeding Patient in the ED: Indications for Anticoagulation Reversal: References: Baugh CW, Levine M, Cornutt D, et al.
Adapted from Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. We recommend considering fentanyl plus propofol or dexmedetomidine as the routine first options for the choice of analgosedation agents in the emergencydepartment. mg/kg 0.01 – 0.1
Date: August 30, 2023 Reference: Griffey et al. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. This is the last show for […] The post SGEM#414: The SQuID Protocol first appeared on The Skeptics Guide to Emergency Medicine.
link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergencydepartment. Joly, 2017; Sawler, 2020) Fresh frozen plasma (FFP) (contains ADMTS-13) may be used to supplement ADAMTS-13 if there is a delay in initiating TPE in the emergencydepartment (i.e. Ann Hematol.
After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to trauma in the EmergencyDepartment. Reference Lin M, Phipps M, Chan TM, et al. Ann Emerg Med.
and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergencydepartment (ED) coughing up blood. He is the founder and host of the Emergency Medicine Cases podcast and website. References Grasl S, Mekhail P, Janik S, et al. Ann Emerg Med.
After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the EmergencyDepartment. Reference Lin M, Phipps M, Chan TM, et al. Ann Emerg Med.
Acad Emerg Med. Holmes, James F et al. Academic emergency medicine 12.9 Inter-Rater Reliability Between CriticalCare Nurses Performing a Pediatric Modification to the Glasgow Coma Scale. Pediatr Crit Care Med. Interrater reliability of Glasgow Coma Scale scores in the emergencydepartment.
Date: January 29th, 2020 Reference: Perry et al. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the EmergencyDepartment and CriticalCaredepartment. first appeared on The Skeptics Guide to Emergency Medicine. Date: January 29th, 2020 Reference: Perry et al.
[display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. EmergeNcyDepartment use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. Reference: Caputo et al.
But does it hold up in the unpredictable world of emergency paediatric intubation ? Thats exactly what Shane George et al. set out to explore in the Kids THRIVE study investigating whether NHF apnoeic oxygenation could improve intubation outcomes in critically unwell children needing emergency airway management.
[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Fever in the EmergencyDepartment Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. CriticalCare Medicine 2017. display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al.
Emergency Medical Journal [Internet] 2022;39;52-56. Available from: [link] Dixon-Woods M, Baker R, Charles K, et al. Fnais N, Soobiah C, Chen MH, et al. Keller S, Yule S, Zagarese V, et al. Bad manners in the EmergencyDepartment: Incivility among doctors. Available at: [link] Fehr R, Gelfand MJ, Nag M.
Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergencydepartment (BUSED) predicts final surgical management decisions. Date: March 22, 2023 Reference: Hilsden et al. He is also now a fully-fledged “sonologist”. He is also now a fully-fledged “sonologist”.
You’re in the paediatric emergencydepartment, typing some notes for the child you’ve just discharged. Trends in Anaesthesia and CriticalCare. Promoting hot debriefing in an emergencydepartment. Team talk and team activity in simulated medical emergencies: a discourse analytical approach.
Date: September 11th, 2019 Reference: Putzu et al. The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. CriticalCare Medicine. Date: September 11th, 2019 Reference: Putzu et al. CriticalCare Medicine.
Paper: Dequin P, Meziani F, Quenot J, et al. Demonstrating a significant reduction in mortality with a single medication in the criticalcare setting is challenging. Current Events In a recent study by Meduri et al. References: Confalonieri M, Urbino R, Potena A, et al. Am J Respir Crit Care Med 2005;171:242-8.
After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the EmergencyDepartment. Reference Lin M, Phipps M, Chan TM, et al. Ann Emerg Med.
Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergencydepartment (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K. The Journal of Emergency Medicine.
Date: September 15, 2022 Reference: Ramnarayan P et al. Effect of high-flow nasal cannula therapy vs continuous positive airway pressure therapy on liberation from respiratory support in acutely ill children admitted to pediatric criticalcare units: a randomized clinical trial. In 2018, Ramnarayan et al.
Date: January 5th, 2021 Reference: Grunau et al. JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and criticalcare as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?
Reference: Peters MJ, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-picu): a UK multicentre, open, parallel-group, randomised clinical trial. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergencydepartment (ED) with fever and respiratory distress.
Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Reference: Matchett, G.
[display_podcast] Date: December 19th, 2017 Reference: Perry J et al. CMAJ Nov 2017 Guest Skeptic: Dr. Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medicine and CriticalCare course.
Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric CriticalCare Attending at Cincinnati Children’s Hospital Medical Center. Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med.
In addition to the reduced risk for major bleeding, use of mechanical thrombectomy techniques has been shown to decrease hospital costs by reducing the need for post-procedural criticalcare following intervention. References Silver MJ, Giri J, Duffy , et al. Shah IK, Merfeld JM, Chun J, et al. 2023;2(1):100548.
2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergencydepartment (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. N Engl J Med.
[display_podcast] Date: February 14th, 2018 Reference: Venkatesh S et al. Guest Skeptic: Dr. Rory Spiegel (@EMNerd_) is a clinical instructor at University of Maryland, a recent graduate of Stony Brook’s Resuscitation Fellowship, and a current CriticalCare fellow at University of Maryland. NEJM January 2018. NEJM January 2018.
Date: January 9th, 2020 Reference: Casey et al. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. NEJM February 2019 Guest Skeptic: Andrew Merelman is a criticalcare paramedic and second year medical student at Rocky Vista University in Colorado. Date: January 9th, 2020 Reference: Casey et al.
Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergencydepartment (ED). JAMA Sept 2021.
Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital EmergencyDepartment. Nearly half of all post-AFT patients presenting to our emergencydepartments required admission and six percent required ICU admission.
Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and criticalcare physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.
Turgeon AF, Fergusson DA, Clayton L,et al. Emerg Med J. PMID: 38238065 Oral vs IV ABs… another negative trial Nielsen AB, Holm M, Lindhard MS, et al. Emergency Medicine Journal Published Online First: 12 September 2024. Trends in Anaesthesia and CriticalCare. Too much ‘aint enough blood?
Sources Adelgais KM, Kuppermann N, Kooistra J, et al. Holmes JF, Lillis K, Monroe D, et al. Ann Emerg Med. Holmes JF, Yen K, Ugalde IT, et al. PECARN prediction rules for CT imaging of children presenting to the emergencydepartment with blunt abdominal or minor head trauma: a multicentre prospective validation study.
In most EmergencyDepartments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the EmergencyDepartment, he initiated ‘ The Pause.’ Kapoor et al.
Differences in intubation outcomes for pediatric patients between pediatric and general EmergencyDepartments. Intubation practice and outcomes among pediatric emergencydepartments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. Paediatr Anaesth. doi: 10.1111/pan.14185.
Date: June 18th, 2022 Reference: Crombie et al. Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Crombie et al.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (ED). Paper: Mason JM, et al. Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergencydepartment. Am J Emerg Med.
Date: March 4th, 2020 Reference: Radonovich et al. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel. first appeared on The Skeptics Guide to Emergency Medicine. Date: March 4th, 2020 Reference: Radonovich et al. A Randomized Clinical Trial. A Randomized Clinical Trial.
Emergencydepartments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Dr. Kluesner is an emergency physician in Iowa City, Iowa, at UnityPoint Health-Iowa Methodist Medical Center. References Morley, Claire, et al. PloS one 13.8
Pediatr EmergCare. Baumann F, Ernstberger T, Neumann C, et al. Leonard JC, Harding M, Cook LJ, et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergencydepartment with blunt trauma: a multicentre prospective observational study. Pediatr EmergCare.
Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults. Am J Emerg Med. If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergencydepartment pharmacist. References: Singer S, et al. 2022 Sep 5.
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