The Skeptics' Guide to EM

JUNE 4, 2017

Case: A 53-year-old woman in good health is brought in by ambulance after a motor vehicle collision. She did not lose consciousness but did bump her head. Her main complaint is chest pain with difficulty breathing. She is tachycardic, tachypnic and has some mild abdominal pain. .

OR 130

OR ALS CPR ICU 130

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. The patient was upgraded to the ICU for closer monitoring. What do you think? ng/mL, BNP 2790, and lactate 3.7.

E-9-1-1 138

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

EMDocs

DECEMBER 18, 2023

F) in the ambulance. Disposition The SSC guidelines suggest that patients with septic shock or critical illness be moved to the intensive care unit (ICU) within six hours of presentation to the ED. Restriction of Intravenous Fluid in ICU Patients with Septic Shock. She had a fever of 38.7 °C 2020;157(2):286-292. N Engl J Med.

E-9-1-1 95

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

Don't Forget the Bubbles

JUNE 30, 2023

Grabbing a pristine white table napkin to apply pressure to the wound, Ranulf’s class teacher and expedition leader called the ambulance as chaos descended on the restaurant. They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

The Overrun

MAY 18, 2020

Signs entering ambulance bays around the US, and the world for that matter; point out in no uncertain terms that “HEROES WORK HERE”. Nor does it improve ED throughput, ICU stay, acuity, or a half-dozen other measurements. Since the entry of COVID-19, EMS has noticed a difference. People wave. And that’s wrong.

EMS 52

EMS Firefighter Paramedicine Paramedicine 52

ACEP Now

JUNE 14, 2024

4,6,11 Antibiotics Antibiotic use for AECOPD patients remains a contentious topic; however, data suggests AECOPD patients requiring admission, particularly to the ICU, should receive antibiotics. Management Oxygen Supplemental oxygen should not be withheld despite risk of hypercapnia. 1 Titrate to oxygen saturation of 88-92 percent.

ALS 52

ALS Coronary OR ED 52

FOAMfrat

NOVEMBER 21, 2024

Today, increased mortality rates, higher transfusion requirements, and lengthened ICU stays are recognized as proximate effects of the Trauma Triad. Increasing cabin temperatures in your aircraft or ambulance might be uncomfortable for you, but important to your patient’s survival.

ICU 119

ICU Emergency Department OR ED 119

Dr. Smith's ECG Blog

APRIL 18, 2025

The patient was transferred to the ICU on pressors, where a repeat bedside echo showed an LVEF of 10-15%. He suffered another cardiac arrest in the ICU with ROSC after another dose of epinephrine and one round of CPR. After discussion with the patients family, the decision was made not to resuscitate in the event of re-arrest.

ED 81

ED ACS ICU OR 81