REBEL EM

MAY 27, 2024

What they did: Prospective randomized controlled trial, unblinded, multicenter study Conducted from January 2017 to December 2022 Patients with confirmed PSVT were randomly assigned to receive MVM, IV Adenosine, or combined therapy. This absence of detail leaves the study open to bias. Evidence suggests that a weight-based dosing approach (0.1

OR 137

OR E-9-1-1 ED ALS 137

Emergency Medicine Cases

OCTOBER 17, 2023

In this ECG Cases blog Dr. Jesse McLaren guides us through 10 cases, driving home the points that sepsis is a common cause of rapid Afib and diffuse ST depression with reciprocal ST elevation in aVR, myo/pericarditis is a diagnosis of exclusion, endocarditis or lyme carditis can cause AV block, PE can cause low grade fever and ECG signs of acute RV (..)

OR 251

OR STEMI EMS 251

ALiEM

FEBRUARY 5, 2024

8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. More specifically, we identified 3 AIR and 5 Honorable Mentions. Please go to the above link.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

Dr. Smith's ECG Blog

MAY 13, 2024

Chest Pain – Benign Early Repol or OMI? Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. But — Which ST-T wave is the "correct" one? (

OR 108

OR STEMI Heart Attack Coronary 108

Dr. Smith's ECG Blog

MARCH 28, 2024

Per EMS report, patient believes he has been in atrial fibrillation for 5 days, since coming down with flu-like illness with rhinorrhea, productive cough, SOB. Patient is on rivaroxaben, carvedilol, and dofetilide (to suppress atrial fib -- rhythm control). He states that he maybe missed a dose or two during recent illness. SVT with aberrancy?

OR 122

OR Emergency Department Ambulance EMS 122

ALiEM

NOVEMBER 3, 2023

8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. More specifically, we identified 3 AIR and 5 Honorable Mentions. Please go to the above link.

Critical Care 211

Critical Care EMS Emergency Department ALS 211

Emergency Medicine Cases

AUGUST 8, 2023

In this ECG Cases blog with Dr. Jesse McLaren we interpret 10 ECG cases and explore cardiac, metabolic and GI causes: We consider anginal equivalents, and look for ECG signs of Occlusion MI, including subacute occlusion from delayed presentations.

STEMI 217

STEMI OR EMS 217

Dr. Smith's ECG Blog

OCTOBER 15, 2024

This is relevant — because among the causes of new low voltage is myocardial "stunning" from a large acute MI, such that this ECG finding may serve as a harbinger of a reduction in LV function that may soon be occuring ( See My Comment at the bottom of the page in the November 12, 2020 post of Dr. Smith's ECG Blog ).

OR 106

OR STEMI Coronary ED 106

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. Approach TCP with skepticism.

Epinephrine 331

Epinephrine Paramedic CPR ED 331

ALiEM

APRIL 14, 2023

6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 2 AIR and 4 Honorable Mentions. These posts have been flagged by and agreed upon by AIR Board members as worthwhile, accurate, unbiased, and appropriately referenced despite an average score.

EMS 246

EMS Emergency Department ED OR 246

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

For more on MINOCA — See My Comment in the November 16, 2023 post in Dr. Smith's ECG Blog ). Review of the 2 ECGs in today's case is insightful ( Figure-1 ): The initial ECG shows sinus rhythm, LAHB and meets Peguero Criteria for LVH ( See My Comment in the August 15, 2022 post of Dr. Smith's ECG Blog for more on LVH criteria ).

Coronary 116

Coronary ACS OR EMR 116

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Background: We’ve discussed out-of-hospital cardiac arrest (OHCA) at least once or twice on the SGEM (see long list at end of blog). You and your partner initiate high-quality CPR, place a supraglottic airway, establish intra-osseous (IO) access and administer epinephrine. Your partner asks if you want to administer naloxone as well.

Naloxone 239

Naloxone NARCAN Overdose CPR 239

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. TCP In Transit: A case reviewing transcutaneous pacing, false electrical capture, and re-arrest.

CPR 312

CPR Paramedic Ambulance Defibrillator 312

EMOttawa

JANUARY 25, 2024

With both ER and ICU experience, this post acts as a quick […] The post Mechanical Ventilation Basics appeared first on EMOttawa Blog. Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU.

ICU 141

ICU ED OR Critical Care 141

ALiEM

OCTOBER 14, 2023

6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. More specifically, we identified 3 AIR and 3 Honorable Mentions. Please go to the above link.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

The Skeptics' Guide to EM

JANUARY 13, 2024

Airway management in OHCA has also been covered in SGEM#247 and SGEM#396. We have looked at OHCA more than a dozen times on the SGEM.

CPR 219

CPR Defibrillator First Responder Epinephrine 219

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Smith : this ECG is definitely not OMI, but could be mistaken for Swirl pattern, which is a septal OMI with STE in V1 and STD in V6. See these cases: Precordial Swirl -- 20 cases of Swirl or Look-Alikes Subsequent serial high sensitivity troponin I measurements were all below the level of detection. AMI was ruled out altogether.

OR 116

OR STEMI EMS ED 116

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

This is diagnostic of full reperfusion.] An old ECG was found: As you can see, this patient has zero baseline STE, and normal T-waves. You never know if a patient's baseline has normal large STE or complete absence of STE, or somewhere in between. 90% of normals have some STE in V2 and V3. I focus my comment on this initial ECG in today's case.

OR 124

OR STEMI Coronary 124

EMOttawa

DECEMBER 18, 2024

Findings: There was no significant difference in reduction of pain scores or adverse […] The post Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatment of Acute Traumatic Pain: A Randomized Clinical Trial appeared first on EMOttawa Blog.

ALS 111

ALS OR 111

Dr. Smith's ECG Blog

OCTOBER 1, 2023

Elevated troponin" After hours of misdiagnosis and ongoing pain, the patient finally gets to go to the cath lab 6 hours after arrival ( could have been an immediate ECG diagnosis of LAD OMI using human expertise OR the Queen ), where they of course find a complete 100% thrombotic occlusion of the mid LAD, at the site of his prior LAD stent.

OR 128

OR STEMI Coronary CAD 128

Dr. Smith's ECG Blog

MAY 29, 2024

Written by Pendell Meyers Two patients with acute chest pain. Do either, neither, or both have OMI and need reperfusion? Patient 1: Patient 2: Patient 1: A man in his 40s with minimal medical history presented with acute chest pain radiating to his R shoulder.

CAD 100

CAD OR STEMI 100

ALiEM

JULY 20, 2023

6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 1 AIR and 5 Honorable Mentions. These posts have been flagged by and agreed upon by AIR Board members as worthwhile, accurate, unbiased, and appropriately referenced despite an average score.

Emergency Department 188

Emergency Department EMS OR 188

ALiEM

JANUARY 5, 2024

Read and Listen to the Other EM Match Advice Episodes Blog posts: [link] Author information Sara M. What does the Electronic Residency Application Service (ERAS) preliminary data show just far for the 2024 residency application season? Has the program signaling option been working? What should students think about in the post-interview stage?

EMS 177

EMS ALS OR 177

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. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Below you will find some of the points we discussed.

CPR 145

CPR ICU EMS ALS 145

FirstNet Authority

FEBRUARY 29, 2024

Update on February 22 Network Outage Blog joseph.rey@fir… Thu, 02/29/2024 - 13:49 By Joe Wassel, Executive Director and CEO, First Responder Network Authority Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters.

Public Safety 128

Public Safety First Responder OR 128

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

See our other blog posts of hypothermia and Osborn waves -- Massive Osborn Waves of Severe Hypothermia (23.6 We've discussed Osborn Waves ( both ischemic and hypothermic ) — on a number of occasions in Dr. Smith's ECG Blog ( Please check out My Comment at the bottom of the page in the February 8, 2022 post ).

ICU 132

ICU OR ALS ED 132

ALiEM

AUGUST 19, 2024

Tips for the personal statement Mentioned Resources CORD website: New MyERAS® Application: Guidance for Emergency Medicine Read and Listen to the Other EM Match Advice Episodes Blog posts: [link] Author information Sara M. A new section allows you to explaining any unplanned training extensions and interruptions.

EMS 152

EMS OR 152

EMOttawa

JUNE 27, 2024

Originating in the 1960s, this practice was propelled by anecdotal evidence and early case reports suggesting that un-immobilized cervical spine injuries could worsen […] The post Spinal Immobilization: a Twisted Tale appeared first on EMOttawa Blog.

EMS 107

EMS OR Critical Care 107

Dr. Smith's ECG Blog

OCTOBER 8, 2024

For more on Precordial Swirl — See the October 15, 2022 post in Dr. Smith's ECG Blog ). In support of my impression that the ST-T wave changes in the chest leads are acute until proven otherwise — is the ST segment flattening and depression in lead II — as well as the J-point ST depression in lead I ( BLUE arrows in these leads ).

OR 108

OR STEMI ICU Coronary 108

The Skeptics' Guide to EM

NOVEMBER 11, 2023

DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY. He will soon be transitioning out of the US military after a 20-year career in the Air Force and is soon to be Clinical Professor of Orthopaedics at UC San Diego.

ALS 240

ALS Emergency Department ED OR 240

Emergency Medicine Cases

OCTOBER 11, 2022

In this month's ECG Cases blog Dr. McLaren explains the PACER mnemonic approach to patients with pacemakers: Pacemaker spike: is it appropriately presence/absent, is there pacemaker-mediated tachycardia (apply magnet) or is there failure to pace (apply magnet to stop sensing, cardio consult)?

OR 130

OR EMS 130

EMS 12-Lead

SEPTEMBER 8, 2024

Complete Heart Block with Altered Mental Status Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the third installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. Rhonchi are auscultated bilaterally.

Paramedic 230

Paramedic EMT EMT EMS 230

EMOttawa

NOVEMBER 28, 2024

Obtaining peripheral ultrasound guided IV access is not only a core […] The post Ultrasound Guided Peripheral IVs appeared first on EMOttawa Blog. Do you spend 20 minutes performing an invasive central line? Does your resident finally get two IO EPAs? Or do you save the day with a slick, ultrasound guided IV?

OR 123

OR 123

FirstNet Authority

MARCH 7, 2024

Follow us on Twitter , Facebook , Instagram , and LinkedIn for the latest FirstNet Authority updates. For information on FirstNet products and services or to access your subscriber account, visit FirstNet.com.

Public Safety 113

Public Safety First Responder OR 113

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

A healthy 45-year-old female presented with chest pain, with normal vitals. The computer interpretation was “ST elevation, consider early repolarization, pericarditis or injury.” What do you think? There’s normal sinus rhythm, normal conduction, borderline right axis, and normal voltages. There’s TWI in aVL but this is concordant to its QRS.

OR 70

OR STEMI ACS Coronary 70

REBEL EM

JUNE 14, 2023

We both highly recommend this manual and will put a link at the bottom of the post for you to consider buying it. to 0.5mg (1mg/mL) IV Bolus: 5 to 20mcg (10mcg/mL) IV Infusion: 1 to 20mcg/min If Poor Response to Conventional Therapy Consider Epinephrine 100mcg IV bolus Norepinephrine infusion 0.1mcg/kg/min Vasopressin 0.01

Allergic Reaction 145

Allergic Reaction Epinephrine OR EMS 145

Dr. Smith's ECG Blog

SEPTEMBER 8, 2023

As we've emphasized on numerous occasions in Dr. Smith's ECG Blog — the problem is that spontaneous reclosure of the "culprit" artery could have occurred at any point in time, potentially with lethal consequence. This is diagnostic of Occlusion MI of the high lateral wall, either from circumflex or first diagonal.

OR 129

OR STEMI Coronary Emergency Department 129