Emergency Medicine Cases

MARCH 9, 2021

Thomas Friedman’s book The World Is Flat is an exploration of how globalization and modern communications technology have changed the world. Our emergency care systems entered the pandemic on decidedly bumpy terrain; can we use technology and innovation to flatten and protect them—to make them more resilient?

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ED EMS 130

Critical Care Scenarios

MAY 31, 2020

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed.

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Critical Care Epinephrine ED ALS 100

The Skeptics' Guide to EM

SEPTEMBER 1, 2018

Case: You are working in the emergency department (ED) and have just been involved in a difficult case in the resuscitation room. A better option is to try kindness as outlined in the excellent book by Dr. Brian Goldman. We discussed Brian’s book on the SGEM Xtra called Don’t Give Up – The Power of Kindness.

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ALS Emergency Department OR EMS 130

ACEP Now

NOVEMBER 7, 2023

Aisha Terry spoke at the Summit on Emergency Department Sickle Cell Care, and discussed point of care tools, standardization of care processes, improving ED care and more. Vetted details, unparalleled access, and actionable insights about group structure, leadership, policies and more, make ACEP Open Book an indispensable resource.

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Emergency Department EMS ED OR 98

ACEP Now

JANUARY 4, 2025

I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr. Clarke said. ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in C booththe main trauma roomwith an ED tech administering CPR. Click to enlarge.) Click to enlarge.)

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ED Emergency Department Ambulance CPR 52

ACEP Now

DECEMBER 6, 2024

His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of nonhealth issues. Today, Dr. Morhaim is donating his time to a recently established Maryland commission focused on ED wait times. His path toward state legislative work was set.

Emergency Department 98

Emergency Department ED Ambulance OR 98

The Skeptics' Guide to EM

JUNE 29, 2018

Background: Lower back pain is one of the most common emergency department (ED) complaints, comprising approximately 2.6 Opioids are frequently used in the ED to treat pain and ED physicians are among the most frequent prescribers of opioids [2]. million visits per year in the US [1]. The first time was with Dr. Al Sacchetti.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

MARCH 13, 2021

Lancet 2021 Case: You’re working a busy evening shift in your community emergency department (ED) when a 58 year old female presents with a rapid onset terrible intensity headache. She has no significant headache history and you are concerned for subarachnoid hemorrhage so you order a head CT which confirms your suspicions.

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ALS Emergency Department ED OR 100

The Overrun Podcast

DECEMBER 13, 2018

On today’s show, Ed interviews the host of The Medic Mindset podcast, Ginger Locke. We also talk about a few books that might change your practice, or how you think. We also talk about a few books that might change your practice, or how you think. How do you learn? How do your students learn? How do you learn?

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Paramedic EMS ED OR 52

ALiEM

AUGUST 9, 2023

Distractions such as a toy, book, or phone/tablet can also help ease anxiety. ED Course The patient received antibiotics for pneumonia. Technique Positioning and Probe Figure 1: Younger children can sit in their parent’s lap and give a hug for lateral and posterior lung scanning. Warm gel helps with the child’s comfort.

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E-9-1-1 Emergency Department ALS OR 246

EMS 12-Lead

APRIL 2, 2022

So, when I first began teaching ECGs and writing my books (in the early 1980s) — I decided to synthesize my impressions of the literature into what I felt (e.g. Chou’s Electrocardiography in Clinical Practice, 6th ed. Goldberger’s Clinical Electrocardiography: A Simplified Approach, 9th ed. 2] Surawicz, B. & Knilans, T.

ALS 130

ALS STEMI Coronary OR 130

The FllightBridge ED

AUGUST 27, 2024

I picked up a new book the other day called The Personal MBA by Josh Kaufman, and within the first few pages, I got hit with a…

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Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

ECG 1 at time zero EARLY REPOLARIZATION ABNORMAL ECG ED final official overread: "early repol vs hyperacute T, minimal changes from previous (previous shown below)" What do YOU think? See these casese (and I have many others): First ED ECG is Wellens' (pain free). A 70-something y.o. male presents to triage with shortness of breath.

STEMI 116

STEMI ACS Critical Care Coronary 116

Prehospital Emergency Care Podcast

APRIL 12, 2019

Prehospital Emergency Care Podcast Small-batch: Paramedic Education Requirements "A mind needs books like a sword needs a whetstone if it is to keep its edge." Tyrion Lannister, Game of Thrones More paramedic education is always beneficial. But should a secondary degree be mandated for paramedicine?

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Paramedicine Paramedicine Paramedic EMS 52

Dr. Smith's ECG Blog

JULY 12, 2023

Turns out that it was a 50-something patient with no previous cardiac history who had called 911 for chest pain and had presented 75 minutes earlier by ambulance to triage (as the entire ED was overloaded). All triage ECGs are immediately shown to triage ED faculty.

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ED Coronary Ambulance OR 94

Dr. Smith's ECG Blog

APRIL 26, 2017

Note 2 other similar cases at the bottom that come from my book, The ECG in Acute MI. To the ED providers, the patient denied CP, SOB, or drug use. This is the ED bedside echo, recorded during ST elevation: Parasternal short axis shows huge concentric LVH. What do you think? Is there a formula to help with this?

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STEMI ACS ED Coronary 52

Don't Forget the Bubbles

AUGUST 7, 2023

Clinicians may under or over-estimate paediatric patients presenting to the ED as being at high-risk for sepsis if there do not have evidence-based heart and respiratory rate ranges, Brennan et al set out to add to our understanding of what is ‘normal ’ in paediatric vital signs. and one in the US by Bonafide et al. What is the problem?

Life Support 98

Life Support Advanced Life Support ALS Emergency Department 98

ACEP Now

NOVEMBER 14, 2023

The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. Following the pandemic, the ED saw a surge in its volume as it raced through 60,000 to 80,000 visits per year. The ED went from daily volumes of 180 patients per day [PPD] to over 210 PPD.)

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Emergency Department Operating Room ED OR 52

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Case A 25-year-old-female presented to the ED in cardiac arrest. Summary This case exemplifies the value of POCUS in cardiac arrest patients in the ED. EKG RV strain. 2014 May;145(5):950-957.

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ED NARCAN ALS OR 98

The Overrun

JANUARY 23, 2023

I’ve read all his books, seen him live, and watched all of his series. In his book, Kitchen Confidential , he talks about the business of cooking food a lot like colleagues I know talk about EMS. In one of the better parts of this book, he shares with you a typical day of his from waking up to end. In Snyder CR, Lopez SJ (eds.).

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Paramedic EMT EMT EMS 52

The FllightBridge ED

OCTOBER 19, 2023

I picked up a new book the other day called The Personal MBA by Josh Kaufman. Within the first few pages, I got hit with…

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REBEL EM

NOVEMBER 30, 2022

Clinical predictors for testicular torsion as seen in the pediatric ED. PMID: 22217895 Ban KM, Easter JS: Selected Urologic Problems; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Am J Emerg Med 2010; 28:786-789. PMID: 20837255 Sidler D et al. S Afr Med J.

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ALS ED OR EMS 52

The Overrun

MARCH 27, 2022

I apologize in advance to Sebastian Junger and his excellent book, The Perfect Storm. If you’ve read it or seen the movie with Mark Wahlberg; (and you should read the book), you know it’s about a combination of circumstances that come together in an unprecedented way to cause devastation. And then, graduation and licensure.

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EMS EMT EMT Emergency Transportation 52

ACEP Now

SEPTEMBER 3, 2024

25 Wesley Barnett had heard disturbing stories about the firm staffing his hometown critical-access ED as he was nearing the end of residency at the University of Kentucky, so he founded an independent physician group to try to take back the contract. Hospital, ED staffer American Physician Partners files for Chapter 11 bankruptcy.

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E-9-1-1 ALS Emergency Department OR 113

ACEP Now

AUGUST 12, 2024

ACEP also requires all exhibiting employers to have completed a profile in the ACEP Open Book encouraging greater transparency of group structure and policies. Topics include: Embracing Diversity in Medicine Working as a Female in the ED Brewing Success in the Transition from Resident to Attending What‘s Next?

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Emergency Department ED OR EMS 52

ACEP Now

JULY 6, 2023

Of course, the bill for any episode of emergency department (ED) care can be substantial, exceeding the billed charges for equivalent care provided in some primary care offices. Now, many acute pyelonephritis patients receive an IV antibiotic, analgesia, and an antiemetic in the ED.

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ALS Emergency Department STEMI ED 52

FEMinEM

FEBRUARY 8, 2021

When I arrived in the ED, I sought out the team leader to receive my assignment. Books, blogs, and mentors have suggested that women should try to emulate traditionally “masculine” characteristics when leading (e.g. A gruff nudge jerked me awake from a brief two hours of sleep. Team members were taking their positions.

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EMS Ambulance OR ED 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

It was worse on the evening prior to presentation while lying in bed, then recurred and resolved while at rest just prior to arriving in the ED. Here is the first ED ECG, with no pain: Sinus rhythm. The above principles are all well illustrated with this figure from my book, The ECG in Acute MI (2002). Computerized QTc = 419.

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Coronary STEMI ALS Emergency Department 52

Dr. Smith's ECG Blog

MARCH 11, 2016

Her prehospital ECG was identical to her first ED ECG, and the cath lab was activated: There is massive ST elevation (greater than 15 mm) in V2 and V3, with ST elevation in I and aVL and reciprocal ST depression in II, III, aVF. This comes from chapter 28 of my book The ECG in Acute MI ). Peterson ED, Hathaway WR, Zabel KM, et al.

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ALS STEMI OR CPR 52

Don't Forget the Bubbles

DECEMBER 16, 2024

This leads to delay or misdiagnosis in the ED, which may lead to missed measles cases. 2017 Dec;17(12) UK Health Security Agency Measles: the green book, chapter 21 (Accessed 14 Oct 2024) Versteegen P, Berbers GAM, Smits G, Sanders EAM, van der Klis FRM, de Melker HE, van der Maas NAT. Lancet Infect Dis.

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E-9-1-1 OR ALS Emergency Department 59

Dr. Smith's ECG Blog

APRIL 22, 2022

WHAT brought this 1st patient to the ED on the day he presented — which was no less than 3 weeks after the onset of his symptoms? C ASE # 2: The history in the 2nd Case was " 3 weeks of exertional chest pain" — in this patient who was "painfree on arrival" in the ED. This ECG is from Case #2. There is an "art" to eliciting the History.

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E-9-1-1 STEMI ALS ED 52

The Good, The Bad & The Ugly Paramedic

SEPTEMBER 30, 2021

The potential adverse patient effects of ambulance ramping, a relatively new problem at the interface between prehospital and ED care. Retrieved from [link] Paramedicine Board AHPRA. 2019/20 Annual Summary. Retrieved from [link] Ting, J. Journal of Emergencies, Trauma and Shock, 1 (2) 129-129. DOI: 10.4103/0974-2700.43201 Kennedy, M.

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Paramedic Paramedicine Paramedicine Ambulance 52

Dr. Smith's ECG Blog

AUGUST 8, 2020

This is a re-posting of a Tweet by Robert Jones (@RJonesSonoEM), reproduced with permission, written by Pendell Meyers A middle aged female with history of smoking presented to the ED with "bad heartburn." Here is her prior baseline ECG (first), and her ED ECG (second): Baseline: ED ECG: What do you think?

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STEMI ED Coronary OR 52

FOAMfrat

OCTOBER 8, 2023

The ventilator book. Ventilator management. FlightBridgeED, LLC. Columbia, SC: First Draught Press. and Mick, N., The Walls Manual of Emergency Airway Management. Wolters Kluwer. Pilbeam's Mechanical Ventilation. College.hamilton-medical.com. online] Available at: [Accessed 4 March 2021]. Hyzy, MD, R. and Jia, MD, S., online] Uptodate.com.

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OR ED Critical Care EMS 52

Dr. Smith's ECG Blog

JUNE 28, 2018

I believe that I was the first to represent Wellens as a reperfusion syndrome, in my book , The ECG in Acute MI , pages 22-23 and 51, and in chapter 27 on Reperfusion and Reocclusion. From my experience, I am confident that if it were formally studied, it would be born out. More outcome Peak troponin I was 0.58

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STEMI Coronary ALS OR 52

ALiEM

OCTOBER 30, 2024

Our experience: Traditionally, ED physicians do not like ordering urine drug screens (UDS). In our study, we used COWS alone in the ED, which does utilize restlessness, anxiety, and tachycardia as part of the formula, as the sole evaluation tool for tranq dope withdrawal. Some patients require re-dosing in the ED. 2023 [book].

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E-9-1-1 Naloxone Emergency Department ALS 161

The Overrun

APRIL 19, 2021

All the book knowledge in the world is useless if you cannot on produce that knowledge you’re learning on demand. And “the book” is a poor substitute for the real world, or the first time they do a procedure on an actual patient. If your student does it differently; that’s OK as long as the overall goal is met.

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Paramedic EMT EMT OR 52