The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services at Tacoma Community College. Case: During a busy emergency department (ED) shift the paramedic phone rings.

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EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

AUGUST 14, 2021

Missy is also now the director for Difficult Airway EMS course in Washington State Case: An EMS crew arrives to your emergency department (ED) with a 58-year-old female who suffered a witnessed ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA). Background: We have covered OHCA multiple times on the SGEM.

BLS 130

BLS CPR Paramedic ALS 130

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This is referred to as CPR I nduced C onsciousness ( CPRIC ). Ann Emerg Med. His name is Ben.

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E-9-1-1 Emergency Department ED CPR 135

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.

EMR 130

EMR Coronary Defibrillator Life Support 130

The Skeptics' Guide to EM

DECEMBER 2, 2017

He is currently deployed, practicing emergency medicine in an undisclosed location. Case: You are working a regular shift in the emergency department when you hear a code blue called. SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine?

CPR 100

CPR Defibrillator ALS Emergency Response 100

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care at Nassau University Medical Center. Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergency department (ED).

Epinephrine 100

Epinephrine Critical Care Life Support Emergency Department 100

Don't Forget the Bubbles

JUNE 19, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. CASP checklist for Clinical Prediction Rule (CPR) studies Is CPR clearly defined? Lancet Child Adolesc Health. 2024 Jun 3:S2352-4642(24)00104-4.

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CPR Operating Room OR Emergency Department 124

ACEP Now

JANUARY 4, 2025

The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established. 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.)

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ED Emergency Department Ambulance CPR 52

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado.

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ED Life Support Advanced Life Support CPR 103

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Laura Melville ( @lmelville535 ) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest.

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ALS CPR ICU EMS 100

ACEP Now

DECEMBER 6, 2024

After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia. This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm.

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Coronary Life Support ALS Emergency Department 98

Dr. Smith's ECG Blog

MAY 19, 2020

She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). ECMO Flow was achieved after approximately 1 hour of high quality CPR. An elderly woman had sudden ventricular fibrillation.

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Defibrillator CPR Coronary CAD 52

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Am J Emerg Med. 1996;40(3):483-485. Accidental hypothermia.

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Defibrillator CPR Epinephrine Life Support 106

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.

Defibrillator 137

Defibrillator Coronary STEMI CPR 137

ACEP Now

AUGUST 15, 2023

Staff interrupt you while you’re in Room 3 with a patient you’ve placed on BiPAP, “We have an incoming patient with CPR in progress in five minutes,” the nurse says before adding, “Room 4’s family really wants to talk with you again.” Dr. Koo is an emergency physician and attending at MedStar Washington Hospital Center in Washington, and St.

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ALS Emergency Department OR CPR 90

Handtevy

FEBRUARY 27, 2024

Every year, countless young lives are impacted by the split-second decisions made in emergency departments across the United States. Only 14% of emergency departments are adequately ready to manage pediatric emergencies, a statistic that speaks volumes about the silent risks our children face. Florida Senate.

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Emergency Department Emergency Medical Services CPR ED 52

NCOAE

AUGUST 12, 2022

Here, we present them in alphabetical order: ABC – Airway, Breathing and Circulation – “This is the Golden Rule of emergency medical professionals” AED – Automated External Defibrillator – The device that delivers electric shock to the heart of patients experiencing sudden cardiac arrest A-EMT – Advanced EMT ALS – Advanced Life Support Anaphylaxis— (..)

EMS 52

EMS EMT EMT Emergency Medical Technician 52

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%.

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E-9-1-1 Critical Care CPR ICU 105

NAEMSP

APRIL 19, 2023

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. The take home message: “Irrespective of presenting rhythm, in patients with cardiac arrest, there is no conclusive evidence that administration of calcium during cardiopulmonary resuscitation (CPR) improves survival.” Wongtanasarasin, W.,

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E-9-1-1 Advanced Life Support Overdose CPR 52

NCOAE

MARCH 8, 2021

Recognizing the Difference Between EMTs, AEMTs, and Paramedics The National Registry of Emergency Medical Technicians (NREMT) — that’s the leading certification agency in the U.S. Some EMT courses require CPR as a prerequisite, while others, including ours, include CPR training and certification.

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EMT EMT Emergency Medical Technician AEMT 52

ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 3 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Am J Emerg Med.

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ALS Emergency Department Emergency Medical Services ED 52

ACEP Now

MAY 9, 2024

But since the mid 80s, we have realized that EMS is the clinical practice of emergency medicine outside of the emergency department. Emergency physicians who are not EMS specialized can turn to a number of resources for assistance. But there weren’t the physician resources to support that need,” he said.

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EMS Emergency Medical Services EMT EMT 52

EMDocs

JANUARY 17, 2024

When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). Upon ED arrival, she had a heart rate (HR) of 160 and blood pressure (BP) of 80s/40s.

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E-9-1-1 Overdose Emergency Medical Services Life Support 84

NCOAE

NOVEMBER 13, 2021

How to stop bleeding, perform CPR, and assist breathing. Many fire departments require that all of their firefighters also be EMTs. They respond to medical emergencies and provide treatment on scene to assist the ambulance crews. First Aid and to how to respond to a cardiac arrest.

EMT 52

EMT EMT Emergency Medical Technician Ambulance Driver 52

REBEL EM

NOVEMBER 20, 2023

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. The enrolled population was severely injured, with a median ISS of 41, and 23% received CPR.

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OR Emergency Medical Technician CPR Emergency Medical Services 91

NAEMSP

FEBRUARY 15, 2023

These can include feeling compelled to attempt resuscitation despite the team feeling it is futile or not consistent with the patient’s wishes, families demanding CPR despite the presence of a DNR, incompletely filled out DNR forms, and more. had performed CPR on a hospice patient, and 17.9% Prehosp Emerg Care. PMID: 35490992.

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Emergency Medical Services EMS CPR Paramedic 52

AAEM RSA

AUGUST 27, 2020

1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Interventions during the acute phase of treatment post return of spontaneous circulation (ROSC) are therefore critical.

E-9-1-1 52

E-9-1-1 CPR ICU ALS 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes. A middle-age woman with h/o hypertension was found down by her husband. With ventilations and epinephrine, she regained a pulse.

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STEMI Coronary ACS Emergency Department 52

BoostPrep

APRIL 26, 2022

Question While performing one-person CPR on a patient, you should use a ratio for compressions to ventilation for the adult patient and a __ ratio for a child patient. Apply an AED Begin CPR Correct Incorrect Question 2 of 10 2. Provide two minutes of CPR prior to attaching the AED. Apply a nonrebreather at 15 lpm.

EMT 52

EMT EMT Emergency Medical Technician CPR 52

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

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ALS ED OR CPR 98

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1.

Coronary 52

Coronary STEMI ACS ALS 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury.

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E-9-1-1 STEMI Coronary ALS 52

Don't Forget the Bubbles

MAY 3, 2023

This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergency department (ED). Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children? Resuscitation.

CPR 52

CPR Emergency Department ALS ICU 52

Don't Forget the Bubbles

DECEMBER 5, 2023

Data was collected at 2 emergency departments in America and included assessment by both clinicians and patients for a total of 31 patients. The device was assessed by the clinicians (emergency medicine doctors) using it on ease of use, speed of use and the appearance of the closed wound. Why does it matter?

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Coronary Epinephrine CPR Emergency Department 111

ACEP Now

OCTOBER 30, 2023

A notable achievement was ESEM’s co-organization of the International Federation of Emergency Medicine Trauma Update Symposium in 2015. These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios.

Emergency Department 52

Emergency Department ALS CPR Critical Care 52

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. 1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC).

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Defibrillator E-9-1-1 ALS Epinephrine 52

REBEL EM

DECEMBER 19, 2022

In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. On the topic of EMS and similar to the pilot study, there was an incredibly high amount of bystander CPR performed. Thus limiting the external validity of this paper’s findings.

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Defibrillator Paramedic CPR EMS 52