REBEL EM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Figure 2 : Extended Glasgow Outcome Scale (GOS-E) (credit: Doc_HG ) Secondary Modified Rankin Score Secondary outcomes included death within 6 months.

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Don't Forget the Bubbles

AUGUST 28, 2023

You contact ICU, anaesthetics, ENT, and oncology with a plan to attempt more definitive imaging in the prone position (which Ginny tells you is much comfier) What’s the evidence for our emergent management? The median age at diagnosis was 47 months (range 1-173 months). 2014;9(9):S102-S109. 2019;43(1):98-103.doi:10.1097/RCT.0000000000000782

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Emergency Management Emergency Manager E-9-1-1 ICU 97

Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? Intensive Care Med. 2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Anaesth Crit Care Pain Med. doi: 10.1007/s00134-021-06577-x. Epub 2021 Dec 14.

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REBEL EM

MAY 8, 2023

Paper: Smith JA, Secombe P, Aromataris E. J Trauma Acute Care Surg. Only 1 RCT and 1 cohort study had only mechanically ventilated patients. References: Smith JA, Secombe P, Aromataris E. J Trauma Acute Care Surg. The pendulum is swinging towards conservative management for occult pneumothoraces.

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AAEM RSA

AUGUST 27, 2020

Interventions during the acute phase of treatment post return of spontaneous circulation (ROSC) are therefore critical. 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.

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ECG & Echo Learning

OCTOBER 2, 2022

Most agents exhibit both vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 Crit Care Med 1991; 19:1395.

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Dr. Smith's ECG Blog

MAY 5, 2022

He was admitted to the ICU and transferred emergently to a facility where he could undergo emergent dialysis as a part of further evaluation and management. It is critically important for all EM and critical care providers to have an intimate understanding of hyperkalemia and its ECG findings. What is it?

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Dr. Smith's ECG Blog

JULY 12, 2020

While calling for some help and arranging to have her transported to our critical care zone, I got this quick ultrasound which confirmed my suspicion: This quick view was all I was able to obtain in the circumstances. The cardiac monitor showed sinus rhythm but the automatic blood pressure cuff was not reading. Prac 15(17), 2017.

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EMDocs

FEBRUARY 12, 2024

Introduction Arterial blood gas (ABG) or venous blood gas (VBG) testing is used to assess the pH and systemic carbon dioxide tension in patients, and, therefore, provide a more complete picture of their acid-base status than an isolated basic metabolic panel (BMP) (1). However, ABGs have many drawbacks compared to VBGs.

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Emergency Department E-9-1-1 ED ICU 98

EMDocs

OCTOBER 7, 2023

1-3 Common causes: Natural disasters such as tornadoes or earthquakes 4,5 Structure or building collapses from home fires or bombings. Critical Care. 2016;20(1):135. Stahl K, Rastelli E, Schoser B. 2012;27 Suppl 1:i1-67. Critical Care. Genthon A, Wilcox SR. J Emerg Med. 2014;46(2):313-319.

EMS 98

EMS E-9-1-1 Emergency Department ALS 98

AAEM RSA

SEPTEMBER 17, 2020

All treatments were given for the assigned time frame or until ICU discharge, whichever came first. In the control group, patients treated for severe sepsis or septic shock in the year prior to the initiation of triple therapy, hydrocortisone was used at the discretion of the intensive care unit (ICU) attending.

ICU 52

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EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

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REBEL EM

NOVEMBER 11, 2024

found no difference in mortality in critical care patients treated with vancomycin and piperacillin- tazobactam compared to vancomycin and cefepime or meropenem. What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018.

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EMDocs

OCTOBER 29, 2024

He was started appropriately on vancomycin and cefepime and accepted for ICU admission but remains in the ED due to boarding and bed lock. Left ventricular outflow tract obstruction in ICU patients. Curr Opin Crit Care. Chu CK, Delia E, Mograder A, Dwyer EM. Anaesth Intensive Care. 2017;45(1):12-20.

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FOAMfrat

NOVEMBER 28, 2024

Hoffman is the editor-in-chief of PulmCCM, a blog that frequently updates its readers on evidence and best practices in critical care medicine. I have always wondered how our work in the field affects a patient's care downstream. The key is ensuring the patient gets individualized care based on their unique physiology."

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Don't Forget the Bubbles

MARCH 24, 2025

While no paediatric studies have confirmed this, the DICE trial ( D exmedetomidine in I nfants undergoing C ooling for Neonatal E ncephalopathy) is underway. This makes it a valuable adjunct in multimodal sedation and analgesia strategies, particularly in paediatric critical care and procedural sedation. 2014;55(1):209-215.

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Don't Forget the Bubbles

MARCH 31, 2025

Article 1: Should we rely on WBC to predict serious bacterial infection in children? It was an observational multi-center study including >17,000 febrile children aged 0-18 across 12 European EDs over 1 year. A raised WBC count >1510^9/L count was significantly associated with SBI (aOR of 1.5, 2023 Nov;7(1):e002094.

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Core EM

JANUARY 16, 2025

Introduction Airway management is a critical ED skill to master. Success at intubation likely takes more time and practice than other procedures, as shown in recent research on ED residents and their success rate at intubating, measured as a function of their total number of intubations (See Figure 1).

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