The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center.

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ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

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The Skeptics' Guide to EM

JUNE 22, 2024

Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergency department (ED) with fever and respiratory distress.

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REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. J Crit Care. J Crit Care. Paper: Owyang CG, et al.

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The Skeptics' Guide to EM

JANUARY 15, 2022

Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Trial: Prospective, randomized, parallel-assignment, open-label, single-center trial ( NCT02643381 )

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Core EM

OCTOBER 23, 2024

The Case A 24-year-old man with no past medical or surgical history presented to the emergency department with 5 days of progressively worsening bilateral leg cramping, paresthesias, and multiple falls. The Internet Book of Critical Care. Acute and emergency care for thyrotoxicosis and thyroid storm.

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The Skeptics' Guide to EM

JULY 16, 2022

Case: A 59-year-old woman presents to the emergency department (ED) with fever, tachycardia, and hypotension. She is admitted to the intensive care unit (ICU) for septic shock. The ICU team is considering using Vitamin C therapy for this patient. The ICU team is considering using Vitamin C therapy for this patient.

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ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission.

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Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ 23 (2), pp.

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Critical Care Scenarios

NOVEMBER 15, 2020

A few rapid-fire cases from the emergency department, with Dr. Seth Trueger (@mdaware), emergency physician at Northwestern University and digital media editor for JAMA Network Open. Continue reading "Episode 19: Emergency medicine with Seth Trueger" A few rapid-fire cases from the emergency department, with Dr. .

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ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Dr. Kluesner is an emergency physician in Iowa City, Iowa, at UnityPoint Health-Iowa Methodist Medical Center. Critical care medicine 40.8 PloS one 13.8

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Emergency Department ED ALS Critical Care 52

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Am J Emerg Med. 2022 Sep 7.

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Emergency Department ALS Critical Care ED 52

REBEL EM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Intensive Care Med. Am J Emerg Med. J Med Toxicol.

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Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. Conclusion Critical care resuscitation is stressful. How do you manage this situation?

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ACEP Now

OCTOBER 15, 2023

Intravenous insulin infusions typically require treatment in highly monitored settings, such as an intensive care unit (ICU) or step-down unit for safety and due to the frequency and intensity of monitoring. ICU and step-down beds are a limited resource and generate higher hospital charges.

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ACEP Now

JULY 7, 2024

Alternatively, the Neurocritical Care Society defines it as a seizure with five minutes or more of continuous clinical or EEG seizure activity, or recurrent seizure activity without recovery between seizures. 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED).

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Emergency Department Critical Care ALS ICU 52

Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Preventing radial arterial catheter failure in critical care – Factoring updated clinical strategies and techniques. Anaesth Crit Care Pain Med. Emerg Med J.

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AAEM RSA

JUNE 30, 2021

1] Graduates of the combined degree may choose to work solely in either field, enter a subspecialty, pursue additional fellowship experience in critical care, or engage in research.[2] This path involves seventy-two months split between emergency medicine and internal medicine with additional experience in the critical care setting.[3]

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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.

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Don't Forget the Bubbles

AUGUST 28, 2023

Management must be multidisciplinary involving anaesthetics, paediatric retrieval service/paediatric intensive care, ENT and oncology teams (as well as the cardiothoracic surgery team – not always available). Five-year-old Ginny presents to the Emergency Department with a syncopal episode. A CXR demonstrates a mediastinal mass.

Emergency Manager 97

Emergency Manager Emergency Management E-9-1-1 Critical Care 97

REBEL EM

SEPTEMBER 29, 2022

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). Recent evidence has challenged the routine use of aggressive hydration as unnecessary. cc/kg/hour.

ICU 52

ICU ALS Critical Care Emergency Department 52

AAEM RSA

AUGUST 27, 2020

However, the decade since the original Hypothermia after Cardiac Arrest trial had seen significant advances in pre-hospital, emergency department, and critical care that may have contributed to these outcomes. These results suggest that targeting a lower temperature of 33ºC confers no additional benefit to targeting 36ºC.

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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. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. Tintinalli, J.E.

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EMDocs

FEBRUARY 12, 2024

In this situation, an ABG should be obtained periodically for correlation, though this is more relevant for the intensive care unit (ICU) setting than in routine ED care (5, 9). Int J Emerg Med. The role of venous blood gas in the emergency department: a systematic review and meta-analysis. Eur J Emerg Med.

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REBEL EM

JULY 31, 2023

Background: The ongoing debate between video laryngoscopy (VL) and direct laryngoscopy (DL) has ignited intense debate within the emergency medicine and critical care communities. 11 medical centers in the United States enrolled 1417 patients from 17 sites, including 7 emergency departments and 10 intensive care units.

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EMDocs

OCTOBER 7, 2023

Critical Care. J Emerg Med. Clinical spectrum of rhabdomyolysis presented to pediatric emergency department. Int J Emerg Med. Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. Critical Care. He has no medical problems. Published June 2009.

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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

JUNE 27, 2024

Critical Care Medicine 41(12):p A191, December 2013. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Roy A, Allareddy V, Lee M, Nalliah R, Rampa S, Allareddy V, Rotta A.

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Emergency Medicine Ireland

MARCH 4, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation. GBS is a clinically important diagnosis for both the emergency department and the ICU. Read More » Welcome back to the tasty morsels of critical care podcast.

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The Skeptics' Guide to EM

FEBRUARY 22, 2025

Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona. He is board-certified in Emergency Medicine, Medical Toxicology, Addiction Medicine, Internal Medicine-Critical Care, and Neurocritical Care.

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Don't Forget the Bubbles

FEBRUARY 17, 2025

1] Fred is a 3-year-old boy who presents to the emergency department. This is because central pressures may not always be pathologically transmitted to the organs we care about (e.g. Taken together, the adult critical care community has shifted towards assessing for venous congestion at the organ level with Doppler ultrasound.

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EMDocs

JANUARY 20, 2025

Volume status Assessing volume status, especially in critically ill patients, can be challenging. Since the 2010s multiple trials have explored the feasibility of fluid restrictive resuscitation both on initial resuscitation in the ED, as well as in the intensive care unit (ICU). The rational clinical examination.

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Don't Forget the Bubbles

MARCH 24, 2025

This makes it a valuable adjunct in multimodal sedation and analgesia strategies, particularly in paediatric critical care and procedural sedation. Dexmedetomidine is currently licensed only for adult sedation in an ICU setting, but guidelines exist to support its off-licence use in paediatric intensive care (PICU).

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EMDocs

JANUARY 16, 2025

New and Progressive Medical Conditions After Pediatric Sepsis Hospitalization Requiring Critical Care. but PPV ranges from 25.1-39.5% years Internal validation cohort: 43,400 patients with mean age 3.7 years External validation cohort: 45,855 patients with mean age 2.6 0.38 (95% CI 0.20-0.39) 0.39) AUROC of 0.71-0.92 0.92 (95% CI 0.70-0.92)

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ALS Critical Care ICU Emergency Department 96

Don't Forget the Bubbles

MARCH 31, 2025

The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. Am J Emerg Med. The sepsis screening tool in paediatric emergency departments can help. 2025.01.054.

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Broome Docs

NOVEMBER 17, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4.

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Epinephrine Emergency Department Critical Care ICU 61

Core EM

JANUARY 16, 2025

Bend the stylet Unless youre a lunatic who likes surprises during critical care procedures, you should bend your own stylet. It is true, someone finally did an RTC on ICU level patients and found that first pass success IS better with VL than DL (Prekker 2023), but the fact remains that sometimes VL fails. Ann Emerg Med.

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