Core EM

JANUARY 25, 2024

Consider these medications if there are signs of end-organ dysfunction, there is a considerable delta in baseline BP, systolic is less than 90 and/or MAP is less than 65 Norepinephrine is a good pressor for a lot of the situations that we encounter in the emergency department, such as septic shock, undifferentiated shock and hypovolemic shock.

Epinephrine 246

Epinephrine Critical Care Emergency Department ED 246

REBEL EM

OCTOBER 5, 2023

Patients enrolled from 31 Intensive Care Units in France. Patients admitted to the ICU with severe community-acquired pneumonia were randomized in a 1:1 ratio to receive hydrocortisone or a placebo. The study was funded by the French Ministry of Health. Population Inclusion Criteria: Adult patients (≥18 years old).

Critical Care 94

Critical Care ICU E-9-1-1 ALS 94

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. 4,5 A recent study found that among 1102 critically ill adults, successful intubation on the first attempt was 80.4 Vital signs on arrival are: Temperature: 38.8 He has an absent gag reflex. percent with use of a bougie and 83.0

OR 73

OR ALS Emergency Department Critical Care 73

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). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Paper: Mason JM, et al.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ALiEM

NOVEMBER 3, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to trauma in the Emergency Department. Ann Emerg Med. Please go to the above link. 2023;82(1):55-65.

Critical Care 211

Critical Care Emergency Department EMS ALS 211

ALiEM

FEBRUARY 5, 2024

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the Emergency Department. Ann Emerg Med. Please go to the above link. 2023;82(1):55-65.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

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.

Emergency Department 130

Emergency Department Critical Care ICU Ambulance 130

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

ED 130

ED Critical Care Emergency Department ALS 130

Don't Forget the Bubbles

OCTOBER 2, 2024

A previously well 6-year-old boy is brought into the emergency department at a major trauma centre via HEMS following a road traffic accident, in which he was hit by a car while crossing the road. Pediatric Critical Care Medicine. A full primary survey is carried out. Imaging is performed, including a CT Head.

OR 49

OR Critical Care ALS Emergency Department 49

Core EM

JANUARY 25, 2024

link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. Patients should undergo comprehensive work-up to rule out alternative causes of thrombocytopenia, evaluate for end-organ damage, and identify underlying infectious or autoimmune etiologies.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

ALiEM

OCTOBER 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. Ann Emerg Med. Please go to the above link. 2023;82(1):55-65.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

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.

Critical Care 40

Critical Care ICU Plasma Emergency Department 40

ALiEM

JULY 22, 2023

Note that conventional pressure bags may not be readily available in emergency departments and could blow the line you worked hard to secure. Trick of the Trade: Manually provide positive pressure fluids using a 3-way stopcock Attach a 3-way stopcock between the angiocatheter and IV tubing. Interested in Other Tricks of the Trade?

Emergency Department 241

Emergency Department OR Critical Care 241

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

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. It’s unbalanced.

Critical Care 133

Critical Care ICU ALS Emergency Department 133

Broome Docs

OCTOBER 6, 2024

PMID: 39025092 Is early CT actually 100% sensitivity for SAH (Of course not) Roberts et al, Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study. Emergency Medicine Journal Published Online First: 12 September 2024. Trends in Anaesthesia and Critical Care.

Critical Care 112

Critical Care ALS Emergency Department EMS 112

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Case: A 28-year-old male with a history of type-1 diabetes mellitus presents to the emergency department (ED) with increase in thirst and light headedness. Because of the complexity of care around managing DKA, the typical approach is an insulin drip with ICU level of care for all degrees of severity.

ICU 201

ICU ED Critical Care ALS 201

The Skeptics' Guide to EM

FEBRUARY 25, 2023

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. Pediatric Crit Care Med. Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU).

CPR 130

CPR ICU Critical Care Defibrillator 130

ACEP Now

JULY 7, 2024

Should emergency physicians rely on standard textbooks for diagnostic and treatment regimens? 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.

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

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. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Reference: Matchett, G.

Emergency Medical Services 107

Emergency Medical Services Firefighter Critical Care Paramedic 107

EM Didactic

OCTOBER 7, 2018

It is commonly used in Emergency Departments, especially in febrile and possibly infectious patients. Procalcitonin has emerged as the most studied and promising sepsis biomarker. For diagnostic and prognostic purposes in critical care, PCT is superior to CRP and other traditional markers of sepsis.

Emergency Department 40

Emergency Department ACS Critical Care Coronary 40

Pediatric EM Morsels

JULY 21, 2023

Inter-Rater Reliability Between Critical Care Nurses Performing a Pediatric Modification to the Glasgow Coma Scale. Pediatr Crit Care Med. We use the GCS score in both trauma and medical patients, but where did this score come from? When is it useful and what does it tell us? Inappropriate speech- No conversation.

Critical Care 246

Critical Care ALS OR Life Support 246

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Critical Care Medicine. Guest Skeptics: Dr. Erin Willard is a PGY-3 Emergency Medicine Resident, Department of Emergency Medicine, University of Arkansas for Medical Sciences.

ICU 130

ICU Critical Care ALS Emergency Department 130

The Skeptics' Guide to EM

SEPTEMBER 3, 2017

EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). He writes an excellent […] The post SGEM#186: Apneic and the O, O, O2 for Rapid Sequence Intubation first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department Operating Room Critical Care ALS 130

ALiEM

APRIL 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to procedures in the Emergency Department. More specifically, we identified 2 AIR and 4 Honorable Mentions.

EMS 246

EMS Emergency Department ED OR 246

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. Your support staff…depending on the amount of bleeding, you are about to have your hands full and may need IV access, medications, airway management, etc. Get a hold of ENT early as OR management and/or admission are common. Get IV access!

E-9-1-1 286

E-9-1-1 Epinephrine Emergency Department OR 286

Core EM

OCTOBER 16, 2024

I enjoy reading studies, discussing their implications, and teaching, which is why I’m considering a critical care fellowship. I strongly considered general surgery and internal medicine, specifically pulmonary critical care or cardiac critical care.

ED 100

ED EMS Critical Care OR 100

REBEL EM

APRIL 29, 2024

Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line. The IO can actually be your “GO-TO” emergency line or your second choice after failed PIV access.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

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 […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

Core EM

SEPTEMBER 24, 2024

I enjoy reading studies, discussing their implications, and teaching, which is why I’m considering a critical care fellowship. I strongly considered general surgery and internal medicine, specifically pulmonary critical care or cardiac critical care.

ED 100

ED EMS Critical Care OR 100

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.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Guest Skeptic: Dr. 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 […] The post SGEM#350: How Did I Get Epi Alone? He had been admitted the night before for a new diagnosis of rapid atrial fibrillation.

Epinephrine 100

Epinephrine Critical Care Emergency Department Life Support 100

ALiEM

APRIL 12, 2024

Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency department (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). The Korean Journal of Critical Care Medicine. 2006;130(6):1857-1863. 2015;30(2):119-122.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

The Skeptics' Guide to EM

JANUARY 25, 2020

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound.

EMS 100

EMS Critical Care Paramedic ALS 100

The Skeptics' Guide to EM

JUNE 18, 2022

Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. first appeared on The Skeptics Guide to Emergency Medicine. He is […] The post SGEM#369: Romeo is Bleeding – Does He Need a RePHILL?

Plasma 100

Plasma Critical Care Paramedic ALS 100

The Skeptics' Guide to EM

JANUARY 7, 2018

CMAJ Nov 2017 Guest Skeptic: Dr. Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medicine and Critical Care course. Case: A 35-year-old female presents to your emergency department three-hours after the onset of a severe frontal headache.

Emergency Department 100

Emergency Department Critical Care ALS OR 100

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.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245