Core Ultrasound

JANUARY 10, 2023

This is definitely not something that needs to be done all the time, but is a great adjunct in the appropriate clinical setting! Airway ultrasound is something that can be quite complex but at its most basic, it can be used to help determine if you have endotracheal versus endobronchial intubation.

130

130

ALiEM

JUNE 10, 2024

High Risk (>12.1% risk of injury) -> Consider CT Altered mental status (GCS 3-8 or AVPU = U) Abnormal airway Breathing Circulation findings Focal neurological deficits Intermediate Risk (2.8% sensitivity and 99.9%

Emergency Department 317

Emergency Department ED OR 317

Core EM

JULY 23, 2024

Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.

Emergency Department 233

Emergency Department OR 233

Core EM

JULY 23, 2024

We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure.

Critical Care 130

Critical Care OR 130

St. Emlyn's

APRIL 2, 2024

Anisa Jafar @EMergeMedGlobal takes us through why definitions really matter. St.Emlyn's - Emergency Medicine #FOAMed The ARC-H principle: re-defining global health & shifting the balance. The post The ARC-H principle: re-defining global health & shifting the balance. appeared first on St.Emlyn's.

86

86

Core Ultrasound

SEPTEMBER 18, 2023

Learn how to effectively perform the exam definitely within the reach of the non-radiologist clinician. Timely and accurate diagnosis is crucial for effective treatment. Bedside ultrasound has become a valuable tool for diagnosing pyloric stenosis quickly and non-invasively.

130

130

REBEL EM

AUGUST 7, 2023

Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation. PMID: 37058727 Clinical Question: Does delayed sequence intubation decrease peri-intubation hypoxia in trauma patients requiring definitive airway control compared to rapid sequence intubation? Anesth Analg 2023.

ALS 92

ALS OR EMS 92

Don't Forget the Bubbles

JUNE 19, 2023

However, there are no agreed-upon definitions for growth restriction, and there are significant knowledge gaps. Refer to your local or national guidelines to decide whether a patient is SGA or not, but remember that, depending on which definition is used, both over- and underdiagnosis can occur. Literature list Beune IM et al.

ALS 143

ALS OR 143

Core EM

NOVEMBER 1, 2023

We discuss Electrical Storm (VT storm) and how to care for the very irritable heart.

OR 130

OR 130

The Skeptics' Guide to EM

DECEMBER 7, 2019

Most of the definition is in the name itself. * The name was not reassuring and the definition was vague. The Journal of Pediatrics published a systematic review of literature regarding the Management of ALTE in 2013 and one of the findings was that there was very little agreement in the literature on how to apply the definition.

CPR 130

CPR ALS OR 130

Core EM

JANUARY 25, 2024

Definition: Catatonia: A behavioral motor dysregulation syndrome marked by an inability to move normally despite full physical capacity, which can occur in the context of many underlying psychiatric and general medical disorders [4].

MICU 246

MICU Emergency Department OR ED 246

Core EM

APRIL 1, 2024

We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure.

Critical Care 130

Critical Care OR 130

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

What lowered my confidence in calling ECG #1 a definite OMI — was the finding of somewhat similar-appearing , upright T waves with slight-but-real J-point ST elevation in so many leads ( ie, leads I,II,aVF; V2-thru-V6 ). Once I identified leads V4 and V5 as definitely abnormal — I looked closer at neighboring leads.

OR 123

OR STEMI Coronary 123

Critical Care Scenarios

NOVEMBER 9, 2022

Reimbursers tend to like sepsis 3 definitions (qSOFA), core metrics may still use the older definitions. Many facilities may have their own policies on what definition to adopt. . * Spell out your findings and reasoning and you’ll get more grace on your diagnoses. Sepsis diagnoses are a mess.

OR 100

OR 100

Pulsara

AUGUST 1, 2024

They've created a new protocol that allows them to bypass the ED and take qualified patients directly to definitive care. Teams in Arkansas are finding new ways to improve outcomes for pediatric behavioral health patients.

ED 85

ED 85

Emergency Medicine Cases

JANUARY 4, 2022

What are the best strategies to efficiently get the patient in cardiogenic shock to definitive care, whether that be the cath lab or the operating room? In which patients would dobutamine be preferred over milrinone and vice versa? How can we best pick up occult cardiogenic shock before it floured shock kicks in?

Operating Room 130

Operating Room OR EMS 130

Emergency Medicine Cases

JUNE 29, 2021

Was CRASH-2 enough to be definitive, or does the classic EBM mantra of "we need more studies" remain true? Should we be using TXA for epistaxis, postpartum hemorrhage, hyphema or hemoptysis? Is it a miracle drug that stops all bleeding? Or has it been drastically overhyped?

OR 130

OR EMS 130

The Overrun Podcast

APRIL 23, 2024

However, this was an observational study and more research is needed to draw definitive conclusions. However, this was an observational study and more research is needed to draw definitive conclusions. The second study explores the use of nitroglycerin in right ventricular myocardial infarctions (MIs).

52

52

International Journal of Paramedicine

JULY 8, 2024

Definitive routes of transmission and subsequent infection are still debated. Despite the continually high incident rates of infection 90% of those infected remain asymptomatic. H.Pylori is a gram-negative, microaerophilic bacteria, mostly found in stomach of affected individuals that causes inflammation and ulceration.

52

52

Core EM

JANUARY 25, 2024

Differentiating between the two is difficult as multiple proposed diagnostic criteria have yet to demonstrate sufficient sensitivity or specificity for a definitive diagnosis. The differential diagnosis for this patient includes Ventricular Tachycardia (VT) and Supraventricular Tachycardia (SVT) with aberrancy.

Coronary 246

Coronary Emergency Department ED OR 246

University of Maryland Department of Emergency Med

JUNE 9, 2023

Adhesive capsulitis aka frozen shoulder Definition: Gradual development of global limitation of both active and passive shoulde. Click to view the rest

79

79

Dr. Smith's ECG Blog

JANUARY 27, 2024

Over the years — various definitions have been proposed for what should constitute a " significant " Q wave , based on width and/or depth of the Q wave. BOTTOM Line: In my opinion — there is no perfect definition for what constitutes a "significant" Q wave ( ie, a Q wave that indicates infarction has occurred at some point in time ).

STEMI 101

STEMI Coronary ACS ED 101

Pediatric EM Morsels

AUGUST 23, 2024

Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. Mild traumatic brain injury also includes a larger group of injuries that may have evidence of structural injury.

Emergency Department 243

Emergency Department OR ED EMS 243

Dr. Smith's ECG Blog

MARCH 31, 2024

I simply texted back: "Definite posterior OMI." The person I was texting knows implicitly based on our experience together that I mean "Definite posterior OMI, assuming the patient's clinical presentation is consistent with ACS." The patient was a middle-aged female who had acute chest pain of approximately 6 hours duration.

STEMI 91

STEMI ACS ED 91

High Performance EMS

AUGUST 9, 2024

No matter how you decide to distinguish the priority of each request, it is triaged to standardize the rules for a consistent response definition. It is the mid-level acuity demand that may be the most complicated, as well as the most rewarding, to properly model.

BLS 264

BLS CAD Advanced Life Support Life Support 264

Dr. Smith's ECG Blog

JUNE 15, 2023

Thus, this does NOT meet STEMI criteria (though, as of 2022, it is a formal "STEMI equivalent", assuming everyone agrees that this is de Winter morphology, for which there is currently no objective definition). Everywhere I'm aware of (only about 5 systems), the ECGs are not even recorded in the "STEMI database." What a farce.

STEMI 90

STEMI Coronary ACS OR 90

ALiEM

SEPTEMBER 29, 2023

In cases where the nature of the missile is known, plain films or POCUS may be a reasonable first step, but CT imaging would be definitive. Penetrating wounds can be deceptively innocuous, and a high index of suspicion is required.

ALS 177

ALS OR 177

NAEMSP

MARCH 5, 2024

There has been literature to support the use of air in trauma-both because of the time to definitive care but also the critical care that can be started at the scene. Ground is the preferred method of transportation when it can provide necessary level of care and timely transport to definitive care.

Critical Care 52

Critical Care Medical Transportation CPR EMS 52

Core EM

JUNE 3, 2024

Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.

Emergency Department 130

Emergency Department OR 130

EMS 12-Lead

APRIL 9, 2024

Many of the changes seen are reminiscent of LVH with “strain,” and downstream Echo may very well corroborate such a suspicion, but since the ECG isn’t the best tool for definitively establishing the presence of LVH, we must favor a subendocardial ischemia pattern, instead. This was deemed “non-specific” by the ED physicians.

Coronary 290

Coronary ACS CAD ED 290

The Skeptics' Guide to EM

MAY 6, 2023

At that time, we recognized there was no universally accepted definition of excited delirium. WJEM 2023 There were five key points raised in the article: Continuing lack of a clear definition for excited delirium Brooks reached out to me recently to see if we could revisit the issue of excited delirium.

Emergency Medical Services 101

Emergency Medical Services Paramedic ALS EMS 101

REBEL EM

SEPTEMBER 27, 2023

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning Click here for Direct Download of the Podcast Definition and Physiology Standard definition of a wide QRS is anything > 120 msec (3 small boxes on the ECG) In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. Boehnert 1985 ).

E-9-1-1 91

E-9-1-1 Overdose EMS 91

EMDocs

SEPTEMBER 7, 2024

The time taken to measure serum hemoglobin and hematocrit (B) and await a result would delay definitive surgical control of likely ongoing hemorrhage given this patient’s incomplete response to fluid resuscitation. Additionally, no current high-quality literature exists regarding the definitive indications for REBOA placement.

EMS 52

EMS E-9-1-1 Operating Room OR 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Definitive diagnosis that ECG #1 is in fact VT is more than academic. This is clinically relevant — because obtaining hard copy of what happened immediately after synchronized shock was delivered ( even if the WCT rhythm resumes quickly thereafter ) will often provide ECG clues to a definitive rhythm diagnosis.

Coronary 136

Coronary OR EMS ED 136

REBEL EM

MARCH 12, 2024

Pretreatment should not delay imaging required for definitive diagnosis. Bottom Line Up Top: Pretreatment is ineffective and unnecessary as it does not significantly reduce the risk of serious adverse reactions to contrast. Clinical Scenario: A 65 year-old woman presents with shortness of breath.

Allergic Reaction 55

Allergic Reaction EMS OR 55

International Journal of Paramedicine

APRIL 3, 2024

Introduction: Tension pneumothorax related to chest trauma is a rapidly lethal condition that requires immediate treatment, often prior to arrival at definitive care. Recent concerns regarding the safety and efficacy of needle thoracostomy (NT) have led to alternatives.

Emergency Medical Services 90

Emergency Medical Services 90

ALiEM

DECEMBER 18, 2023

The regiSCAR diagnostic criteria is the most used diagnostic criteria and is based on a scoring system for possible, probable, or definite diagnosis. Diagnosis can be extremely challenging due to the variability in clinical presentation. Case Question: How should this condition be managed?

Emergency Department 177

Emergency Department OR 177