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EM@3AM: Pneumocephalus

EMDocs

We’ll keep it short, while you keep that EM brain sharp. A 58-year-old female with a history of diabetes, hypertension, and chronic back pain presents to the ED with severe headache and nausea.  An Pediatr (Engl Ed). 2019 Demos Medical Publishing. On arrival, she is awake and alert and in obvious distress. Cushing Reflex.

EMS 114
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APOT: Why It Matters and How To Cut Down on It

ESO

Ambulance Patient Offload Time (APOT) is a new metric introduced in the 2024 ESO EMS Index that measures the duration from when an ambulance arrives at the hospital to the transfer of patient care to hospital personnel. They not only add friction to the patient care continuum, but they also tax already limited EMS and hospital resources.

MIH 59
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Suspicion

Peter Canning

There have been a lot of changes in EMS over the years that I have chronicled. When it’s a bad call — cardiac arrest, trauma, stroke — we still need to get the demos. New meds, new equipment, new procedures, new trends, etc. Name, date of birth and social security number. Often first responders on scene will find it for us.