Document, E-9-1-1 and ICU - Paramedicine Now

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

REBEL EM

NOVEMBER 30, 2023

Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis [published online ahead of print, 2023 Aug 9]. References: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM.

E-9-1-1

E-9-1-1 ALS ACS ICU

Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

JUNE 17, 2024

Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. C Examination notable for diaphoresis, 1+ bilateral lower extremity edema, regular heart rate and rhythm, and no signs of respiratory distress with normal breath sounds. The patient was upgraded to the ICU for closer monitoring.

E-9-1-1

E-9-1-1 ACS Emergency Department Coronary

Corticosteroids in Severe Community Acquired Pneumonia: Could CAPE COD catalyze a change in critical care management?

REBEL EM

OCTOBER 5, 2023

1-6 We now have the Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial. ClinicalTrials.gov: NCT02517489 7 Clinical Question: In adult patients with severe community-acquired pneumonia admitted to the ICU, does early hydrocortisone treatment, compared to standard therapy, reduce mortality at 28 days?

Critical Care

Critical Care ICU E-9-1-1 ALS

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

REBEL EM

SEPTEMBER 26, 2022

2020;71(1):235-246. Article: Kumar M et al. Thromboelastography-Guided Blood Component Use in Patients With Cirrhosis With Nonvariceal Bleeding: A Randomized Controlled Trial. Hepatology. Significant coagulopathy: INR > 1.8 Significant coagulopathy: INR > 1.8 Significant coagulopathy: INR > 1.8

FFP

FFP E-9-1-1 ICU ALS

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

JANUARY 11, 2024

The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. Digestive Management Takeaway: Start enteral feeds when the patient gets to the ICU. 2023 Dec 1. Start low and go slow.

Critical Care

Critical Care E-9-1-1 OR ICU

ABG Versus VBG in the Emergency Department

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.

Emergency Department

Emergency Department E-9-1-1 ED ICU

Resident Journal Review: Do Adjunctive Therapies Beyond Infection Control and Appropriate Fluid Resuscitation Change Outcomes in Sepsis and Septic Shock?

AAEM RSA

SEPTEMBER 17, 2020

Thiamine also plays a role in key metabolic processes, including cellular energy production and generation of cellular antioxidants, and thiamine deficiency has been well-documented in sepsis, with observational studies indicating a signal for improved outcomes with supplementation. Keh D, Trips E, Marx G, et al. 2016:316(17);1775-85.

ICU

ICU E-9-1-1 ALS OR

Is Pip-Tazo Harming Sepsis Patients?

REBEL EM

NOVEMBER 11, 2024

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. Imbalances Between Treatment Groups : ICU Admissions : Higher in piperacillin-tazobactam (33% vs. 30%). 9 Instrumental Variable Analysis? vs. 52.2%).

E-9-1-1

E-9-1-1 ICU ALS Critical Care

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

Figure 1: Clinical manifestations and long-term consequences of sickle cell disease Training and education on sickle cell disease: Training and education are crucial to improve morbidity and mortality. Investigations : Bloods show Hb of 8 g/L, White cell count 13x 10 9 /L, Platelets 570 x10 9 /L, CRP 35mg/L.

E-9-1-1

E-9-1-1 ACS OR ICU

An EM Resident’s Guide to Basic Airway Management

Core EM

JANUARY 16, 2025

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). This document will focus on the anatomical considerations and aspiration risk.

E-9-1-1

E-9-1-1 EMS ALS OR

ED care of refugee populations from sub-Saharan Africa

EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 1 By the end of 2023, 117.3 million people had been forcibly displaced, representing 1 in 69 individuals or 1.5% seconds (normal 30-40 seconds), creatinine of 3.11

ED

ED E-9-1-1 ALS Emergency Department

Paramedicine Now

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Trending Sources

Corticosteroids in Severe Community Acquired Pneumonia: Could CAPE COD catalyze a change in critical care management?

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

AHA/NCS Statement on Critical Care Management of Post ROSC Patients

ABG Versus VBG in the Emergency Department

Resident Journal Review: Do Adjunctive Therapies Beyond Infection Control and Appropriate Fluid Resuscitation Change Outcomes in Sepsis and Septic Shock?

Is Pip-Tazo Harming Sepsis Patients?

Sickle Cell Disease Module

An EM Resident’s Guide to Basic Airway Management

ED care of refugee populations from sub-Saharan Africa

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