REBEL EM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

ICU 81

ICU Operating Room Critical Care ALS 81

REBEL EM

NOVEMBER 30, 2023

Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. Kuttab et al’s findings, constituting 45% of the review’s weight, suggest that administering <30cc/kg IVF is associated with increased odds of mortality, delayed hypotension, and increased ICU utilization. 2.89, p = 0.01.

E-9-1-1 121

E-9-1-1 ALS ACS ICU 121

ESO

MARCH 7, 2024

Blood Component Timing: It was documented that 76% of patients requiring PRBCs received them within four hours of arriving at the hospital. This is a significant increase from last year’s findings, where just 46% of qualifying trauma patients received PRBC within four hours of arrival.

Operating Room 105

Operating Room ICU OR ED 105

Dr. Smith's ECG Blog

OCTOBER 23, 2023

She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval. She had an uneventful ICU course and was extubated for ongoing care with the inpatient psychiatric service.

ICU 131

ICU OR Defibrillator EMS 131

REBEL EM

JUNE 8, 2023

The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Human Errors and Adverse Hemodynamic Events Related to “Push Dose Pressors” in the Emergency Department. J Med Toxicol. Epub 2019 Jul 3. PMID: 31270748 Maheshwari K, et al. Intensive Care Med. 2018;44(6):857–67.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

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. 2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? Paper: Owyang CG, et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

EMDocs

SEPTEMBER 19, 2023

Propofol utilized for sedation; patient admitted to ICU for EEG monitoring. This document covers high sensitivity troponin, risk disposition pathways, and STEMI equivalents. While second attempt ongoing, neck prepped and marked for cric. Second attempt with DL and bougie successful; ETT position confirmed with US.

STEMI 98

STEMI Coronary Emergency Department ICU 98

Dr. Smith's ECG Blog

JUNE 17, 2024

The patient was upgraded to the ICU for closer monitoring. I cannot tell you how many times such "written" documentation was off, due to the tendency to inscribe a normal number instead of counting for 30 seconds because "the patient looked like they were breathing normally".

E-9-1-1 139

E-9-1-1 ACS Emergency Department Coronary 139

REBEL EM

SEPTEMBER 26, 2022

The TEG group had a shorter ICU length of stay in the first admission. Patients exclusively managed in the ICU which decreases applicability for patients in other locations Very small sample size of 96 patients No definition was provided for exclusion criteria of significant cardiopulmonary disease.

FFP 52

FFP E-9-1-1 ICU ALS 52

Emergency Medicine Ireland

AUGUST 1, 2022

Diagnosis and management of infections with this bug are a common occurence in the ICU and it behoves us to have a working knowledge of some of the complexities of its investigation and treatment that often fall to our micro or ID colleagues. The next job is to document clearance from the blood.

Critical Care 40

Critical Care ICU OR 40

EMDocs

JANUARY 11, 2024

Digestive Management Takeaway: Start enteral feeds when the patient gets to the ICU. Statements: Initiate EN as soon as possible after ICU admission (100%, 20/20). These conversations should occur frequently and be clearly documented for other health care professionals who are not present during the conversations (96%, 22/23).

Critical Care 97

Critical Care E-9-1-1 OR ICU 97

EMDocs

FEBRUARY 9, 2024

Source: [link] As you are calling the ICU and cardiology team, the patient has recurrence of her symptoms and repeat ECG shows return of the PVT. The literature base for the use of lidocaine for torsade storm is documented primarily by case studies in drug-induced TdP. Another ECG is obtained and shown below. Adapted from wikipedia.

Defibrillator 96

Defibrillator OR ED ALS 96

Emergency Medicine Ireland

JULY 3, 2023

This segues relatively nicely into a section of the document on palliative care. It is important to realise that a referral to ICU for refractory cardiorenal syndrome may simply be a sign that the patient is reaching end of life.

Critical Care 96

Critical Care ACS OR ALS 96

Emergency Medicine Ireland

DECEMBER 17, 2020

Intensivists have embraced the tracheostomy as an ICU procedure. There is a substantial ANZICS document on tracheostomy that forms the structure for this tasty morsel. In a breaking from what could only loosely be described as tradition at this point, this podcast is going to be in 2 parts.

Critical Care 40

Critical Care ACS ICU OR 40

Dr. Smith's ECG Blog

JANUARY 9, 2024

The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment. A bed side echocardiography revealed a severely depressed LVEF of about 20-25%. When looking at the above ECG you will find that the QRS following ventricular pacing is very long.

Coronary 119

Coronary ACS ED OR 119

Emergency Medicine Ireland

MAY 3, 2021

. * the hyperaemic phase: about a quarter will have this at around day 3-7 and it seems ill defined but it’s suggestive you can lower your MAP targets here a bit Overall the basic bundle of interventions in the ICU for ICP include: * sedation – this is needed for the tube but also it reduces metabolic rate considerably and reduces ICP.

Critical Care 40

Critical Care ICU OR 40

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission.

Emergency Department 52

Emergency Department ED ALS Critical Care 52

Medgadget

MAY 3, 2023

Other times, present AI may simply fall short of a human’s ability to identify a net new diagnosis that is not based on existing documented knowledge, or is currently classified as “idiopathic.” Finally, AI algorithms require large amounts of data to be accurate and reliable, which can be difficult to obtain in some cases.

Critical Care 80

Critical Care OR ICU 80

Emergency Medicine Ireland

OCTOBER 28, 2020

This has relevance to the ICU population in 2 major ares * Sepsis. * EF does not correlate with particularly well with mortality in sepsis though diastolic dysfunction does * It may be due to under filling and the reduced diastolic filling due to the ubiquitous tachycardia in sepsis.

Critical Care 40

Critical Care ICU OR 40

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). Importantly, the comparison between an ABG and VBG is site-specific, as illustrated below (Table 1) (1, 3-6).

Emergency Department 98

Emergency Department E-9-1-1 ED ICU 98

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. The primary outcome was hospital survival.

ICU 52

ICU E-9-1-1 ALS OR 52

REBEL EM

NOVEMBER 11, 2024

Reliance on Electronic Health Records Data : As with many retrospective studies, reliance on EHR data for identifying eligible patients and outcomes is prone to inaccuracies, missing data, and variability in clinical documentation practices. Comorbidity Index : Higher in the cefepime group (median 2 vs. 1). vs. 52.2%). Pettigrew et.

E-9-1-1 113

E-9-1-1 ICU ALS Critical Care 113

Don't Forget the Bubbles

JULY 5, 2023

They should be admitted to hospital in case of clinical deterioration to receive ICU treatment. However, there are documented adverse events such as haemorrhagic cerebrovascular accidents or recurrence of VOC after drug withdrawal, which represent a drawback in its regular use. This treatment is usually done in the ICU setting.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

Don't Forget the Bubbles

DECEMBER 9, 2024

Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document. Implementation of a Risk-Stratified Opioid and Benzodiazepine Weaning Protocol in a Pediatric Cardiac ICU. Am J Respir Crit Care Med. 2023;207(1):17-28.

ALS 59

ALS Critical Care OR ICU 59

Core EM

JANUARY 16, 2025

This document will focus on the anatomical considerations and aspiration risk. 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. fiber optic through the nose).

E-9-1-1 130

E-9-1-1 EMS ALS OR 130

EMDocs

JANUARY 6, 2025

4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. 84 All patients with severe malaria need inpatient admission, ideally to the intensive care unit (ICU). Severe malaria is typically caused by P.

ED 75

ED E-9-1-1 ALS Emergency Department 75