Broome Docs

MARCH 28, 2024

PMID: 34890894 Myth 1: Kayexalate is safe and useful. 2024 Jan 2;53(1):afad255. Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A. Casey wrote a protocol for peripheral noradrenaline 9 years ago… in 2015! Am J Emerg Med. 2022 Feb;52:85-91. doi: 10.1016/j.ajem.2021.11.030.

E-9-1-1 107

E-9-1-1 ICU Emergency Department ALS 107

EMDocs

APRIL 10, 2024

1-5] Since then, many more medications have been developed and deployed. These medications are a vital tool in the care of ED patients, from simple local analgesia for a laceration repair to regional analgesia for painful procedures. 1] CV manifestations include: Bradycardia, tachycardia, ventricular dysrhythmias, cardiac arrest. [1-5]

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E-9-1-1 Plasma Epinephrine Life Support 94

EMDocs

JUNE 7, 2023

F, HR 48, RR 28, BP 104/62, SPO2 88% on non-rebreather mask The patient’s friend who brought her to the ED tells you the patient made suicidal statements earlier in the day and was found in her yard shed. 1-5 Farmers also treat sheep for parasites using OPs and may become symptomatic after exposure, an illness called Dipper’s Flu.

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E-9-1-1 ICU Emergency Department ED 84

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

E-9-1-1 76

E-9-1-1 ICU ACS EMS 76

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. Here are ten things to think about: 1. 2014 Jun 26;23(12):653-9. 2020 Jan 1;35(1):70-6.

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E-9-1-1 Critical Care CPR ICU 105

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. with thanks A 15-month-old Kenyan boy presents to ED with right hand swelling. Blood culture is pending.

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E-9-1-1 ACS OR ICU 126

EMDocs

OCTOBER 19, 2024

to 1 case per 100,000 children. 2][3][9] Hypoxia, respiratory muscle retractions, fatigue, altered mental status, and decreased breath sounds are signs indicative of impending airway failure. [2] 2][3][9] Glucocorticoid were not shown to alter clinical course or patient outcomes. [2][3] 2017;7(1):16-23. Rev Infect Dis.

EMS 87

EMS E-9-1-1 Epinephrine OR 87

EMDocs

SEPTEMBER 7, 2024

A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness. 1 Risk Factors: 1-4 Spontaneous Anticoagulants (Apixaban, Rivaroxaban, etc.)

EMS 75

EMS E-9-1-1 Operating Room OR 75

Don't Forget the Bubbles

AUGUST 28, 2023

You contact ICU, anaesthetics, ENT, and oncology with a plan to attempt more definitive imaging in the prone position (which Ginny tells you is much comfier) What’s the evidence for our emergent management? The median age at diagnosis was 47 months (range 1-173 months). 2014;9(9):S102-S109. Arch Dis Child Educ Pract Ed.

Emergency Management 97

Emergency Management Emergency Manager E-9-1-1 Critical Care 97

EMDocs

DECEMBER 6, 2024

On arrival to the ED the patient’s initial vital signs are temperature 38.5C, BP 102/48, HR 106, RR 20. 1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Table 1: Iron content of various preparations.

E-9-1-1 76

E-9-1-1 Frozen Plasma Plasma Overdose 76

Dr. Smith's ECG Blog

DECEMBER 13, 2019

On review of systems the patient reported back pain for approximately 1 week which he was treating with NSAIDs with minimal relief. in the ICU but survived with excellent function. 15-9/6/2017 ). Figure-1: Excerpt from ESC review on acute pericarditis ( See text ).

E-9-1-1 52

E-9-1-1 ACS Coronary CAD 52

Don't Forget the Bubbles

OCTOBER 19, 2023

You, however, are working an ED shift, and when you see the name “Barbie Junior” on your computer screen, your heart does a flutter. It can be in started in the ED, and many of us are already using it. Secondary outcome analysis showed there was no difference in length of hospital stay, ICU stay, or duration of oxygen therapy.

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E-9-1-1 ED OR Emergency Department 81

REBEL EM

MAY 8, 2023

Paper: Smith JA, Secombe P, Aromataris E. 95% Confidence Interval) Strengths: The study addresses a patient-centered clinical question that is relevant to ED practice. 95% Confidence Interval) Strengths: The study addresses a patient-centered clinical question that is relevant to ED practice. J Trauma Acute Care Surg.

E-9-1-1 58

E-9-1-1 Critical Care ICU OR 58

AAEM RSA

APRIL 1, 2021

1 The American College of Surgeons’ (ACS) Trauma Quality Improvement Program (TQIP) Massive Transfusion in Trauma Guidelines leave a good amount of flexibility for hospitals regarding transfusion protocols, focusing more on systems-level aspects of designing and implementing MTPs.2,3 in the 1:1:1 group vs. 17.0%

E-9-1-1 52

E-9-1-1 Plasma ACS ALS 52

Dr. Smith's ECG Blog

MAY 26, 2023

mg/dL (sorry, Europeans, for the weird units) Here was the initial ED ECG: There is a junctional rhythm with retrograde P-waves (see the dip in the T-wave in lead II across the bottom; you can follow that up to all the other leads and see the retrograde P wave). He was admitted to the ICU and was unstable, in shock, overnight.

Overdose 80

Overdose E-9-1-1 Coronary OR 80

ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. or 9 size endotracheal tube to allow for bronchoscopy and/or endobronchial blocker placement whenever necessary. These patients are at imminent risk of respiratory failure.

E-9-1-1 52

E-9-1-1 ALS Emergency Department OR 52

Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. What is it?

E-9-1-1 52

E-9-1-1 OR STEMI ED 52

ALiEM

OCTOBER 30, 2024

Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2]. Some patients require re-dosing in the ED.

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E-9-1-1 Naloxone Emergency Department ALS 161

EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Importantly, the comparison between an ABG and VBG is site-specific, as illustrated below (Table 1) (1, 3-6).

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

EMDocs

DECEMBER 18, 2023

On arrival to the ED, her blood pressure is 84/36 mmHg with a heart rate of 110 beats per minute. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1).

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65

EMDocs

JANUARY 6, 2024

A 64-year-old male presents by EMS to the ED with shortness of breath. 1 There are over 50,000 visits related to heart transplant in the United States each year and over half of these patients are admitted to the hospital from the ED. We’ll keep it short, while you keep that EM brain sharp.

EMS 63

EMS E-9-1-1 ACS Coronary 63

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 84

E-9-1-1 ALS ICU Critical Care 84

EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. Labs Laboratory workup in the ED is notable for a leukocytosis of 41,000/L, hemoglobin of 6.5 g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 1 By the end of 2023, 117.3 of the global population.

ED 57

ED E-9-1-1 ALS Emergency Department 57

EMDocs

OCTOBER 29, 2024

A 43-year-old male with a history of mitral valve regurgitation s/p valvular replacement, hypertension, hyperlipidemia was evaluated in the ED for septic shock secondary to a pyelonephritis with a renal abscess. Left ventricular outflow tract obstruction in ICU patients. Chu CK, Delia E, Mograder A, Dwyer EM. 2017;45(1):12-20.

E-9-1-1 87

E-9-1-1 ICU Epinephrine EMS 87