Broome Docs

MARCH 28, 2024

Am J Emerg Med. PMID: 34890894 Myth 1: Kayexalate is safe and useful. A non-inferiority randomized controlled trial comparing nebulized ketamine to intravenous morphine for older adults in the emergency department with acute musculoskeletal pain. 2024 Jan 2;53(1):afad255. 2022 Feb;52:85-91. doi: 10.1016/j.ajem.2021.11.030.

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E-9-1-1 ICU Emergency Department ALS 96

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 94

Critical Care ICU E-9-1-1 ALS 94

EMDocs

FEBRUARY 26, 2024

1 While PJP gained significant recognition among HIV-positive adults during the early AIDS epidemic, the growing utilization of immunosuppressants has resulted in an increased incidence of the disease in individuals who are HIV-negative. 9 The signs and symptoms of PJP infection are non-specific. for detecting pulmonary opacities.

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E-9-1-1 ED ALS OR 110

Don't Forget the Bubbles

AUGUST 28, 2023

Five-year-old Ginny presents to the Emergency Department with a syncopal episode. 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? 2014;9(9):S102-S109.

Emergency Management 97

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

Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. 2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. Emerg Med J. Intensive Care Med.

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E-9-1-1 Defibrillator ICU Critical Care 52

AAEM RSA

AUGUST 27, 2020

1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Kirkegaard H, Soreide E, de Haas, I et al. De Fazio C, Skrifvars MB, Soreide E et al. 2019;23(1):1–9.

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E-9-1-1 CPR ICU ALS 52

Don't Forget the Bubbles

OCTOBER 19, 2023

Secondary outcome analysis showed there was no difference in length of hospital stay, ICU stay, or duration of oxygen therapy. The bottom line is: Early high-flow nasal cannula oxygen started in the ED resulted in a longer length of hospital stay than standard oxygen therapy in children aged 1 – 4 with respiratory failure.

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

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

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 98

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

EMDocs

DECEMBER 18, 2023

This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1). 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

E-9-1-1 91

E-9-1-1 ALS Emergency Department Plasma 91

EMDocs

OCTOBER 7, 2023

1-3 Common causes: Natural disasters such as tornadoes or earthquakes 4,5 Structure or building collapses from home fires or bombings. 2016;20(1):135. J Emerg Med. Stahl K, Rastelli E, Schoser B. 6 Motor vehicle collisions that produce significant challenges to passenger extrication. He has no medical problems.

EMS 97

EMS E-9-1-1 Emergency Department ALS 97

EMDocs

JANUARY 6, 2024

1 Indications for transplant include: Non-ischemic cardiomyopathy (49%) Ischemic cardiomyopathy (35%) Restrictive cardiomyopathy (4%) Retransplantation following failed prior transplant (3%) Hypertrophic cardiomyopathy (3%) Congenital heart disease (3%) Valvular cardiomyopathy (3%) The median survival after heart transplant is over 12 years.

EMS 89

EMS E-9-1-1 ACS Coronary 89

EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

E-9-1-1 97

E-9-1-1 ICU ACS EMS 97

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?

E-9-1-1 113

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

EMDocs

JUNE 7, 2023

1-5 Farmers also treat sheep for parasites using OPs and may become symptomatic after exposure, an illness called Dipper’s Flu. 8 Intermediate syndrome Occurs 1 to 5 days after acute exposure in up to 40% on individuals. 7, 9 Often have absence of excessive cholinergic stimulation. 7 May lead to respiratory failure.

E-9-1-1 98

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

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-9-1-1 126

E-9-1-1 ACS OR ICU 126

EMDocs

DECEMBER 6, 2024

1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Commercially available formulations of iron have varying elemental components. 1 Table 1: Iron content of various preparations. Be wary of this stage.

E-9-1-1 98

E-9-1-1 Frozen Plasma Plasma Overdose 98

EMDocs

FEBRUARY 8, 2025

He reported having a COVID-19 infection 3 weeks ago but felt better 1-2 weeks ago. The most appropriate disposition for this patient is admission to an ICU due to increasing oxygen requirements, high mortality rates of IPA, and IDSA recommendation for bronchoscopy with lavage/tissue sampling. mortality: 42-63% 5 Invasive Candida spp.

ED 72

ED E-9-1-1 EMS ICU 72

Don't Forget the Bubbles

MARCH 24, 2025

Emerging evidence from animal studies also suggests that Dexmed may have neuroprotective properties. While no paediatric studies have confirmed this, the DICE trial ( D exmedetomidine in I nfants undergoing C ooling for Neonatal E ncephalopathy) is underway. Adv Emerg Nurs J. 2014;55(1):209-215. 2023;23(1):341.

E-9-1-1 59

E-9-1-1 Emergency Department ALS Critical Care 59

Don't Forget the Bubbles

MARCH 31, 2025

Article 1: Should we rely on WBC to predict serious bacterial infection in children? The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. 2023 Nov;7(1):e002094.

E-9-1-1 59

E-9-1-1 Emergency Department ICU OR 59

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 is reassuring as the uvula points towards the epiglottis (See figure 19) E.

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E-9-1-1 EMS ALS OR 130

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 75

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