EMDocs

SEPTEMBER 7, 2023

1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity? DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Toxicity typically evolves through three phases: 2,3,7,8,9 Phase 1: Gastrointestinal symptoms (e.g.,

E-9-1-1 87

E-9-1-1 ALS Plasma Emergency Department 87

EMDocs

MARCH 4, 2024

A wide variety of conditions can result in either type of cholestasis (Figure 1). 1 Extrahepatic obstruction is due to mechanical obstruction occurring downstream of the hepatic ducts such as pancreatic disease, gallstone obstruction of the common bile duct, and cancer. 9 How are cholestatic labs defined?

Emergency Department 104

Emergency Department E-9-1-1 ALS OR 104

EMDocs

AUGUST 7, 2023

1 A D-dimer level can, therefore, be used as a non-specific and indirect biomarker for the presence of intravascular clotting, which may be useful in the diagnosis of VTE. 1-3 In this patient population, the NPV of a negative D-dimer level is high, such that a negative test makes further evaluation for VTE unnecessary.

E-9-1-1 91

E-9-1-1 ALS Plasma OR 91

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

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 86

E-9-1-1 ALS Emergency Department Plasma 86

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

EMDocs

JUNE 14, 2023

Patellar reflexes are 1+. 1, 2, 4, 9 Organophosphates are one of many types of insecticide and are used worldwide to manage crops. 1, 2 Symmetric sensorimotor axonopathy: leg cramping to extremity weakness and paralysis. 1, 2 Sensory > Motor neurons with predilection for long axons. Muscle tone is normal.

E-9-1-1 92

E-9-1-1 Emergency Department Plasma ACS 92

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Investigations : Bloods show Hb of 8 g/L, White cell count 13x 10 9 /L, Platelets 570 x10 9 /L, CRP 35mg/L. Blood culture is pending.

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. 1 Obtain a single view abdominal x-ray.

E-9-1-1 96

E-9-1-1 Frozen Plasma Plasma Overdose 96

EMDocs

JANUARY 22, 2025

1 Most heroin in the United States actually contains fentanyl and fentanyl analogs. Naloxone reverses the analgesic, respiratory, sedative , and miotic e ffects of opioids. 6 Image 1: Structure of naloxone. Published 2023 Sep 1. doi:10.15585/mmwr.mm7235a3 Park JN, Rashidi E, Foti K, Zoorob M, Sherman S, Alexander GC.

Naloxone 93

Naloxone E-9-1-1 Overdose NARCAN 93

EMDocs

FEBRUARY 3, 2025

Although these autoantibodies may be present in a variety of individuals, the development of clinical disease is thought to require exposure to an environmental risk factor such as certain viruses, cigarette smoke or other environmental toxins (1). million have been diagnosed with lupus, with 90% of cases occurring in females (1).

ED 66

ED E-9-1-1 ALS OR 66

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). Introduction Airway management is a critical ED skill to master. Figure 7: (modified from Tanoubi 2009).

EMS 130

EMS E-9-1-1 ALS OR 130

EMDocs

FEBRUARY 22, 2025

Answer : CSF Leak Epidemiology: CSF leaks are broken into three main causes Craniofacial trauma: approximately 80% of cases 1 3% of blunt head and 9% of penetrating head trauma patients have CSF leaks Basilar skull fractures commonly occur with CSF leaks (up to 30%) Iatrogenic: approximately 16% of cases 1 3.8% Epub 2021 Sep 9.

EMS 62

EMS E-9-1-1 Plasma OR 62

EMDocs

NOVEMBER 2, 2024

Answer : Neurosyphilis Introduction Neurosyphilis is a clinical manifestation of syphilis, a rapidly disseminating sexually transmitted infection caused by the spirochete Treponema pallidum, and humans are the only known host [1] Neuroinvasion by the treponeme may occur in the days following primary infection and is often asymptomatic.

EMS 112

EMS E-9-1-1 Plasma ALS 112

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 73

ED E-9-1-1 ALS Emergency Department 73