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On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine (..)
In this part 1 of our 2-part podcast series on Asthma Management we explore a systematic approach to managing patients presenting to the ED with asthma exacerbations. We answer questions such as: which patients, if any, require peak expiratory flow measurements in the ED? and many more.
We’ll keep it short, while you keep that EM brain sharp. A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities. .: Infect Dis Rep.
Let’s consider Inborn Errors of Metabolism Presenting in the ED : Inborn Errors of Metabolism: Basics Common Presentations, Uncommon Kiddos For the child with lethargy, vomiting, acidosis, hypoglycemia , organomegaly, or cardiopulmonary arrest remember to consider Inborn Errors of Metabolism (IEM) on your DDx. Samantha A.
The post EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality appeared first on Emergency Medicine Cases.
Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Katie Lin on pearls for neuroprotective intubation. Eric Wortmann on preventing burnout in emergency medicine.
Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration. Background: There are many ways to define artificial intelligence.
The post EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma appeared first on Emergency Medicine Cases.
Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. 10.1007/s00384-021-03971-1.
In order fix EM, each of us needs to understand systems issues and systems thinking, and advocate for a better system based on sound systems principles and specific solutions. In this main episode EM Cases podcast Anton is joined by Dr. Alecs Chochinov and Dr. Davie Petrie, two systems thinkers and leaders in EM. and many more.
Br Med J (Clin Res Ed). EM Cases – Burn and Inhalation Injuries: Ed Wound Care, Resuscitation and Airway Management.” Management of Local Burn Wounds in the Ed.” 4 Survival rate for all burn injuries is around 97%, which is a notable increase from 75% in the 1960’s. Tintinalli, et al. 1987 Jul 18;295(6591):181.
The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. Fidelity was examined by the frequency of required q2h glucose checks, safety by seeing how many patients required rescue dextrose for hypoglycemia, and operational impacts including ED LOS and ICU admission. Image from cited article.
The post Ep 188 Hemoptysis – ED Approach and Management appeared first on Emergency Medicine Cases. What is the role of bronchoscopy and how should it be integrated into the hemoptysis management algorithm? How does one's hemorrhage control strategy change when pulmonary embolism is the underlying diagnosis? and many more.
Dizziness Background Acute dizziness represents ~1-3% of ED visits and has a disproportionately high cost, resource use, and length of stay, largely due to imaging (much of which is unnecessary). EM physicians should receive training in the HINTS exam, Epley, and Dix-Hallpike maneuvers. Only about 3.2-6%
To support EM Cases, please consider a donation here: [link] The post EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments appeared first on Emergency Medicine Cases.
She is an executive lead for the EMS for Children Innovation and Improvement Center. She is the co-Principal Investigator for the EMS for Children Data Center. She is nationally known for her work as an EMS researcher and educator. July 2023 * Population: ED leadership across the United States. JAMA Netw Open.
Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. A 36-year-old male presents to the emergency department after being found down at home by his spouse. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.
Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr. Katie Lin and Dr. What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage?
In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. How does one differentiate between meningitis and retropharyngeal abscess on physical exam? and many more.
Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. Upon EMS arrival, they find the patient is sweaty with normal vital signs. AEM November 2023. AEM November 2023.
Literature Review Few case studies have touched on the subject of terminal extubation performed by EMS providers during the initial patient contact. More commonly, patients are transported to the Emergency Department (ED), where extensive conversations between ED providers and family occur.
You diagnose uncomplicated appendicitis in the ED. Dr. Rohit Mohindra and Dr. Shelley McLeod analyze the latest RCT that attempts to answer this question, the PERFECT study, on this EM Cases Journal Club. The on call General Surgery team wants to wait until the next morning to perform an appendectomy.
Dr. Casey Patrick is the EMS medical director of Montgomery County Hospital District (Texas). As an EM physician, he shares how he decides to care for his own patients in the ED who present with rapid atrial fibrillation. Want CE for listening? Here’s how.
A narrow pulse pressure has been shown to predict the need for hemorrhage control in the ED setting but has not been assessed as a predictor in the prehospital setting. A narrow pulse pressure occurs due to compensatory increased systemic vascular resistance in the setting of decreased cardiac output.
The AVAPS mode is as effective and safe as BPAP S/T in treating patients with hypercapnic respiratory failure in the ED.” Clinical Take Home Point: I n patients presenting to the ED with hypercapnic respiratory failure, AVAPS did lead to a faster improvement in pH and PaCO2 levels compared to BPAP S/T. AVAPS: 0.07 AVAPS: 10.20
Annals of EM 2024. Case: You’re working your usual day shift in the emergency department (ED) from 9 am to 5 pm on a Tuesday. In recent years, ketamine has gained popularity in the ED, particularly for treating acute pain. Annals of EM 2024. It is used at lower doses than those required for anesthesia (0.1–0.3
TXA has been mentioned previously on PEM Morsels in the following contexts: Post Tonsillectomy Hemorrhage , Hemophilia in the ED , Von Willebrand Disease , Epistaxis in Children , Hereditary Angioedema , Hemoptysis in Children , Hyphema , and even in Neonatal Subgaleal Hemorrhage. Am J Emerg Med. 2022;55:103-110. doi:10.1016/j.ajem.2022.01.069
David Didlake @DidlakeDW EMS personnel responded to the residence of an 81 y/o Male with syncope. At the time of ED arrival he was alert, oriented, and verbalizing only a headache with a normalized BP. The ED activated trauma services, and a 12 Lead ECG was captured. This was deemed “non-specific” by the ED physicians.
To get a sense of how medical students feel about emergency medicine, we interviewed three students who are interested in EM: Nick, a graduating M4 pre-matched into EM residency, Charlotte, an M2 currently planning to pursue EM, and Annie, an M1 considering EM. What sparked your interest in emergency medicine?
To get a sense of how medical students feel about emergency medicine, we interviewed three students who are interested in EM: Nick, a graduating M4 pre-matched into EM residency, Charlotte, an M2 currently planning to pursue EM, and Annie, an M1 considering EM. What sparked your interest in emergency medicine?
Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM. Before attending medical school, he was a New York City Paramedic.
We’ll keep it short, while you keep that EM brain sharp. A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. link] j.ajog.2016.03.012 2016.03.012 Patel, P.,
Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.
We’ll keep it short, while you keep that EM brain sharp. A 58-year-old female with a history of diabetes, hypertension, and chronic back pain presents to the ED with severe headache and nausea. An Pediatr (Engl Ed). 2019 The post EM@3AM: Pneumocephalus appeared first on emDOCs.net - Emergency Medicine Education.
Understanding why ETCO2 is recommended in cardiac arrest with Swami, practical steps to organ donation in the ED with Dr. Andrew Healy, using your hospital food court to treat paraphimosis, rectal prolapse and food bolus obstruction with Dr. Sarah Foohey, QI Corner with Dr. Tahara Bhate, 4 Medicolegal Myths with Dr. Jennifer C.
We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Vital signs include BP 168/89, HR 96, T 98.3,
Highlighted Quality Posts: Procedures Site Article Author Date Label Rebel EM Intra Articular Lidocaine vs Sedation in Shoulder Reductions Nordia Matthews, MD 30 Jan 2023 AIR EM Docs Video Laryngoscopy in the ED Cameron Jones, MD 8 Aug 2022 AIR First 10 EM Lacerations: Does closure technique matter?
The post Ep 171 Posterior Stroke, EP Lead, HEAR Score, Ketamine for Suicidal Ideation, Peer Support Workers – Highlights from Calgary EM Hodsman Lecture Day appeared first on Emergency Medicine Cases.
Case: A 70-year-old woman was brought into the emergency department by EMS after her family reported she was having trouble talking. When she arrives in your ED, her family tells you she was last seen normal about 12 hours ago.
His research focuses on the pre-hospital care of children by EMS. He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). EMS placed him in a C-collar and brought him to you.
We’ll keep it short, while you keep that EM brain sharp. The post EM@3AM: Sialadenitis appeared first on emDOCs.net - Emergency Medicine Education. She is breathing comfortably but seems to experience significant pain at the associated site of swelling. Available from: [link] Wilson KF, Meier JD, Ward PD. Salivary gland disorders.
The post EM Quick Hits 37 Introducing QI Corner, Skin Abscess, O2 Sat Monitor Pearls, Infantile Spasms, Atrial Fibrillation Rate Control appeared first on Emergency Medicine Cases.
We’ll keep it short, while you keep that EM brain sharp. A 6-year-old girl presents to the ED with 1 day of fevers up to 104.1°F link] The post EM@3AM: Bacterial Tracheitis appeared first on emDOCs.net - Emergency Medicine Education. Labs and x-ray can be nonspecific, and definitive diagnosis is made with direct visualization.
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