International Journal of Paramedicine

JULY 8, 2024

However, ketamine may be associated with adverse clinical events including a higher intubation rate. The primary endpoint was incidence of endotracheal intubation occurring during transportation and within one hour after arrival to the emergency department (ED).

Emergency Department 98

Emergency Department Ambulance ED OR 98

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. He had no other complaints and denied any other trauma or loss of consciousness during the event.

Emergency Department 161

Emergency Department OR ED 161

The Skeptics' Guide to EM

MAY 2, 2020

This is Bob’s eleventh visit […] The post SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens? July 2019 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. first appeared on The Skeptics Guide to Emergency Medicine. Date: April 24th, 2020 Reference: Watanabe et al.

ED 100

ED Ambulance Medical Transportation EMS 100

EM Didactic

OCTOBER 22, 2018

Diplopia is one such complaint which we might come across in ED. Primary eye disorders or systemic diseases presenting as ophthalmologic complaints may present to the Emergency Department especially when symptoms are acute in onset. Key Questions when evaluating diplopia: 1. Is it Monocular or Binocular Diplopia?

ED 52

ED Emergency Department OR EMS 52

Broome Docs

DECEMBER 9, 2023

Is it a good idea to keep geriatric patients in the ED overnight? Are you being irradiated by the portable Xray machines in your ED? Metronidazole-associated Neurologic Events: A Nested Case-control Study. Adverse events of undiluted intravenous push levetiracetam. How good is my intuition about PE diagnosis? 2023.05.023.

Emergency Department 120

Emergency Department ALS ED 120

ALiEM

JANUARY 12, 2024

There were no adverse events with the first two doses of the vaccine except for mild transient sore throat and cough after the 2nd dose. Laboratory Data Laboratory workup in the ED revealed resolution of proteinuria with serum creatinine returning to normal baseline value (0.89 Vaccine Adverse Events Reporting System [Internet].

Emergency Department 130

Emergency Department EMS ED 130

The Skeptics' Guide to EM

JULY 2, 2022

Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Case: You are working a shift in your local community emergency department (ED) when a 47-year-old male presents with chest pain.

Coronary 100

Coronary Heart Attack ACS CAD 100

Core EM

JANUARY 25, 2024

We go over the essential and complex topic of vasopressors in the ED.

Epinephrine 246

Epinephrine Critical Care Emergency Department ED 246

EMOttawa

DECEMBER 28, 2023

Pediatric trauma is a high acuity but low frequency event (2). There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog. Trauma is the leading cause of child and youth mortality globally (1).

EMS 82

EMS ED Critical Care 82

Dr. Smith's ECG Blog

OCTOBER 1, 2023

He called EMS who brought him to the ED. ED Diagnoses: 1. The basic principles of emergency ECG interpretation in patients who present to an ED with new symptoms include the following: Respect the History. This history immediately places this patient in a high -prevalence population for having an acute event.

OR 129

OR STEMI Coronary CAD 129

Dr. Smith's ECG Blog

MARCH 1, 2024

First responders found him to be very tachycardic , confused, perserverating and with no memory of the event. First ED ECG is Wellens' (pain free). He was unconscious for 8 minutes and slowly awoke in the ambulance, complaining of nausea only. There was tongue biting. Lightheadedness continued. Interpretation. It can be much lower.

First Responder 98

First Responder ED Ambulance Paramedic 98

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. Here is the ED ECG (a photo of the paper printout) What do you think? The initial ECG in today's case was recognized as definitely abnormal — but the question arose as to whether this ECG indicated old infarction vs a new acute event.

EMS 107

EMS CPR ED Coronary 107

The Skeptics' Guide to EM

APRIL 2, 2022

Case: A 15-year-old male presents to the pediatric emergency department (ED) with right ankle pain sustained while twisting his ankle during dance practice. Background: Pediatric emergency department (ED) visits and related procedures can invoke pain and anxiety among children. The right ankle is swollen and tender.

Emergency Department 130

Emergency Department ALS ED OR 130

Chicago EMT Training

AUGUST 6, 2021

It's important to keep in mind that you are not functioning as an EMT when you're an ED Tech/Assistant. Standby EMS for events The company that comes to mind in Chicago is Event Medical Solutions. The biggest event they provide EMS for recently is Lollapalooza.

EMT 130

EMT EMT Paramedic Ambulance 130

Don't Forget the Bubbles

NOVEMBER 29, 2023

Intubated, awake, and paralysed: a never event. Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). Br J Anaesth.

E-9-1-1 135

E-9-1-1 Emergency Department ED CPR 135

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

Here is his ECG on arrival to the ED, still with active pain: ED1 at 0727 A baseline ECG was available from 1 month ago: First troponin was drawn before cath, which would soon return at 14 ng/L ( within normal limits ). Even before looking at the initial ECG — this patient is in a high prevalence group for having an acute event.

STEMI 86

STEMI EMS ACS ED 86

Core EM

JANUARY 25, 2024

Three children (2.1%) had true hyperkalemia: one had known chronic renal failure and was referred to the ED due to concern for electrolyte abnormalities; the other 2 patients had diabetic ketoacidosis (DKA).

Epinephrine 246

Epinephrine OR ED 246

Pediatric EM Morsels

SEPTEMBER 22, 2023

Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Main symptoms include hypotension and bradycardia. References Coleman-Satterfield, TT.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

ESO

MARCH 7, 2024

of patients with open long bone fractures receive antibiotics within the critical first 60 minutes of ED arrival. A major benefit of the Trauma Index is that it not only examines this year’s performance, but also makes comparisons to the previous years’ data. Antibiotics and Open Long Bone Fractures: The 2023 Index points out that 67.3%

Operating Room 105

Operating Room ICU OR ED 105

Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Here is the first ED ECG recorded, now pain free after sublingual Nitro: There is what appears to be a reperfusion T-wave in I and aVL. link] = My Comment by K EN G RAUER, MD ( 11/14 /2023 ): = One of the most helpful clinical clues in support that an acute cardiac event is ongoing — is the finding of " dynamic " ECG changes.

E-9-1-1 110

E-9-1-1 Coronary EMS ED 110

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency department (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.

ALS 152

ALS Emergency Department OR ED 152

The Skeptics' Guide to EM

OCTOBER 10, 2020

Case: A 41-year-old man without a significant past medical history presents to the emergency department (ED) with a chief complaint of lower back pain that started 48 hours prior to the ED visits after attempting to move a couch in his house. Background: Pain is one of the most frequent reasons to attend an ED.

Emergency Department 130

Emergency Department ALS ED OR 130

ACEP Now

JANUARY 14, 2024

Many common presentations to the emergency department (ED) are related to drug interactions that are commonly missed and largely preventable. 1-3 We may be unaware of potentially dangerous drug interactions when we order and prescribe medications in the ED. Adverse drug events in hospitalized patients. Acad Emerg Med.

E-9-1-1 52

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

Dr. Smith's ECG Blog

JUNE 27, 2024

By Sofiya Diurba MD, reviewed by Meyers, Grauer A woman in her 50s with PMH known RBBB and prior syncopal events presents to the ED for five syncopal events over the last 24 hours. Each event is associated with a prodrome of mild substernal CP, SOB, and “brain fog.” This is her first ECG in the ED: What do you see?

ED 121

ED OR Emergency Department Emergency Manager 121

Don't Forget the Bubbles

AUGUST 23, 2023

This simple intervention aims to acknowledge the tragic and unexpected event humanely and respectfully. The Pause creates an opportunity for loved ones and healthcare workers to respectfully honour the patient and the significant event they have been involved in before moving on to the next task ahead. & Liska, H. 23 (2), pp.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

ALiEM

OCTOBER 26, 2023

In order to avoid connectivity issues with Wifi, the event administrators broadcasted from an ethernet-connected computer. Topics were selected based on disease prevalence in Pakistani EDs, published literature describing gaps in resident education and expertise, and gaps identified during academic core meetings.

EMS 161

EMS Emergency Department ALS ED 161

The Skeptics' Guide to EM

JULY 27, 2019

Background: Inappropriate antibiotic use exposes patients to opportunistic infections, accelerates the development of antibiotic resistant bacteria and leads to adverse drug events [1]. Emergency departments (EDs) in the United States write 10 million antibiotic prescriptions each year, approximately half of which are inappropriate [2, 3, 4].

Emergency Department 130

Emergency Department ED ALS 130

Don't Forget the Bubbles

MAY 24, 2023

A 5-year-old boy with a past medical history of Crouzon syndrome presents in the Pediatric ED. Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. One large observational study found a 35-fold higher increase in events leading to death or brain damage in ED intubations.

Emergency Department 98

Emergency Department ED ALS OR 98

REBEL EM

JANUARY 30, 2023

PSA, also referred to as intravenous sedation in this paper, requires considerable resources, including 1:1 nursing observation, and burdens the emergency department (ED). 1.01, I2 = 69%, low certainty) Fewer adverse events occurred in the IAL group compared to the PSA group. hours less in the ED. vs. 91.4%; RR 0.93; 95% CI 0.86–1.01,

E-9-1-1 55

E-9-1-1 Emergency Department ED OR 55

ACEP Now

AUGUST 12, 2024

Some other different features this year include: Integrated Research Forum: Get ready for an electrifying experience at ACEP’s Research Forum, emergency medicine’s premier research event! Topics include: Embracing Diversity in Medicine Working as a Female in the ED Brewing Success in the Transition from Resident to Attending What‘s Next?

Emergency Department 52

Emergency Department ED OR EMS 52

EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. The absence of preeclampsia symptoms prior to the acute event makes eclampsia less likely. We’ll keep it short, while you keep that EM brain sharp. She had a precipitous delivery while the ambulance was pulling in.

EMS 96

EMS Ambulance FFP ICU 96

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

ECG 1 at time zero EARLY REPOLARIZATION ABNORMAL ECG ED final official overread: "early repol vs hyperacute T, minimal changes from previous (previous shown below)" What do YOU think? See these casese (and I have many others): First ED ECG is Wellens' (pain free). A 70-something y.o. male presents to triage with shortness of breath.

STEMI 115

STEMI ACS Critical Care OR 115

The Skeptics' Guide to EM

NOVEMBER 19, 2022

Intimate partner violence (IPV) in the Emergency Department (ED). Intimate partner violence (IPV) in the Emergency Department (ED). She is the VP of Finance of a not-for-profit emergency education organization creating educational events for community emergency doctors.

Emergency Department 101

Emergency Department ED OR 101

The Skeptics' Guide to EM

APRIL 10, 2021

JAMA Intern Med 2021 Case: A 60-year-old man presents to the emergency department (ED) after his wife found him to be drowsy and confused at home. On arrival to the ED his vitals are normal aside from a decreased level of consciousness and he is found to have a serum sodium concentration of 118 mmol/L.

Emergency Department 130

Emergency Department Coronary ED OR 130

Don't Forget the Bubbles

MAY 6, 2024

Arch Dis Child Fetal Neonatal Ed. It has a high rate of first-attempt failure and carries the risk of severe procedure-related adverse events. Secondary outcomes included tracheal intubation adverse events (TIAEs) or severe desaturation. Similar adverse events were reported ( 3-4% ). 2024 Feb 28:fetalneonatal-2023-326501.

E-9-1-1 75

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

EMDocs

MAY 27, 2023

Source Tenecteplase versus alteplase in acute ischaemic cerebrovascular events (TRACE-2): a phase 3, multicentre, open-label, randomised controlled, non-inferiority trial. Source The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. Annals of emergency medicine vol. 81,4 (2023): 453-465.

ED 57

ED OR 57

EMDocs

SEPTEMBER 16, 2024

Author: Joshua Lowe, MD (EM Attending Physician, San Antonio, TX) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Manpreet Singh, MD (@MPrizzleER); Brit Long, MD (@long_brit) The fluorescent lights above cast a clinical pallor over the bustling ED. Stay Calm Under Pressure: The ED can be chaotic, and emotions can run high.

Heart Attack 52

Heart Attack ED OR Emergency Department 52