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Their hospital has struggled with a growing number of adverse events that often occur without warning. With emergency department (ED) volumes rising, administrators are eager to explore AI-driven solutions to improve patient safety and reduce staff burnout. Reference: Verma et al.
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.
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. 2010Jul 03;376(9734):23-32.
A total of eleven intensive care units (ten PICUs and one non-maternity NICU) and four emergency departments (EDs) took part in the study. In NICU patients, the nasal high-flow group experienced fewer hypoxaemic events, although there was no difference in first-attempt intubation success between the groups. in the standard care group.
At the time of ED arrival he was alert, oriented, and verbalizing only a headache with a normalized BP. He denied any specific prodrome of gross palpitations, however did endorse feeling quite dizzy just before the event. The ED activated trauma services, and a 12 Lead ECG was captured. The fall was not a mechanical etiology.
The emergency department (ED) evaluation reveals an unremarkable chemistry panel with normal renal function and a white blood cell count of 10,000. Background: We have discussed agitation in the ED on the SGEM several times. They are afebrile and tolerate oral intake. These conflicts can ultimately lead to moral injury [1,2,3].
Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado. Which one do you select?
Today’s video evaluates inhaled corticosteroids (ICS) for asthma in the ED setting. EBM Updates: Inhaled Corticosteroids for Asthma in the ED Background : Asthma is a common ED issue, with patient presentations ranging from needing a medication refill to severe exacerbation in respiratory failure.
In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. US, compared with CXR and CT, offers the absence of ionizing radiation and high reproducibility. Emerg Med J. 2023;40(10):700-707.
That discussion can be deferred until the patient is stable, the risk of such an event is mitigated, and other medications can be given for their withdrawal symptoms and pain. Our experience: Traditionally, ED physicians do not like ordering urine drug screens (UDS). Some patients require re-dosing in the ED. JAMA Network Open.
Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. Nick: Triaging your time and priorities as an ED doc on shift is so challenging.
Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. Nick: Triaging your time and priorities as an ED doc on shift is so challenging.
The trade off to using FI for these challenging airways is the consideration of an aspiration event, the initial indication for RSI. However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). To date, ketamine has been the agent of choice (12).
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.
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.
June & July Recap After exhibiting at four trade shows in June, our event schedule dropped off in July. They've created a new protocol that allows them to bypass the ED and take qualified patients directly to definitive care. Before we get too far ahead of ourselves, let's take a look at the past few months.
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).
Given the high propensity for police officers to be exposed to such events, it is not surprising that we see a higher rate of PTSD in officers than in the general population (Lewis-Schroeder et al., PTSD is a unique mental health condition as it is one of the only disorders that specifically requires a precipitating event. text rev.).
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).
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.
He arrived to the ED by helicopter at 1507, about three hours after the start of his chest pain while chopping wood around noon. He arrived to the ED by ambulance at 1529, only a half hour after the start of his chest pain around 1500 while eating. Patient 2 , EKG 1: What do you think? He went to the cath lab at 0900 the next morning.
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].
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.
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.
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.
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.
Background: Patients with decreased level of consciousness due to alcohol, drugs, or medications commonly present to the ED. These patients can be at risk of vomiting and aspiration and often prompts clinicians to pursue definitive airway management to avoid pneumonia and other complications. References: Freund Y et al.
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.
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.
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].
In this issue, we collaborated with the CJEM team to present “Hypotension and respiratory events related to electrical cardioversion for atrial fibrillation or atrial flutter in the emergency department” in a visual abstract format1. Welcome back to the 2024 CJEM year!
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.
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.
One solution to decrease ICU admission is to treat these patients in the ED until their anion gap is closed and the patient can be transitioned from IV insulin infusion to SQ insulin. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. Paper: Griffey RT et al. Acad Emerg Med 2023.
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.
However, the unblinded nature of the trial confounds a bit of interpretation of the influence of the crossover event. These were, effectively, stable-but-not-fully-improved inpatients at a small risk for further deterioration, not the acute respiratory distress seen in the ED.
SGEM#71 : Like a Rolling Kidney Stone (A Systematic Review of Renal Colic) * Bottom Line: Tamsulosin is useless in most ED patients with ureteral colic unless their stone size exceeds at least 4mm. *
Background: Patients present commonly to their primary care providers (PCPs) and to the emergency department (ED) with complaints of a sore throat. million visits annually to PCPs and EDs for sore throat. The ibuprofen did not help and he is requesting antibiotics so he can get back to work sooner. In the US, adults accounted for 6.6
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.
Some bench work, observational studies, and now two large, unblinded, cluster-randomized single-center trials ( SMART and SALT-ED ) suggested a benefit to using balanced crystalloids (i.e. In the two large trials, this benefit was seen as a reduction in a composite outcome of major adverse kidney events within 30 days (MAKE-30).
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.
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