ACEP Now

JULY 7, 2024

I have learned more from my failures than my successes. My current practice is a hybrid of academic and community sites, and I have worked in myriad community hospitals from busy ones to single coverage critical access hospitals. Each has its own challenges and lessons. Emergency medicine residencies focus heavily on foundational knowledge, procedural competency, and professionalism.

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OR ED Ambulance 98

The Bottom Line

JULY 7, 2024

In adult patients scheduled for cardiac surgery with cardiopulmonary bypass does infusion of a balanced solution of amino acids, commencing at the time of surgery, compared with balanced crystalloid alone (Ringer's Lactate) reduce the incidence of acute kidney injury (AKI)?

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Dr. Smith's ECG Blog

JULY 7, 2024

Written by Jesse McLaren A previously healthy 60 year old developed exertional chest pain with diaphoresis, and called EMS. Here’s the EMS ECG, digitized with PM cardio. What do you think? There’s sinus arrhythmia with normal conduction, normal axis and normal voltages. There’s loss of R waves in V2-3 with hyperacute waves V1-5. There’s no significant ST elevation but there are two forms of ST depression: deWinter T wave V3-5 and precordial swirl with ST depression V6 reciprocal to subtle STE in

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STEMI Coronary ALS OR 66

ACEP Now

JULY 7, 2024

A 40-year-old woman with a history of untreated hypertension presented by ambulance after she was thrown from an ATV at unknown speeds and then crushed by the vehicle. The vehicle had no seatbelt or airbags, she was not helmeted, and she did not hit her head or lose consciousness. She reported 10/10 pain localized to her right arm and right flank, with no other complaints.

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ALS Ambulance OR Critical Care 59

ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. According to family at the scene, he has a history of seizures but has not been taking his medication recently. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. On arrival, he is obtunded, foaming at the mouth, and exhibiting generalized tonic-clonic seizure activity.

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ACEP Now

JULY 7, 2024

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

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Emergency Department 52

ACEP Now

JULY 7, 2024

One night I found myself on the other side of the stretcher, as a patient waiting for a psychiatric assessment in an emergency department (ED). After drinking a couple of beers and texting a friend about my depression and marital issues, my friend was respectfully concerned about me. I had said that sometimes I would rather be dead than feeling this sad, so my friend convinced the police to place me under a mental hygiene arrest.

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E-9-1-1 First Responder ALS Emergency Department 52

ACEP Now

JULY 7, 2024

Answer: The correct answer is a) Olecranon bursitis. The most pathognomonic symptom is swelling in the posterior olecranon (elbow). It can be painless and may or may not have associated erythema or warmth. Pain, erythema, and warmth are much more common in septic compared with aseptic bursitis but can be present in either condition. Fever is associated with septic bursitis.

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OR 52