The Skeptics' Guide to EM

NOVEMBER 30, 2024

Date: November 10, 2024 Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington's MEDEX program.

Epinephrine 168

Epinephrine OR CPR Paramedic 168

Core EM

NOVEMBER 30, 2024

The Case An 88-year-old woman with a history of dementia, major depressive disorder, and hyperlipidemia presented to the ED via EMS after a near syncopal episode. She was running to catch the bus to visit her husband in the hospital when she developed acute onset shortness of breath, nausea,vomiting, and near loss of consciousness. The following ECG was obtained: Initial vitals: BP 85/52, HR 62, RR 22, Temp 98.4F, SpO2 92% on RA EKG Show Details EKG Characteristics Rate 66 Rhythm Normal Sinus Rh

Coronary 130

Coronary STEMI MICU ACS 130

Dr. Smith's ECG Blog

NOVEMBER 30, 2024

Written by Jesse McLaren, with edits from Meyers Four patients presented with chest pain or shortness of breath, and ECGs labeled ‘inferior STEMI’. Using principles of hyperacute T waves, do any have inferior occlusion MI? Patient 1 : 60 year old with shortness of breath Patient 2 : 40 year old with chest pain Patient 3 : 65 year old with chest pain Patient 4 : 55 year old, prior inferior MI, with chest pain See this recent post on the new and evolving science of hyperacute T waves, including 1.

STEMI 114

STEMI OR Coronary 114

SSCOR

NOVEMBER 30, 2024

Almost all children become infected with the respiratory syncytial virus (RSV) by the age of two. For neonates and immunocompromised babies, this can be a life-threatening disease. The unique airways of very young babies can compromise their ability to clear airway secretions, increasing the risk of serious complications. Deep suctioning can reduce their discomfort—and in some cases—even save their lives.

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