EMS 12-Lead

AUGUST 31, 2022

Acute LAD occlusion in the setting of Right Bundle Branch Block and Left Anterior Fascicular Block. Case Review: [link] Key features of Right Bundle Branch Block: In general, there is no ST elevation throughout the 12 Lead ECG. RBBB has expected slight ST depression, with T wave inversion, in V1-V3 when discordant to a positive R' wave. A possible normal variant is lateral ST elevation (i.e., I/aVL/V5/V6) with bulky T waves when subsequent to a large, slurred S wave.

Coronary 130

Coronary 130

Emergency Medicine Cases

AUGUST 30, 2022

In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant

EMS 130

EMS ED 130

The Skeptics' Guide to EM

AUGUST 20, 2022

Date: August 18th, 2022 Reference: Munn et al. Fragility Index Meta-Analysis of Randomized Controlled Trials Shows Highly Robust Evidential Strength for Benefit of The post SGEM Xtra: Are tPA Stroke Trials Really Fragile? first appeared on The Skeptics Guide to Emergency Medicine. Date: August 18th, 2022 Reference: Munn et al. Fragility Index Meta-Analysis of Randomized Controlled Trials Shows Highly Robust Evidential Strength for Benefit of <3 Hour Intravenous Alteplase.

Critical Care 130

Critical Care ALS EMS OR 130

EMergucate

AUGUST 16, 2022

You are reviewing the ECG of a man who has had an intermittent history of chest pain during exercise. His PMH includes being an active smoker but he has no other cardiac risk factors.

130

130

Medgadget

AUGUST 22, 2022

Researchers at the University of Pennsylvania have developed a microrobot system that can help with biofilm disruption, drug delivery, and sample retrieval, all within the restrictive space of the root canal. It can be difficult for dentists to know if they have removed all the infectious material when performing a root canal, and failure to do so will typically result in an infection reoccurring.

OR 133

OR 133

Critical Care Scenarios

AUGUST 28, 2022

Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submission. Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submis

100

100

EMS 12-Lead

AUGUST 30, 2022

New onset chest discomfort with demonstrable Hyperacute T waves that went undetected by EMS, EM, and cardiology. Case review presentation: [link] Learning Objectives Hyperacute T waves are disproportionately large in comparison to their paired QRS, and represent Grade I Sclarovsky-Birnbaum ischemia. Diffuse / global ST depression is consistent with subendocardial ischemia (supply-demand mismatch) when maximal in Leads II and V5.

EMS 130

EMS 130

The Skeptics' Guide to EM

AUGUST 27, 2022

Date: August 23rd, 2022 Reference: Schoenfeld et al. “Just give them a choice”: Patients’ perspectives regarding starting medications for opioid use disorder in the ED. AEM August 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. […] The post SGEM#374: Bad Habits – Medications for Opioid Use Disorder in the Emergency Department fir

Emergency Department 100

Emergency Department Overdose Naloxone ED 100

EMergucate

AUGUST 10, 2022

You are reviewing a 16 year old girl who has taken an estimated 66-222mg/Kg overdose of her grandmothers SR Theophylline … Continue reading →

Overdose 130

Overdose 130

Medgadget

AUGUST 18, 2022

Enovis , a medtech company based in Delaware formerly known as DJO, recently announced the launch of ARVIS (Augmented Reality Visualization and Information System), an augmented reality technology that is designed to assist surgeons during implant placement in the hip and knee. The hands-free technology consists of an eyepiece that is mounted on a surgical helmet that provides the surgeon with real-time information about the position of an implant with respect to patient anatomy.

OR 133

OR 133

Critical Care Scenarios

AUGUST 14, 2022

We look at the rib fracture patient requiring ICU admission, including a discussion of surgical repair, with Dr. Ron Barbosa (@rbarbosa91), Portland trauma surgeon and SICU director at Legacy Emmanual Medical Center. Takeaway lessons Algorithms and protocols for admitting disposition exist but are generally poorly predictive. ICU admission in rib fracture patients is still most … Continue reading "Episode 50: Rib fractures and surgical plating with Ron Barbosa" We look at the rib fracture patien

ICU 100

ICU OR 100

EMS 12-Lead

AUGUST 29, 2022

It's back to the basics! Take a seat and relax as the maestro, Tom Bouthillet, guides us through a stepwise approach to assessing Left Bundle Branch Block-- especially in the nefarious context of Occlusive Myocardial Infarction.

130

130

Emergency Medicine Cases

AUGUST 16, 2022

In this EM Quick Hits podcast: Anand Swaminathan on limitations and practical tips on intraosseus access,Tahara Bhate QI corner on missed ectopic pregnancy, Sarah Reid from EM Cases Summit on oxygen saturation monitoring in bronchiolitis and management of infant gastro-esophageal reflux, Brit Long on the value of rectal exam in diagnosis of cauda equina syndrome, Hans Rosenberg & Ariel Hendin on withdrawal of life-sustaining care in the ED.

EMS 130

EMS ED 130

The Skeptics' Guide to EM

AUGUST 7, 2022

Date: August 7th, 2022 Host Skeptic: Dr. Dennis Ren is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. You might remember him from the SGEM episodes on febrile infants, aseptic meningitis, and community acquired pneumonia. This is an SGEM Xtra episode. Season 10 is coming to an end. We want to thank all our listeners […] The post SGEM Xtra: The SGEM Goes to Eleven – for Kids first appeared on The Skeptics Guide to Emergency Medicine.

OR 100

OR ED 100

EMergucate

AUGUST 18, 2022

The pelvic x-ray is from a 15 year old footie player with sudden pain in the right hip during a … Continue reading →

EMS 130

EMS 130

Medgadget

AUGUST 25, 2022

Researchers at the Ohio State University Wexner Medical Center have tested the PUP (Patient is Up) Smart Socks, developed by a medtech company called Palarum , in their ability to reduce falls among at-risk patients. The socks contain pressure sensors that alert caregivers when a patient is attempting to stand up. This can include situations such as a patient getting out of bed to go to the toilet.

OR 127

OR 127

Critical Care Scenarios

AUGUST 21, 2022

How do PAs and other APPs compare with physicians in the clinical context? How do PAs and other APPs compare with physicians in the clinical context?

100

100

EMS 12-Lead

AUGUST 22, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary and peer review by Dr. Jesse McLaren @ECGcases [link] [link] This case was kindly submitted by Dr. Paco Dardon (@PacoDardon), and it’s a privilege to present it as a formal review due to the many pathophysiological, and electrophysiological, phenomenon at play.

E-9-1-1 130

E-9-1-1 Coronary ALS ICU 130

Emergency Medicine Cases

AUGUST 2, 2022

In this main episode podcast, Dr. David Carr joins Anton to give us his simplified approach to syncope based solely on history, physical and ECG to help guide disposition decisions. We answer questions such as: What features have the best likelihood ratios to help distinguish syncope from seizure? What key clinical features on history and physical exam can help us distinguish orthostatic and reflex syncope from the more sinister cardiac syncope?

EMS 130

EMS 130

EMCrit Project

AUGUST 26, 2022

It is unacceptable to have the rates of Awareness during Paralysis seen in a recent ED sedation study--We are better than this. EMCrit Project by Scott Weingart, MD FCCM.

ICU 100

ICU ED 100

EMergucate

AUGUST 9, 2022

The following ankle x-rays are from a 12 year old with ankle pain & swelling following fall off a horse.

EMS 130

EMS 130

Medgadget

AUGUST 29, 2022

Researchers at UCLA have developed a fingertip sensor that can rapidly provide data on the levels of lithium in the body. Used as a treatment for bipolar disorder and depression, lithium requires very accurate and sensitive dosing, with too little providing no therapeutic benefit but slightly too much potentially leading to unwanted side-effects. At present, the most common method to assess lithium levels involves a blood draw and subsequent lab testing, which is inconvenient and cumbersome.

ACS 115

ACS 115

REBEL EM

AUGUST 22, 2022

Background: Traumatic lacerations presenting to the emergency department are, by definition, contaminated (ie non-sterile). Standard management involves irrigation, local anesthesia, closure and tetanus update if required. The existing literature has never shown benefit to sterile gloves in these types of injuries if we irrigate and clean the site appropriately.

Emergency Department 59

Emergency Department ALS ED EMS 59

EMS 12-Lead

AUGUST 14, 2022

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic @DidlakeDW A 50 y/o Male was taking his dog for a leisurely stroll through the park when he suddenly experienced new onset chest discomfort. He waited for it to subside, but after 30 minutes of persistence he called 911. EMS personnel found him seated on a bench, uncomfortable, but without gross distress.

MICU 130

MICU STEMI CAD Coronary 130

EMT City

AUGUST 27, 2022

I know that this is a long-shot with the volume of traffic on here anymore, but what the hell, I'll ask. Does anyone know of a source for obtaining the ring that goes around diaphragm bell of the Classic II? I don't need an entire kit. I just need to replace the ring. Thanks.

52

52

EMCrit Project

AUGUST 27, 2022

Historically, many patients admitted with congestion due to heart failure have been treated with furosemide monotherapy. However, a strategy of furosemide monotherapy has numerous drawbacks: Furosemide tends to stimulate production of dilute urine, leading to a greater amount of water loss than sodium loss. Predominant loss of water may cause loss of volume from the […].

95

95

EMergucate

AUGUST 30, 2022

The ankle x-rays are from a 10 year old with injury following fall from a trampoline. What can be seen?

EMS 130

EMS 130

Medgadget

AUGUST 18, 2022

Scientists at Linköping University in Sweden have developed a collagen-based corneal implant that can restore sight to blind patients with corneal disease. The breakthrough could pave the way for such patients to receive effective treatment for corneal disease without requiring a corneal transplant from a human donor. There is a shortage of donor corneas, so creating an off-the-shelf alternative could be very useful.

115

115

REBEL EM

AUGUST 29, 2022

Background: The use of ketamine and etomidate for induction in rapid sequence intubation is heavily debated. The Ketased Trial (Jabre 2009) reported no significant difference between the two induction agents. However, recently the National Emergency Airway Registry reported ketamine is associated with more-frequent hypotension than etomidate in critically ill patients (Mohr 2020).

MICU 52

MICU ICU OR Emergency Department 52

Prehospital Emergency Care Podcast

AUGUST 25, 2022

PEC podcast Deep Dive In this episode our PEC Podcast team talks in detail about the manuscript: Prehospital Providers’ Perspectives about Online Medical Direction in Emergency End-of-Life Decision with the authors: Michael Waldrop MD Clinical Instructor of Emergency Medicine Albany Medical College & Brian Clemency DO Professor of Emergency Medicine State University of New York at Buffalo Click here to download it today!

52

52

Handtevy

AUGUST 25, 2022

The primary focus of the study was to understand the characteristics of pediatric patients who received ketamine during EMS transports and to assess the effectiveness, dosing deviations, and potential adverse outcomes. Background: Ketamine, developed in 1962, has been widely used for pediatric sedation in emergency departments before painful procedures.

Overdose 52

Overdose EMS Emergency Department Ambulance 52

EMCrit Project

AUGUST 15, 2022

This chapter explores some general aspects of neurological infectious diseases, including important historical features and high-risk groups. It also includes a more general discussion of lumbar puncture performance and interpretation. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes. EMCrit Project by Josh Farkas.

94

94

EMergucate

AUGUST 16, 2022

You are reviewing the ECG of a man who has had an intermittent history of chest pain during exercise. His PMH includes being an active smoker but he has no other cardiac risk factors.

100

100

Medgadget

AUGUST 19, 2022

Researchers at New York University have created a wearable system that can measure electrodermal activity, a property of the skin that is influenced by mental states, such as stress or excitement. The system is called Multimodal Intelligent Noninvasive brain state Decoder for Wearable AdapTive Closed-loop arcHitectures (MINDWATCH) and it can assess electrodermal activity by measuring skin conductance.

OR 111

OR 111

Stem EMS

AUGUST 24, 2022

One of the most complex and at the same time least treated topics during the training courses for rescuers is undoubtedly the secondary damage for transport, i.e. all the alterations […] L'articolo Risk of vibrations in the ambulance. How to reduce secondary damage for transport proviene da Stem Ems.

Ambulance 52

Ambulance EMS 52

First Responders Wellness Center

AUGUST 23, 2022

FRWC now has a Chicago office location at 1412 W. Washington 2nd floor Chicago IL. The location is at the Chicago FOP building on the second floor. We maintain confidentiality. We hope to provide more services for Chicago Police officers due to the amount of stressors, lack of time off, and feelings of a lack of support from others. Contact us at 630-909-9094.

First Responder 52

First Responder OR 52

The Overrun Podcast

AUGUST 22, 2022

Greg Friese is the Editorial Director of EMS1.com among other things. He brings a very interesting view of how EMS providers should be compensated for the work they do. In January of 2022, he wrote a piece discussing the importance of EMS providers not just receiving a living wage, but rather for EMS workers to make much greater than a living wage. He recently wrote about the dismal raise that Austin EMS providers received to provide a voice to workers who felt voiceless.

EMS 52

EMS 52