The Skeptics' Guide to EM
OCTOBER 5, 2024
Date: October 2, 2024 Reference: Paxton et al. Headpulse measurement can reliably identify large-vessel occlusion stroke in prehospital suspected stroke patients: Results from the EPISODE-PS-COVID study. AEM Sept 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the UMass Chan Medical School – Baystate.
Emergency Medicine Cases
OCTOBER 1, 2024
In this ECG Cases blog we look at 5 cases of ECGs falsely labeled 'normal'. Can you spot the critical abnormality? Written by Jesse McLaren; Peer Reviewed and edited by Anton Helman. October 2024 Five patients presented with ECGs labeled ‘normal’. Can you use systematic ECG interpretation to identify the [.] The post ECG Cases 51 – ECGs falsely labeled “normal” appeared first on Emergency Medicine Cases.
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American Ambulance Association
OCTOBER 10, 2024
FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 10, 2024 Congressman Mike Bost Honored with Legislative Recognition Award from the American Ambulance Association Washington, D.C. — The American Ambulance […] The post Congressman Mike Bost Honored with Legislative Recognition Award appeared first on American Ambulance Association.
Critical Care Scenarios
OCTOBER 16, 2024
We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC (@HomeIcu), host of the Walking Home from the ICU podcast, and consultant to ICUs working on these issues. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC ( @HomeIcu ), host of the Walking Home from the ICU podcast, and consultant to ICUs working
First 10 EM
OCTOBER 28, 2024
As with everything that comes out of the PECARN group, this is a huge study, and is therefore one that everyone needs to know about. That being said, despite working in two very busy community hospitals with a high percentage of pediatrics visits, c-spine injuries are just not an issue I struggle with. I have […] The post The PECARN c-spine rule could cause a lot of harm appeared first on First10EM.
Core EM
OCTOBER 16, 2024
Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% Febrile Non-hemolytic (FNHTR) – 1% Transfusion-associated circulatory overload (TACO) – 1% Transfusion-related acute lung injury (TRALI) – <0.01% Anaphylaxis/ABO incompatibility –
The Skeptics' Guide to EM
OCTOBER 19, 2024
Date: October 7, 2024 Reference: Nguyen et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. Guest Skeptic: Dr. Brendan Freeman is an emergency medicine physician, assistant professor of emergency medicine, and medical education fellow at Staten Island University Hospital.
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
American Ambulance Association
OCTOBER 8, 2024
FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 8, 2024 Senator Jerry Moran Honored with Legislative Recognition Award from the American Ambulance Association Washington, D.C. — The American Ambulance Association […] The post Senator Jerry Moran Honored with Legislative Recognition Award appeared first on American Ambulance Association.
ALiEM
OCTOBER 21, 2024
A 5-year-old generally healthy fully immunized boy presented to the ED with worsening left ear redness, swelling, and tenderness that his family noticed the day before presentation. His family had also recently noticed an abrasion over that ear. The patient was on amoxicillin for strep throat, which was diagnosed a week before the onset of his symptoms and was improving.
ACEP Now
OCTOBER 29, 2024
On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? His vitals are fine…”. Seemingly unsure, she pauses, “I’m getting an interpreter, and I think he has belly pain, but something just doesn’t seem right.” Coming into triage, I see a young man—Georgian-speaking—bracing himself with a hand against the wall and holding his lower abdomen.
FOAMfrat
OCTOBER 28, 2024
In this episode of FOAMfrat, Tyler speaks with paramedic Kyle Rice to discuss a deeply personal and eye-opening experience—rolling his ambulance after running a red light. Kyle shares the lessons he learned about complacency, crew resource management, and the often-overlooked dangers of driving with lights and sirens. Together, they explore how EMS providers can stay vigilant behind the wheel, adopt safer driving practices, and shift their mindset when responding to emergencies.
EMergucate
OCTOBER 29, 2024
The following chest x-ray is from an elderly patient with cough & dyspnoea.
Emergency Medicine Cases
OCTOBER 1, 2024
In this EM Cases podcast Anton chats with Dr. Peter Brindley and Dr. Leon Byker who have a deep interest in the Culture of Medicine to explore what culture in medicine is, why culture is so important, and then drive home 10 strategies to improving the culture in our departments emphasizing the importance of human connection, empathy, open communication, and a willingness to learn from mistakes in creating a positive and fulfilling work environment, so that we love our work, we love our departmen
American Ambulance Association
OCTOBER 23, 2024
FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 10, 2024 Senator Debbie Stabenow Receives Inaugural EMS Legacy Award from the American Ambulance Association Washington, D.C. — Senator Debbie Stabenow […] The post Senator Stabenow Receives Inaugural EMS Legacy Award appeared first on American Ambulance Association.
ALiEM
OCTOBER 7, 2024
A 52-year-old female with a past medical history of hypertension and prediabetes presented to the emergency department with double vision that started one day prior to arrival. She stated that her double vision improved when she closed one eye. She denied trauma, headache, neck pain, dizziness, dysphagia, numbness, tingling, weakness, or gait instability.
Core EM
OCTOBER 23, 2024
The Case A 24-year-old man with no past medical or surgical history presented to the emergency department with 5 days of progressively worsening bilateral leg cramping, paresthesias, and multiple falls. The following ECG is obtained: EKG Show Details EKG Characteristics Rate 88 Rhythm Sinus Rhythm with PAC's Intervals Normal PR and QRS interval, Prolonged QTc interval (619 ms) Axis Normal ST Segments Normal Additional Features Diffuse, prominent, prolonged T-waves Diagnosis Diagnosis : Hypokalem
Dr. Smith's ECG Blog
OCTOBER 20, 2024
Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness. The syncope lasted about 2-3 minutes according to his wife. He woke up alert and with chest pain which he also had experienced intermittently over the previous few days.
EMergucate
OCTOBER 29, 2024
17-year-old boy with wrist fracture. This patient became blue during manipulation of the fracture under bier’s block anaesthetic effect.
EMOttawa
OCTOBER 24, 2024
Precedex (dexmedetomidine) is an alpha-2 adrenergic agonist increasingly used in critical care environments for sedation and anxiolysis. It offers a unique profile of sedation without respiratory depression, making it an attractive option in various clinical scenarios. Historically, it has been used more frequently in the ICU than in Emergency Departments, likely due to provider comfort. […] The post Is there a Precedence for Precedex in the ED?
American Ambulance Association
OCTOBER 10, 2024
FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 10, 2024 Congressman Ryan Zinke Honored with Legislative Recognition Award from the American Ambulance Association Washington, D.C. — The American Ambulance […] The post Congressman Ryan Zinke Honored with Legislative Recognition Award appeared first on American Ambulance Association.
ALiEM
OCTOBER 11, 2024
A 76-year-old female presented with a lingering cough and an oral lesion to the left lower cheek. She reported ten days of improving flu-like symptoms but had a persistent cough and nasal congestion. On the day of presentation, she developed a painful, intermittently bleeding “blood blister” to the left lower cheek that had increased in size, as well as new red spots on her arms and legs.
Core EM
OCTOBER 16, 2024
We discuss migraines with one of the authorities in the field. Hosts: Benjamin Friedman, MD of Montefiore Brian Gilberti, MD [link] Download Leave a Comment Tags: Neurology Show Notes Initial Approach to Diagnosing Migraines: Differentiating between primary headaches (migraine, tension-type, cluster) and secondary causes (e.g., subarachnoid hemorrhage).
Dr. Smith's ECG Blog
OCTOBER 3, 2024
This was sent to me from Sam Ghali ( @EM_Resus ) with no other information. I assumed it was a patient with acute chest pain. "What do you think, Steve? Real or just fake?" What do YOU think? It has some inferior ST elevation with some reciprocal ST depression and inverted T in aVL. This usually indicates inferior OMI. My answer: "Fake: pretty certain, but not 100% certain.
EMergucate
OCTOBER 28, 2024
This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days. PH = 7.52, that is moderate alkalaemia. pCO2 = 21 mmHg. So, we have respiratory alkalosis.
NAEMSP
OCTOBER 9, 2024
Author: Joshua Stilley, MD FACEP FAEMS This article was written in collaboration with the National Adrenal Diseases Foundation Background: Adrenal crisis occurs when the adrenal glands are unable to produce enough endogenous steroids under stress. This is often due to primary adrenal insufficiency, also known as Addison’s disease, or secondary causes like chronic exogenous steroid use leading to adrenal suppression.
American Ambulance Association
OCTOBER 7, 2024
FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 7, 2024 Senator Jon Tester Honored with Legislative Recognition Award from the American Ambulance Association Washington, D.C. — The American Ambulance Association […] The post Senator Jon Tester Honored with Legislative Recognition Award appeared first on American Ambulance Association.
ALiEM
OCTOBER 23, 2024
Ultrasound-guided procedures are difficult enough just identifying the anatomy. Performing a nerve block with the ultrasound in one hand and the needle in the other hand adds extra challenges. The simplest 1-person approach involves attaching a syringe with local anesthetic directly to the end of the procedural needle. A 2-person approach involves attach the syringe to a custom tubing-needle setup such as below.
Core EM
OCTOBER 1, 2024
We discuss migraines with one of the authorities in the field. Hosts: Benjamin Friedman, MD of Montefiore Brian Gilberti, MD [link] Download Leave a Comment Tags: Neurology Show Notes Initial Approach to Diagnosing Migraines: Differentiating between primary headaches (migraine, tension-type, cluster) and secondary causes (e.g., subarachnoid hemorrhage).
Dr. Smith's ECG Blog
OCTOBER 8, 2024
This was sent to me by a reader who wishes to remain anonymous. A lady in her 60s came to the ER with chest discomfort and shortness of breath. She had a history of previous anterior MI treated by primary PCI to the proximal LAD. The first EKG is from 2:30 PM on the day of presentation to the ER. Smith : To me this is a blatantly obvious acute anterior OMI.
EMergucate
OCTOBER 27, 2024
Today’s ECG is a 45yr male who presents to ED with a 12hr history of epigastric pain and diaphoresis. He is an ex smoker, no other cardiac risk factors.
Critical Care Scenarios
OCTOBER 2, 2024
We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse.
American Ambulance Association
OCTOBER 25, 2024
As many of you are aware, OSHA has published the NPRM titled the Emergency Response Rule. This rule will have substantial impacts on EMS and Fire Emergency Service Organizations should […] The post SBA Informational Session on OSHA Emergency Response Rule appeared first on American Ambulance Association.
NVFC
OCTOBER 3, 2024
100 departments will each receive a $10,000 grant to purchase needed equipment Photo courtesy of Sejal Dave, Oronoco Fire Department. Just in time for Fire Prevention Week October 6-12, State Farm ® and the National Volunteer Fire Council have announced $1 million in grants to local volunteer fire departments. Through the State Farm Good Neighbor Firefighter Safety Program, 100 departments will each receive a $10,000 grant to obtain critical equipment that will help increase their responders’ sa
St. Emlyn's
OCTOBER 26, 2024
St.Emlyn's - Emergency Medicine #FOAMed This article reviews a recent study on the use of Tranexamic Acid (TXA) in traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH), focusing on prehospital care. The study, a subgroup analysis from the Prehospital TXA for TBI Trial, compared different TXA dosing regimens and found that a 2-g TXA bolus significantly reduced 28-day mortality compared to placebo.
Dr. Smith's ECG Blog
OCTOBER 15, 2024
This was sent to me by an undergraduate name Hans Helseth, who is an EKG tech, but who is an expert OMI ECG reader. He wrote most of it and I (Smith) edited. A prehospital “STEMI” activation was called on a 75 year old male ( Patient 1 ) with a history of hyperlipidemia and LAD and Cx OMI with stent placement. He arrived to the ED by helicopter at 1507, about three hours after the start of his chest pain while chopping wood around noon.
EMergucate
OCTOBER 20, 2024
This chest x-ray is from a 23-year-old with right shoulder tip pain. What can be seen?
Life in the Fastlane
OCTOBER 30, 2024
Casey Parker and James Rippey Ultrasound Case 112 A 30 year old woman who is currently 30 weeks gestation presents to the ED with abrupt, severe right loin pain.
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