ALiEM
JUNE 10, 2024
For years, adult literature has provided clear guidelines for cervical spine imaging through the NEXUS and Canadian C-spine Rule (CCR) tools. These have been invaluable in helping clinicians decide when to image the neck in trauma patients. Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children.
Emergency Medicine Cases
JUNE 18, 2024
Dr. Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg. acute Q waves or loss of R waves, hyperacute T waves, or reciprocal STD/TWI) and if the ECG is nondiagnostic, consider other OMI signs including clinical (refractory isc
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The Skeptics' Guide to EM
JUNE 15, 2024
Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program.
High Performance EMS
JUNE 20, 2024
Sadly, this is not an adventure story of heroic first responder actions on the scene of an emergency incident but rather about how current EMS operations are failing us and their missions. Across the country, a quarter of positions in the dispatch center , the folks we rely on to keep resources coordinated, are going unfilled. Recent annual surveys also show that over 10% of EMS clinicians will leave the field entirely each year.
Pediatric EM Morsels
JUNE 7, 2024
Knowing how to manage a severe asthma exacerbation in the ER is a vital ingredient to being a successful ER doctor, but what about the more mild cases? The kids with a history of wheezing that are at the start of a viral URI but not yet in the midst of an exacerbation? What recommendations should we be giving these families? Lucky for us, in 2020 there were some updates made to the NIH Asthma Management Guidelines and we’re going to discuss which ones can help us in the Emergency Department!
Critical Care Scenarios
JUNE 26, 2024
We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr.
ALiEM
JUNE 24, 2024
With some things in life, speed is everything. Adenosine is one of those things. With an ultrafast half-life estimated to be between 0.6 to 10 seconds [1], parenterally administered adenosine needs to reach the cells of the AV-node and cardiac pacemaker cells in an expedited fashion to facilitate the termination of supraventricular tachycardias (SVTs).
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
The Skeptics' Guide to EM
JUNE 29, 2024
Date: June 29, 2024 Reference: Herbert L. Fred M.D. (1998) Old-Fashioned Doctors, Hospital Practice. This is an SGEM Xtra episode. I was honoured to be invited by Dr. Fernada Bellolio to the Mayo Clinic and present to the Department of Emergency Medicine. They were kind enough to allow me to speak about any topic. I decided to talk about an article Dr.
St. Emlyn's
JUNE 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed Presentation skills - what are they and why do we need to have them? This post covers the things to consider before you even open any presentation software. The post Ten Tips for Better Presentations – Part 1 appeared first on St.Emlyn's.
Pediatric EM Morsels
JUNE 14, 2024
Ooooo the infamous chief complaint of “ weakness ” ……. We just love those don’t we? Although neurological complaints may not be a crowd’s favorite, it is one we must become comfortable with. Timely recognition and treatment can be life-improving and life-saving! So, with that goal in mind, let us digest another delicious morsel on weakness – Acute Transverse Myelitis in Children : Acute Transverse Myelitis in Children: Basics Rare, non-compressive, inflammatory condition of the spinal cord
Dr. Smith's ECG Blog
JUNE 17, 2024
Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. What do you think? If this EKG were handed to you to screen from triage without any clinical information, what would you think?
ALiEM
JUNE 25, 2024
Dr. Sara Krzyzaniak (podcast host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale University Clerkship Director and 2024 CDEM Clerkship Director of the Year award winner) in this episode to discuss how one might approach their emergency medicine sub-internship. Dr. Bod shares her her wealth of experience and wisdom to provide not only general advice but also answers more detailed questions like: What are some things NOT to do on a rotatio
EMCrit Project
JUNE 13, 2024
the PREOXI trial validates what I have been saying for 15 years about preoxygenation for the critically ill patient EMCrit Project by Scott Weingart, MD FCCM.
The Skeptics' Guide to EM
JUNE 1, 2024
Reference: Tavender E, et al. Triage tools for detecting cervical spine injury in paediatric trauma patients. Cochrane Database Syst Rev. 2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC.
First 10 EM
JUNE 24, 2024
A can’t intubate can’t oxygenate scenario will always be scary, but after years of mental rehearsal and some real world experience, the idea of surgical front of neck access in an adult doesn’t bother me much. (I think that is an important mental space for emergency physicians to find if you want to be able […] The post The pediatric can’t intubate can’t oxygenate scenario (Use a knife) appeared first on First10EM.
American Ambulance Association
JUNE 30, 2024
While the majority of EMS and fire-rescue agencies provide emergency care to children, pediatric calls are rare. In fact, because most agencies see fewer than eight pediatric patients per month, […] The post PPRP | Make Sure You’re Ready for Children – Complete the Assessment! appeared first on American Ambulance Association.
EMergucate
JUNE 25, 2024
PH = 7.238, that is moderate acidaemia. pCO2 = 49.1 mmHg. that is suggestive of respiratory acidosis HCO3 = 20.2 mmol/L, that is suggestive of metabolic acidosis.
Core EM
JUNE 3, 2024
We discuss an approach to the acutely agitated patient and review medications commonly used. Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.
EMCrit Project
JUNE 1, 2024
intro: the challenge of procedural sedation in critical illness Procedural sedation for critically ill patients is a minefield for several reasons: Patients are already physiologically unstable. Procedures are emergent (a factor widely associated with greater complications). Time constraints often prevent a complete pre-anesthetic evaluation (e.g., medical history and laboratory studies may be unknown).
The Skeptics' Guide to EM
JUNE 22, 2024
Reference: Peters MJ, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-picu): a UK multicentre, open, parallel-group, randomised clinical trial. Lancet. December 2023 Guest Skeptic: Dr. Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia.
Chicago EMT Training
JUNE 1, 2024
Marty and I created a new show. We hope to catch with up with old friends, discuss current events and policies, and cultivate discussions with healthcare adjacent professionals. Thanks for being here.
American Ambulance Association
JUNE 26, 2024
Health Insurance Coverage Projections For The US Population And Sources Of Coverage, By Age, 2024–34 Abstract In the Congressional Budget Office’s projections of health insurance coverage, 92.3 percent of the US […] The post HealthAffairs | Health Insurance Coverage Projections appeared first on American Ambulance Association.
EMergucate
JUNE 25, 2024
21 year old girl presented with sudden left sided weakness. Her CT head showed intracerebral haemorrhage.
First 10 EM
JUNE 13, 2024
Preparation for intubation, appropriate preoxygenation, and preventing peri-intubation arrests has been one of my core topics for conference talks. My initial airway series emphasized “optimizing the basics” and carefully considering “is this patient ready for intubation?”. My “RSI and then they die” lecture is by far my most watched video on YouTube.
EMCrit Project
JUNE 17, 2024
introduction Bilevel Sequence Intubation (BSI) refers to initiation of noninvasive bilevel positive pressure ventilation with a backup rate prior to intubation (either using a BiPAP machine or a full-featured mechanical ventilator). BSI is distinct from traditional rapid sequence intubation (RSI), since BSI involves the delivery of machine-initiated, pressure-controlled breaths following administration of sedation and paralytics. […] EMCrit Project by Josh Farkas.
Don't Forget the Bubbles
JUNE 19, 2024
Why is this study needed? Cervical spine injuries are a rare but serious finding following blunt trauma, affecting around 1-2% of presentations. In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR).
Dr. Smith's ECG Blog
JUNE 5, 2024
Written by Magnus Nossen The patient in todays case is a 50 year old male. He has a medical hx notable for hypertension, hyperlipidemia and previous tobacco use disorder. The patient presented due to chest pain that was typical in nature, retrosternal and radiating to the left arm and neck. He denied any exertional chest pain. The below ECG was recorded.
American Ambulance Association
JUNE 20, 2024
CMS recently posted an updated Medicare Ground Ambulance Data Collection System (GADCS) webinar on Public Safety Organizations on their Ambulance Events webpage. The post CMS GADCS: Public Safety Webinar Recording appeared first on American Ambulance Association.
EMergucate
JUNE 25, 2024
The following ECG is from a 48-year-old man who presented feeling generally unwell and “restless” He has been suffering from … Continue reading →
Critical Care Scenarios
JUNE 12, 2024
We explore the profession of respiratory therapy in the US, including their role and training and how to optimize our clinical relationships, with Keith Lamb (@kdlamb1), RRT, RRT-ACCS, FAARC, FCCM. Keith is an RT at the University of Virginia in Charlottesville, working clinically in neuro/surgical/trauma critical care, who has been active in research and has … Continue reading "Lightning rounds 41: Respiratory therapy with Keith Lamb" We explore the profession of respiratory therapy in the US,
EMCrit Project
JUNE 3, 2024
Today, we talk about a paper that showed impressive neurologically intact survival for all-rhythms presenting in cardiac arrest, both OHCA and IHCA. It uses a new set of strategies and technologies called CARL. The Paper Treatment of Refractory Cardiac Arrest by Controlled Reperfusion of the Whole Body: A Multicenter, Prospective Observational Study Supplemental Material […] EMCrit Project by Scott Weingart, MD FCCM.
EM Literature of Note
JUNE 5, 2024
Every so often a masterclass performance arises in the medical literature. A performance transcending the boundaries of what was once thought possible. A shining exemplar of human achievement. This is a trial, published in the New England Journal of Medicine , with the following features: Conducted by an institute sponsored by pharma. Designed by the first author, a consultant for pharma, and two employees of pharma.
Dr. Smith's ECG Blog
JUNE 27, 2024
By Sofiya Diurba MD, reviewed by Meyers, Grauer A woman in her 50s with PMH known RBBB and prior syncopal events presents to the ED for five syncopal events over the last 24 hours. Each event is associated with a prodrome of mild substernal CP, SOB, and “brain fog.” EMS reports intermittent sinus tachycardia and bradycardia secondary to some type of heart block during transport.
American Ambulance Association
JUNE 12, 2024
CMS recently posted an updated Medicare Ground Ambulance Data Collection System (GADCS) webinar on Labor Costs on their Ambulance Events webpage. The post CMS GADCS: Labor Costs Webinar Recording appeared first on American Ambulance Association.
EMergucate
JUNE 18, 2024
The following ECG is from a 38-year-old type 1 diabetic who has come by ambulance with epigastric pain, dyspnoea and feeling generally unwell. What are the key ECG features?
Critical Care Scenarios
JUNE 5, 2024
Responsible self-directed learning occurs in a zone between comfort and novelty. Find us on Patreon here! Buy your merch here! Responsible self-directed learning occurs in a zone between comfort and novelty. Find us on Patreon here! Buy your merch here!
St. Emlyn's
JUNE 11, 2024
St.Emlyn's - Emergency Medicine #FOAMed Discover the highlights of Day 1 at the Premier conference on Paediatric Emergency Medicine. The post Paediatric Emergency Medicine – Premier Conference – Day 1 appeared first on St.Emlyn's.
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