November, 2024

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Ep 199 Trauma Airway and Airway Trauma

Emergency Medicine Cases

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma?

EMS 287
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SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

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.

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SAEM Clinical Images Series: Rectal Bulge

ALiEM

A 13-month-old, full-term male presented due to intermittent emesis over a 3-week period. He and his parents had COVID one week prior to presentation. He had multiple episodes of non-bloody, non-bilious vomit the day before and the day of presentation. Parents noted he had been listless and unable to tolerate food. The mother was also concerned that he was straining to have bowel movements and that a mass was coming out of his bottom on the ride to the hospital.

OR 183
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Elbow Dislocations

REBEL EM

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (80%) Demographics Most commonly affects patients between ages 10-20 years old As age increases, elbow dislocation rates tend to d

E-9-1-1 118
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Targeted Temperature Management in Paediatric Traumatic Brain Injury

Don't Forget the Bubbles

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. Should we aim to prevent fever, or should we cool patients? A 12-year-old boy presents with a significant head injury following a road traffic accident. At the scene, his lowest GCS was 5 (E1V2M2).

ALS 116
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What makes a T-wave Hyperacute? And: 30 Examples of Hyperacute T-waves, 10 in each of 3 myocardial territories.

Dr. Smith's ECG Blog

Pendell and I and the geniuses at Powerful Medical (Producers of the PMCardio Queen of Hearts OMI AI app ) are working on an objective, mathematical definition of hyperacute T-waves , based on real OMI outcomes and hyperacute T-wave annotation that has excellent interrater agreement (between me and Pendell), and it will end up being a logistic regression using these 3 variables: 1) area under the curve (AUC) relative to the QRS size 2) increased symmetry , as defined by time from T-wave onset to

STEMI 110
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ECG of the week 27th November

EMergucate

The following ECG is from a 62-year-old man who presented following an MVA.

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SAEM Clinical Images Series: A Rash with Cranial Nerve Deficits

ALiEM

A 48-year-old male with no significant past medical history presented to the Emergency Department with a left-sided facial rash and associated burning left eye pain that started four days prior. He was seen at an ophthalmology clinic when his symptoms started and given oral valacyclovir which he took for three days without improvement. He also endorsed left-sided facial weakness and diplopia for the last eight days.

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Registration Open! Public Meeting on December 4 for NACCD

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Registration Open! Public Meeting on December 4 for NACCD appeared first on American Ambulance Association.

Ambulance 130
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NREMT Psychomotor Exam for BLS

Chicago EMT Training

We are ready to begin hosting psychomotor exams for BLS providers that successfully completed their written NREMT requirement. Assessments include: Medical Assessment (Neuro) Trauma Assessment (Head to Toe) Airway Management (with iGel) CPR//AED/choking for adults, pediatrics, and infants Bleeding Control (tourniquet) Penetrating Chest Trauma Spinal Motion Restriction OB Delivery Please schedule an appointment with Victor at info@chicagoemttraining.com To prepare, you can utilize our study guide

BLS 130
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Critical Care Evidence Updates – October 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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Lab case 452 interpretation

EMergucate

Question 1: PH = 7.30, that is mild acidaemia. HCO3 = 18, that is low (less than 24), So we have metabolic acidosis.

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SGEM#460: Why Do I Feel Like, Somebody’s Watching Me – CHARTWatch to Predict Clinical Deterioration

The Skeptics' Guide to EM

Date: October 28, 2024 Reference: Verma et al. Clinical evaluation of a machine learning–based early warning system for patient deterioration. CMAJ September 2024 Guest Skeptic: Michael Page is currently the Director of Artificial Intelligence (AI) Commercialization at Unity Health Toronto. He leads an AI team intending to improve patient outcomes and healthcare system efficiency.

ICU 213
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Building a Learning Culture in the ED: Why It Matters and How to Make It Happen.

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Creating a learning culture in the emergency department (ED) fosters psychological safety, open communication, and continuous improvement. This approach supports team resilience, enhances patient care, and reduces burnout. Learn practical steps to build a strong learning culture in your ED, promoting growth and collaborative excellence in emergency medicine.

ED 121
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Spending End of Year Funds? ⚠️Don’t Go Out To Bid!⚠️

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Spending End of Year Funds? Don’t Go Out To Bid! appeared first on American Ambulance Association.

Ambulance 130
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Ankle Sprains

Core EM

Introduction: - Ankle sprains are among the most common injuries, affecting both athletes and everyday pedestrians. - The streets of New York City illustrate how treacherous surfaces can lead to ankle injuries. - The ankle is the most commonly injured joint in sports; jogging is a frequent cause. Anatomy of the Ankle: - The ankle joint, or mortise, is formed by the talus bone fitting snugly between the distal fibula and tibia. - Key ligaments securing the ankle include: Medial deltoid ligament S

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Everyday Use of Pulsara Helps Prepare Personnel for the ‘Big One’

Pulsara

EDITOR'S NOTE: This article originally appeared on EMS1.com under the title "Everyday use of this care platform helps prepare personnel for the 'big one.'" Special thanks to our guest author, John Erich, for EMS1 BrandFocus Staff. __ MCIs are no time to be learning new tools – this one is suitable for use on every call as well as major incidents In Texas, there’s rarely a dull moment for emergency responders.

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Lab case 453

EMergucate

72 year-year-old man with history of type II DM and has a single kidney. Presented with 2 weeks of diarrhoea. He has been in bed for 2 weeks. Unresponsive. Last proper meal was 2 weeks ago.

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SGEM#459: Domo Arigato Misuta Roboto – Using AI to Assess the Quality of the Medical Literature

The Skeptics' Guide to EM

Date: October 28, 2024 Reference: Woelfle T et al. Benchmarking Human–AI collaboration for common evidence appraisal tools. J Clin Epi Sept 2024. Guest Skeptic: Dr. Laura Walker is an Associate Professor of Emergency Medicine and the vice chair for digital emergency medicine at the Mayo Clinic. In addition to finding ways to use technology in emergency department (ED) care, she is interested in how health systems work and how patients move through the healthcare system.

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National Emergency Response Information System Launched to Modernize Incident Data Collection for American Fire Departments

NVFC

The National Emergency Response Information System (NERIS) launched on November 4 to modernize incident data collection and provide vital intelligence for local fire departments across the United States. NERIS is a secure, cloud-based platform developed in collaboration with the American fire service to capture all-hazards incident data and provides analytic tools for local fire and emergency service leaders in near-real time.

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Now Available: Materials from October EMS Focus Webinar

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Now Available: Materials from October EMS Focus Webinar appeared first on American Ambulance Association.

EMS 130
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5 Min Sono: The VExUS Score (2024)

Core Ultrasound

In this Five Minute Sono video we provide a streamlined, step-by-step walkthrough on how to accurately conduct the VEXUS Score, perfect for clinicians who are already familiar with its purpose and clinical applications. IVC VTI Courses The post 5 Min Sono: The VExUS Score (2024) first appeared on Core Ultrasound.

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How to Best Inspect, Protect, and Dress Wounds in the Emergency Dept.

ACEP Now

This is the second visit in two weeks for an elderly gentleman who is concerned about his legs being red and swollen. During the first visit, he was diagnosed with cellulitis and placed on cephalexin. Today, he notes worsening swelling and a blister forming near his left ankle. The pain makes it difficult for him to ambulate unassisted through his home.

ED 97
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Imaging Case of the Week 607 Answer

EMergucate

There is a sliver of air under the right hemi-diaphragm.

EMS 130
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JC: Small versus Large-Bore Thoracostomy for Traumatic Hemothorax.

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Traditionally, large-bore chest tubes have been standard for managing hemothorax, but smaller tubes are now proving just as effective in stable patients, with added benefits like reduced pain and fewer tube days. This review explores outcomes in drainage efficacy, complication rates, and patient comfort, showing that small-bore thoracostomy may be a reliable alternative for non-emergent cases.

OR 99
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Thinking: Rapid A-fib

Medic Mindset

Want CE for listening? Here’s how. Dr. Casey Patrick is the EMS medical director of Montgomery County Hospital District (Texas). As an EM physician, he shares how he decides to care for his own patients in the ED who present with rapid atrial fibrillation. He wants paramedics to ask the same question he asks: Is the rapid A-fib the primary problem or secondary to another critical condition like sepsis, PE, DKA, hypovolemia, etc?

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OSHA Emergency Response Proposed Rule Hearing Links Published

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post OSHA Emergency Response Proposed Rule Hearing Links Published appeared first on American Ambulance Association.

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IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO)

First 10 EM

In the most recent BroomeDocs podcast, we talk about an attempt to use the IM route to give cardiac arrest victims epinephrine faster. (The podcast and Research Roundups blog post might actually come out next week.) I was skeptical about the outcomes, partly because the evidence that epinephrine helps at all in cardiac arrest is […] The post IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO) appeared first on First10EM.

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Ultrasound Guided Peripheral IVs

EMOttawa

What do you do when expert nurses tell you they can’t obtain IV access? Do you spend 20 minutes performing an invasive central line? Does your resident finally get two IO EPAs? Or do you save the day with a slick, ultrasound guided IV? Obtaining peripheral ultrasound guided IV access is not only a core […] The post Ultrasound Guided Peripheral IVs appeared first on EMOttawa Blog.

OR 123
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Imaging Case of the Week 608 Answer

EMergucate

The chest x-ray reveals sail sign.

EMS 130
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PulmCrit Wee: Why MedTwitter should move to Bluesky

EMCrit Project

Medtwitter was great. We met amazing people and exchanged ideas. There were endless arguments about electrolytes and intubation. But the strength of Medtwitter was never the platform – it was the people. Twitter has been deteriorating for years. For example, the algorithm is horrific, the blocking feature has been largely removed, posts from paid users […] EMCrit Project by Josh Farkas.

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GM Awards Grant to National Volunteer Fire Council to Focus on Roadway Safety

NVFC

For the fourth year, General Motors (GM) has awarded the National Volunteer Fire Council (NVFC) a grant to make the roadways safer for emergency responders and the public. The grant for $155,000 will be used to provide critical training to emergency responders as well as promote driving safety and slow down, move over messaging. The new grant will build on the NVFC’s previous efforts to positively impact vehicle and road safety for volunteer responders and road users.

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2024 AAA Board of Directors Election Results

American Ambulance Association

The winners of the 2024 AAA Board of Directors election are listed below. Each board member’s term will begin on January 1, 2025. Please join us in thanking all candidates […] The post 2024 AAA Board of Directors Election Results appeared first on American Ambulance Association.

Ambulance 130
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Classic EM: How profound is the PROFUNDUS study?

Core EM

Diagnosis of acute aortic syndromes with ultrasound and d-dimer: the PROFUNDUS study European Journal of Internal Medicine, 2024 Background Acute aortic syndromes (AAS) are rare causes in patients presenting with chest/abdominal/back pain or syncope. Types of AAS include aortic dissection, intramural aortic hematoma, and penetrating aortic ulcer. Diagnosis of AAS requires urgent advanced aortic imaging (AAI), such as computed tomography angiography (CTA).

EMS 100
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November 8, 1895

Life in the Fastlane

Mike Cadogan November 8, 1895 On November 8, 1895 Wilhelm Röntgen, chair of physics at Würzburg, noted an unusual phenomenon, that would change the world of medicine

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Imaging Case of the Week 609 Answer

EMergucate

The lateral view of ankle demonstrates an avulsion fracture above the posterior calcaneus.

EMS 130
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PulmCrit: How to quickly create a useful professional account in BlueSky

EMCrit Project

I discussed the reasons for migrating to BlueSky here. I've received positive feedback from several FOAMed expats who migrated to Bluesky and enjoy it there. I've also received some questions about getting started on BlueSky, so here is a brief guide to moving into MedSky. [1] Set up your account & profile This is essentially […] EMCrit Project by Josh Farkas.

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