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A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.
We discuss the recognition and treatment of necrotizing fasciitis. Hosts: Aurnee Rahman, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , General Surgery Show Notes Table of Contents 0:00 – Introduction 0:41 – Overview 1:10 – Types of Necrotizing Fasciitis 2:21 – Pathophysiology & Risk Factors 3:16 – Clinical Presentation 4:06 – Diagnosis 5:37 – Treatment 7:09 – Prognosis and Recovery 7:37 – Take Home points Int
By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.
St.Emlyn's - Emergency Medicine #FOAMed This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. Drawing on a systematic review and meta-analysis, it examines the evidence, evaluates key benefits, and critically appraises the limitations. The discussion highlights the potential of this model to enhance pre-hospital emergency care while addressing challenges in implementation across dive
Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.
Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 14, 2025] In the aftermath of the devastating New Years Eve fireworks explosion in Honolulus Salt Lake neighborhood, which overwhelmed Hawaiis burn care capacity, and the ongoing challenges posed by the recent California wildfires, the American Burn Association (ABA) recognizes the extraordinary efforts of burn care
Today on the emDOCs cast with Brit Long ( @long_brit) , we cover immune checkpoint inhibitors and adverse events. Episode 113: Immune Checkpoint Inhibitor Adverse Events Several cancers (melanoma, non-small cell lung cancer, renal cell carcinoma, hepatocellular carcinoma, others) suppress the innate T-lymphocyte function by activating checkpoint signals.
When I started as a paramedic in Hartford in January of 1995, I was given a 100-page protocol book to memorize. There were fewer than 50 protocols in the book, along with pages for 24 medications and 8 procedures. The book was approved by the two largest hospitals in Hartford. Looking through the book today, it is truly an antiquated. For instance, there was no protocol for stroke or STEMI.
When I started as a paramedic in Hartford in January of 1995, I was given a 100-page protocol book to memorize. There were fewer than 50 protocols in the book, along with pages for 24 medications and 8 procedures. The book was approved by the two largest hospitals in Hartford. Looking through the book today, it is truly an antiquated. For instance, there was no protocol for stroke or STEMI.
Happy New Year, and w elcome back to another edition of ESO product updates. Thanks to our new and improved feedback process, our customers have been more involved than ever in our Product Roadmap. Your input is invaluable to our team and integral to the improvements and enhancements you’ll find below. So, without further ado, here are the latest updates from ESO in Q4 2024 and whats just ahead on the horizon , all of which h as been made possible by our incredible ESO community : Content
Welcome to the first episode of the Broomedocs podcast for 2025. Justin and I are back for more nerdy goodness to make you smarter in the Resus room, or at a pub trivia night more likley… wether it is about salt correction, dissection or infection we can help you out! Listen in and learn! Or if you don’t have enough Youtube content featuring aging bearded men – you can watch over on Justin’s channel here: Airway, breathing, cellphone: a new vital sign?
In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy.
Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 10, 2025] As wildfires rage across California, the American Burn Association (ABA) is prepared to assist burn centers and healthcare providers in responding to burn injuries resulting from these devastating events.
Author: Christopher Blanton, MD, MBA (EM Resident, UTSW / Dallas, TX); Joslin Gilley-Avramis, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
Methodology 3/5 Usefulness 3/5 Connolly SJ, et al. N Engl J Med. 2024 May 16;390(19):1745-1755. Editorial: Reversing Oral Anticoagulation in Intracerebral Hemorrhage. Question and Methods: This unblinded, multicentre randomized controlled trial studied whether Andexanet improved hemostatic efficacy compared to usual care in patients with acute intracerebral hemorrhage using factor Xa inhibitors.
Happy New Year from Our New Association President Dear Fellow Members, I am saddened to begin the New Year with such grim and shocking news from Louisiana and New […] The post A Message from AAA President Jamie Pafford-Gresham appeared first on American Ambulance Association.
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections BALANCE Investigators. NEJM 2024; DOI: 10.1056/NEJMoa2404991 Clinical Question In hospitalised patients with bloodstream infections (BSI), is antibiotic treatment for 7 days, compared to treatment for 14 days, non-inferior with respect to mortality at 90 days?
We all know the key to a thorough patient assessment is to approach it systematically so that we dont become distracted (by that bleeding scalp wound) or skip steps that may yield valuable information (like listening to breath sounds). Theres a reason we are all taught head-to-toe surveys: so that we work our way through essential assessment points, avoiding a haphazard exam where key signs are missed.
Instructions to join are below description and speakers. February 6th, 2025 | 9:00 am PST (12:00 pm EST) Join us for an in-depth exploration of the innovative Preburn Project: Preventing Burnout by Predicting Compromised Wellness in EMS Workers. This session is designed for EMS directors, EMS administrators, paramedics, dispatchers, mental health professionals and researchers who are committed to improving the well-being of frontline EMS workers.
St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). The post Prehospital Emergency Anaesthesia (PHEA) vs. Emergency Department RSI: A Comparative Study on Trauma Care Timelines and Outcomes appeared first on St.Emlyn's.
In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED). However, their use is far from straightforwardbalancing […] The post These are the ‘Roids you are looking for – Steroids in the ED appeared first on EMOttawa
Understanding this vital tool for EMTs in diagnosing and monitoring heart conditions An Electrocardiogram, commonly known as an EKG or ECG, is a medical test that measures the electrical activity of the heart. For Emergency Medical Technicians (EMTs), understanding EKGs is a critical skill. In the fast-paced environment of emergency medical services (EMS), EMTs are […] The post What is an EKG?
Do you change your practice when new evidence is published? Will these articles change your practice? Will you read them? Does anyone read them? I dont know, but here is another month of my reading summarized. For the regular readers, you will have noticed I have taken a few weeks off. February is also likely […] The post Research Roundup for January 2025 appeared first on First10EM.
How do EMS clincians process the trauma they witness dailyand how can they be better supported? In this episode of The EMS Educator podcast, hosts Rob Lawrence, Hilary Gates and Maia Dorsett explore the critical topic of trauma stewardship with guest Ronit Reguer, the first behavioral health coordinator for DC Fire and EMS. Together, they unpack the challenges of emotional resilience, the importance of proactive mental health care, and the cultural shifts shaping the future of first responder su
Approximately 10% of geriatric patients (adults over the age of 65) transported via ambulance will have a mental status altered from baseline, otherwise known as delirium. Many of these patients will be agitated, posing a management challenge for EMS practitioners. Existing protocols for delirium in the pre-hospital setting were designed for younger adults, who have different etiologies and different levels of tolerance for medications than most older adults.
St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). This retrospective study explores time efficiency, injury severity, and patient outcomes, highlighting the role of HEMS in delivering critical care to severely injured patients in remote locations.
Authors: Rebecca Dupree, DO and Emerson Franke, MD FAEMS FAAEM Case The dreaded scenario: youre performing high quality CPR in the field, youve successfully intubated the patient, and suddenly you hear, I found their DNR form! just as youve gotten ROSC. You manage to get in contact with family and determine the patient is enrolled in hospice. The family does not want the patient transported to the hospital.
GEDCs Spotlight Series shares the great work that member organizations are doing in the field of geriatric emergency medicine. Through the pursuit of GEDA accreditation, implementation of meaningful QI initiatives, and provision of educational resources for clinicians, health systems that take advantage of GEDC membership are setting the standard for outstanding geriatric emergency medicine.
This content is for AAA members only. Please either Log In or Join! The post CAAS Launches ANSI-Approved CAAS Standards Version 4.0 appeared first on American Ambulance Association.
Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr.
St.Emlyn's - Emergency Medicine #FOAMed Explore the variability in maintaining prehospital anaesthesia for trauma patients in this comprehensive summary of a multinational survey. With insights into drug protocols, administration methods, and governance, the article highlights challenges and opportunities for standardisation in prehospital care.
Long, physically demanding hours coupled with life-and-death decision-making can lead to more than just burnout for first responders. Nearly 22% of all fire service members are expected to experience PTSD at some point in their careers. Due to this, protecting your team members wellbeing should be a top priority for EMS agencies and fire departments alike, right up there with their physical safety.
I was talking to a doctor friend about the movie Asphalt City. He mentioned the scene where the old crackhead lady was relentlessly berating the young paramedic who just sat there saying nothing, looking all burnt to hell already, not two months into the job. We talked about burnout. Burnout comes in waves, I said. When you are new and getting beat to s**t every night, it can come on hard.
The American Ambulance Association is pleased to release its 2025 State Medicaid Rate Survey. This survey sets forth the fee-for-service Medicaid rates for all 50 states. For each state, the […] The post 2025 Medicaid Rate Survey Released appeared first on American Ambulance Association.
St.Emlyn's - Emergency Medicine #FOAMed Day 2 of the London Trauma Conference delivered impactful discussions on trauma care innovations, including advanced resuscitation strategies, rib fracture management, and prehospital interventions. The post Talking Trauma – London Trauma Conference 2024 Day 2 appeared first on St.Emlyn's.
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