Emergency Medicine Cases

SEPTEMBER 10, 2024

On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG.

Coronary 251

Coronary EMS 251

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Date: September 18, 2024 Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Before attending medical school, he was a New York City Paramedic.

Naloxone 239

Naloxone NARCAN Overdose CPR 239

Core EM

SEPTEMBER 8, 2024

We discuss a new class of medications, Immune Checkpoint Inhibitors, and their side effects. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Oncology Show Notes Overview of Immune Checkpoint Inhibitors (ICIs) ICIs are a relatively new class of oncologic drugs that have revolutionized cancer treatment. Unlike chemotherapy, ICIs help the immune system develop memory against cancer cells and adapt as the cancer mutates.

OR 230

OR 230

EMS 12-Lead

SEPTEMBER 8, 2024

Complete Heart Block with Altered Mental Status Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the third installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using information from different cases where paramedics attempted TCP in the field.

Paramedic 230

Paramedic EMT EMT EMS 230

ALiEM

SEPTEMBER 20, 2024

A 50-year-old male with insulin-dependent Type 2 Diabetes presented to the emergency department with three days of pain and swelling on the right side of his neck. He endorsed progression of his symptoms, reporting that he was now having fevers, myalgias, and intermittent difficulty swallowing solid foods. Additional Images Physical Exam Vitals : BP 153/96; HR 110; T 100.0°F; RR 16; O2 sat 97% General : Appears uncomfortable HEENT : Mild right-sided facial swelling.

Emergency Department 177

Emergency Department OR 177

American Ambulance Association

SEPTEMBER 4, 2024

Video Transcript Hello, I’m Shawn Baird, past president of the American Ambulance Association. Together with my fellow ambulance profession representatives Ted Van Horne, Regina Crawford, and Rhonda Holden, I was […] The post GAPBAC Balance Billing Report Released to Congress appeared first on American Ambulance Association.

Ambulance 162

Ambulance 162

Critical Care Scenarios

SEPTEMBER 18, 2024

We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr. Joe Chaffin (@bloodbankguy), the “Blood Bank Guy” and transfusion medicine specialist. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr.

OR 152

OR 152

EMergucate

SEPTEMBER 24, 2024

The following left thigh x-ray is from a neonate with thigh swelling. What can be seen?

EMS 130

EMS 130

Core EM

SEPTEMBER 16, 2024

The Case A 96-year-old female with a history of coronary artery disease, hypertension, and complete heart block status post dual-chamber pacemaker (remote) presents to the ED by EMS with generalized weakness and lethargy. EKG Show Details EKG Characteristics Rate 130 Rhythm Wide Complex Tachycardia, Paced Intervals QRS 180, QT/QTc 406/596 Axis Left axis deviation ST Segments Non-specific Additional Features Paced Rhythm with LBBB morphology Diagnosis Pacemaker-Mediated Tachycardia Questions What

Coronary 130

Coronary ED EMS OR 130

ALiEM

SEPTEMBER 30, 2024

A 23-year-old healthy male presented to the emergency department with left eye pain, soreness, and blurry vision after being hit in the left eye with a Nerf gun bullet two days prior. He had no prior ophthalmologic history and does not wear corrective lenses. Physical Exam Left eye : Visual acuity 20/30. Intraocular Pressure 17. Pupil 3mm, irregular, minimally reactive.

Emergency Department 161

Emergency Department 161

American Ambulance Association

SEPTEMBER 23, 2024

Press Contact Tristan North Senior Vice President American Ambulance Association tnorth@ambulance.org FOR IMMEDIATE RELEASE Congressman Brad Finstad Honored as 2024 Legislator of the Year by the American Ambulance Association Washington, […] The post Press Release: Congressman Brad Finstad Honored as Legislator of the Year appeared first on American Ambulance Association.

Ambulance 147

Ambulance 147

Critical Care Scenarios

SEPTEMBER 4, 2024

Experts in critical care share their approach to post-intubation sedation. Contributors: Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! Experts in critical care share their approach to post-intubation sedation. Contributors: * Jason Wieland * Casey Albin * Jace Mullen * Kali Dayton * Nick Ghionni * Emily Fridenmaker Check out the Intensive Care Academy here!

Critical Care 136

Critical Care 136

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. AEM August 2024. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: It’s another day, another dollar in the emergency department (ED). The next patient is a 63-year-old woman with a cough and fever.

ICU 136

ICU Emergency Department ALS ED 136

EMergucate

SEPTEMBER 22, 2024

47yr female presents with 2 day history of right infra-scapula pain. In ED has right sided pleuritic chest pain and is diaphoretic.

ED 130

ED OR EMS 130

Core EM

SEPTEMBER 11, 2024

The Case A 96-year-old female with a history of coronary artery disease, hypertension, and complete heart block status post dual-chamber pacemaker (remote) presents to the ED by EMS with generalized weakness and lethargy. EKG Show Details EKG Characteristics Rate 130 Rhythm Wide Complex Tachycardia, Paced Intervals QRS 180, QT/QTc 406/596 Axis Left axis deviation ST Segments Non-specific Additional Features Paced Rhythm with LBBB morphology Diagnosis Pacemaker-Mediated Tachycardia Questions What

Coronary 130

Coronary ED EMS OR 130

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. The patient presented to an outside “eye doctor” and was told to go to the nearest hospital for evaluation.

Emergency Department 161

Emergency Department OR ED 161

American Ambulance Association

SEPTEMBER 23, 2024

Press Contact Tristan North Senior Vice President American Ambulance Association tnorth@ambulance.org FOR IMMEDIATE RELEASE Congresswoman Gluesenkamp Perez Awarded 2024 Legislator of the Year by the American Ambulance Association Washington, […] The post Press Release: Congresswoman Gluesenkamp Perez Honored as Legislator of the Year appeared first on American Ambulance Association.

Ambulance 147

Ambulance 147

St. Emlyn's

SEPTEMBER 18, 2024

St.Emlyn's - Emergency Medicine #FOAMed Case series of dirty epi drips in Australia. A potentially useful tool in austere/remote settings, but lots of caveats and cautions before we all start doing this! Be careful, but do learn about this potential therapy. #FOAMed @stemlyns The post The Dirty Adrenaline (Epi) drip. appeared first on St.Emlyn's.

Critical Care 128

Critical Care 128

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. The pain radiated to both shoulders. He arrived to the ED at around 6:45am, and stated the pain has persisted. He has had similar pain in recent weeks that has occurred at rest, but it typically goes away after about an hour.

Coronary 123

Coronary ACS OR EMR 123

EMergucate

SEPTEMBER 17, 2024

The chest x-ray is from a toddler taken post choking episode at home. What can be seen?

EMS 130

EMS 130

Core EM

SEPTEMBER 2, 2024

We discuss a new class of medications, Immune Checkpoint Inhibitors, and their side effects. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Oncology Show Notes Overview of Immune Checkpoint Inhibitors (ICIs) ICIs are a relatively new class of oncologic drugs that have revolutionized cancer treatment. Unlike chemotherapy, ICIs help the immune system develop memory against cancer cells and adapt as the cancer mutates.

OR 130

OR 130

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Associated symptoms included nausea and a mild headache for one day, and one episode of vomiting prior to arrival.

Emergency Department 152

Emergency Department ED OR 152

American Ambulance Association

SEPTEMBER 18, 2024

This content is for AAA members only. Please either Log In or Join! The post OSHA Statement on Volunteer Agency Impact appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

St. Emlyn's

SEPTEMBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed The diagnosis of subarachnoid haemorrhage in the emergency department is a constant source of anxiety. How do we make sure we pick up everyone with a bleed, but not overinvestigate […] The post The Subarachnoid Haemorrhage in the Emergency Department (SHED) Study appeared first on St.Emlyn's.

Emergency Department 126

Emergency Department 126

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

Written by Pendell Meyers A man in his 40s called EMS for acute chest pain that awoke him from sleep, along with nausea and shortness of breath. His history included known heart failure with prior EF 18%, insulin dependent diabetes, and polysubstance abuse. Vitals were within normal limits except for tachypnea. Here are his EMS ECGs along with the Queen of Hearts interpretations below each one: EMS1 0650 EMS2 0707 Click here to sign up for Queen of Hearts Access The ECGs show RBBB and LAFB, with

STEMI 123

STEMI EMS ACS ED 123

EMergucate

SEPTEMBER 16, 2024

10-years-old asthmatic boy, presented with croupy cough and wheezy chest. His blood gases showed the following: PH = 7.

130

130

NVFC

SEPTEMBER 10, 2024

Acclaimed volunteer fire service documentary Odd Hours, No Pay, Cool Hat is hitting TVs across the nation this fall. Over 180 PBS stations will air a one-hour version of the film in September and October in conjunction with the 9/11 anniversary, October’s Fire Prevention Week, and National First Responders Day (Oct. 28). The documentary takes audiences behind the lines of America’s volunteer fire service community by sharing the stories of volunteer responders as they face challenges and triumph

Firefighter 122

Firefighter First Responder OR 122

ALiEM

SEPTEMBER 25, 2024

A 24-year-old male with a history of microscopic hematuria presented to the emergency department (ED) with left lower quadrant abdominal pain. His pain started about two weeks ago and has been intermittent. He describes the pain as stabbing. He decided to come to the ED today because of the persistent nature of the pain. He denies chest pain, cough, shortness of breath, fevers, nausea, vomiting, diarrhea, constipation, rectal bleeding, dysuria, and increased urinary frequency.

Emergency Department 141

Emergency Department ED ALS OR 141

American Ambulance Association

SEPTEMBER 12, 2024

The Department of Veterans Affairs (VA) has notified Senate Committee on Veterans Affairs Chairman Jon Tester (D-MT) and Ranking Member Jerry Moran (R-KS) that the Department will be delaying implementation […] The post VA Notifies Tester/Moran of Delay of Final Rule until 2029 appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

EMCrit Project

SEPTEMBER 29, 2024

The HAPPEN Trial on NIPPV for AECOPD EMCrit Project by Scott Weingart, MD FCCM.

119

119

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Written by Willy Frick with edits by Ken Grauer A woman in her 70s with a history of hypertension presented with acute onset shortness of breath. She was out walking her dog when she developed sudden dizziness and light-headedness. When EMS found her, she was dyspneic and diaphoretic. Her ECG is shown below: What do you think? The conventional machine algorithm interpreted this ECG as STEMI.

E-9-1-1 118

E-9-1-1 Coronary STEMI ALS 118

EMergucate

SEPTEMBER 15, 2024

Our ECG site precedes the birth of Emergucate and has been left in it’s comfy blogspot home.

130

130

NVFC

SEPTEMBER 24, 2024

Practical tips for diversity, equity, and inclusion in your community Intergeneration Month is held worldwide each September. First launched in 2000, Intergeneration Month is a time to examine, strengthen, and celebrate the connections between generations of people. Like all industries, fire and emergency services organizations can experience challenges and opportunities by having first responders from several generations working together.

Firefighter 116

Firefighter First Responder EMS OR 116

St. Emlyn's

SEPTEMBER 29, 2024

St.Emlyn's - Emergency Medicine #FOAMed This blog post reviews a study comparing non-invasive blood pressure (NIBP) and invasive blood pressure (IBP) monitoring in pre-hospital critical care. Using a retrospective cohort design, the study found that NIBP measurements are often inaccurate in patients with haemodynamic instability, particularly in hypotensive and hypertensive states.

OR 115

OR Critical Care 115

American Ambulance Association

SEPTEMBER 11, 2024

This content is for AAA members only. Please either Log In or Join! The post Federal Departments Issue Final Report and Recommendations of the GAPB Advisory Committee appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

REBEL EM

SEPTEMBER 2, 2024

Background: Emergency intubations present a unique set of challenges, particularly when dealing with heavily contaminated airways. Anesthesiologist, Dr. James DuCanto, developed the DuCanto catheter to enhance airway management in these high-stakes situations. The commonly used 14 Fr Yankauer catheter, with its smaller bore, may struggle to clear heavily contaminated airways effectively.

OR 115

OR EMS ED 115

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

A 70-something y.o. male presents to triage with shortness of breath. He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. ECG 1 at time zero EARLY REPOLARIZATION ABNORMAL ECG ED final official overread: "early repol vs hyperacute T, minimal changes from previous (previous shown below)" What do YOU think?

STEMI 118

STEMI ACS Critical Care Coronary 118