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What agent would most likely be responsible for these ECG findings? Cyclobenzaprine Digoxin Flecainide Sotalol Reveal the Answer 3. Flecainide Background [1-3] Flecainide is a class IC antiarrhythmic that binds to the voltage-gated sodium channel of the myocardium, slowing depolarization and prolonging phase 0 of the action potential. In toxicity, bradydysrhythmias, AV nodal blockade, ventricular tachycardia, and rate-dependent QRS widening occur.
Written by Pendell Meyers A woman in her 30s called EMS for acute symptoms including near-syncope, nausea, diaphoresis, and abdominal pain. EMS arrived and found her to appear altered, critically ill, and hypotensive. An ECG was performed: What do you think? Extremely wide complex monomorphic rhythm just over 100 bpm. The QRS is so wide and sinusoidal that the only real possibilities left are hyperkalemia or Na channel blockade.
Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. Historically the administration of vasopressors was restricted to central venous catheters (CVC) due to concerns for local tissue injury resulting from vasoconstriction if extravasation occurred from a peripheral IV.
The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway. The following ECG is obtained upon arrival to the emergency department.
Proton Pump Inhibitor Use and Risk of Serious Infections in Young Children Marion Lassalle, PharmD, PhD1; Mahmoud Zureik, MD, PhD1,2; Rosemary Dray-Spira, MD, PhD1 August 14, 2023 doi:10.1001/jamapediatrics.2023.
A 20-something type, 1 diabetic presented by EMS with altered mental status. Blood pressure was 117/80, pulse 161, Resp 45, SpO2 100 on oxygen. Here is the 12-lead ECG: Wide complex tachycardia What do you think? The providers thought that this wide QRS was purely due to (severe) hyperkalemia. They treated with 4 ampules (200 mL) of bicarb and 1 gram of calcium gluconate.
Dave and Kelly’s Inspiring Journey Meet Dave Raymond, a dedicated firefighter EMT, and his wife, Kelly, who has been on a courageous four-year quest to find a kidney donor. In […] The post EMS Gives Life | EMT Dave and Wife Kelly Need Your Help appeared first on American Ambulance Association.
The following ECG is from a 60 year old lady with chest pain and dyspnoea a few hours after finishing a triathlon. At the scene she was hypothermic at 32 degrees.
Nail bed injuries aren’t quite common enough to cause the same debates as TXA, or IV antibiotics, or tPa, but talk to 10 different emergency doctors and you are likely to get 10 different opinions about the management of these injuries. Therefore, even though the NINJA study doesn’t answer the most important question (in my […] The post The NINJA trial: Do you replace the fingernail after nail bed repair?
From GoAEROprize.com Heroes who look past danger to help people in need, Heroes to step in to be the difference between triumph and tragedy, And Heroes who use their minds to […] The post GoAERO Competition + Informational Webinar Details appeared first on American Ambulance Association.
Written by Willy Frick A woman in her 90s with a history of end stage renal disease and complete heart block status post dual chamber pacemaker presented from home with acute onset dyspnea. ECG is shown below. What do you think? The ST and T wave abnormalities jump off the page, but let's set that aside just for a moment to review the tracing systematically.
Welcome to the emDOCs Videocast – please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today we look at the WATERFALL trial and hypertriglyceridemic pancreatitis. The post emDOCs Videocast: EBM Update – Pancreatitis appeared first on emDOCs.net - Emergency Medicine Education.
The Centers for Medicare & Medicaid Services (CMS) released a new “Reporting for Rural and Super-Rural Organizations Tip Sheet” on February 16, 2024. This guide assists ground ambulance organizations in […] The post CMS Releases New GADCS Tip Sheet for Rural, Super Rural Services appeared first on American Ambulance Association.
Because there are always many unknowns, preparing for a disaster is an enormous undertaking. For rural hospitals, this challenge is further amplified due to issues such as remote location, limited resources, and staffing shortages. Yet by actively preparing for the types of disasters that rural hospitals are most likely to face, such difficulties can be lessened.
Welcome to the emDOCs Videocast – please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today we focus on pancreatitis. Fluids in Pancreatitis #1 : de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis.
HHS Announces New Cybersecurity Performance Goals to Enhance Cybersecurity The U.S. Department of Health and Human Services (HHS), through the Administration for Strategic Preparedness and Response (ASPR), announced on January […] The post EMS.gov | HHS Announces New Performance Goals to Enhance Cybersecurity appeared first on American Ambulance Association.
Let's face it: Pediatric patients can be intimidating. They're small, they cry a lot, they require different medication dosages, and, fortunately, we don't run into them with great frequency.
Authors: Katey DG Osborne, MD (EM Attending Physician: Tacoma, WA) and Rachel Bridwell, MD (EM Attending Physician: Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital); Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! This series provides evidence-based updates to previous posts so you can stay current with what you need to know.
In the fast-paced and critical world of emergency medical services, EMTs are often the first healthcare professionals to interact with patients in distress. The initial assessment of a patient can be crucial in determining the course of treatment and can significantly impact outcomes. This is where the SAMPLE history and OPQRST pain assessment come into play, serving as essential tools in an EMT’s diagnostic arsenal.
Lacerations are a common presenting complaint to emergency department. In 2013, in the United States there were 7 million visits to the emergency department (ED) for lacerations making up a total of 5.2% of ED visits(1). Let’s review some of the evidence (or lack thereof) surrounding laceration repair so that we can be better at […] The post Lacerations: The secrets they don’t want you to know appeared first on EMOttawa Blog.
Sheralyn Guilleminot and Franz Wiesbauer Making a medical podcast using AI AI can work for Spotify's music DJ, so we wondered if it can also work for a cardiology podcast intended for clinicians. Here are the pros and cons we discovered.
Welcome to the first episode for 2024 – and we have a range of papers covering the big life threatening issues to the tiniest pinky finger injuries and a lot in between. There is something for everyone in here! We try to answer a few questions that you may have not even pondered such as: should all Psych patinets get an MRI? Should you replace fingernails on crushed digits?
Answers: PH = 7.34, that is very mild acidaemia. HCO3 = 14 mmol/L. So, we have metabolic acidosis. Next we need to calculate Anion Gap and compensation.
REBEL Core Cast 118.0 – IM vs PO NSAIDs Click here for Direct Download of the Podcast Bottom Line Up Top: There is no difference in analgesic efficacy between oral and intramuscular NSAIDs. Clinical Scenario: A 34-year-old woman presents to the ED with back pain. After your history and physical, you conclude that the patient’s pain is muscular in origin and likely secondary to heavy lifting while moving apartments.
In a world where gaming addiction is on the rise, and at the same time, we see the benefits of gaming and grassroots Esports, you can see how confusing and contradictory the different narratives are around gaming. Despite becoming more mainstream in the last decade, there is plenty of misunderstanding from parents and professionals if they don’t play, and a lack of understanding from many young people who do.
The question of whether drug rehab can fail lingers in the minds of many who are struggling with addiction. The straightforward answer is yes, drug rehab has the potential to… The post Is It Possible for Drug Rehab to Not Work? appeared first on Paramedics World.
The eight-week baby check, usually carried out in primary care, provides an opportunity to assess a baby’s development, screen for potential issues, and address any concerns parents or guardians may have. NICE Guideline NG194 from 2021 covers in fine detail what should be done. Let’s walk through the key steps and considerations when performing an eight-week baby check, including what to note, what to review and what to refer.
In recent years, an alarming trend has emerged within pharmaceutical circles: the surge in lawsuits surrounding Suboxone tooth decay. For individuals grappling with opioid addiction, Suboxone, a medication combining buprenorphine… The post The Reasons for the Increase in Suboxone Tooth Decay Lawsuits appeared first on Paramedics World.
Why might the genetic mutations leading to hereditary hemochromatosis have offered an evolutionarily advantage to our Neolithic ancestors? Take Home Points Hereditary hemochromatosis is most commonly caused by variants in the HFE gene, which affect the regulation of iron uptake in the bowel and in immune cells. HFE gene variants may have had beneficial advantage for avoiding iron deficiency during the shift to agrarian lifestyles and consumption of iron-chelating cereal grains in Europe in the N
We all have those drugs in our medics, squads, or helicopters that sit and collect dust, right? The usual statement is something to the effect of, “We don’t give that medication too often because it takes a long time to take effect.” I heard this story with a few specific medications, but I wanted to zero in on a specific one – Steroids. Namely, Solumedrol and Dexamethasone (Decadron).
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