ALiEM

SEPTEMBER 1, 2023

A 65-year-old male presented with chest and abdominal pain for three weeks. He endorsed a poor appetite and a weight loss of 16 kilograms in the last month. He denied fever, vomiting, diarrhea, and tarry stools and described having his usual bowel movements. Additional Images Physical Exam Vitals : BP 172/71; HR 127; T 35.9°C; O2 Sat 100% General : In acute distress Cardiovascular : Regular rate and rhythm; no murmur; bilateral upper extremity and lower extremity pulses palpable Gastrointestin

161

161

American Ambulance Association

AUGUST 30, 2023

This content is for AAA members only. Please either Log In or Join! The post Proposed Changes to the FLSA Overtime Exemption Salary Level appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

Core Ultrasound

AUGUST 30, 2023

Knee Aspiration/Injection Elbow Aspiration/Injection Knee Exam The post Ankle Effusion – Identification, Aspiration, Injection (5MS) first appeared on Core Ultrasound.

130

130

Dr. Smith's ECG Blog

SEPTEMBER 1, 2023

A 50-something male had onset of chest pain 1 hour prior to ED arrival. It is constant, 9/10, left-sided CP that radiates into left arm and jaw. Endorses some associated SOB, but denies back pain, fever, cough, chills, leg swelling, or other new symptoms. Has never had this before. Takes metoprolol for HTN. Here is the triage ECG: What do you think?

STEMI 123

STEMI Critical Care OR ED 123

ALiEM

AUGUST 28, 2023

A 44-year-old female presented to the emergency department with the complaint of a “stone under [her] tongue.” She reported that the “stone” had been present and painless for two years. The day prior, she began experiencing pain at this site while brushing her teeth. She squeezed the area in an attempt to expel it, but this action only increased her pain.

Emergency Department 130

Emergency Department OR 130

American Ambulance Association

AUGUST 28, 2023

Celebrate EMS Excellence Nominations are Open Now for Vanguard & EMSNext Awards Vanguard and EMS Next honorees will be recognized at the American Ambulance Association Annual Conference & Trade Show, […] The post Nominations Open for the Vanguard Awards & EMS Next! ?? appeared first on American Ambulance Association.

EMS 130

EMS Ambulance 130

Core Ultrasound

AUGUST 28, 2023

Rotator Cuff Non-Rotator Cuff Shoulder Exam Knee Exam The post Elbow effusion – Identification, Aspiration, Injection (5MS) first appeared on Core Ultrasound.

130

130

Medgadget

AUGUST 30, 2023

Researchers at New York University have developed a new method to target many viruses that cause disease. For viruses with a lipid membrane, which includes many that commonly cause disease, this new technique could prove to be fatal. By targeting the lipid membrane, the approach may circumvent the treatment resistance that arises when viruses mutate to alter their surface proteins, which are the most common targets for conventional anti-viral drugs.

105

105

American Ambulance Association

SEPTEMBER 1, 2023

This content is for AAA members only. Please either Log In or Join! The post VA Final Rule on Ambulance Services Update appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

EM Literature of Note

SEPTEMBER 1, 2023

It’s a trick question – in the end, all of us have already lost. This is a short retrospective report evaluating, primarily, the Epic Sepsis Prediction Model, and the mode in which is deployed. The Epic SPM generates a “prediction of sepsis score”, calculated at 15 minute intervals, providing a continuous risk score for the development of sepsis.

OR 105

OR 105

REBEL EM

AUGUST 30, 2023

Take Home Points Clinical presentation is very nonspecific; evaluate all patients presenting with back pain for infectious risk factors. Baseline labs should not guide diagnosis, but may assist in later management. MRI is key to diagnosis, obtain this imaging in all patients who raise clinical suspicion Patients with hemodynamic instability and neurologic compromise warrant empiric antibiotics.

E-9-1-1 104

E-9-1-1 ALS ED OR 104

Don't Forget the Bubbles

AUGUST 28, 2023

Depending on the location of the mediastinal mass, lying a child flat or using a rapid sequence induction protocol may cause cardiorespiratory arrest. As clinicians, we need to be prepared. What causes a mediastinal mass? The mediastinum is the segment of the thorax that includes structures vital to life – the heart, major blood vessels, and the airway.

Emergency Manager 97

Emergency Manager Emergency Management E-9-1-1 Critical Care 97

First 10 EM

AUGUST 28, 2023

This is a guest post by Dr. Katie Lin. Dr. Katie Lin is an Assistant Professor of Emergency Medicine at the University of Calgary, a Stroke Attending with the Calgary Stroke Program, and a critical care Flight Transport Physician with STARS Air Ambulance in Alberta. She completed her residency training and stroke fellowship in Calgary and a Masters of Public […] The post The Crashing Brain: Approach to the first 10 minutes appeared first on First10EM.

Critical Care 96

Critical Care Ambulance 96

Dr. Smith's ECG Blog

AUGUST 30, 2023

Case sent by Logan Stark MD, written by Pendell Meyers A woman in her 70s presented with acute chest pain. It started 10 hours prior to arrival, then had improved, then recently returned. No prior ECG was available. Here is her triage ECG: What do you think? The ECG was sent to me with no information, and I replied "OMI". I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: V1 and V2 have abnormal STE, and V2 has a hyperacute T wave.

Coronary 71

Coronary OR STEMI ED 71

EMCrit Project

AUGUST 29, 2023

A deeper dive on accidental hypothermia in anticipation of my much awaited winter EMCrit Project by Scott Weingart, MD FCCM.

81

81

EMDocs

AUGUST 28, 2023

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

ED 64

ED EMS OR 64

Clinical Correlations

AUGUST 31, 2023

By Marie T. Mazzeo Peer Reviewed Anemia poses a significant threat to public health and affects approximately 2 billion people, nearly one-quarter of the world’s population.1,2 Iron deficiency is the most common cause of anemia worldwide and is the most common nutrient deficiency. 1,2.

59

59

REBEL EM

AUGUST 31, 2023

Background: Bleeding complications are an uncommon but potentially a significant risk during central venous catheter (CV C) placement. Thrombocytopenia is associated with increased bleeding complications but there is no good-quality evidence showing that prophylactic platelet transfusions decrease that risk. Previous studies were retrospective and current society guidelines have differing thresholds (20,000 – 50,000 per cubic millimeter) for prophylactic transfusions.

ICU 59

ICU ALS OR EMS 59

The Bottom Line

AUGUST 26, 2023

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

Critical Care 97

Critical Care 97

University of Maryland Department of Emergency Med

AUGUST 29, 2023

Patient restraint is a high risk, high liability encounter for all levels of emergency medical practitioners. Often, acutely agitated patients be.

66

66

First Responders Foundation

SEPTEMBER 1, 2023

The First Responders Foundation is honored to be inducting Maker’s Mark & Southern Glazer’s Wine and Spirits into the Ancient Order of the National Society of St. Florian and St. Michael at the 7th Annual 9/11 Luncheon of Honor on September 11, 2023. Accepting the award from Maker’s Mark will be Katie Ruhga and from Southern Glazer’s Wine and Spirits will be Jeremy Kirby.

First Responder 52

First Responder ALS OR 52

Prehospital Emergency Care Podcast

AUGUST 31, 2023

PEC Journal Volume 27 Number 4 In this episode, the PEC podcast team covers the Prehospital Emergency Care Journal Volume 27 Number 4. We talk about engaging manuscripts in this journal like: Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review & A Proposed Theoretical Framework for Clinical Judgment in EMS Click here to download it today!

Emergency Medical Services 52

Emergency Medical Services EMS 52

ESO

AUGUST 31, 2023

In both fire and EMS services, response time is obviously a crucial part to a successful resolution of an incident. However, it’s just one of a few different factors to consider when analyzing the safety and effectiveness of your department’s overall performance. Factors such as siren and light use, alarm handling, turnout time, and travel time should also be considered.

NFPA 52

NFPA Firefighter EMS OR 52

NHCPS Save a Life

AUGUST 30, 2023

In the ever-evolving landscape of healthcare, staying at the forefront of medical knowledge and skillfulness is not just a goal—it’s a necessity. As a dedicated nurse, we understand that maintaining your expertise is crucial to providing the highest level of patient care. Enter online certificate programs, the modern avenue for elevating your nursing career to […] The post Elevate Your Nursing Career with Online Certificate Programs appeared first on SaveaLife.com.

Life Support 52

Life Support 52

ACEP Now

AUGUST 29, 2023

The Southeast region’s numbers. (Click to enlarge.) Nearly two years since COVID disrupted the emergency medicine job market, things are finally looking up. The Fall 2023 market is up about 20 percent from last year but still lags behind the 2019 market by 32 percent! Of note, 32 percent of openings are in rural, low volume/acuity facilities. In 2019, 63 percent of available jobs were with national contract groups, with 53 percent open to primary care physicians.

OR 52

OR 52

FOAMfrat

AUGUST 28, 2023

We have all heard the phrase “treat the patient, not the monitor.” Even though this quote is overused and often misapplied, it stems from the fact that the equipment we use to assess and construct a field diagnosis is sometimes. well, just flat-out wrong. Every provider can probably think of a time they had to go back and fix some vital signs imported from the monitor that did not make sense in the patient care report.

Critical Care 52

Critical Care Ambulance OR ALS 52

REBEL EM

AUGUST 28, 2023

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. You contemplate analgesic options and decide that a NSAID makes sense. Should you give her PO ibuprofen or IM ketorolac? Bottom Line Up Top: There is no difference in analgesic efficacy between oral and intramuscular NSAIDs.

E-9-1-1 52

E-9-1-1 Emergency Department ALS ED 52

The Bottom Line

AUGUST 26, 2023

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

Critical Care 75

Critical Care 75

ACEP Now

AUGUST 29, 2023

You vs. Your Brain—A Session to Make You Think Kick off your ACEP23 experience with an exciting opening session that could change the way you and your brain work together. Did you know our brains are wired to take short cuts that sometimes lead to cognitive distortions? Understanding how and why our biases work is an important first step in improving our decision-making, determining information we’re willing to trust, and building relationships.

E-9-1-1 52

E-9-1-1 Naloxone Emergency Department EMS 52

EMS 20/20

AUGUST 30, 2023

Chris and Spencer see if they can solve why a man with the most rancid of toots can't stay upright. And also. Chris totally screws up! Also be sure to check out this week's sponsor, In Case at getincase.com/EMS2020! Chris and Spencer see if they can solve why a man with the most rancid of toots can't stay upright. And also. Chris totally screws up! Also be sure to check out this week's sponsor, In Case at getincase.com/EMS2020!

40

40

University of Maryland Department of Emergency Med

AUGUST 30, 2023

Click to view the rest

52

52

Pediatric EM Morsels

SEPTEMBER 1, 2023

While the “excitement” of the Emergency Department that is seen on TV may make people think that the only skills we need are those that help us manage Critical Illnesses or Traumatic Injuries , as we have digested in prior Morsels (ex, Developmental Milestones , Formula Primer , Vegan Diets ) all aspects of patient care are important for us to be adept at.

ED 161

ED Emergency Department Overdose ALS 161

ACEP Now

AUGUST 29, 2023

What does your program offer that residents can’t get anywhere else? Our program pairs training at one of the busiest emergency departments in the country at a nationally recognized county, safety-net, Level I Trauma and Regional Burn Center (MetroHealth) with a world-renowned quaternary academic referral center (Cleveland Clinic). This unique combination exposes residents to an impressive variety of pathology and truly prepares them to practice in any environment after graduation.

Emergency Department 52

Emergency Department EMS OR 52

EMDocs

AUGUST 31, 2023

Authors: Sean Trostel, MD (EM Resident Physician, Carolinas Medical Center, Charlotte, NC); Kathryn T Kopec, DO (@KopecToxEM, EM Attending Physician, Medical Toxicologist, Carolinas Medical Center, Charlotte, NC) // Reviewed by: James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Please see Part 1 of this series for guidance on the management of the crotalid envenoma

Allergic Reaction 72

Allergic Reaction Plasma ALS EMS 72

Don't Forget the Bubbles

AUGUST 30, 2023

The Choosing Wisely ® campaign is an initiative that promotes collaborative conversations between clinicians and families to safely avoid unnecessary and potentially harmful tests. The American Academy of Paediatrics Section on Emergency Medicine (AAP SOEM) created a list of five key recommendations for Paediatric Emergency Medicine after a structured review process and expert consensus opinion.

E-9-1-1 131

E-9-1-1 Emergency Department ALS OR 131

The Skeptics' Guide to EM

AUGUST 26, 2023

Date: August 20th, 2023 Reference: Milne WK, Challen K, Young T. Skeptics’ Guide to Emergency Medicine Season #10 Book Guest Host: Dr. Kirsty Challen is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). She completed undergrad and postgrad training in North West England, acquiring a History of […] The post SGEM Xtra: Skeptico Evidentium – SGEM Season#10 Book first appeared on The Skeptics Guide to Emergency Medici

EMS 118

EMS OR 118

Don't Forget the Bubbles

AUGUST 29, 2023

This post accompanies Dani’s talk at DFTB23 in Adelaide It was Winter 2021—the height of the COVID-19 pandemic. We were in lockdown. In the emergency department, we were working our way through tonnes of PPE, masks, aprons, and gloves. We were exhausted. Our patients were scared. Headlines were terrifying. One of our nurses worked on her days off in the vaccination centre.

ALS 98

ALS ED Emergency Department OR 98