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With some things in life, speed is everything. Adenosine is one of those things. With an ultrafast half-life estimated to be between 0.6 to 10 seconds [1], parenterally administered adenosine needs to reach the cells of the AV-node and cardiac pacemaker cells in an expedited fashion to facilitate the termination of supraventricular tachycardias (SVTs).
We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr.
Reference: Peters MJ, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-picu): a UK multicentre, open, parallel-group, randomised clinical trial. Lancet. December 2023 Guest Skeptic: Dr. Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia.
A can’t intubate can’t oxygenate scenario will always be scary, but after years of mental rehearsal and some real world experience, the idea of surgical front of neck access in an adult doesn’t bother me much. (I think that is an important mental space for emergency physicians to find if you want to be able […] The post The pediatric can’t intubate can’t oxygenate scenario (Use a knife) appeared first on First10EM.
Dr. Sara Krzyzaniak (podcast host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale University Clerkship Director and 2024 CDEM Clerkship Director of the Year award winner) in this episode to discuss how one might approach their emergency medicine sub-internship. Dr. Bod shares her her wealth of experience and wisdom to provide not only general advice but also answers more detailed questions like: What are some things NOT to do on a rotatio
Health Insurance Coverage Projections For The US Population And Sources Of Coverage, By Age, 2024–34 Abstract In the Congressional Budget Office’s projections of health insurance coverage, 92.3 percent of the US […] The post HealthAffairs | Health Insurance Coverage Projections appeared first on American Ambulance Association.
PH = 7.238, that is moderate acidaemia. pCO2 = 49.1 mmHg. that is suggestive of respiratory acidosis HCO3 = 20.2 mmol/L, that is suggestive of metabolic acidosis.
By Sofiya Diurba MD, reviewed by Meyers, Grauer A woman in her 50s with PMH known RBBB and prior syncopal events presents to the ED for five syncopal events over the last 24 hours. Each event is associated with a prodrome of mild substernal CP, SOB, and “brain fog.” EMS reports intermittent sinus tachycardia and bradycardia secondary to some type of heart block during transport.
By Sofiya Diurba MD, reviewed by Meyers, Grauer A woman in her 50s with PMH known RBBB and prior syncopal events presents to the ED for five syncopal events over the last 24 hours. Each event is associated with a prodrome of mild substernal CP, SOB, and “brain fog.” EMS reports intermittent sinus tachycardia and bradycardia secondary to some type of heart block during transport.
St.Emlyn's - Emergency Medicine #FOAMed Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite emergency medical services (EMS) interventions. Patients presenting […] The post JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.
For decades, “spinal immobilization”, or spinal motion restriction (SMR) using backboards and cervical collars has been a “cornerstone of EMS protocols, aimed at minimizing secondary spinal cord injuries during trauma patient management. Originating in the 1960s, this practice was propelled by anecdotal evidence and early case reports suggesting that un-immobilized cervical spine injuries could worsen […] The post Spinal Immobilization: a Twisted Tale appeared first on EM
Written by Willy Frick A man in his 50s was at home with his family when they heard a thud and rushed into the room to find him unconscious with agonal respirations. His daughter immediately started CPR and another family member called EMS. When EMS arrived the patient was in ventricular fibrillation. They shocked him twice before return of spontaneous circulation.
Authors: Kyle Smiley, MD (EM Resident Physician, San Antonio, TX) and Brit Long, MD (@long_brit, EM Attending Physician) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital); Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. Here was his initial ED ECG: Formal interpretation by interventional cardiologist: There is "Non-diagnostic" ST Elevation in V2-V4 and aVL. Therefore, according to ACC/AHA guidelines based on the COACT and TOMAHAWK trials, this patient should not go emergently to angiography.
The National Volunteer Fire Council (NVFC) is excited to announce the release of our new resource for fire service families. What to Expect: A Guide for New Firefighter Families (Second Edition) is designed to help new fire and EMS recruits along with their spouses/significant others, children, parents, siblings, and other family members make the adjustment to the volunteer fire service lifestyle.
St.Emlyn's - Emergency Medicine #FOAMed The latest St Emlyn's monthly podcast with all the best from the blog in May 2024. The post Podcast – May 2024 Monthly Round Up – RCEM conference highlights, being EPIC and more appeared first on St.Emlyn's.
Introduction The first time I read about high-altitude illness was a handful of years ago while studying for my FP-C. I immediately (and naively) built a mental association between these conditions and places like Mount Everest and stored it in my “Makes No Difference to Me” folder. Since then, I’ve developed a habit for outdoor recreation and light versions of mountaineering, which led me to realize that altitude illness can occur in much less extreme conditions than I’d previously thought and
Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the evaluation and management of the patient with a burn injury. Episode 103: Thermal Burn Injury Initial evaluation of thermal burns Range of burn severities and types: minor sunburns to full thickness burns and severe inhalation injury. Immediate goals are addressing the airway and hemodynamic instability.
St.Emlyn's - Emergency Medicine #FOAMed Background – What is Double Sequential External Defibrillation? Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite […] The post JC: The impact of double sequential external defibrillation timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.
Residents of a skilled nursing facility are significantly more likely than other people to go to the hospital. These hospital stays can be disruptive and frightening, especially for people with dementia. The right medical equipment can manage many minor medical conditions, preventing them from worsening and reducing the need to transport residents to the hospital.
Categories Advocacy Burn News MAC Spotlight Media Member Services Organization News Prevention Quality Care Research Return to News & Activities On June 18, 2024, the Senate passed S.870 , the Fire Grants and Safety Act. This bill reauthorizes funding for the U.S. Fire Administration, the Assistance to Firefighters Grants Program, the Fire Prevention and Safety Grants Program, and the Staffing for Adequate Fire and Emergency Response Grant Program.
Sometimes I encounter basic pharmacokinetic questions that don't seem to be readily answered in the immediately available literature. I've found FOAMed to be a useful way to make sure I'm doing this right (e.g., see a prior discussion of the appropriate loading dose based on intermittent maintenance dosing and half-life here). Today I want to […] EMCrit Project by Josh Farkas.
St.Emlyn's - Emergency Medicine #FOAMed Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite emergency medical services (EMS) interventions. Patients presenting […] The post JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.
Nasopharyngeal and nasotracheal suctioning are safe, effective alternatives to oral suctioning, especially for patients with oral obstructions such as loose dentures or patients who are unable to cooperate with oral suctioning. Though the procedures are similar, nasotracheal suctioning requires deeper penetration. Here’s what you need to know about these two important interventions.
Take Home Points Always obtain an EKG in patients with ESRD upon presentation Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause If the patient with hyperkalemia is unstable or has significant EKG changes (wide QRS, sine wave) rapidly administer calcium salts In patients who are anuric, early mobilization of dialysis resources is critical REBEL Core Cast 125.0 – Hyperkalemia Click here for Direct Download of the Podcast.
The PEC podcast team covers the Prehospital Emergency Care Journal Volume 28 Number 1. We talk about engaging manuscripts in this journal like: Mobile Integrated Health Care Roles of US EMS Clinicians: A Descriptive Cross-Sectional Study & A Systematic Review of Methodologies and Outcome Measures of Mobile Integrated Health-Community Paramedicine Programs Click here to download it today!
As more and more highly potent and lethal batches of opioids hit the streets, it’s becoming abundantly clear that the need for high-dosage naloxone is at a critical high. Zimhi… The post Zimhi Injectable Naloxone Is High Dosage but Less Popular Than Inhalers appeared first on Paramedics World.
Seattle Fire Assistant Chief Chris Lombard receives national leadership award for advancing public safety communications Press Releases michelle.fordi… Tue, 06/25/2024 - 22:36 The First Responder Network Authority (FirstNet Authority) is an independent authority within the U.S. Department of Commerce. Created in 2012, its mission is to ensure the building, deployment, and operation of the nationwide broadband network that equips first responders to save lives and protect U.S. communities.
First responders make sacrifices to serve their communities, sometimes to the detriment of their own mental health. Mental health challenges such as depression, anxiety, and post-traumatic stress injury occur at higher rates among first responders compared to the general population. These issues can often lead to dangerous and unhealthy coping strategies, such as substance abuse.
The word “poison” is much more subjective than it may first appear. It’s likely you’ve come across the phrase, “the dose makes the poison”, referring to some compounds that are beneficial in small amounts but deadly in others – such as digitalis. And then there’s the intended recipient of the “poison”; a poison to one animal might be a boon to another, like milkweeds and monarch butterflies.
Automated liquid handling is key for many scientific and industry procedures. It guarantees exact and effective liquid distribution. Quality control along with validation are important parts of automated liquid handling… The post Quality Control and Validation in Automated Liquid Handling appeared first on Paramedics World.
FirstNet Authority awards prestigious Patriot Awards to five public safety leaders Press Releases michelle.fordi… Tue, 06/25/2024 - 22:39 The FirstNet Authority is an independent entity within the U.S. Department of Commerce’s National Telecommunications and Information Administration (NTIA). Created in 2012, its mission is to ensure the building, deployment, and operation of the nationwide broadband network that equips first responders to save lives and protect U.S. communities.
Methodology: 3.5/5 Usefulness: 2/5 Nasr Isfahani M, et al. BMC Emerg Med. 2024 Jan 25;24(1):15. Question and Methods: This triple blinded RCT of 158 patients with isolated closed limb fractures assessed pain scores at 1-hour following the administration of intravenous acetaminophen, acetaminophen plus ibuprofen, or morphine. Findings: The study findings demonstrate that parenteral ibuprofen in […] The post Comparing the efficacy of intravenous morphine versus ibuprofen or the combination
Kane Guthrie and Mike Cadogan LITFL Update 030 Update 029. Sending you FOAMed content from around the globe. Latest trends and best articles so that you stay top of your field.
As more and more highly potent and lethal batches of opioids hit the streets, it’s becoming abundantly clear that the need for high-dosage naloxone is at a critical high. Zimhi… The post Zimhi Injectable Naloxone Is High Dosage but Less Popular Than Inhalers appeared first on Paramedics World.
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