Sat.Jun 22, 2024 - Fri.Jun 28, 2024

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EM Match Advice 44: Approaching your EM sub-internship clerkship – “Just gotta roll with it”

ALiEM

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

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Episode 76: Rehabilitation psychology, with Megan Hosey

Critical Care Scenarios

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.

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HealthAffairs | Health Insurance Coverage Projections

American Ambulance Association

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.

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ECG of the Week – June 26th

EMergucate

The following ECG is from a 48-year-old man who presented feeling generally unwell and “restless” He has been suffering from … Continue reading →

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SGEM#444: I Need Oxygen…But How Much Oxygen for Critically Ill Children

The Skeptics' Guide to EM

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.

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The pediatric can’t intubate can’t oxygenate scenario (Use a knife)

First 10 EM

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.

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A woman in her 50s with multiple episodes of syncope

Dr. Smith's ECG Blog

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.

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Spinal Immobilization: a Twisted Tale

EMOttawa

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

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NVFC Releases Guide for New Fire Service Families

NVFC

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.

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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

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.

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Lab case 447

EMergucate

21 year old girl presented with sudden left sided weakness. Her CT head showed intracerebral haemorrhage.

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JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest

St. Emlyn's

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.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

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.

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Guidelines would (erroneously) say that this patient who was defibrillated and resuscitated does not need emergent angiography

Dr. Smith's ECG Blog

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.

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HEMOTION – transfusion thresholds in TBI

The Bottom Line

Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury Turgeson AF. NEJM June 13 2024; doi:10.

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The High Life: an Altitude Illness Guidebook

FOAMfrat

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

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PulmCrit Wee: Rational selection of infusion rate based on loading dose

EMCrit Project

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.

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Podcast – May 2024 Monthly Round Up – RCEM conference highlights, being EPIC and more

St. Emlyn's

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.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

Author: Kyle Smiley, MD (EM Resident Physician / San Antonio, TX); Jon athan Henderson, MD (PEM Attending, Washington, DC) Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // 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!

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Nasopharyngeal vs. Nasotracheal Suctioning

SSCOR

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.

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EMCrit Wee – Adaptive Support Ventilation (ASV)

EMCrit Project

a unique ventilatory mode unfortunately only available on Hamilton vents EMCrit Project by Scott Weingart, MD FCCM.

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JC: The impact of double sequential external defibrillation timing on outcomes during refractory out-of-hospital cardiac arrest

St. Emlyn's

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.

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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

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.

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Alert! Senate Passes Fire Grants and Safety Act on to the President’s Desk

American Burn Association

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.

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Medical Equipment Every Skilled Nursing Facility Should Have on Hand

SSCOR

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.

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JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest

St. Emlyn's

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.

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REBEL Core Cast 125.0 – Hyperkalemia

REBEL EM

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.

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Ep. 141 Vol 28 No 1

Prehospital Emergency Care 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!

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Zimhi Injectable Naloxone Is High Dosage but Less Popular Than Inhalers

Paramedics World

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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Seattle Fire Assistant Chief Chris Lombard receives national leadership award for advancing public safety communications

FirstNet Authority

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.

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LITFL Update 030

Life in the Fastlane

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.

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Bringing Moral Injury to Light

First Responder Wellness

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.

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Quality Control and Validation in Automated Liquid Handling

Paramedics World

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.

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FirstNet Authority awards prestigious Patriot Awards to five public safety leaders

FirstNet Authority

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.

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Special Episode: Dr. Noah Whiteman & Most Delicious Poison

This Podcast Will Kill You

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.

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Comparing the efficacy of intravenous morphine versus ibuprofen or the combination of ibuprofen and acetaminophen in patients with closed limb fractures: a randomized clinical trial

EMOttawa

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

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Zimhi Injectable Naloxone Is High Dosage but Less Popular Than Inhalers

Paramedics World

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.