EMS 12-Lead

AUGUST 31, 2022

Acute LAD occlusion in the setting of Right Bundle Branch Block and Left Anterior Fascicular Block. Case Review: [link] Key features of Right Bundle Branch Block: In general, there is no ST elevation throughout the 12 Lead ECG. RBBB has expected slight ST depression, with T wave inversion, in V1-V3 when discordant to a positive R' wave. A possible normal variant is lateral ST elevation (i.e., I/aVL/V5/V6) with bulky T waves when subsequent to a large, slurred S wave.

Coronary 130

Coronary 130

Emergency Medicine Cases

AUGUST 30, 2022

In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant

EMS 130

EMS ED 130

EMergucate

AUGUST 30, 2022

The ankle x-rays are from a 10 year old with injury following fall from a trampoline. What can be seen?

EMS 130

EMS 130

Critical Care Scenarios

AUGUST 28, 2022

Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submission. Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submis

100

100

EMS 12-Lead

AUGUST 30, 2022

New onset chest discomfort with demonstrable Hyperacute T waves that went undetected by EMS, EM, and cardiology. Case review presentation: [link] Learning Objectives Hyperacute T waves are disproportionately large in comparison to their paired QRS, and represent Grade I Sclarovsky-Birnbaum ischemia. Diffuse / global ST depression is consistent with subendocardial ischemia (supply-demand mismatch) when maximal in Leads II and V5.

EMS 130

EMS 130

The Skeptics' Guide to EM

AUGUST 27, 2022

Date: August 23rd, 2022 Reference: Schoenfeld et al. “Just give them a choice”: Patients’ perspectives regarding starting medications for opioid use disorder in the ED. AEM August 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. […] The post SGEM#374: Bad Habits – Medications for Opioid Use Disorder in the Emergency Department fir

Emergency Department 100

Emergency Department Overdose Naloxone ED 100

EMergucate

AUGUST 28, 2022

The pelvic x-ray shows an avulsion fracture of anterior superior iliac spine (ASIS avulsion).

EMS 130

EMS 130

EMS 12-Lead

AUGUST 29, 2022

It's back to the basics! Take a seat and relax as the maestro, Tom Bouthillet, guides us through a stepwise approach to assessing Left Bundle Branch Block-- especially in the nefarious context of Occlusive Myocardial Infarction.

130

130

EMCrit Project

AUGUST 27, 2022

Historically, many patients admitted with congestion due to heart failure have been treated with furosemide monotherapy. However, a strategy of furosemide monotherapy has numerous drawbacks: Furosemide tends to stimulate production of dilute urine, leading to a greater amount of water loss than sodium loss. Predominant loss of water may cause loss of volume from the […].

95

95

EMergucate

AUGUST 31, 2022

A 81 year old male presents to a regional ED with chest pain for the last 4 hours.

ED 130

ED 130

REBEL EM

SEPTEMBER 1, 2022

Background: The Calcium for Out-of-Hospital Cardiac Arrest (COCA) trial was a randomized, placebo-controlled, double-blind trial of calcium compared to placebo in OHCA. COCA found no improvement in sustained ROSC but, rather, a trend towards harm for their primary outcome. Additionally, there were non-statistically significant trends toward lower survival and lower survival with good neurologic outcomes in patients receiving calcium at 30 to 90 days.

Epinephrine 52

Epinephrine Overdose ALS OR 52

EMT City

AUGUST 27, 2022

I know that this is a long-shot with the volume of traffic on here anymore, but what the hell, I'll ask. Does anyone know of a source for obtaining the ring that goes around diaphragm bell of the Classic II? I don't need an entire kit. I just need to replace the ring. Thanks.

52

52

EMCrit Project

SEPTEMBER 2, 2022

Sleep for Shift Workers--this info may add years to your life and keep you performing optimally. EMCrit Project by Scott Weingart, MD FCCM.

97

97

EMergucate

AUGUST 28, 2022

Answers: PH = 7.24 that is moderate acidaemia. HCO3 = 16 mmol/L, so we have metabolic acidosis. Next, we need to calculate the anion gap and the compensation.

100

100

REBEL EM

AUGUST 29, 2022

Background: The use of ketamine and etomidate for induction in rapid sequence intubation is heavily debated. The Ketased Trial (Jabre 2009) reported no significant difference between the two induction agents. However, recently the National Emergency Airway Registry reported ketamine is associated with more-frequent hypotension than etomidate in critically ill patients (Mohr 2020).

MICU 52

MICU ICU OR Emergency Department 52

EMS 20/20

SEPTEMBER 1, 2022

SORRY FOR THE DELAY! BLAME CHRIS! The guys review a call with a patient that needs just a touch of magic to a large neck wound. Was the crew able to cast the right spell? Listen and find out! SORRY FOR THE DELAY! BLAME CHRIS! The guys review a call with a patient that needs just a touch of magic to a large neck wound. Was the crew able to cast the right spell?

40

40

A Paramedic's Notebook

AUGUST 29, 2022

I’ve recently been turned onto Van Neistat’s YouTube channel. Van, the older brother of Casey Neistat, is a true pleasure to watch – he’s the DIYer’s DIYer and his style is untainted by modern social media. He’s the best of the Gen X cohort without the pretension or cynicism. In his video meditating on the nature of burnout , he described slow burnout in terms of a motor with the cylinders breaking down one at a time.

OR 40

OR 40

EMergucate

AUGUST 30, 2022

A 81 year old male presents to a regional ED with chest pain for the last 4 hours.

ED 100

ED 100