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On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG.
We discuss a new class of medications, Immune Checkpoint Inhibitors, and their side effects. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Oncology Show Notes Overview of Immune Checkpoint Inhibitors (ICIs) ICIs are a relatively new class of oncologic drugs that have revolutionized cancer treatment. Unlike chemotherapy, ICIs help the immune system develop memory against cancer cells and adapt as the cancer mutates.
Complete Heart Block with Altered Mental Status Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the third installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using information from different cases where paramedics attempted TCP in the field.
A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. The patient presented to an outside “eye doctor” and was told to go to the nearest hospital for evaluation.
The Department of Veterans Affairs (VA) has notified Senate Committee on Veterans Affairs Chairman Jon Tester (D-MT) and Ranking Member Jerry Moran (R-KS) that the Department will be delaying implementation […] The post VA Notifies Tester/Moran of Delay of Final Rule until 2029 appeared first on American Ambulance Association.
The Case A 96-year-old female with a history of coronary artery disease, hypertension, and complete heart block status post dual-chamber pacemaker (remote) presents to the ED by EMS with generalized weakness and lethargy. EKG Show Details EKG Characteristics Rate 130 Rhythm Wide Complex Tachycardia, Paced Intervals QRS 180, QT/QTc 406/596 Axis Left axis deviation ST Segments Non-specific Additional Features Paced Rhythm with LBBB morphology Diagnosis Pacemaker-Mediated Tachycardia Questions What
A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Associated symptoms included nausea and a mild headache for one day, and one episode of vomiting prior to arrival.
A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Associated symptoms included nausea and a mild headache for one day, and one episode of vomiting prior to arrival.
This content is for AAA members only. Please either Log In or Join! The post Federal Departments Issue Final Report and Recommendations of the GAPB Advisory Committee appeared first on American Ambulance Association.
Acclaimed volunteer fire service documentary Odd Hours, No Pay, Cool Hat is hitting TVs across the nation this fall. Over 180 PBS stations will air a one-hour version of the film in September and October in conjunction with the 9/11 anniversary, October’s Fire Prevention Week, and National First Responders Day (Oct. 28). The documentary takes audiences behind the lines of America’s volunteer fire service community by sharing the stories of volunteer responders as they face challenges and triumph
Written by Pendell Meyers A man in his 40s called EMS for acute chest pain that awoke him from sleep, along with nausea and shortness of breath. His history included known heart failure with prior EF 18%, insulin dependent diabetes, and polysubstance abuse. Vitals were within normal limits except for tachypnea. Here are his EMS ECGs along with the Queen of Hearts interpretations below each one: EMS1 0650 EMS2 0707 Click here to sign up for Queen of Hearts Access The ECGs show RBBB and LAFB, with
On September 6, 2024, the Centers for Medicare and Medicaid Services (CMS) announced that CMS and its contractor, Wisconsin Physician Service Insurance Corporation (WPS), have begun the process of notifying […] The post CMS Notifies Individuals Potentially Impacted by WPS Data Breach appeared first on American Ambulance Association.
On September 11, 2001, hundreds of first responders made the ultimate sacrifice while trying to save others. Twenty-three years after the tragic events of that day, the National Volunteer Fire Council (NVFC) remembers and honors their bravery and selflessness. The NVFC is here to support you. September is National Preparedness Month , and the NVFC has the following resources to help you and your department be safe, healthy, and ready for the next emergency.
A 70-something y.o. male presents to triage with shortness of breath. He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. ECG 1 at time zero EARLY REPOLARIZATION ABNORMAL ECG ED final official overread: "early repol vs hyperacute T, minimal changes from previous (previous shown below)" What do YOU think?
This content is for AAA members only. Please either Log In or Join! The post Cybersecurity & Fleet Interest Groups appeared first on American Ambulance Association.
September 11: Honoring first responders across the nation Blog joseph.rey@fir… Wed, 09/11/2024 - 12:03 By Joe Wassel, Executive Director and CEO, First Responder Network Authority (FirstNet Authority) Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters.
A former resident texted me this case: "Hey Dr. Smith. Hope you’re doing well! How excited would you have been about this case?" Here is the case: Report from EMS was witnessed syncope, his son did CPR, but the patient had pulses when EMS arrived. When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. No Chest Pain, but somnolent.
The Science Alliance has released infographics to help fire departments communicate messages relating to diversity, equity, and inclusion (DEI) as well as reproductive health to their members. The infographics address critical issues including discrimination and harassment, inclusion and acceptance, pregnancy in the fire service, considerations for OB/Gyns, and much more.
It’s astonishing how fast a 12-hour shift in the hospital can go. You find yourself in constant motion, carefully assessing each patient and making sure to complete all of your necessary duties before the next nurse comes on to relieve you.
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 IV blood pressure medications in patients with neurovascular emergencies. EBM Update: IV BP Meds in NV Emergencies Background: There is no one agent that is recommended over others for reducing elevated BP in those with neurovascular emergencies.
James Miers and John Mackenzie Procedure: Pericardiocentesis Emergency Procedure: Pericardiocentesis. one of the most difficult and risky emergency procedures, but one you already have the ultrasound and line skills to perform well.
Firefighters, EMS providers, and rescue workers are routinely exposed to traumatic incidents and difficult calls. In addition, volunteer responders deal with the stress of juggling work-life-volunteer responsibilities. Due to these factors and more, responders face high risks for behavioral health issues, including post-traumatic and acute stress, depression, suicidal thoughts, and substance misuse.
This post accompanies Andy Tagg’s talk for Grand Rounds for RU OK Day I have a confession to make to you all. And I know this is a safe space, so here it goes… I am burnt out. I have been a doctor for half of my life, and my journey to burnout has been a 25-year slow burn that began the day I graduated. I had always wanted to be a doctor, and only now do I recognise my parents’ sacrifices to get me to where I am today.
Author: Iosif Davidov, MD (EM/IM/CC/Ethics Fellow at North Shore/LIJ Northwell Health System) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
Mark Corden Funtabulously Frivolous Friday Five 360 Funtabulously Frivolous Friday Five 360 - Just when you thought your brain could unwind, enter the medical trivia of FFFF.
Every year, we have our peak of respiratory viruses – traditionally influenza, respiratory syncytial virus, and their accompanying lessor demons. These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources.
Exploring the trailblazing achievements and persistent challenges for women in Emergency Medical Services. Women in EMS play a crucial role in delivering emergency medical care, their impact resonating deeply in patient outcomes and shaping the future of the field. Historically, women’s involvement was limited and often underestimated, but their increasing presence has been pivotal in […] The post Women in EMS: Breaking Barriers and Achieving Success appeared first on Unitek EMT.
Welcome back to another research roundup. This edition doesn’t have any immediate practice changers, but I think there are some very important topics. Enjoy. The BroomeDocs podcast: [link] The BroomeDocs podcast on YouTube: (I am on vacation, so this will probably be inserted later.) In a surprise to no one who reads First10EM, clinical judgment […] The post The September 2024 Research Roundup appeared first on First10EM.
Written by Willy Frick A 40 year old woman was at home cooking when she developed chest pain. She took an oxycodone and called EMS. Her presenting ECG is shown below: ECG 1 What do you think? I sent this to Drs. Meyers and Smith and the response was: "I’m quite confident that this is OMI." Here is the Queen's verdict with explainability: She sees OMI with low confidence.
Fire Prevention Week (FPW) is coming up on October 6-12, and this year’s theme is “Smoke alarms: Make them work for you! ” Many departments utilize this week to host an open house, conduct community education, or jump-start their fire prevention initiatives. The NFPA’s Fire Prevention Week web site has many tools to help. In addition, utilize the following resources and trainings from the NVFC: Roundtable Talk: Planning for Fire Prevention Week – September 26 at 2pm ET This live panel disc
Both basic and advanced airway management can save lives. Neither is more important than the other, and neither is a “better” option. When basic airway management is the safest and most effective option, immediately escalating to advanced airway management can be immensely harmful.
A newborn boy presents to the emergency department shortly after a home delivery. The mother had routine prenatal care and reports that he was due in 2 days. The patient appears term and vigorous but is in respiratory distress and gasping for air. His heart rate is 80 bpm. What percent of oxygen should you initially use while providing positive pressure ventilation to this patient?
This is a case of profound unstable hyperkalemia encountered in the American pre-hospital 911 setting, with subsequent aggressive treatment and stabilization. Although hyperkalemia may be present in the prehospital setting, it is difficult to diagnose without laboratory testing or a reliable history of illness. It is frequently encountered in the pre-hospital setting, especially in communities with high levels of comorbidities and multiple dialysis centers.
The National Volunteer Fire Council (NVFC), the leading national association representing the volunteer fire, EMS, and rescue services, has received a grant for $30,000 from the Motorola Solutions Foundation, the charitable arm of Motorola Solutions. Through this grant, the NVFC will provide training to the volunteer fire and emergency services. This is the ninth consecutive grant the NVFC has received from the Motorola Solutions Foundation.
National Preparedness Month helps communities prepare for when disaster strikes. It also provides an opportunity to celebrate the work of emergency managers (EMs) and the role they play in disaster preparedness, response, and mitigation. In recognition of the month, Trevin Hunter of Louisville Metro Emergency Services in Kentucky talks about his work as an EM and shares his support for the emergency management community.
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