Sat.Sep 07, 2024 - Fri.Sep 13, 2024

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EM Quick Hits 59 Traumatic Coronary Artery Dissection, Proper Use of Insulin, Mesenteric Ischemia, Exercise Associated Hyponatremia, AI for OMI

Emergency Medicine Cases

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.

Coronary 239
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Episode 200: Immune Checkpoint Inhibitors

Core EM

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.

OR 230
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Transcutaneous Pacing: Part 3

EMS 12-Lead

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.

Paramedic 299
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SAEM Clinical Images Series: What’s Coming Out of Your Eye?

ALiEM

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.

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VA Notifies Tester/Moran of Delay of Final Rule until 2029

American Ambulance Association

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.

Ambulance 130
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Pacemaker Associated Tachycardia

Core EM

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

Coronary 130
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Imaging Case of the Week 602 Answer

EMergucate

The hand x-ray shows punched out lesions with overhanging margins in the distal IP joints of index & middle fingers.

EMS 130

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Federal Departments Issue Final Report and Recommendations of the GAPB Advisory Committee

American Ambulance Association

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.

Ambulance 130
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Watch Odd Hours, No Pay, Cool Hat on PBS Stations This Fall

NVFC

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

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Imaging Case of the Week 603

EMergucate

The abdominal x-ray is from a patient with vomiting, abdominal pain & distension. What can be seen?

EMS 130
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September 11: Honoring first responders across the nation

FirstNet Authority

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.

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CMS Notifies Individuals Potentially Impacted by WPS Data Breach

American Ambulance Association

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.

Ambulance 130
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Be Ready This National Preparedness Month with Resources from the NVFC

NVFC

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.

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Imaging Case of the Week 600 Answer

EMergucate

The chest x-ray shows medial displacement of the gastric bubble by an enlarged spleen.

EMS 130
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An elderly male with shortness of breath

Dr. Smith's ECG Blog

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?

STEMI 116
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Cybersecurity & Fleet Interest Groups

American Ambulance Association

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.

Ambulance 130
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NVFC Provides Resources to Support Responder Behavioral Health

NVFC

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.

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Imaging Case of the Week 601 Answer

EMergucate

The pelvic x-ray shows a fracture of the right ilium.

EMS 130
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Texted from a former EM resident: 70 yo with syncope and hypotension, but no chest pain. Make their eyes roll!

Dr. Smith's ECG Blog

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.

EMS 108
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Procedure: Pericardiocentesis

Life in the Fastlane

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.

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Women in EMS: Breaking Barriers and Achieving Success

Unitek EMT

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.

EMS 79
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emDOCs Videocast: EBM Update – IV BP Meds in NV Emergencies

EMDocs

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.

ALS 81
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Acute chest pain, right bundle branch block, no STEMI criteria, and negative initial troponin.

Dr. Smith's ECG Blog

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

STEMI 95
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The September 2024 Research Roundup

First 10 EM

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.

EMS 80
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6 Tips for Airway Management: Improving Your Suction Technique

SSCOR

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.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

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.

EMS 75
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"The dye don't lie".except when it does. Angiogram Negative, or is it?

Dr. Smith's ECG Blog

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.

OR 70
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Get Ready for Fire Prevention Week

NVFC

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

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Basic vs. Advanced Airway Management

SSCOR

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.

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Advocating for Patients

ACEP Now

Imagine a 9-week pregnant patient who comes to the emergency department with vaginal bleeding and abdominal cramping. Like nearly a quarter of pregnancies, she is experiencing early pregnancy loss, also referred to as spontaneous abortion or miscarriage. As she continues to bleed, she becomes progressively tachycardic and hypotensive, entering hemorrhagic shock, requiring an emergent procedure in order to preserve her health and save her life.

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Aggressive Hyperkalemia Treatment in the Prehospital Setting

International Journal of Paramedicine

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.

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NVFC Receives Motorola Solutions Foundation Grant to Support Training Initiatives

NVFC

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.

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Funtabulously Frivolous Friday Five 360

Life in the Fastlane

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.

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Episode 81: Voices from the Field: National Preparedness Month 2024

FirstNet Authority

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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Peer Support Training for Waukegan Police Department

First Responders Wellness Center

Great job to all of the peer support members of the Waukegan Police Department. Thank you for all you take time to be peer support members and learn more on how to help other officers!

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Rosh Review My EMCert Monthly Question

REBEL EM

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?

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Early Intervention Orthodontics Singapore: What are they?

Paramedics World

For babies, early dental problems might not only affect their eating habits. They can also impact speech and damage self-esteem. What’s more, they could lead to more significant issues in… The post Early Intervention Orthodontics Singapore: What are they? appeared first on Paramedics World.