ALiEM

OCTOBER 2, 2023

A 6-year-old male presented to the pediatric emergency department (PED) for scalp lesions. He was seen by his pediatrician 2 weeks prior and prescribed antibiotics and a delousing shampoo for suspected cellulitis versus lice infestation. Symptoms did not improve despite completion of treatment. An outpatient ultrasound was performed showing “multiple scalp echogenic nodular lesions measuring from 0.5 cm to 1.2 cm in the long axis diameter.

E-9-1-1 189

E-9-1-1 Emergency Department OR 189

Pediatric EM Morsels

OCTOBER 6, 2023

Post-COVID everyone seems to be posting the perfect picture of their travels to the far reaches of the world. While this is an exciting change, it allows transmission of illness to countries where they are not endemic. Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. In addition to my passion for PEM, I also share a passion for global health.

OR 161

OR EMS ED 161

American Ambulance Association

OCTOBER 6, 2023

Elissa Schilmeister Paramedic Westchester EMS Chappaqua, New York Share on: Facebook | Instagram | X/Twitter | LinkedIn How did you come to be in EMS? I have always been interested […] The post EMS Profiles | Meet Elissa Schilmeister appeared first on American Ambulance Association.

EMS 130

EMS Ambulance Paramedic 130

EMergucate

OCTOBER 3, 2023

75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55.

Emergency Department 130

Emergency Department ED 130

Dr. Smith's ECG Blog

OCTOBER 1, 2023

This is a re-post of an excellent case from 2021. See it again now, along with our new Queen of Hearts functionality. We've come a long way in 2 years! And the pace only quickens. A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. He called EMS who brought him to the ED.

OR 127

OR STEMI Coronary CAD 127

Critical Care Scenarios

OCTOBER 4, 2023

What are the ways that patients fail breathing trials, and what can they tell us about how to optimize them for next time? What are the ways that patients fail breathing trials, and what can they tell us about how to optimize them for next time?

100

100

American Ambulance Association

OCTOBER 5, 2023

NAEMSP is deeply saddened by the news that E. Brooke Lerner, PhD, FAEMS has passed away after a courageous battle with cancer. Over the past two decades, Brooke has dedicated […] The post NAEMSP | Rest in Peace E. Brooke Lerner, PhD, FAEMS appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

Don't Forget the Bubbles

OCTOBER 4, 2023

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

E-9-1-1 111

E-9-1-1 ALS Emergency Department OR 111

ACEP Now

OCTOBER 4, 2023

Exploring Unique Careers in Emergency Medicine Dr. Liz Clayborne didn’t set out to become an entrepreneur. She had her mind set on academic emergency medicine, with specific interests in health policy, medical ethics, and health disparities. The spark that ignited her entrepreneurial journey was a common problem when she was an EM resident at George Washington University: nosebleeds.

EMS 105

EMS OR 105

American Ambulance Association

OCTOBER 5, 2023

Brett Zingarelli Lieutenant Saint Francis EMS Wilmington, Delaware Share on Instagram | Facebook | LinkedIn | Twitter / X How did you come to be in EMS? My grandfather passed […] The post EMS Profiles | Meet Brett Zingarelli appeared first on American Ambulance Association.

EMS 130

EMS Ambulance Firefighter 130

EMergucate

OCTOBER 3, 2023

Question 1: PH = 7.599 That is moderate alkalaemia (very close to the severe range – Moderate alkalaemia is PH between 7.5 – 7.6. Severe alkalaemia is PH > 7.6). PCO2 = 22 mmHg, that is low.

100

100

First 10 EM

OCTOBER 2, 2023

Although I think we all now recognize the fundamental importance of social determinants of health, I don’t think emergency medicine has found a way to adequately integrate this into our care. That is a shame, considering the huge amount of effort we put into things like tetanus shots or TXA therapy that have tiny (or […] The post Unconditional cash transfers to reduce homelessness?

OR 101

OR EMS 101

ACEP Now

OCTOBER 3, 2023

In April 2023, the third edition of the Brain Trauma Foundation’s evidence-based guidelines for the prehospital management of traumatic brain injury (TBI) was published in Prehospital Emergency Care. 1 The practice guidelines were written by a multi-disciplinary group of experts and went through an extensive peer review process. This document is an update of guidelines first published in 2000, and then updated in 2007.

Emergency Medical Services 98

Emergency Medical Services EMS OR Overdose 98

American Ambulance Association

OCTOBER 2, 2023

Rosetta Scott, NREMT Emergency Medical Technician Saint Francis Hospital EMS Wilmington, Delaware Share on Facebook | Instagram| LinkedIn | X/Twitter How did you come to be in EMS? My father […] The post EMS Profiles | Meet Rosetta Scott appeared first on American Ambulance Association.

Emergency Medical Technician 130

Emergency Medical Technician EMS Ambulance 130

EMDocs

OCTOBER 3, 2023

Today on the emDOCs cast, we have a guest piece by Rob Orman, MD. Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus Podcast Learn more at roborman.com If you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it’s here. Episode 87: Conquering Mid-Shift Overwhelm Mid-shift in an emergency department is a special beast.

EMR 97

EMR EMS OR Emergency Department 97

EM Literature of Note

OCTOBER 1, 2023

And, most importantly, if you put the symptoms related to your fever into ChatGPT, it will generate a reasonable differential diagnosis. “So?” This brief report in Annals describes a retrospective experiment in which 30 written case summaries lifted from the electronic documentation system were fed to either clinician teams or ChatGPT. The clinician teams (either an internal medicine or emergency medicine resident, plus a supervising specialist) and ChatGPT were asked to generate a &

Emergency Department 95

Emergency Department OR 95

Dr. Smith's ECG Blog

OCTOBER 6, 2023

What is the infarct artery? I usually don't ask this question, as it is rarely relevant to the decision to activate the cath lab. This is one case where it made a difference: Right Ventricular MI seen on ECG helps Angiographer to find Culprit Lesion Nevertheless, it is sometimes a fun academic exercise to try to predict the infarct artery: An elderly patient had onset of chest pain one hour prior.

ALS 69

ALS Coronary OR 69

American Ambulance Association

OCTOBER 2, 2023

Updated Ground Ambulance Crash Safety Materials Available Comprehensive Analysis and Safety Recommendations for Ambulance Crashes Ground ambulance crashes remain one of the leading causes of death on the job among […] The post NHTSA | Updated Ground Ambulance Crash Safety Materials Available appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

University of Maryland Department of Emergency Med

OCTOBER 5, 2023

It's finally spooky season with Halloween around the corner and candy to be ingested, so let's talk about pediatric ingestions. Here are some comm.

77

77

EMDocs

SEPTEMBER 30, 2023

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: BP Wildly Varies With Wrong Cuff Size Spoon Feed This randomized controlled trial demonstrated a clinically significant difference in blood pressure measurements when inappropriately sized BP cuffs were used on pati

OR 59

OR 59

Clinical Correlations

OCTOBER 6, 2023

By Zachary Henig Peer Reviewed Atherosclerosis is the primary risk factor for cardiovascular disease, the leading cause of mortality worldwide. To understand the pathophysiology of atherosclerosis, we turn to advances made in molecular biology. Understanding the.

52

52

The Curious Clinicians

OCTOBER 4, 2023

Why don’t we use immunosuppressants for artificial heart valves? Progressive heart valve failure leads to dreadful outcomes, including heart failure and death. Valve replacement surgery emerged in the 1950s and 1960s as a surgical remedy for calcified aortic stenosis and regurgitation. This began in 1952 when Charles Hufnagle was the first to implant a plastic ball valve into the descending thoracic aorta a 30-year-old woman who had experienced rheumatic fever with the resulting damage to her ao

ALS 52

ALS OR ACS 52

University of Maryland Department of Emergency Med

SEPTEMBER 30, 2023

"The main findings were the following: (1) there was no evidence of an effect of HTS compared with other agents (mainly mannitol) on long-term n.

OR 71

OR 71

First Responders Childrens' Foundation

OCTOBER 3, 2023

New York, Oct. 3 … First Responder’s Children’s Foundation (FRCF) is pleased to announce that Allison Isaacson Beahm, Director of Communications at SERVPRO , has joined its Board of Directors. The Tennessee-based company is a leading U.S. property restoration and construction franchise company. Mrs. Beahm, a 2012 graduate of Vanderbilt University, led the search for a nonprofit partner that aligned with SERVPRO’s brand and discovered First Responder Children’s Foundation through that process.

First Responder 52

First Responder 52

ACEP Now

OCTOBER 3, 2023

The last few years have been a tumultuous time for the emergency medicine (EM) specialty, especially as it pertains to our workforce. Per Medscape, emergency physicians have the highest burnout rate—65 percent—among all surveyed specialties. 1 Attrition rates within the profession are high and rising, especially for female physicians and those working in rural settings. 2–5 If many emergency physicians are unsatisfied with their jobs, what prevents more emergency physicians from finding a better

Emergency Department 52

Emergency Department EMS ALS 52

FOAMfrat

OCTOBER 2, 2023

In this episode, we sit down with Dr. Bram Duffee. He is a career paramedic and professor with a particular interest in advancing and studying the EMS profession. He has recently co-authored a book on hypnotic states and their relation to EMS. He also recently released a study on stress effects on paramedics. Don't miss this episode!

EMS 52

EMS Paramedic 52

University of Maryland Department of Emergency Med

OCTOBER 4, 2023

BACKGROUND: Emergency Medical Services (EMS) systems, especially those within urban jurisdictions, struggle to effectively meet the need.

Overdose 62

Overdose Emergency Medical Services EMS 62

EMCrit Project

OCTOBER 1, 2023

A slightly different kind of topic was my inspiration for the John Hinds Keynote at SMACC EMCrit Project by Scott Weingart, MD FCCM.

52

52

ACEP Now

OCTOBER 3, 2023

Urge Your Legislators to Support New Bill to Combat Boarding, Support Mental Health Access from the ED The bipartisan Improving Mental Health Access from the Emergency Department Act was recently reintroduced in the House for the 118th Congress by Reps. Raul Ruiz, MD (D-CA) and Brian Fitzpatrick (R-PA). The legislation is the House companion to identical Senate legislation (S. 1346) that was one of ACEP’s emergency department boarding priorities at the 2023 Leadership and Advocacy Conference in

Emergency Department 40

Emergency Department ED 40

FOAMfrat

OCTOBER 1, 2023

HEY-HEY everyone. It’s been a minute since I wrote a blog so I thought I would drop one on you all about drop factor calculations… (Giggles to self ). We’re going to be discussing all things DROP FACTOR, including tubing and formula calculations! This is your warning. This is a MATH BLOG. Drop factors can be intimidating if we don’t have a good understanding of how med math works or what drop tubing is.

OR 52

OR Epinephrine 52

University of Maryland Department of Emergency Med

OCTOBER 3, 2023

Bottom line: As part of a systematic protocol, peripheral pressors administered through a peripheral line greater 22Ga or larger reduced t.

OR 59

OR 59

ALiEM

OCTOBER 4, 2023

What potential terrorism agent could be treated with the pictured antidote? Anthrax Botulism Dioxin Ricin Soman Reveal the Answer 5. Soman The pictured autoinjector is a MARK-1 kit containing 2 mg of atropine and 600 mg of pralidoxime. This kit has historically been issued to US service members for treating nerve agent toxicity from agents such as soman, sarin, tabun, and VX, all of which are organophosphates and cause a cholinergic toxidrome.

Plasma 195

Plasma OR ED 195

REBEL EM

OCTOBER 5, 2023

Background: Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. Corticosteroids have excellent anti-inflammatory and immunomodulatory effects that could mitigate some of the inflammation caused by pneumonia. There have been several randomized trials that have shown glucocorticoids have positive effects in patients with CAP.

Critical Care 93

Critical Care ICU E-9-1-1 ALS 93

Dr. Smith's ECG Blog

OCTOBER 3, 2023

By Magnus Nossen, from Norway I was shown this print out of a rhythm strip from a patient on telemetry. I was asked what's going on? There are four leads shown (II, dV2, V1 and V5). The three images beneath one and other are consecutive rhythm strips each 10 seconds long. The patient was on telemetry due to acute MI. Can you correctly describe what's going on in this interesting rhythm strip?

OR 98

OR 98

Don't Forget the Bubbles

OCTOBER 2, 2023

With millions of journal articles published yearly, it is impossible to keep up. P aediatric R esearch A cross the M idlands ( PRAM ) is a trainee-led research collaborative across the West Midlands, networking since 2016. Learn more about past and future projects on our website www.pramnetwork.com. Join our mailing list by contacting pramnetwork1@gmail.com and following us on Twitter @PramNetwork.

ALS 137

ALS OR ED Emergency Department 137

ALiEM

OCTOBER 6, 2023

A 52-year-old male presents to the Emergency Department with a chief complaint of right lower abdominal pain with urinary frequency and urgency over the past week. The pain radiates from his right groin with 10/10 severity at times. He reports multiple diagnoses of urinary tract infections over the last year requiring oral antibiotics. He claims intermittent constipation, denies any trauma, and is a truck driver by trade.

Emergency Department 169

Emergency Department OR 169

The Skeptics' Guide to EM

SEPTEMBER 30, 2023

Date: September 28, 2023 Reference: Jarman et al. Sex Differences in Guideline-Consistent Diagnostic Testing for Acute Pulmonary Embolism Among Adult Emergency Department Patients Aged 18-49. AEM September 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Case: During a shift in the emergency department […] The post SGEM#416: She’s Always A Woman, Query PE?

Emergency Department 186

Emergency Department ALS ED OR 186