The Skeptics' Guide to EM

AUGUST 19, 2023

Date: August 14, 2023 Reference: Ma et. al. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial. Lancet 2023 Guest Skeptic: Dr. Mike Pallaci is a Professor of Emergency Medicine (EM) for the Northeast Ohio Medical University, and an Adjunct Clinical Professor of […] The post SGEM#413: But Even You Cannot Avoid…Pressure – Intensive Care Bundle with Blood Pressure Reductio

EMS 186

EMS ALS Emergency Department OR 186

Emergency Medicine Cases

AUGUST 22, 2023

In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer questions like: at what age is it safe to attempt reimplantation of an avulsed tooth in the ED? What are the 3 most time-sensitive dental trauma emergencies?

ED 186

ED OR EMS 186

American Ambulance Association

AUGUST 24, 2023

Thank you to American Ambulance Association Secretary @WayneJurecki for standing up for patients and #EMS providers. @NewsHour #SupportEMS #GAPBAC #AlwaysOpen #NotJustaRide [link] @EMS1 @jemsconnect @UKROBL1 @AIMHI_MIH @EMSWorldOFCL — AmericanAmbulanceAsc (@amerambassoc) […] The post PBS NewsHour | The No Surprises Act left out ground ambulances.

Ambulance 130

Ambulance EMS 130

Core Ultrasound

AUGUST 23, 2023

Knee Aspiration/Injection Elbow Aspiration/Injection Knee Exam The post Wrist Effusion – Identification, Aspiration, Injection (5MS) first appeared on Core Ultrasound.

130

130

ALiEM

AUGUST 21, 2023

A 50-year-old male with a history of polysubstance use disorder and poorly-controlled type 2 diabetes mellitus presents with left hand pain. One week ago, the patient sustained a macerating injury of the left distal middle digit. Since that time he has experienced worsening pain throughout the digit, now associated with diffuse swelling and discoloration.

OR 130

OR ED 130

Emergency Medicine Cases

AUGUST 22, 2023

Podcast CAMP 2023 tickets are on sale now through podcastcamp.org. Podcast CAMP the only online comprehensive course dedicated to medical education podcast production – by podcasters – for podcasters. Whether you’re a beginner or a seasoned pro, this interactive, small-group, hands-on immersive experience with Anton Helman will help you not only sharpen your technical podcasting skills, but give you valuable knowledge, tips and tricks to produce your own high quality educational and impactful po

OR 130

OR 130

American Ambulance Association

AUGUST 24, 2023

Congratulations to the board of the Mississippi Ambulance Alliance on the publication of their insightful op-ed in the Clarion Ledger. “Response Times” are the loudest complaint, both locally and around […] The post Clarion Ledger | Ambulance ‘response times’ miss the big picture: health outcomes appeared first on American Ambulance Association.

Ambulance 130

Ambulance ED 130

Critical Care Scenarios

AUGUST 23, 2023

When are patient outcomes your fault? When are patient outcomes your fault?

100

100

Don't Forget the Bubbles

AUGUST 23, 2023

Siren and blue lights. Team allocated and primed. Voices command, ears listen, and hands swiftly execute. Monitors beep—loops of communication. As the second hand sweeps, loud voices grow quieter, and pulse checks fall into an unfortunate pattern. Realisation, its time, knowing looks, a shake of the head, a pain, heaviness. Winding down…. “Time of Death 10:43”.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

American Ambulance Association

AUGUST 23, 2023

This content is for AAA members only. Please either Log In or Join! The post EMS Workforce Quick Take: Sign-on and Referral Bonuses appeared first on American Ambulance Association.

EMS 130

EMS Ambulance OR 130

EMergucate

AUGUST 19, 2023

The supine chest x-ray shows a lucent right lung field. There appears to be mild mediastinal shift to the left.

EMS 130

EMS 130

ACEP Now

AUGUST 22, 2023

There is no shortage of guidelines, protocols, or quality measures across emergency medicine. Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. A common limitation to many of these guidelines, however, is the lack of recognition of available resources or the unique challenges of certain patient groups.

Emergency Department 98

Emergency Department ALS ED OR 98

Dr. Smith's ECG Blog

AUGUST 19, 2023

Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal disease was sent to the ED after dialysis for three days of nausea, vomiting, loose stool, lightheadedness and fatigue. RR18 sat 99% HR 90 BP 90/60, afebrile. Below is the 15 lead ECG. What do you think? There’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression and normal voltages.

STEMI 98

STEMI ACS OR ALS 98

American Ambulance Association

AUGUST 23, 2023

This content is for AAA members only. Please either Log In or Join! The post 2023 Mentorship Guide for EMS appeared first on American Ambulance Association.

EMS 130

EMS Ambulance OR 130

EMergucate

AUGUST 19, 2023

The chest x-ray shows right upper lobe collapse consolidation.

EMS 130

EMS 130

EMDocs

AUGUST 24, 2023

Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles. Today we look at the FABLED trial. Authors: Brannon L Inman, MD (Critical Care Fellow, Orlando, FL) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis AKA the “FABLED” Trial Clinical question: In adults with severe manifestations of s

Critical Care 94

Critical Care Emergency Department ALS OR 94

Medgadget

AUGUST 25, 2023

Researchers at the Mount Sinai Hospital have developed an mRNA-based treatment for cancer. The approach combines the delivery of mRNA therapy in lipid nanoparticles and also involves co-delivering dendritic cells that have also been primed through treatment with lipid-encased mRNA. The technology aims to overcome some of the immune evasive tricks that tumors use to circumvent the immune system, some of which can hamper more traditional immunotherapies.

OR 92

OR 92

American Ambulance Association

AUGUST 23, 2023

Dear NAEMSP members, The subspecialty of EMS continues to evolve every day. As a member of NAEMSP, I hope you feel a part of this continued evolution. Our […] The post NAEMSP | Board Nominations Open appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

EMergucate

AUGUST 22, 2023

32 year old man presented with right knee pain and swelling. He also complained of UTI that didn’t respond to Cephalexin and Augmentin.

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100

EMDocs

AUGUST 22, 2023

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we discuss capnography. Episode 84: Capnography Background: Capnography is the noninvasive measurement of carbon dioxide partial pressure. Displayed as colorimetric/qualitative, quantitative and waveform Normal range for EtCO 2 35-45 mm Hg Waveform has several different phases: Phase 0 – inspiration – clearing of CO 2 Phase I – expiration – anatomical dead space, should not contains CO 2 Phase II – expi

Emergency Department 93

Emergency Department ALS Life Support OR 93

REBEL EM

AUGUST 21, 2023

Background Information: Cardiac arrest is a devastating event that imposes considerable human and financial burdens. While it is widely recognized that cardiac arrest leads to brain injury, what is often overlooked is the persistent cerebral hypoperfusion that continues even after circulation is restored. The sustained cerebral hypoperfusion can be attributed to impaired cerebrovascular auto-regulation, which renders normal arterial carbon dioxide tension (PaCO2) insufficient in achieving and ma

E-9-1-1 92

E-9-1-1 Critical Care CPR ALS 92

American Ambulance Association

AUGUST 22, 2023

Ground Ambulance and Patient Billing (GAPB) Advisory Committee Public Meeting #2 (August 16, 2023) The Ground Ambulance and Patient Billing (GAPB) Advisory Committee Second Public Meeting was held on August […] The post GAPBAC | Follow Up from Committee Meeting #2 appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

EMergucate

AUGUST 21, 2023

Answers: Volume of 25 ml is large, normal amount of synovial fluid in a knee joint is 0.5 to 4 ml. This indicates effusion.

100

100

Medgadget

AUGUST 25, 2023

Scientists at New York University have developed a gene therapy for chronic pain. The technology works by targeting the NaV1.7 sodium ion channel present on neurons, which is an important component of the pain response. The researchers encoded a version of a peptide that allows a modulatory protein, called CRMP2, to bind to NaV1.7 sodium ion channels and modulate their activity.

85

85

REBEL EM

AUGUST 24, 2023

Background: Sports-related concussions are among the most common injuries in children and adolescents, affecting millions of youth athletes annually. 1 Given their prevalence in this population, providers must be up to date on diagnosis and management. Historical practice recommends rest to prevent adverse outcomes; however, evidence suggests strict rest is harmful.

ALS 84

ALS OR EMS 84

American Ambulance Association

AUGUST 21, 2023

Free E-book download from Relias. Creating a Trauma-Informed System of Care: Addressing Individuals, Professionals, and Organizations Nellie Galindo, MSW, MSPH Melissa Lewis-Stoner, MSW, LCSW-C The post Relias E-Book | Creating a Trauma-Informed System of Care appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

EMDocs

AUGUST 19, 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: SCOUT RCT | 5 or 10-day Treatment for Pediatric UTI? Spoon Feed This multi-center, double-blinded, non-inferiority trial found that short-course antimicrobial therapy had relatively low treatment failure rates compa

OR 79

OR 79

Medgadget

AUGUST 25, 2023

LumaFlo , a medtech company based in Israel, has developed a decontamination technology that does not require UV light, something that can be dangerous for people nearby. The COVID-19 pandemic highlighted the need for safe and effective decontamination technologies for both public spaces and healthcare facilities. However, many such technologies rely on UV light to kill pathogens, but this can also have negative effects on those exposed.

Emergency Response 76

Emergency Response OR ALS 76

First 10 EM

AUGUST 21, 2023

This is a guest post by Dr. Julia Dmytryshyn. Julia completed medical school at the University of Toronto and is now a 2nd year Family Medicine resident at the University of Toronto. She is the co-creator of the popular medical education podcast series The Vulva Diaries. Her areas of interest include emergency medicine and women’s […] The post Miscarriage (Mis)management part 2: Management and Counselling appeared first on First10EM.

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74

EM Literature of Note

AUGUST 23, 2023

In a world of doors, truck beds, furniture, and other finger-crushing nuisances, emergency department visits for injuries involving the distal digits are common. Injuries range from tuft fractures, to degloving injuries, to all manner of nail and nailbed derangement. Perusing any textbook or online resource will typically advise some manner of repair, including, but not limited to, replacing an avulsed nail back into the proximal nail fold and securing it in place.

Emergency Department 71

Emergency Department OR 71

University of Maryland Department of Emergency Med

AUGUST 20, 2023

Settings: Single ICU in Poland, randomized trial Participants: intubated patients who needed arterial catheter placement. Patients who h.

ICU 60

ICU 60

Medgadget

AUGUST 22, 2023

Researchers at MIT have developed a wearable ultrasound system that is intended to allow women at high risk of breast cancer to perform an ultrasound scan on themselves at home, and may also let patients with early-stage malignancy or suspicious lesions to monitor how they are progressing. The technology can help patients to avoid having to attend a clinic, and may also help them to identify tumors that arise between routine breast checks at a clinic.

OR 75

OR 75

The FllightBridge ED

AUGUST 25, 2023

In this episode, Eric looks at warm fluids… or lack thereof in resuscitation.

OR 52

OR 52

First Responders Foundation

AUGUST 24, 2023

The First Responders Foundation is honored to be inducting Justin Cooley into the Ancient Order of the National Society of St. Florian and St. Michael at the 7th Annual 9/11 Luncheon of Honor on September 11, 2023. Justin was the keynote speaker for the 6th Annual 9/11 Luncheon of Honor in 2022. Justin Cooley Sees A Problem And Makes A Difference Captain Cooley is a captain with the Omaha Fire Department and the father of three teenagers.

First Responder 52

First Responder Firefighter Emergency Medical Services EMS 52

The Overrun Podcast

AUGUST 22, 2023

Jason Patton is a firefighter with 17 years of experience that discusses EMS and Firefighting misadventures on his Tiktok channel (@firedepartmentchronicles). Jason joins Ed, Jess, and Kevin to discuss how we can use social media to advance the message of EMS and improve the industry. Follow The Overrun on IG: @OverrunProductions Follow The Overrun on TikTok: @TheOverrun Follow The Overrun on Youtube: Youtube.com/theovverun Follow Jason Patton on Tiktok: @Firedepartmentchronicles Jason Patton is

Firefighter 52

Firefighter EMS ED 52

Medgadget

AUGUST 21, 2023

Researchers at the University of Leeds in the UK have developed a magnetic tentacle robot that is intended for use in minimally invasive medical procedures, such as the treatment of tumors in the lungs. The soft tentacles are made from silicone. They are unlikely to cause tissue damage, and contain a series of magnets that can be influenced by external magnetic robots.

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ACEP Now

AUGUST 22, 2023

More is not always better. This is notably true when it comes to the treatment of acute hyperkalemia. Emergent treatment of acute hyperkalemia is bread-and-butter emergency medicine. Many of us have order sets that simplify care: maybe calcium, an insulin shifter or two (intravenous [IV] insulin and/or inhaled beta-agonist), coupled with perhaps a diuretic and/or a potassium binder.

Emergency Department 52

Emergency Department ALS OR 52