ALiEM

OCTOBER 11, 2023

What is the most common primary cause of death from ingesting the pictured marine animal? Acute liver failure Acute renal failure Coagulopathy and DIC Respiratory failure Status epilepticus [Image from Canstockphoto] Reveal the Answer 4. Respiratory Failure The pufferfish, considered a delicacy in multiple countries, contains tetrodotoxin which causes sodium channel blockade and can lead to muscle paralysis, respiratory failure, and death.

E-9-1-1 204

E-9-1-1 ALS OR 204

American Ambulance Association

OCTOBER 9, 2023

CoAEMSP is Adding to its Site Visitor Cadre! Now Accepting Applications for Site Visitors The CoAEMSP is increasing its site visitor cadre and is seeking Paramedic educators and physicians to […] The post CoAEMSP Accepting Applications for Site Visitors appeared first on American Ambulance Association.

Ambulance 130

Ambulance Paramedic Emergency Medical Services 130

ACEP Now

OCTOBER 13, 2023

The CHRISTUS Health-Texas A&M Spohn Emergency Medicine Residency Program announced Friday that its program will close in June 2026 after the current emergency medicine residents complete their training. An official reason for the closure was not immediately available from the hospital administration, but residents there said they were told the surprise move was likely because of financial reasons.

ICU 132

ICU Emergency Department EMS 132

Critical Care Scenarios

OCTOBER 11, 2023

We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective. Find us on Patreon here! Buy your merch here! Takeaway lessons We explore aortic dissection with Travis Hughes, vascular surgery fellow from the University of Kentucky, including classification, medical management, and nuances of the surgical perspective.

Naloxone 100

Naloxone Coronary OR 100

REBEL EM

OCTOBER 11, 2023

Take Home Points: Patients with recent onset atrial fibrillation can safely be cardioverted if they are 1) on anticoagulation 2) Low risk based on CHADS-VASC with onset < 48 hours or 3) High risk based on CHADS-VASC with onset < 12 hours. In anaphylaxis, think, “If A, B or C, give E.” If the patient has compromise to airway, breathing or circulation, they should get immediate epinephrine.

Epinephrine 116

Epinephrine EMS OR 116

Don't Forget the Bubbles

OCTOBER 11, 2023

A curious young girl was playing with rare earth magnets and wondered what they would taste like. She has had no abdominal pain or vomiting, and her observations were normal. Imaging confirmed two spherical magnets stuck together in the stomach. When you review her later in the week, they appear to have moved. Abdominal X-ray AP 12 hours post-ingestion Lateral view 12 hours post-ingestion Abdominal X-ray 24 hours later showed no progression of magnets.

OR 116

OR 116

ACEP Now

OCTOBER 9, 2023

Each time she moved her hand it caught my eye: the glint of her bejeweled fingers sharply contrasting with the spare gurney and paper-thin blanket. The fat heaviness of her rings seemed startling against her bony fingers, as if they should have shrunk in parallel with her collagen and fat. She fought against the technician removing her belongings while her protestations melded with my trauma survey.

Heart Attack 126

Heart Attack Life Support Emergency Department Ambulance 126

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Imagine you just started your ED shift. It's a busy Friday afternoon. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician. All of the patients presented with chest pain , and they are all in triage. Which, if any, of these patients has OMI, with myocardium at risk and need for emergent PCI?

ED 109

ED Coronary OR 109

EMCrit Project

OCTOBER 13, 2023

Hello fellow nerds, let's take a look at the new American Association of Neurology (AAN) brain death guidelines. Instead of a tweetorial, I'll jot my thoughts here, so they're accessible to everyone. Disclaimer: the following discussion applies only to adult medicine. Most of these guidelines are consistent with the 2020 World Brain Death Project, so […] EMCrit Project by Josh Farkas.

110

110

EMergucate

OCTOBER 9, 2023

Question 1: We should consider ascending cholangitis in any patient with fever and features of obstructive jaundice till prove otherwise.

100

100

Medgadget

OCTOBER 11, 2023

Scientists at the University of Galway in Ireland and MIT have collaborated to create a soft robotic implant that can work to fight fibrotic encapsulation and deliver drugs despite the presence of fibrous scar tissue. The device, which the researchers have termed the FibroSensing Dynamic Soft Reservoir (FSDSR), is designed to reside in the body for extended periods and deliver drugs.

97

97

Dr. Smith's ECG Blog

OCTOBER 12, 2023

B elow are 4 ECGs from the same patient. Accompanying the ECGs is some clinical information. Look at the ECGs and consider the timeline and other information. At the bottom will be five alternative clinical scenarios to explain the findings. Which one do you think fits better with the ECGs and their timeline? The patient is a 60 something female. She was admitted to the hospital with clinical signs of infection.

Coronary 103

Coronary OR ED 103

EMCrit Project

OCTOBER 8, 2023

The first version of the first guideline in the foundational stabilization project - post-intubation sedation EMCrit Project by Scott Weingart, MD FCCM.

109

109

EMDocs

OCTOBER 9, 2023

Author: Michael J. Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado. His initial vital signs are 126/83 mmHg, heart rate of 104 beats per minute, respiratory rate of 32 breaths per minute, and saturation of 92% on room air.

ED 81

ED Life Support Advanced Life Support CPR 81

Medgadget

OCTOBER 11, 2023

Researchers at the University of Washington have developed a technique to make saliva collection for diagnostic purposes a little less disgusting and a little more fun and pleasant. Saliva collection often acts as a less invasive alternative than throat swabs in the detection of a variety of pathogens, such as that causing streptococcal soar throat (strep throat).

95

95

EMergucate

OCTOBER 9, 2023

22 year-old-girl from african origin presented with severe chest pain.

100

100

University of Maryland Department of Emergency Med

OCTOBER 13, 2023

This UK study randomized 90 trauma patients suspected of having major life threatening torso hemorrhage to receive standard resuscitative.

83

83

EMDocs

OCTOBER 11, 2023

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

ED 69

ED EMS OR 69

International Journal of Paramedicine

OCTOBER 12, 2023

Objectives Following the launch of its ‘Long Term Plan’ in 2019, the English National Health Service (NHS England) started piloting body worn cameras (BWCs) in ambulance services. The intervention rationale was that BWCs would act as a deterrent and facilitate the prosecution of assailants, thus improving the safety and wellbeing of ambulance crew. This paper explores views on the purpose and value of BWCs among ambulance crews and leadership staff who have used them or supported their implement

Ambulance 52

Ambulance OR 52

American Burn Association

OCTOBER 10, 2023

Categories Advocacy Burn News MAC Spotlight Media Member Services Organization News Prevention Quality Care Research Return to News & Activities Cleveland, OH — October 10, 2023 — The American Burn Association (ABA) will receive a generous donation from Cleveland Browns tight end, David Njoku, to raise awareness, resources, and support for burn-related care, prevention, education, and research.

52

52

University of Maryland Department of Emergency Med

OCTOBER 13, 2023

This large UK and US study looked at the addition of high dose cryoprecipitate to mass transfusion protocols and found: “Among pat.

74

74

This Podcast Will Kill You

OCTOBER 10, 2023

“Throbbing, pulsating pain.” “Like a drill boring into your head.” “As though your head is gripped by a vise.” “Stabbing pain hammering through your brain.” There is no shortage of metaphors used to describe the horrific, incapacitating pain of migraines. But try as we might, can any of them truly convey what it feels like to be at the mercy of such pain?

ALS 52

ALS OR 52

International Journal of Paramedicine

OCTOBER 12, 2023

Introduction: There has been increasing interest in utilizing EMS to address patient social determinants of health, which are thought to be the cause of many unnecessary transports, particularly for “superutilzing” patients. However, existing research is limited regarding EMS providers’ attitude toward addressing patient social needs and willingness to utilize potential interventions.

EMT 52

EMT EMT EMS Paramedic 52

ACEP Now

OCTOBER 10, 2023

Ethylene glycol (EG), also known as ethane-1,2-diol, with the molecular formula CH2OHCH2OH, is a colorless, odorless, water-soluble liquid commonly used as antifreeze fluid in automobile radiators, and remains an important cause of significant and sometimes fatal toxicity in the United States, with approximately 6,000 exposures and 20 deaths reported to poison centers in 2021. 1 After possible exposures, early diagnosis and treatment are critical for preventing morbidity and mortality.

ALS 52

ALS OR ED 52

University of Maryland Department of Emergency Med

OCTOBER 7, 2023

This article reminds us that using a small bore chest tube to drain traumatic hemothorax is supported by small studies and the Easterm So.

71

71

FOAMfrat

OCTOBER 8, 2023

"What is the difference between assist control and SIMV?" This is a question I would get all the time, or at least some variation of it. A while back, a colleague asked me this question to answer on the RSI podcast. But The RSI Podcast's purpose is short and to-the-point answers, and I didn't think I could adequately answer the question in a short time frame.

OR 52

OR ED Critical Care EMS 52

International Journal of Paramedicine

OCTOBER 12, 2023

Purpose: Workflow analysis is an important approach for understanding clinical care in complex systems. This is particularly true for low frequency events such as the care of children in the out-of-hospital setting. The purpose of this study was to characterize emergency medical service (EMS) workflow in the care of children during simulated emergency, prehospital encounters.

Emergency Medical Services 52

Emergency Medical Services EMS OR 52

Unitek EMT

OCTOBER 9, 2023

The Essential Role of EMTs and Vital Safety Insights. Emergency Medical Technicians (EMTs) play a critical role in the prehospital care of individuals facing medical emergencies. EMTs are often the first responders on the scene, providing initial medical assessment, treatment, and transportation to those in need. Their responsibilities encompass a wide range of emergencies, from […] The post 9 Most Common EMT Emergencies During the Winter appeared first on Unitek EMT.

EMT 52

EMT EMT Emergency Medical Technician First Responder 52

University of Maryland Department of Emergency Med

OCTOBER 10, 2023

Diverticular disease is a common condition, with 60% of individuals over age 80 and 30% of those over age 45 (!) having diverticula. Recent es.

64

64

Emergency Medicine Education

OCTOBER 12, 2023

A recent study by Savage et al., utilizing propensity score matching, revealed that children under 17 years of age diagnosed with acute sinusitis demonstrated no significant difference in the rate of treatment failure between those receiving amoxicillin and those receiving augmentin. However, it is worth noting that the latter group had a higher risk of experiencing adverse effects.

OR 40

OR ALS 40

International Journal of Paramedicine

OCTOBER 12, 2023

Aim: The aim of this study was to investigate whether the height of a stretcher is associated with the risk of tipping, and to examine strategies to prevent the tipping of a stretcher during transportation. Methods: This was a mechanical simulation study using Stryker’s Power-PRO ™ XT. The stretcher and manikin were placed on a board and the board was inclined at a gradient of approximately 1 degree per second.

EMS 52

EMS 52

EMS 20/20

OCTOBER 11, 2023

It might sounds crazy, but it ain't no lie. Spencer and Chris try to navigate what to do when a big mistake is made on a severe trauma patient. and it's not a mistake that is hard to make, either. It might sounds crazy, but it ain't no lie. Spencer and Chris try to navigate what to do when a big mistake is made on a severe trauma patient. and it's not a mistake that is hard to make, either.

40

40

University of Maryland Department of Emergency Med

OCTOBER 13, 2023

This excellent review article discussing damage control resuscitation in traumatically injured children highlights several points including: Click to view the rest

56

56

Emergency Medicine Education

OCTOBER 12, 2023

In a recent article published in the British Journal of Surgery, Jain et al. conducted a multicenter superiority randomized controlled trial (RCT) involving 451 children with nail bed injuries.

OR 40

OR ALS 40

Dr. Smith's ECG Blog

OCTOBER 13, 2023

This ECG was texted to me with no other information, with this quote: "You will see this in the Queen of Hearts." I assumed it was in real time. The Queen said "Not OMI with low confidence" What do you think? The conventional algorithm said: SINUS RHYTHM ABNORMAL QRS-T ANGLE [QRS-T AXIS DIFFERENCE > 60] ABNORMAL ECG This was my response: "I am not certain that I agree with the queen on this one.

STEMI 109

STEMI OR Coronary Emergency Department 109

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. Symptoms began just prior to presentation. Her blood pressure (BP) is 195/104 mmHg. The CT scan reveals a hemorrhage in the right internal capsule, suggestive of acute hypertensive hemorrhagic stroke. Should the BP be treated aggressively, what is the target, and how quickly should we achieve that target?

ALS 52

ALS Critical Care Emergency Department OR 52

University of Maryland Department of Emergency Med

OCTOBER 11, 2023

Background: It is estimated that nearly 6% of U.S. adults and children report having a food allergy.1,2 Epinephrine autoinjector.

Epinephrine 63

Epinephrine 63