Sat.Oct 07, 2023 - Fri.Oct 13, 2023

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ACMT Toxicology Visual Pearls: A Meal Worth Dying For

ALiEM

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.

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CoAEMSP Accepting Applications for Site Visitors

American Ambulance Association

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.

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Texas Residency Program Unexpectedly Announces Closure

ACEP Now

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.

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Episode 66: Aortic dissection with Travis Hughes

Critical Care Scenarios

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.

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The DEVICE trial: Not as convincing as you think?

First 10 EM

Is there anything emergency doctors love to debate more than airway? We have fancy new tools versus old school badassery. I sort of want to fit into both camps. I want to be the doc who has always succeeded with direct laryngoscopy, while also being young enough to adapt to new technology as it comes […] The post The DEVICE trial: Not as convincing as you think?

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PulmCrit Blogitorial – Why the new brain death guidelines are unacceptable

EMCrit Project

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.

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Traumatizing Patients with Trauma Activations

ACEP Now

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.

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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

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?

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EMCrit 359 – FoundStab Project – Foundational Stabilization Provisional Guideline for Post-Intubation Sedation

EMCrit Project

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

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Soft Implant Uses AI to Deliver Drugs Despite Fibrous Encapsulation

Medgadget

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.

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Systemic Steroids: An ED Focused Overview

EMDocs

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.

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What clinical scenario fits best?

Dr. Smith's ECG Blog

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.

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REBEL Core Cast 110.0 – On Shift Learning Pearls

REBEL EM

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.

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Lollipop Puts the Fun in Saliva Collection

Medgadget

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).

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Lab case 423

EMergucate

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

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Does REBOA improve survival in trauma patients?

University of Maryland Department of Emergency Med

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

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Tips for Working With Interpreters in the Emergency Department

ACEP Now

Clinical Case Your next patient is a Spanish-speaking 24-year-old female who begins by telling you that she is embarazada. Despite her bashfulness, you debate whether or not to call in the interpreter, since the waiting room is overflowing and between her broken English and your high-school Spanish you think you can get by without formal interpretation.

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NEW CSSP Call for Proposals now open! | NOUVEL appel de propositions pour le PCSS maintenant ouvert!

Paramedic Chiefs of Canada

Click here to download (PDF) Please see the call for proposals for funding available from the Defence Research Development Canada (DRDC), in conjunction with the Department of National Defense. As you can see below, DRDC is looking to develop several research micro-nets to advance the application of promising artificial intelligence (AI) and machine learning technologies to support first responders.

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Implementing Body Worn Cameras to Reduce Violence Against Ambulance Crew

International Journal of Paramedicine

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

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Does empiric high dose cryoprecipitate added to MHP improve survival?

University of Maryland Department of Emergency Med

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

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American Burn Association Receives Generous Support from NFL Player David Njoku

American Burn Association

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.

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Episode 126 Migraine: A Cacophony in Four Movements

This Podcast Will Kill You

“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?

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Social Needs in the Prehospital Setting (SNIPS)

International Journal of Paramedicine

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.

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Large bore vs small bore chest tube for traumatic hemothorax

University of Maryland Department of Emergency Med

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

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Toxicology Answer: An Illustrated Case of Ethylene Glycol, Direct and Indirect

ACEP Now

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.

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Difference Between CMV and SIMV

FOAMfrat

"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.

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Reasons for Calling EMS

International Journal of Paramedicine

Background: Frequent callers of emergency medical services comprise a disproportionate percentage of emergency department visits. This study aims to describe reasons for calling 911 and healthcare services among frequent callers in Ontario. Methods: Cross-sectional research design. A mailed self-administered survey was conducted. Participants were residents of an urban City in Canada, 18 years or older, and had called 911 at least 5 times in the past year.

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9 Most Common EMT Emergencies During the Winter

Unitek EMT

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.

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Goal-Oriented, Bundled Care For Intracerebral Hemorrhage Improves Outcomes

ACEP Now

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?

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Outpatient management of uncomplicated acute diverticulitis without antibiotics

University of Maryland Department of Emergency Med

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

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Examining Workflow for Simulated Pediatric Emergency Medical Services Care

International Journal of Paramedicine

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.

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Amoxicillin OR Augmentin for Pediatric Acute Sinusitis

Emergency Medicine Education

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.

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You're Tearing Up My Heart

EMS 20/20

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.

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Challenges of resuscitation in pediatric trauma

University of Maryland Department of Emergency Med

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

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Investigation of Strategies to Prevent Stretcher Tripping

International Journal of Paramedicine

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.

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Nail bed repair in with or without replacing the fingernail

Emergency Medicine Education

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.

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Medical Malpractice Insights: Dirt left in wound leads to infection

EMDocs

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.

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