Emergency Medicine Cases

OCTOBER 17, 2023

In this month's EM Quick Hits podcast: Sarah Reid on an approach to Infant Vomiting, Brit Long on Orbital Cellulitis essentials, Justin Morgenstern on the PATCH trial - Prehospital TXA in Trauma, Christina Shenvi on Prevention and Treatment of Delirium, Jason Hines on Procedural Skills Decay, Aaron Billin on Altitude Sickness. The post EM Quick Hits 52 Infant Vomiting, Orbital Cellulitis, Prehospital TXA in Trauma, Prevention and Treatment of Delirium, Procedural Skills Decay, Altitude Sickness

EMS 235

EMS 235

The Skeptics' Guide to EM

OCTOBER 14, 2023

Reference: Brennan L et al. Time to change the reference ranges of children’s physiological observations in emergency care? A prospective study. J Paediatr Child Health. March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom. She is also a member […] The post SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs first appeared on The Skeptics Guide to Emergency Medicine.

Life Support 221

Life Support Advanced Life Support Emergency Department ALS 221

ALiEM

OCTOBER 14, 2023

Welcome to the AIR Respiratory Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. 6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

American Ambulance Association

OCTOBER 17, 2023

Highlighting Key Commitments to Diversity, Equity, Inclusion and Accessibility With this reinforced dedication, FICEMS can better achieve and enhance the EMS mission for all persons. FICEMS’ newly released Diversity, Equity, […] The post FICEMS DEIA Statement Now Available appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

Emergency Medicine Cases

OCTOBER 17, 2023

In this ECG Cases blog Dr. Jesse McLaren guides us through 10 cases, driving home the points that sepsis is a common cause of rapid Afib and diffuse ST depression with reciprocal ST elevation in aVR, myo/pericarditis is a diagnosis of exclusion, endocarditis or lyme carditis can cause AV block, PE can cause low grade fever and ECG signs of acute RV strain and that fever can unmask Brugada syndrome.

OR 229

OR STEMI EMS 229

The Bottom Line

OCTOBER 18, 2023

In patients with trauma and critical bleeding who require activation of a major haemorrhage protocol, does the empiric administration of 3 pools of cryoprecipitate (6g fibrinogen) within 90 minutes of randomisation (and no more than 3 hours after injury) improve survival, compared to standard care?

140

140

ALiEM

OCTOBER 20, 2023

A 50-year-old Caucasian female with a history of hypertension, coronary artery disease, and insulin-dependent diabetes mellitus presents to the emergency department with a complaint of painful sores on the top of her left foot. She notes that ulcerations have formed over the past two weeks and reports a history of multiple recurrent usually non-tender skin lesions to her lower extremities, forearms, and hands over the past twenty years.

Plasma 161

Plasma Coronary Emergency Department OR 161

Dr. Smith's ECG Blog

OCTOBER 18, 2023

Written by Jesse McLaren Four patients presented with chest pain. All initial ECGs were labeled ‘normal’ or ‘otherwise normal’ by the computer interpretation, and below are the ECGs with the final cardiology interpretation. If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation?

STEMI 118

STEMI Emergency Department Coronary OR 118

Critical Care Scenarios

OCTOBER 18, 2023

The value of being curious about practice differences, not judgmental. The value of being curious about practice differences, not judgmental.

100

100

ALiEM

OCTOBER 16, 2023

An otherwise healthy 34-year-old male presented to the Emergency Department with two weeks of anterior neck pain. Symptoms began with several days of pain in his mandibular molars, progressing to pain and swelling in the neck. In the last several days, the patient developed warmth and redness in the chest wall associated with subjective fever and chills.

Emergency Department 152

Emergency Department OR 152

American Ambulance Association

OCTOBER 14, 2023

The Prehospital Guidelines Consortium is collaborating with the National Registry of EMTs to continually identify current scientific literature to incorporate into certification activities. We seek input from the EMS community […] The post Prehospital Guidelines Consortium | EMS Research Reading List Submissions appeared first on American Ambulance Association.

EMS 130

EMS EMT EMT Ambulance 130

Dr. Smith's ECG Blog

OCTOBER 18, 2023

The patient is a 20 something female. She is healthy with no known cardiac disease. She was admitted to the neurology department due to headache and vomiting. She was found to have a viral CNS infection. A few days into her hospital stay she developed chest discomfort and the following ECG was recorded. What do you think? Why such large T-waves? Are these hyperacute T-waves?

Defibrillator 105

Defibrillator Advanced Life Support Coronary Life Support 105

Medgadget

OCTOBER 19, 2023

Researchers at Northwestern University have developed a sensor that can monitor transplanted organs for signs of rejection. Patients who receive transplants require immunosuppressive medication to ensure that their body does not reject the transplanted tissue, but this can still happen, sometimes years after the initial transplant. Current methods to monitor for immune rejection involve taking biopsies or monitoring blood markers, but these techniques are invasive and blood markers may not show

OR 94

OR 94

First 10 EM

OCTOBER 15, 2023

In the massive hemorrhage deep dive, I mentioned that there were a number of large trials in the works that would further define practice. One of those trials – CRYOSTAT-2 – was just published, and adds important information about the role of empiric fibrinogen administration (in the form of cryoprecipitate) in trauma patients. The paper […] The post CRYOSTAT-2: Empiric cryoprecipitate in traumatic massive hemorrhage appeared first on First10EM.

EMS 96

EMS 96

American Ambulance Association

OCTOBER 14, 2023

In honor of Pedestrian Safety Month throughout October, the U.S. Department of Transportation Office of the Secretary will host a webinar to highlight USDOT and National Roadway Safety Strategy Allies in […] The post 10/23 | US DOT Allies in Action Pedestrian Safety Month Webinar appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

Dr. Smith's ECG Blog

OCTOBER 15, 2023

Submitted by anonymous, written by Pendell Meyers I was at triage when this ECG was presented to me. What do you think? Here's what the Queen of Hearts thinks: Note that the Queen has "HIGH" confidence that this is OMI. As noticed by the AI, if the patient presented with chest pain , then even this subtle ECG is diagnostic of OMI. Specifically , this ECG is diagnostic of acute LAD OMI, with hyperacute T waves likely in V3 and V4, very small but abnormal STE in V2-V4 (because of its there is a lo

ACS 101

ACS ED STEMI OR 101

Medgadget

OCTOBER 19, 2023

Scientists at Purdue University have developed a microRNA therapy designed to slow tumor growth. The technology takes advantage of the tendency of several cancer types to express an excess of surface receptors that bind folate (vitamin B9) and draw it into the cell interior. By attaching the microRNA strand to a folate molecule, the researchers could target it to cancer cells.

OR 91

OR 91

Don't Forget the Bubbles

OCTOBER 19, 2023

Dani gave this talk at the Irish Association of Emergency Medicine Annual Scientific Conference in October 2023 Once upon a time, there were two beautiful people, Barbie and Ken. Through the play and make-believe of many children, they enjoyed a romance spanning many decades. Sure, they had their ups and downs (what couple doesn’t?), but after more than 40 years of courtship, Ken proposed to Barbie.

E-9-1-1 81

E-9-1-1 ED OR Emergency Department 81

EMergucate

OCTOBER 17, 2023

19 year-old-man recently returned from Sudan presented with fever.

100

100

ACEP Now

OCTOBER 15, 2023

The treatment of diabetic ketoacidosis (DKA) is, in many ways, unchanged: intravenous fluids, electrolyte repletion, insulin, and treatment of any precipitating factors. However, as with many treatments, there has been substantial de-escalation in intensity of therapy over time. Historically, patients were given a bolus of intravenous insulin followed by an insulin infusion.

ICU 104

ICU ALS ED Emergency Department 104

Medgadget

OCTOBER 19, 2023

Researchers at the University of Cincinnati have developed a lateral flow assay that can detect bacterial toxins from Porphyromonas gingivalis , the causative bacteria for gingivitis. The technology could make it easier and faster to identify early-stage gingivitis, which can lead to periodontitis and eventual tooth loss, as well as contributing to a variety of other diseases such as stroke and heart disease.

OR 85

OR 85

The Bottom Line

OCTOBER 19, 2023

What’s new in the Critical Care literature – monthly updates

Critical Care 114

Critical Care 114

EMergucate

OCTOBER 17, 2023

Hb = 83 g/L, that is moderate anaemia.

OR 100

OR 100

EMDocs

OCTOBER 14, 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: What’s the BEST Target SBP Post-Embolectomy for Stroke? Spoon Feed More aggressive systolic blood pressure (SBP) goals, beyond keeping it <180 mmHg, probably don’t make much of a difference in outcomes for patie

OR 63

OR 63

Medgadget

OCTOBER 19, 2023

Researchers at the University of Bath in the United Kingdom have developed a shape-shifting ball that can inflate and deflate in response to someone’s breath. The idea is an advancement of many techniques designed to help people de-stress and manage their mental health, which all focus on awareness of the breath. For instance, mindfulness meditation often requires people to focus on their own breath, which can help to reduce anxiety and stress, but maintaining this focus is difficult.

OR 80

OR 80

University of Maryland Department of Emergency Med

OCTOBER 17, 2023

The typical bag valve mask ventilator (BVM) for adults has a reservoir volume between 1500-2000 mL depending on the manufacturer while th.

Ambulance 76

Ambulance 76

Dr. Smith's ECG Blog

OCTOBER 16, 2023

This is a case I posted Saturday, October 14. This ECG was texted to me after the fact with no information. What do you think? This is the ECG that I used for the post. It is high quality screenshot of a pdf: I had said that the Queen said this is Not OMI with low confidence However , the image that had been texted to me and submitted to the Queen was not this one above.

OR 58

OR 58

FOAMfrat

OCTOBER 20, 2023

Previously, I wrote a blog on pre-oxygenation, referencing my personal “weapon of choice” as chosen from the 7 Ps of RSI. I discuss that pre-oxygenation, to me, is ONE of the most important Ps of the 7, also mentioning physiologic optimization as a same-tier choice. But, putting them both into one blog would make for a read far too long to maintain even my attention span (which honestly is pretty short).

E-9-1-1 52

E-9-1-1 ALS ACS OR 52

Medgadget

OCTOBER 17, 2023

Arsenal Medical , a medtech company based in Massachusetts, has developed Neocast , an embolic biomaterial designed for catheter-mediated embolization procedures. Conventional materials for embolization can have several limitations, including a lack of radiopacity, catheter clogging, catheter entrapment at the delivery site, solvent-mediated pain at the delivery site, and they can even cause sparking of electrocautery tools.

OR 69

OR 69

The Curious Clinicians

OCTOBER 19, 2023

Why can a ketogenic diet help control seizures in epilepsy? Many forms of dietary therapy make intuitive sense. 18th-century sailors with scurvy were treated with lime juice and other sources of the missing vitamin C. Patients with diabetes mellitus are counseled to avoid foods with a high glycemic index. And those with chylothoraces, where a chylous (fatty fluid) leak into the pleural space causes an effusion, are told to consume low-fat diets to reduce chyle flow and help prevent fluid from re

ACS 52

ACS OR 52

Unitek EMT

OCTOBER 18, 2023

The importance of reading books in the pursuit of excellence as an EMT. Reading plays a pivotal role in the professional development of Emergency Medical Technicians (EMTs) due to its significant impact on their knowledge, skills, and empathetic understanding of patients. EMTs are entrusted with providing immediate medical care in critical situations, necessitating a comprehensive […] The post 25 Books Every EMT Should Read appeared first on Unitek EMT.

EMT 52

EMT EMT Emergency Medical Technician EMS 52

FOAMcast

OCTOBER 17, 2023

Apple Podcasts , Spotify , Listen Here Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive way of providing resuscitative aortic occlusion in severe hemorrhage to gain temporary hemorrhage control as a bridge to definitive procedures. Despite initial enthusiasm for widespread use, there are minimal data suggesting significant mortality benefit.

ACS 52

ACS ALS OR 52

CanadiEM

OCTOBER 17, 2023

Infective endocarditis refers to an infection (i.e., bacteria such as Strep, Staph or fungal) that seeds onto the endocardial surface of valves.​1​ The mortality rate of endocarditis is 25%.​2​ Systemic complications include septic embolization and can result in end-organ damage. Although native heart valves are the most commonly affected, prosthetic heart valves, heart valve disease, congenital heart disease, previous history of endocarditis and IV drug use are risk factors for endocarditis and

OR 52

OR 52

Emergency Medicine Ireland

OCTOBER 16, 2023

Welcome back to the tasty morsels of critical care podcast. Today we’re going to verge into challenging territory for an audio podcast in that we’re going to the discuss the very visual topic of dynamic LV outflow tract obstruction. This is something fairly dependent on echocardiography for diagnosis which as you can imagine translates poorly to audio format.

Critical Care 52

Critical Care ICU OR ALS 52

Unitek EMT

OCTOBER 16, 2023

Learn how EMTs address the symptoms associated with common summer emergencies. Emergency Medical Technicians (EMTs) stand as frontline responders in the realm of healthcare, offering a pivotal role in addressing a spectrum of emergencies. Their expertise and immediate response capabilities can make a significant difference in preserving lives and reducing the severity of injuries.

EMT 52

EMT EMT Emergency Medical Technician EMS 52

ACEP Now

OCTOBER 15, 2023

There is no shortage of evidence regarding the harms of opiate use and misuse. With this in mind, prescriptions for opiates have been dropping in the United States, but were still dispensed at a rate of 43.4 prescriptions annually per 100 persons in 2020. 1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations.

Emergency Department 52

Emergency Department Naloxone ALS OR 52

University of Maryland Department of Emergency Med

OCTOBER 16, 2023

Settings: Retrospective study of a national inpatient database (Japan). Participants: All patients who were admitted between.

70

70