Critical Care Scenarios

OCTOBER 30, 2024

We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making.

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177

ALiEM

NOVEMBER 1, 2024

A 67-year-old male with a past medical history of CHF, MI, hypertension, and diabetes presented to the ED with complaints of headache, chest pain, and dyspnea for the past four days. He stated that he has been without his medications for the past few months due to cost. He denied any past surgical history. He stated that he primarily presented because he felt like “my blood pressure is high” Additional Images Physical Exam Cardiovascular : Tachycardic, 2+ pedal edema bilaterally Re

ED 161

ED OR 161

Core EM

NOVEMBER 1, 2024

We review Sexually Transmitted Infections and pertinent updates in diagnosis and management. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: gynecology , Infectious Diseases , Urology Show Notes Table of Contents (1:49) Chlamydia (3:31) Gonorrhea (4:50) PID (6:14) Syphilis (8:08) Neurosyphilis (9:13) Tertiary Syphilis (10:06) Trichomoniasis (11:13) Herpes (12:49) HIV (14:10) PEP (15:13) Mycoplasma Genitalium (18:00) Take Home Points Chlamydia: Prevalence: M

OR 130

OR 130

American Ambulance Association

OCTOBER 29, 2024

The American Ambulance Association is proud to announce the winners of the 2024 AAA Legislative Awards. Each Member of Congress is being recognized for their strong advocacy for emergency medical […] The post 2024 AAA Legislative Awards appeared first on American Ambulance Association.

Ambulance 130

Ambulance ALS 130

EMergucate

OCTOBER 28, 2024

This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days. PH = 7.52, that is moderate alkalaemia. pCO2 = 21 mmHg. So, we have respiratory alkalosis.

130

130

ALiEM

OCTOBER 30, 2024

‘Dope’ is no longer heroin in an increasing number of our communities. The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2].

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

FirstNet Authority

OCTOBER 30, 2024

FirstNet Authority Welcomes New, Returning Board Members Press Releases michelle.fordi… Wed, 10/30/2024 - 13:08 The First Responder Network Authority (FirstNet Authority) is an independent authority within the U.S. Department of Commerce National Telecommunications and Information Administration. Established in 2012, the FirstNet Authority’s mission is to ensure the building, deployment, and operation of the nationwide broadband network that equips first responders to save lives and protect U.S.

First Responder 117

First Responder 117

EMergucate

OCTOBER 27, 2024

Today’s ECG is a 45yr male who presents to ED with a 12hr history of epigastric pain and diaphoresis. He is an ex smoker, no other cardiac risk factors.

ED 130

ED EMS 130

ALiEM

OCTOBER 28, 2024

A 2-year, 11-month-old female with a history of constipation was brought to the ED by her mother for abdominal pain. The mother noticed that the patient’s abdomen had been enlarging for months. When they visited the pediatrician several months ago, the pediatrician also noticed a mildly enlarged abdomen but the patient was asymptomatic at that time.

ED 161

ED OR 161

Life in the Fastlane

OCTOBER 30, 2024

Casey Parker and James Rippey Ultrasound Case 112 A 30 year old woman who is currently 30 weeks gestation presents to the ED with abrupt, severe right loin pain.

ED 110

ED 110

First 10 EM

OCTOBER 28, 2024

As with everything that comes out of the PECARN group, this is a huge study, and is therefore one that everyone needs to know about. That being said, despite working in two very busy community hospitals with a high percentage of pediatrics visits, c-spine injuries are just not an issue I struggle with. I have […] The post The PECARN c-spine rule could cause a lot of harm appeared first on First10EM.

EMS 107

EMS 107

EMergucate

OCTOBER 29, 2024

17-year-old boy with wrist fracture. This patient became blue during manipulation of the fracture under bier’s block anaesthetic effect.

130

130

The Curious Clinicians

NOVEMBER 1, 2024

How could you live with only one lung? The math seems simple. If you only have one lung, you only have 50% of your normal lung function, you can only get 50% of the normal amount of oxygen into your blood, and you’ll be dead in a few minutes. However, there are many patients who undergo pneumonectomies and not only survive, but don’t need supplemental oxygen and even can exercise.

ACS 97

ACS OR 97

St. Emlyn's

OCTOBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed This article reviews a recent study on the use of Tranexamic Acid (TXA) in traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH), focusing on prehospital care. The study, a subgroup analysis from the Prehospital TXA for TBI Trial, compared different TXA dosing regimens and found that a 2-g TXA bolus significantly reduced 28-day mortality compared to placebo.

OR 107

OR Critical Care 107

Dr. Smith's ECG Blog

OCTOBER 27, 2024

This was submitted by a paramedic, Hailey Kennedy A late 50s male called 911 following 2 hours of chest pain that started while working at his desk. He reported the crushing chest pain radiated down his left arm. Pt took an antacid with no relief and decided to call at the request of his wife. Here is his EMS ECG: What do you think? This was sent to me with no clinical information, and my initial impression viewing it on my phone was "It’s a tricky one.

STEMI 99

STEMI ED Coronary EMS 99

EMergucate

OCTOBER 29, 2024

The following chest x-ray is from an elderly patient with cough & dyspnoea.

EMS 130

EMS 130

EMDocs

OCTOBER 29, 2024

Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA), Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

E-9-1-1 87

E-9-1-1 ICU Epinephrine EMS 87

Pulsara

OCTOBER 30, 2024

OCTOBER RECAP As the weather cools down, birds begin their migration, and bears prepare for hibernation, you won't find our teams curled up waiting for spring to arrive—they've been hitting the road! In October, we exhibited at twelve shows traveling from New York to New Orleans. If you weren't able to connect with us this time around, don't worry! You'll have more opportunities to catch us before the year ends.

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72

Dr. Smith's ECG Blog

OCTOBER 30, 2024

Smith Introduction: Saddleback ST Elevation is often an OMI mimic, so one needs to scrutinize these ECGs!! Written by Magnus Nossen Below are ECGs from six different patients. All of the patients contacted EMS due to acute onset chest pain. Imagine you get these ECGs in real time and you are asked whether or not the cath lab should be activated? All ECGs in this case have saddleback ST elevation.

Coronary 83

Coronary EMS OR STEMI 83

St. Emlyn's

OCTOBER 30, 2024

St.Emlyn's - Emergency Medicine #FOAMed All the best from the blog from August 2024, in our easy to digest podcast. The post August 2024 Round-Up – Goldilocks Moments, Nasal Analgesia, and Public Health in the ED appeared first on St.Emlyn's.

ED 70

ED 70

SSCOR

OCTOBER 31, 2024

Chronic obstructive pulmonary disease (COPD) affects almost 12 million people in the United States. Though people of widely varying health profiles can develop this disorder, it is more common among people who smoke. Suctioning these patients demands skill and compassion. Here’s what you need to know about suctioning a patient with COPD.

59

59

REBEL EM

OCTOBER 30, 2024

Take Home Points Early diagnosis: erythema and warmth of the skin surrounding the umbilicus isn’t normal. Get labs, start abx and get the patient admitted Consult peds surgery on all of these patients as progression to nec fast, while uncommon, is devastating If the patient appears toxic or has systemic symptoms, the simply omphalitis has progressed and aggressive treatment including surgery is likely indicated REBEL Core Cast 130.0 – Omphalitis Click here for Direct Download of the Podcas

EMS 58

EMS OR 58

Dr. Smith's ECG Blog

OCTOBER 31, 2024

This case was sent by an old residency friend, Kirk Lufkin. He works in a small hospital in Northern Michigan. Case A 61 year old female. hypertension no other past history presented with 30 minutes of fluctuating non-radiating heaviness in chest, with diaphoresis and nausea. VS normal. No cardiac past history. Here is her ECG: What do you think? There are inferior hyperacute T-waves (diagnostic of inferior OMI), with 1) reciprocal ST depression in aVL, 2) a reciprocally inverted hyperacute T-wa

STEMI 77

STEMI Coronary 77

St. Emlyn's

OCTOBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed This article reviews a recent study on the use of Tranexamic Acid (TXA) in traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH), focusing on prehospital care. The study, a subgroup analysis from the Prehospital TXA for TBI Trial, compared different TXA dosing regimens and found that a 2-g TXA bolus significantly reduced 28-day mortality compared to placebo.

OR 72

OR Critical Care 72

ACEP Now

OCTOBER 29, 2024

On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? His vitals are fine…”. Seemingly unsure, she pauses, “I’m getting an interpreter, and I think he has belly pain, but something just doesn’t seem right.” Coming into triage, I see a young man—Georgian-speaking—bracing himself with a hand against the wall and holding his lower abdomen.

Emergency Department 59

Emergency Department ALS Emergency Medical Services OR 59

The Bottom Line

OCTOBER 26, 2024

Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury @fabio_taccone. JAMA. 2024. PMID: 39382241 Clinical Question In patients with acute brain injury, does a liberal, compared to a restrictive strategy of blood transfusion, improve neurological outcomes at 180 days?

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Clinical Correlations

NOVEMBER 1, 2024

By Chloe Fong Peer Reviewed The correlation between vitamin deficiency and alcohol use disorder (AUD) has been well documented in the literature, with a study from 1963 finding that 70% of patients admitted to the hospital.

52

52

NVFC

NOVEMBER 1, 2024

MSA Safety teamed up with the National Volunteer Fire Council (NVFC) to give away four MSA Cairns® 1836 Fire Helmets in 2024. The final entry period is now open. NVFC members who are active U.S. volunteer firefighters have until November 30 to enter. The MSA Cairns® 1836 Fire Helmet showcases the iconic traditional design with innovative features that address today’s fire service needs.

Firefighter 52

Firefighter First Responder EMS OR 52

The EMS Educator

OCTOBER 31, 2024

How should EMS educators expand their reach beyond the classroom? Prodigy's new Associate Medical Director of Pediatrics Sylvia Owusu-Ansah, MD, MPH, FAAP shares her profound dedication to public health education and CPR training in Pittsburgh’s community and beyond. Join hosts Rob Lawrence, Hilary Gates, and Maia Dorsett as they discuss Sylvia's live-saving training of University of Pittsburgh athletes to discussing her global initiatives, including her impactful work in Ghana.

Organ Donor 52

Organ Donor CPR Ambulance EMS 52

SSCOR

OCTOBER 26, 2024

With the advent of minimally invasive in-office procedures, patients are increasingly choosing sedation instead of general anesthesia. Sedation exists on a continuum, ranging from very mild sedation to deep sedation, but it is generally safer than anesthesia and requires a shorter recovery time. Patients also may require sedation in some emergency medicine scenarios.

59

59

EMOttawa

OCTOBER 28, 2024

Methodology: 4/5 Usefulness: 4/5 Geraghty LE, et al. N Engl J Med. 2024 May 30;390(20):1885-1894. doi: 10.1056/NEJMoa2402785. Question and Methods: Study aimed to determine if video laryngoscopy improves first-attempt intubation success in neonates compared to direct laryngoscopy through a randomized controlled trial. Findings: 74% first pass success with video laryngoscopy and 45% with direct laryngoscopy […] The post Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infa

ALS 56

ALS Critical Care 56

NHCPS Save a Life

OCTOBER 30, 2024

Basic Life Support, BLS, is a type of certification that shows you know what to do to help save someone’s life. Those who participate in this type of education and eventual certification have the tools they need to provide life-saving treatment to people who are often in critical parts of their lives. Those who obtain […] The post BLS Renewal Guide: Key Steps to Maintain Your Certification appeared first on SaveaLife.com.

BLS 52

BLS Life Support 52

FirstNet Authority

OCTOBER 30, 2024

CEO, NetAesthetics Rasheid Scarlett brings over 25 years of telecommunications and network infrastructure expertise to the FirstNet Authority Board. His extensive experience in mission-critical communications and proven track record of implementing innovative technology solutions make him uniquely qualified to help shape the future of public safety communications.

Public Safety 52

Public Safety 52

ACEP Now

OCTOBER 29, 2024

Our patient is a 33-year-old male with spastic quadriparesis due to cerebral palsy with chronic indwelling suprapubic catheter (SPC) who presented to the emergency department (ED) due to concern for Foley catheter obstruction. The patients’ mother has attempted to flush the SPC multiple times unsuccessfully at home. The catheter was reportedly due for an exchange the following week.

ED 52

ED Emergency Department OR 52

This Podcast Will Kill You

OCTOBER 29, 2024

When the Massachusetts Institute of Technology admitted in 1999 that they had discriminated against women on its faculty, it sent shockwaves throughout institutions of higher learning across the country. In this TPWKY book club episode, Pulitzer Prize-winning journalist Kate Zernike joins us to discuss her book The Exceptions: Nancy Hopkins, MIT, and the Fight for Women in Science , which details the sequence of events that led sixteen scientists to demand the equality that had been denied to th

52

52

FOAMfrat

OCTOBER 28, 2024

In this episode of FOAMfrat, Tyler speaks with paramedic Kyle Rice to discuss a deeply personal and eye-opening experience—rolling his ambulance after running a red light. Kyle shares the lessons he learned about complacency, crew resource management, and the often-overlooked dangers of driving with lights and sirens. Together, they explore how EMS providers can stay vigilant behind the wheel, adopt safer driving practices, and shift their mindset when responding to emergencies.

Ambulance 52

Ambulance Paramedic EMS 52

First Responders Wellness Center

OCTOBER 27, 2024

Too often I see first responders who are not checked for a concussion at an emergency after a OIS, traffic crash or fall. Please start demanding to have all first responders checked for this when at the hospital. Here is a new easy way to be checked. New testing options could change the way concussions are assessed, and that could have big implications for the future.

First Responder 52

First Responder OR 52