The Skeptics' Guide to EM

FEBRUARY 11, 2024

Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. EMJ Nov 2023. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Sy

ED 301

ED Emergency Department ALS OR 301

Emergency Medicine Cases

FEBRUARY 13, 2024

In this month's ECG Cases blog Dr. Jesse McLaren reviews interpretation of the pre-arrest ECG: identifying high risk ECGs requiring empiric treatment like calcium for hyperkalemia, magnesium for long QT, or reperfusion for Occlusion MI; the intra-arrest ECG: identifying pseudo-PEA; and post-arrest ECG: the importance of serial ECGs to reduce false positive STEMI, role of POCUS to help with the differential of diffuse ST depression with reciprocal ST elevation in aVR, and identifying signs of Occ

STEMI 273

STEMI OR EMS 273

ALiEM

FEBRUARY 16, 2024

An 86-year-old man with a past medical history of coronary artery disease, hypertension, hyperlipidemia, chronic kidney disease, COPD, choledocholithiasis requiring ERCP and sphincterotomy 2 years ago presented with five days of feeling unwell. History was limited due to cognitive impairment. His daughter had reported to staff he had been feeling unwell for five days, intermittently having nausea and generalized abdominal pain, subjective fevers, chest pain, and shortness of breath.

Coronary 161

Coronary OR 161

American Ambulance Association

FEBRUARY 13, 2024

AAA President Randy Strozyk will testify tomorrow, February 14, at 10:00 am (eastern) before the Health Subcommittee of the Energy and Commerce Committee of the U.S. House of Representatives. The […] The post AAA President Strozyk to Testify Before Congressional Committee appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

Critical Care Scenarios

FEBRUARY 14, 2024

A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation. Thanks to Pat Posa, Martha Roberts, Juliana Barr, Kelly Drumright, and Ben Lassow for their input. Resources A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation.

ICU 136

ICU Critical Care 136

Emergency Medicine Cases

FEBRUARY 13, 2024

In order fix EM, each of us needs to understand systems issues and systems thinking, and advocate for a better system based on sound systems principles and specific solutions. In this main episode EM Cases podcast Anton is joined by Dr. Alecs Chochinov and Dr. Davie Petrie, two systems thinkers and leaders in EM. They discuss solutions for how to fix EM in 5 spheres: having a coordinated mission, optimizing access points, accountability, disaster preparedness and adaptation/evolution.

EMS 198

EMS ED 198

NVFC

FEBRUARY 13, 2024

On December 21, the Occupational Safety and Health Administration (OSHA) announced that it will issue a Notice of Proposed Rulemaking (NPRM) to modernize the agency’s “Fire Brigades” standard. This standard was first published and last updated in 1980. This proposed updated standard would issue several new requirements that would be very burdensome, and in many cases impossible, for volunteer fire departments to comply with.

Emergency Response 131

Emergency Response 131

EMOttawa

FEBRUARY 15, 2024

We’re increasingly cognizant of the physiological importance of maintaining specific hemodynamics during resuscitation. Practice patterns vary broadly, so we’ve done a deep dive into the various evidence around the use of ketamine and etomidate in specific clinical scenarios. Physiology of the rapid sequence intubation Rapid sequence intubation (RSI) is the nearly simultaneous administration […] The post Ketamine and Etimodate: Into the Void appeared first on EMOttawa Blog.

125

125

Dr. Smith's ECG Blog

FEBRUARY 16, 2024

Written by Pendell Meyers A teenager was playing basketball when he suddenly developed palpitations and lightheadedness. He presented soon afterward at the Emergency Department with ongoing symptoms. Mentation and blood pressure were normal. He had no chest pain or shortness of breath. Heart rates on the monitor fluctuated from 180-250 bpm. Here is his triage ECG: What do you think?

Emergency Department 127

Emergency Department OR 127

NVFC

FEBRUARY 13, 2024

The application period for the FY 2023 Assistance to Firefighters Grant (AFG) is now open. These grants provide funding to fire departments for needed resources such as equipment, gear, vehicles, and training. The Notice of Funding Opportunity, guidance documents, and other materials are available on the AFG web site. In addition, FEMA is hosting a series of Q&A sessions over the next month to provide applicants an opportunity to interact with AFG staff and ask questions about the program, t

Firefighter 122

Firefighter 122

This Podcast Will Kill You

FEBRUARY 13, 2024

For our season 6 finale, we’re spending some time with menopause. How many nicknames can you think of for menstruation? Quite a few, I’m sure. “That time of the month”, “Aunt Flo”, “the red wave”, “period”, the list goes on. But what about euphemisms for menopause? We’ve got “the change” or “change of life”, “climacteric”, and… that’s it? There may be more out there, but the comparison is revealing.

ALS 98

ALS OR 98

EMT Training Station

FEBRUARY 11, 2024

In the realm of emergency healthcare, the terms EMS (Emergency Medical Services) and EMT (Emergency Medical Technician) are often used interchangeably, yet they represent distinct aspects of medical response and care. This article aims to demystify these acronyms, shedding light on their unique roles within the healthcare system. Understanding the difference between EMS and EMT is not just a matter of semantics; it’s crucial for appreciating the depth and breadth of emergency medical servi

EMT 98

EMT EMT Emergency Medical Technician Emergency Medical Services 98

FirstNet Authority

FEBRUARY 13, 2024

FirstNet Authority, AT&T Announce 10-Year Investment to Transform America’s Public Safety Broadband Network Press Releases michelle.fordi… Tue, 02/13/2024 - 06:51 About the First Responder Network Authority The First Responder Network Authority (FirstNet Authority) is an independent authority within the U.S. Department of Commerce. Created in 2012, its mission is to ensure the building, deployment, and operation of the nationwide broadband network that equips first responders to save lives and p

Public Safety 102

Public Safety First Responder 102

NVFC

FEBRUARY 13, 2024

Has your department received much-needed funding for equipment or recruitment from the Assistance to Firefighters Grants (AFG) and Staffing for Adequate Fire and Emergency Response (SAFER) grants? These critical fire service grants are in danger – if Congress does not act, AFG and SAFER grants will cease to exist on September 30. We need your help. Rep.

Firefighter 116

Firefighter Emergency Response OR 116

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Louis); Marina Boushra, MD (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case Emergency Medical Services brings in a 62-year-old male with COPD in acute on chronic hypoxemic respiratory failure (usually on 3 L nasal cannula, now o

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

EMT Training Station

FEBRUARY 11, 2024

In the world of emergency medical services, encountering victims of electrical burns presents a unique set of challenges. As a veteran emergency medical technician (EMT), I’ve seen firsthand the critical importance of prompt and effective prehospital care in these situations. Electrical burns, often invisible yet dangerously profound, require a nuanced approach combining swift action with a deep understanding of their complex nature.

EMT 98

EMT EMT Emergency Medical Technician First Aid 98

SSCOR

FEBRUARY 10, 2024

Airway obstructions are common and potentially lethal emergencies, especially among vulnerable populations such as children and geriatrics. Obstruction from a foreign body is the most common airway obstruction in young children. Among geriatrics, obstructive airway diseases, dysphagia, and aspiration are more prevalent. The odds of airway obstruction increase with age.

EMS 93

EMS 93

First 10 EM

FEBRUARY 12, 2024

Usually, I reserve stand alone blog posts for high quality papers. Usually, garbage science is either ignored, or reserved for brief mentions in the Research Roundups. However, the conclusion of this paper, which states “it is becoming increasingly difficult to justify not making MRI a mandatory part of the clinical assessment of [first episode psychosis]”, […] The post No, you don’t need to order an MRI in first episode psychosis appeared first on First10EM.

OR 91

OR EMS 91

EMDocs

FEBRUARY 15, 2024

Authors: Angela Pikus, MD Emergency Medicine Resident, Atrium Health’s Carolinas Medical Center); Christine Murphy, MD (Emergency Medicine Attending, Medical Toxicologist, Atrium Health’s Carolinas Medical Center) // Reviewed by: Anthony Spadaro, MD (@TSpadaro91, Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK); Brit

E-9-1-1 89

E-9-1-1 Overdose ED OR 89

EMT Training Station

FEBRUARY 10, 2024

Imagine being the person who answers the call in the darkest hours – that’s what Emergency Medical Technicians (EMTs) do every day. They’re not just employees in the healthcare system; they’re life-savers, comfort-givers, and community heroes. We are going to look at 15 reasons why you should consider a career as an EMT. You might be surprised at where this exciting career path can take you. 1.

EMT 98

EMT EMT Emergency Medical Technician First Responder 98

Unitek EMT

FEBRUARY 12, 2024

Tactical Emergency Medical Support (TEMS) providers play a pivotal role in ensuring the well-being of individuals engaged in high-risk and tactical environments where law enforcement and military operations take place. TEMS providers shoulder a range of unique responsibilities and confront distinct challenges in their demanding roles. Frequently, they are the initial medical responders on the […] The post How to Become a Tactical EMT (TEMS) appeared first on Unitek EMT.

EMT 90

EMT EMT EMS 90

FOAMcast

FEBRUARY 16, 2024

Apple Podcasts , Spotify , Listen Here In this episode, we review a new consensus guideline from the American College of Emergency Physicians (initially developed with the American Academy of Ophthalmology) on the use of topical anesthetics in corneal abrasions.

81

81

Pulsara

FEBRUARY 14, 2024

On any given day, healthcare providers interact with many forms of technology. Communication apps, EHRs, ePCRs, patient portals, and digital health trackers are just a few of the types of technology designed to make life easier for clinicians. From fostering better communication to digitizing patient information, mobile technology platforms are intended to help medical professionals in a number of areas.

81

81

Dr. Smith's ECG Blog

FEBRUARY 12, 2024

A 60-something complained of vomiting, diarrhea overnight, and "bubbles in my chest" that started just prior to calling 911. He had this ECG recorded prehospital: Smith interpretation: There are hyperacute T-waves in III and aVF, and reciprocal STD in aVL with a reciprocally inverted T-wave in aVL. There are also hyperacute T-waves in V3 and V4. There is STD in V1 and V2.

CAD 83

CAD ED OR Coronary 83

SSCOR

FEBRUARY 15, 2024

In the event of a pandemic or other health emergency, hospital emergency departments and intensive care units can become overwhelmed. Doctors, nurses, and medical personnel are being asked to go above and beyond to protect patients — and to do it quickly.

Emergency Department 59

Emergency Department OR 59

FirstNet Authority

FEBRUARY 15, 2024

Versatile FirstNet deployables for any scenario Blog joseph.rey@fir… Thu, 02/15/2024 - 09:23 By Harry Markley, Senior Public Safety Advisor, First Responder Network Authority Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters.

Public Safety 59

Public Safety First Responder OR 59

Don't Forget the Bubbles

FEBRUARY 12, 2024

It’s a classic presentation. Your patient is a toddler with a sticky red eye that – despite their parent’s best efforts to pull their hands away from their face – they cannot help but rub. Their parent is asking you if it’s contagious and if they need antibiotics. Conjunctivitis: An overview Conjunctivitis, inflammation of the conjunctiva, is characterised by infection or inflammation of the conjunctiva.

OR 59

OR 59

Dr. Smith's ECG Blog

FEBRUARY 11, 2024

This was a patient with chest pain. The ECG was faxed to a cardiologist. But it was very difficult for him to see. He showed this to me the next day.

63

63

Stem EMS

FEBRUARY 16, 2024

In the midst of an acute and pressing emergency, the German health emergency system faces a critical juncture. With staff and ambulance shortages pressing on the entire system, the country […] L'articolo The German Health Emergency: Staff Shortage and Increased Calls Jeopardize Patient Safety proviene da Stem Ems.

Ambulance 52

Ambulance EMS 52

FirstNet Authority

FEBRUARY 16, 2024

FirstNet and the Future of Public Safety Broadband joseph.rey@fir… Fri, 02/16/2024 - 09:40 FirstNet now operates in every state and territory, and the FirstNet Authority is continuing to evolve, enhance, and expand the network — meeting public safety’s needs every day and for every emergency. Learn more at FirstNet.gov/history.

Public Safety 52

Public Safety 52

Don't Forget the Bubbles

FEBRUARY 12, 2024

It’s a classic presentation. Your patient is a toddler with a sticky red eye that – despite their parent’s best efforts to pull their hands away from their face – they cannot help but rub. Their parent is asking you if it’s contagious and if they need antibiotics. Conjunctivitis: An overview Conjunctivitis, inflammation of the conjunctiva, is characterised by infection or inflammation of the conjunctiva.

OR 59

OR 59

Paramedics World

FEBRUARY 15, 2024

In the journey of healing and remembrance, planting a memorial tree stands out as a profound and touching gesture. This tradition, rooted in various cultures worldwide, uniquely honors the memory… The post Planting Peace: How Memorial Trees Help Process Loss appeared first on Paramedics World.

Paramedic 52

Paramedic 52

ACEP Now

FEBRUARY 15, 2024

Answer: The correct answer is necrotizing fasciitis (b). Necrotizing fasciitis is a deep and often devastating bacterial infection that tracks along fascial planes and expands well beyond any outward cutaneous signs of infection. Necrotizing fasciitis can occur without a clear portal of entry, although predisposing risk factors include major penetrating trauma (e.g., crush injury, deep penetrating wound), minor non-penetrating trauma (e.g., muscle strain, sprain, or contusion), and breaches in t

OR 52

OR 52

REBEL EM

FEBRUARY 12, 2024

Bottom Line Up Top: In selective patients presenting with flank pain, we can diagnose renal colic without a CT scan. There is also a subset of patients that would benefit from IV contrast enhanced CT scanning. Clinical Scenario: A 35-year-old man with no PMH presents with left flank pain, hematuria and history of kidney stones. His vitals are: HR 90, BP 150/90, Temp 98, O2 Sat 99% on RA, RR 18.

Emergency Department 58

Emergency Department ALS ACS EMS 58

NVFC

FEBRUARY 13, 2024

Junior firefighter programs allow youth to learn about local fire/EMS organizations while providing departments with nonoperational support and a powerful recruitment mechanism. Learn how your department can engage with local youth, schools, and other organizations to promote youth fire service programs at this Roundtable Talk on 2/21 at 2pm ET. Watch live on Facebook or register on Zoom.

Firefighter 52

Firefighter EMS OR 52

First Responders Foundation

FEBRUARY 12, 2024

In Omaha, Nebraska, where the weather can swiftly shift from peaceful to perilous, the importance of emergency preparedness cannot be overstated. From the tornadoes that sweep through the plains to the icy storms of winter, Omaha’s diverse climate presents unique challenges that necessitate a tailored approach to emergency planning and response. In this guide, we provide tips on how Omaha and its surrounding communities can enhance their readiness for emergencies, ensuring the safety and resilie

First Responder 52

First Responder First Aid Public Safety Emergency Response 52

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. On ED presentation, he was experiencing 10 out of 10 pain level. Physical examination was notable for left lower extremity with foreshortening and external rotation. A radiograph is shown (see figure 1). Problem How should his pain be managed? LEARN MORE The most common nerve blocks in this study are shown in Table 1.

E-9-1-1 52

E-9-1-1 Emergency Department ED ALS 52