ALiEM
FEBRUARY 9, 2024
How do we best use high-sensitivity cardiac troponin (hs-cTn) to risk stratify patients with symptoms concerning for an acute myocardial infarction (AMI)? The 2022 American College of Cardiology (ACC) pathway provides timely guidance [1]. We help you translate this to your clinical practice, by illustrating with a case. Time to know your hs-cTn better.
American Ambulance Association
FEBRUARY 8, 2024
This content is for AAA members only. Please either Log In or Join! The post OHSA Notice of Proposed Rule Making (NPRM) Emergency Response Standard appeared first on American Ambulance Association.
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The Skeptics' Guide to EM
FEBRUARY 3, 2024
Reference: Curry SD, et al. Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma. Laryngoscope. March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. She is also the director of the Pediatric Otolaryngology […] The post SGEM #429: It’s CT Angio, Hi.
EMergucate
FEBRUARY 4, 2024
A police recruit doing a 20 km pack hike. Collapsed. GCS on arrival was 7. His temperature was 39.2 on arrival. His venous blood gases showed the following: PH = 7.
ALiEM
FEBRUARY 5, 2024
Welcome to the AIR Toxicology 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 toxicology in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board.
American Ambulance Association
FEBRUARY 7, 2024
Dear Ground Ambulance Providers and Suppliers, Starting January 1, 2024, selected ground ambulance organizations in Year 3 and Year 4 are required to report cost, utilization, revenue, and other information to CMS. Organizations that […] The post CMS Updates GADCS User Guide | Feb 29 Office Hours appeared first on American Ambulance Association.
Critical Care Scenarios
FEBRUARY 7, 2024
How to document your ultrasound findings. Find us on Patreon here! Buy your merch here! How to document your ultrasound findings. Find us on Patreon here! Buy your merch here!
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
Core EM
FEBRUARY 9, 2024
Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial. PubMed, 2023 Background Methylene blue is a potential last-line treatment for patients experiencing refractory septic shock. Limited evidence is available regarding its use as a supplementary treatment in early septic shock, the most effective timing for administration, the ideal dosage, and its safety profile.
American Ambulance Association
FEBRUARY 7, 2024
From the Journal of Emergency Medical Services on February 1, 2024 Why are females and individuals who identify as Black, indigenous and/or People of Color underrepresented in EMS? Knolan Rawlins, […] The post JEMS | Adapting to Survive EMS Workplace Shortages, Part I appeared first on American Ambulance Association.
St. Emlyn's
FEBRUARY 6, 2024
St.Emlyn's - Emergency Medicine #FOAMed This week I am in Zermatt, Switzerland for ‘The Big Sick’ conference. This is something I have been looking forward to years, but major heart surgery (valves not pipes) and […] The post Top resus papers for TBS. St Emlyn’s appeared first on St.Emlyn's.
First 10 EM
FEBRUARY 8, 2024
Long time readers will know that I generally dislike guidelines. Although there are exceptions, I think that guidelines are often more problematic than helpful. However, I know that many people work in places that have medicolegal structures that leave them feeling completely paralyzed, and unable to practice in the absence of a relevant guideline. The […] The post ACEP says its OK to use topical anesthetics for simple corneal abrasions appeared first on First10EM.
EMergucate
FEBRUARY 6, 2024
The following chest x-ray is from an adult with cough and fever. What can be seen?
American Ambulance Association
FEBRUARY 7, 2024
The U.S. Department of Health and Human Services Office of the Administration for Strategic Preparedness and Response (ASPR) and Project ECHO have launched this program designed to create peer-to-peer learning […] The post HHS/ASPR Project ECHO Clinical Readiness Rounds are Returning appeared first on American Ambulance Association.
Life in the Fastlane
FEBRUARY 8, 2024
Sheralyn Guilleminot and Mike Cadogan AI-Assisted Learning and Teaching AI-assisted learning and teaching is an often-overlooked use of artificial intelligence in medicine! Here are 4 ways to do it.
First 10 EM
FEBRUARY 5, 2024
In the Rapid Review series, I briefly review the key points of a clinical review paper (which often extends to multiple papers because I can’t help myself). The topic this time: Propofol Related Infusion Syndrome (PRIS). Like many rapid review topics, this was chosen for my own education because I have next to no experience […] The post Propofol Related Infusion Syndrome (PRIS) appeared first on First10EM.
Dr. Smith's ECG Blog
FEBRUARY 9, 2024
Written by Jesse McLaren A 65 year old with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chest pain, which was ongoing at triage. What do you think? Do you need posterior leads? There’s atrial flutter with controlled ventricular response, a non-specific intra-ventricular conduction delay, borderline right axis, normal R wave progression and normal voltages.
EMergucate
FEBRUARY 4, 2024
Answers: PH = 7.391, that is within the normal range, slightly to the acidic side. pCO2 = 57 mmHg, that is high. So we have respiratory acidosis.
REBEL EM
FEBRUARY 5, 2024
Background: The optimal management of primary, spontaneous pneumothorax (sPTX) remains an area of active debate. The British Thoracic Society recommends the least invasive approach possible. In contrast, the American College of Chest Physicians favors first-line chest tube drainage for any sPTX with an estimated volume of over 20%.(3) A Cochrane systematic review comparing simple aspiration with drainage for adult cases identified several randomized controlled trials of small, heterogeneous po
SSCOR
FEBRUARY 3, 2024
Here are a few questions for all you paramedics out there: When was the last time you decompressed a tension pneumothorax? How many surgical airways have you performed? Have you ever delivered a baby in the prehospital setting? And how many times have you performed a rapid sequence intubation?
Dr. Smith's ECG Blog
FEBRUARY 6, 2024
Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. He was intubated for altered mental status. Chest trauma was suspected on initial exam. Here is his initial ECG around 1330: What do you think? The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia.
The EMS Educator
FEBRUARY 9, 2024
Could your next work partner be… Australian? If some folks in California have their way, the answer is yes. Working to solve the ongoing staffing shortage, a group of innovative EMS leaders in California and Australia are thinking differently: bringing well-trained EMS clinicians from Australia to join the U.S. ranks. How do they do it? Hosts Rob Lawrence and Hilary Gates interview the impressive cast of characters.
FOAMfrat
FEBRUARY 3, 2024
[link] Most transport programs & hospitals have a "max dose" for pressors. When we think of a maximum dose for medications, typically, one of two things will happen when you approach that dose. No further benefit Negative effect There is another reason max doses are put in place, and it may have nothing to do with ceiling effects or harmful doses.
Paramedics World
FEBRUARY 7, 2024
Few things in the world can get you down like losing your teeth does. You lose your smile, become self-conscious, and might even lose your confidence in the process. Not… The post Comparing Dentures, Bridges, And Implants For Replacing Missing Teeth appeared first on Paramedics World.
Life in the Fastlane
FEBRUARY 4, 2024
Oliver Flower EVACUATE: ICH Management Amal Abou-Hamden discusses intracerebral haemorrhage (ICH), and the history of management of surgical management of ICH including the STICH1, STICH2 and EVACUATE trial
EMDocs
FEBRUARY 7, 2024
Author: Ryan Leone, MSc, Medical Student at Columbia University // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) What’s the issue? Across several sectors, labor strikes and unionization were prominent throughout the last year. Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. and gained national attention, including high-profile strikes by the United Auto Workers (UAW), the Screen Actors Guild – American F
The Bottom Line
FEBRUARY 8, 2024
In patients with severe brain injury who require mechanical ventilation, does an early, single dose of ceftriaxone compared with placebo reduce the incidence of early VAP?
EMCrit Project
FEBRUARY 9, 2024
The acute crit care med rec EMCrit Project by Scott Weingart, MD FCCM.
FirstNet Authority
FEBRUARY 9, 2024
Super-sizing safety communications for the Big Game Blog michelle.fordi… Fri, 02/09/2024 - 17:51 By Margaret Harding McGill, NTIA Senior Advisor for Public Affairs, Michael Varney, FirstNet Authority Director of Stakeholder Collaboration 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.
EMDocs
FEBRUARY 7, 2024
Today on the emDOCs cast with Jess Pelletier and Brit Long, we discuss the GLP-1 agonist craze, complications, and medication compounding. Episode 94: GLP-1 Agonist Complications Background: GLP-1 agonists are used for weight loss and diabetes; include the following: Semaglutide (Wegovy) GLP-1 agonist FDA approved for weight loss by SQ injection Liraglutide (Saxenda) GLP-1 agonist FDA approved for weight loss by SQ injection Semaglutide (Ozempic) GLP-1 agonist FDA approved for type 2 diabetes by
The Bottom Line
FEBRUARY 7, 2024
What’s new in the Critical Care literature – monthly updates
SSCOR
FEBRUARY 8, 2024
It’s important to regularly reevaluate your team’s knowledge of common bleeding disorders, their symptoms, and the unique challenges they present for EMS personnel during airway suctioning and treatment.
FirstNet Authority
FEBRUARY 6, 2024
Kansas uses cutting-edge technology to enhance 911 services Blog joseph.rey@fir… Tue, 02/06/2024 - 11:39 By John Hunt, 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.
EMDocs
FEBRUARY 9, 2024
Authors: Adam Roussas, MD, MBA, MSE // Reviewed by: Jamie Santistevan, MD ( @jamie_rae_EMdoc, EM Physician, Presbyterian Hospital, Albuquerque, NM); Manpreet Singh, MD ( @MPrizzleER ); and Brit Long, MD ( @long_brit ) Case A 40-year-old female presents to the emergency department for palpitations and lightheadedness. She has a history of depression on citalopram, migraines on amitriptyline, and was recently prescribed tramadol after she broke her wrist.
NVFC
FEBRUARY 8, 2024
The National Volunteer Fire Council (NVFC) is asking all first responders to participate in a survey to measure the influence of our health and safety programming. The survey should take no more than 10 minutes to complete and will be used to help increase the effectiveness of the NVFC’s health and safety initiatives and better serve volunteers across the country.
CanadiEM
FEBRUARY 6, 2024
Venus is a 29-year-old female who presents to the ED with tremor and diaphoresis. You learn that she has presented to the ED with similar symptoms before, and has a 5yr history OUD, using about 5 points (0.5 g) a day. She has no other medical conditions and blood work is within normal limits. Venus is tachycardic at 105 bpm, with dilated pupils, piloerection, slight tremors, and flushed face.
NAEMSP
FEBRUARY 6, 2024
Article by Karlee De Monnin CASE During my first ambulance ride-along as a fourth-year medical student on an EMS elective, my unit responded to a call for abdominal pain. On arrival to the apartment building, we stepped inside to find a tearful, but otherwise well-appearing young woman lying on the floor of her living room. She was an otherwise healthy 23-year-old who called us for abdominal pain and vomiting.
ACEP Now
FEBRUARY 6, 2024
Point: A Less Than Glowing Interpretation of Urine Fluorescence by Jessica Shenoi, MD; Michael E. Mullins, MD; and Ari B. Filip, MD We disagree with Dr. Hack’s recommendation for examining urine under ultraviolet (UV) light for suspected ethylene glycol ingestions. 1 This test is inherently unreliable with poor sensitivity, specificity, and accuracy (49 percent, 75 percent, and 59 percent, respectively). 2 Parsa, et al. found 100 percent of pediatric urine specimens fluoresced even in the absenc
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