The Skeptics' Guide to EM
NOVEMBER 30, 2024
Date: November 10, 2024 Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington's MEDEX program.
Emergency Medicine Cases
DECEMBER 3, 2024
In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more.
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ALiEM
DECEMBER 3, 2024
A 26-year-old male with a past medical history of eczema presented to the Emergency Department with a rash for two days. The patient stated he first noticed a rash on his right arm that rapidly spread to his face, chest, and left arm. He reported having similar rashes before but never to this extent. The patient stated he was given Bactrim and amoxicillin about one month ago for another rash, though he was unsure of the diagnosis.
American Ambulance Association
DECEMBER 6, 2024
The OSHA Emergency Response Team shared an update on the Emergency Response Rulemaking Process on Friday, December 6, 2024. The update can be read below. AAA President, Randy Strozyk, provided […] The post OSHA’s Emergency Response Rulemaking Update appeared first on American Ambulance Association.
EMergucate
DECEMBER 3, 2024
The x-ray is from a toddler with fever and abdominal pain. What can be seen? Answer will be posted later.
EMCrit Project
DECEMBER 1, 2024
John Holcomb, author of the PROPPR trial, on massive transfusion in 2024 EMCrit Project by Scott Weingart, MD FCCM.
Emergency Medicine Cases
DECEMBER 3, 2024
On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips.
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
Dr. Smith's ECG Blog
DECEMBER 3, 2024
This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He had recently returned from overseas travel where these symptoms had been intermittently bothersome over the preceding weeks and had been attributed to heartburn.
EMDocs
DECEMBER 1, 2024
Authors: Grant Gerstner, DO (EM Resident Physician, San Antonio, TX); Kyle Smiley, MD (EM Resident Physician, San Antonio, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
EM Literature of Note
DECEMBER 4, 2024
The emergency department is a place of risk and errors. Those who work in the ED are acutely aware of this, and it conjures up tremendous cognitive pressures on staff every shift. Every ED clinician knows the most benign-appearing triage complaint may obfuscate lurking catastrophe. The vision changes that are actually an acute aortic dissection. A sore shoulder that is necrotizing fasciitis.
American Ambulance Association
DECEMBER 6, 2024
This content is for AAA members only. Please either Log In or Join! The post OSHA’s Emergency Response Rulemaking-Update appeared first on American Ambulance Association.
St. Emlyn's
DECEMBER 2, 2024
St.Emlyn's - Emergency Medicine #FOAMed Uncover the truth about alcohol poisoning. Find out how toxic alcohols can be ingested accidentally or intentionally and the serious consequences they can have with a focus on Emergency medicine management. #FOAMed @stemlyns The post Toxic alcohol poisoning: What do we know about fomepizole, methanol and ethylene glycol?
Dr. Smith's ECG Blog
DECEMBER 6, 2024
A 50-something man presented with worsening severe exertional chest pain which was just resolving as he had an ECG recorded in triage. Time zero. Are the T-waves in leads I and II hyperacute? Hard to tell. How can we know? By the evolution of the ECG! Watch what happends as the heart recovers from its episode of ischemia. The T-waves deflate, demonstrating that the first one was indeed hyperacute. 2 hours T-waves in lead II are significant smaller In lead I not much difference Troponins returned
Unitek EMT
DECEMBER 4, 2024
A Guide to the Various Levels of EMT Certification, Including Education, Training, and Testing Requirements The National EMS Scope of Practice Model defines “scope of practice” as the set of activities a licensed individual is legally authorized to perform. It not only distinguishes the roles of professionals from those of a lay person but also […] The post The 4 Levels of EMT Certification appeared first on Unitek EMT.
American Ambulance Association
DECEMBER 2, 2024
The American Ambulance Association (AAA) is pleased to announce its 2025 Board of Directors. These experienced mobile healthcare leaders bring passionate commitment to shaping the future of EMS policy. 2024 […] The post 2025 American Ambulance Association Board of Directors Announced appeared first on American Ambulance Association.
First Responder Wellness
DECEMBER 6, 2024
Emergencies do not stop for the holidays, and neither do First Responders. As a public safety professional, working through the holidays while trying to maintain your family life, personal health, and social life may feel like juggling more than you can handle. As a result, you may find yourself attending more to one over the other, leading you to feel off balance.
Peter Canning
DECEMBER 6, 2024
Why are overdoses fatalities dropping? There has been much speculation and the answer probably doesnt lie with one factor but with many, including increased availability of naloxone, the efforts of harm reduction workers, the end of the COVID isolation, the trend away from injecting to snorting or smoking, a less toxic drug supply, and expanded treatment.
REBEL EM
DECEMBER 4, 2024
Take Home points : If the patient is low risk with CHA 2 DS 2 -VASc (men < 2, women < 3), cardioversion is safe up to 48 hours from onset. In higher risk patients, we should reserve cardioversion unless there is clear onset less than 12 hours or the patient has been anticoagulated for 3 weeks. Consider anticoagulation in every patient with atrial fibrillation whether they are cardioverted or referred.
American Ambulance Association
DECEMBER 2, 2024
This content is for AAA members only. Please either Log In or Join! The post 12 Days of Savvik Giveaway! appeared first on American Ambulance Association.
EMDocs
DECEMBER 6, 2024
Authors: Haley Dusek, MD (Emergency Medicine Resident, Carolinas Medical Center ); Erik Fisher, MD (Emergency Medicine Attending/Medical Toxicologist, 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); and Brit Long, MD (@long_brit) Case: A 27-
Core Ultrasound
DECEMBER 5, 2024
Unlock the foundational skills you need to perform ultrasound-guided nerve blocks in this detailed tutorial! In Part 1 of this two-part series, we dive into the basics, including needle selection, general methods, and safety protocols. You’ll also learn step-by-step techniques for performing forearm, femoral and tibial nerve blocks, complete with practical tips and sonographic guidance.
ACEP Now
DECEMBER 6, 2024
By some definitions, you could call former Maryland state legislator Dan Morhaim, MD, FACEP, a retired emergency physician. He thinks of it as re-deployed. Dr. Morhaim spent more than two decades in the Maryland House of Delegates, fighting for legislation to protect health care workers and patients before his final legislative term ended in 2019. His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of
American Ambulance Association
DECEMBER 2, 2024
This content is for AAA members only. Please either Log In or Join! The post Manchin and Collins Introduce Senate TIP Bill appeared first on American Ambulance Association.
NVFC
DECEMBER 3, 2024
The holidays can be stressful for first responders and their families, but the NVFC has resources to help. The NVFC First Responder Helpline provides counseling, resources, and referrals to assistance for a range of issues, including stress management, family conflict, anxiety, relationships, financial or legal concerns, child or elder care, and more.
ACEP Now
DECEMBER 6, 2024
What does your program offer that residents cant get anywhere else? We see a high volume of critically ill patients within our department (approximately 210,000 visits per year). Our catchment area is extensive, including all of Delaware and portions of Maryland, New Jersey, and Pennsylvania. Our three campuses that we work at are within 35 minutes of each other and provide a diverse patient population.
American Ambulance Association
DECEMBER 4, 2024
On November 21, 2024, the HHS Office of the Inspector General (OIG) issued Advisory Opinion 24-09. The opinion relates to a proposal by a municipal ambulance service to begin billing […] The post HHS OIG Issues Favorable Advisory Opinion on Ambulance Treatment-in-Place appeared first on American Ambulance Association.
Don't Forget the Bubbles
DECEMBER 2, 2024
Merry Christmas and Season’s Greetings! With millions of journal articles published yearly, it is impossible to keep up. An international team joining DFTB Bubble Wrap from Aghia Sophia Childrens Hospital ED , Athens, Greece, tell us what is new in thepaediatric literature Led by Spyridon Karageorgos, a Paediatrician enthusiastic about Paediatric Emergency Medicine, reducing antibiotic use in paediatric patients, and Medical Education.
ACEP Now
DECEMBER 6, 2024
A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. During initial assessment, an ECG was obtained and revealed ST-segment elevation (STE) in the inferior leads with ST depression anteriorly. FIGURE 1. Initial ECG demonstrating inferolateral ST segment elevation and anteroseptal depression, just prior to cardiac arrest.
Life in the Fastlane
DECEMBER 2, 2024
Chris Nickson ICM Clinical Refresher Course Returning to the clinical coalface after a prolonged absence is inherently challenging. The good thing is there are courses that can help you get back in the swing of things.
EMOttawa
DECEMBER 5, 2024
Quantitative End-Tidal CO2 (ETCO2) was in vogue for a while, and seemingly some centres adopted it as standard of care, while others found that it did not make a significant clinical impact so it fell out of style and left to ‘practitioner preference’ With increasing experience and use, we have mounting evidence to do a […] The post Quantitative End-Tidal CO2 – the New Scoop appeared first on EMOttawa Blog.
ACEP Now
DECEMBER 6, 2024
A 46-year-old female with a prior medical history of asthma presented to the emergency department with shortness of breath and wheezing. After three DuoNeb treatments and 16 mg of dexamethasone, her wheezing improved; however, she continued to report shortness of breath on exertion. Given the persistent symptoms, a cardiac point-of-care ultrasound was obtained.
First 10 EM
DECEMBER 2, 2024
Despite being widely talked about in glowing terms, the original WOMAN trial was clearly negative, with no benefit in their primary outcome, and no change in all cause mortality, and therefore no hint of benefit. (There is a lot of confusion about what disease specific mortality means when this paper is discussed, but it only […] The post WOMAN-2: TXA has no role in postpartum hemorrhage appeared first on First10EM.
EMS 20/20
DECEMBER 4, 2024
A trauma call with a complicated patient and a ship that desperately needs a captain. Does the crew get it together or is it the end of the world as we know it? A trauma call with a complicated patient and a ship that desperately needs a captain. Does the crew get it together or is it the end of the world as we know it?
The FllightBridge ED
DECEMBER 2, 2024
I love attending airway training courses.
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