The Skeptics' Guide to EM

NOVEMBER 16, 2024

Date: October 28, 2024 Reference: Verma et al. Clinical evaluation of a machine learning–based early warning system for patient deterioration. CMAJ September 2024 Guest Skeptic: Michael Page is currently the Director of Artificial Intelligence (AI) Commercialization at Unity Health Toronto. He leads an AI team intending to improve patient outcomes and healthcare system efficiency.

ICU 214

ICU Emergency Department ALS EMS 214

ALiEM

NOVEMBER 22, 2024

A 13-month-old, full-term male presented due to intermittent emesis over a 3-week period. He and his parents had COVID one week prior to presentation. He had multiple episodes of non-bloody, non-bilious vomit the day before and the day of presentation. Parents noted he had been listless and unable to tolerate food. The mother was also concerned that he was straining to have bowel movements and that a mass was coming out of his bottom on the ride to the hospital.

OR 183

OR ED 183

American Ambulance Association

NOVEMBER 20, 2024

This content is for AAA members only. Please either Log In or Join! The post Spending End of Year Funds? Don’t Go Out To Bid! appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

EMergucate

NOVEMBER 19, 2024

The chest x-ray is from an adult with chest pain post MVA. What can be seen?

EMS 130

EMS 130

Pulsara

NOVEMBER 20, 2024

EDITOR'S NOTE: This article originally appeared on EMS1.com under the title "Everyday use of this care platform helps prepare personnel for the 'big one.'" Special thanks to our guest author, John Erich, for EMS1 BrandFocus Staff. __ MCIs are no time to be learning new tools – this one is suitable for use on every call as well as major incidents In Texas, there’s rarely a dull moment for emergency responders.

Ambulance 99

Ambulance Firefighter EMS 99

ALiEM

NOVEMBER 18, 2024

A 48-year-old male with no significant past medical history presented to the Emergency Department with a left-sided facial rash and associated burning left eye pain that started four days prior. He was seen at an ophthalmology clinic when his symptoms started and given oral valacyclovir which he took for three days without improvement. He also endorsed left-sided facial weakness and diplopia for the last eight days.

Emergency Department 177

Emergency Department ALS OR ED 177

American Ambulance Association

NOVEMBER 18, 2024

This content is for AAA members only. Please either Log In or Join! The post Now Available: Materials from October EMS Focus Webinar appeared first on American Ambulance Association.

EMS 130

EMS Ambulance OR 130

St. Emlyn's

NOVEMBER 19, 2024

St.Emlyn's - Emergency Medicine #FOAMed Traditionally, large-bore chest tubes have been standard for managing hemothorax, but smaller tubes are now proving just as effective in stable patients, with added benefits like reduced pain and fewer tube days. This review explores outcomes in drainage efficacy, complication rates, and patient comfort, showing that small-bore thoracostomy may be a reliable alternative for non-emergent cases.

OR 106

OR 106

The Bottom Line

NOVEMBER 16, 2024

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

Critical Care 117

Critical Care 117

Core EM

NOVEMBER 19, 2024

Introduction: - Ankle sprains are among the most common injuries, affecting both athletes and everyday pedestrians. - The streets of New York City illustrate how treacherous surfaces can lead to ankle injuries. - The ankle is the most commonly injured joint in sports; jogging is a frequent cause. Anatomy of the Ankle: - The ankle joint, or mortise, is formed by the talus bone fitting snugly between the distal fibula and tibia. - Key ligaments securing the ankle include: Medial deltoid ligament S

Emergency Department 130

Emergency Department Ambulance OR 130

NVFC

NOVEMBER 19, 2024

For the fourth year, General Motors (GM) has awarded the National Volunteer Fire Council (NVFC) a grant to make the roadways safer for emergency responders and the public. The grant for $155,000 will be used to provide critical training to emergency responders as well as promote driving safety and slow down, move over messaging. The new grant will build on the NVFC’s previous efforts to positively impact vehicle and road safety for volunteer responders and road users.

Firefighter 116

Firefighter EMS OR 116

St. Emlyn's

NOVEMBER 22, 2024

St.Emlyn's - Emergency Medicine #FOAMed This retrospective study explores the link between intra-arrest arterial blood pressure (IBP) and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). Analysing data from 80 patients attended by the East Anglian Air Ambulance, it found that higher diastolic blood pressure (DBP) during CPR significantly increased the likelihood of ROSC.

CPR 116

CPR Ambulance 116

EMDocs

NOVEMBER 19, 2024

Authors: Bricey Bayonnet, MD ( EM Resident Physician, Atrium Health’s Carolinas Medical Center, Charlotte, NC); Christine Murphy, MD (EM Attending Physician; Medical Toxicologist, Atrium Health’s Carolinas Medical Center, Charlotte, NC) // Reviewed by: James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Anthony Spadaro MD, (@TSpadaro91, Fellow in Medical Toxicology, Rutgers NJMS); Alex Koyfman, MD (@EMHighAK); Brit Long, M

Overdose 91

Overdose EMS Emergency Medical Services OR 91

EMCrit Project

NOVEMBER 22, 2024

Experts' guide to the use of the Bougie for Emergency Airway Management EMCrit Project by Scott Weingart, MD FCCM.

87

87

Core Ultrasound

NOVEMBER 18, 2024

In this virtual interview, Dr. Longino and Dr. Riscinti—both from Denver Health—share their expertise on the background of the VExUS (Venous Excess UltraSound) exam. Whether you’re a clinician seeking to refine your ultrasound skills or a learner diving into advanced techniques, this discussion offers expert insights from two leaders in the field. This episode is part one of a two part interview where I personally learned so much and I’m thankful for all of the knowledge translation from Drs.

OR 100

OR 100

REBEL EM

NOVEMBER 18, 2024

View Course Dates This 2-day course provides an in-depth look at effective surgical airway management techniques that you will actually use in your next emergency airway. There is a unique focus on airway anatomy and imaging combined with one-of-a-kind opportunity to practice the techniques on a large variety of non-embalmed, specially prepared cadavers.

Critical Care 72

Critical Care EMS OR 72

The Bottom Line

NOVEMBER 16, 2024

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

Critical Care 70

Critical Care 70

EM Literature of Note

NOVEMBER 20, 2024

This article regarding the cost of upgrading emergency departments to be “ready” for sick children has been bouncing around in the background since its publication, with some initial lay press coverage. The general concept here is obviously laudable and the culmination of at least a decade of hard work from these authors and the team involved – with the ultimate goal of ensuring each emergency department in the country is capable of caring for critically unwell children.

Emergency Department 86

Emergency Department ED OR 86

FirstNet Authority

NOVEMBER 20, 2024

The evolution of technology has changed the landscape of search and rescue missions — clearing radio airwaves for essential traffic and mission critical information. Travis Hull, Kate Cummings, Ben Lawrence, and Jason Day explore how broadband solutions have increased operation efficiencies, live at 5x5: The Public Safety Innovation Summit.

Public Safety 64

Public Safety 64

Don't Forget the Bubbles

NOVEMBER 18, 2024

As you roll into your night shift, getting briefed and handed the urgent pager, you exit the briefing room and go into the hum of the neonatal intensive care unit. The familiar beeps of monitors and the soft cries of a premature infant fill the air, but then—a sharp, unusual beep cuts through. Moments later, a nurse calls, “Doctor, could you check this blood pressure?

OR 59

OR Critical Care Coronary Emergency Department 59

EMDocs

NOVEMBER 22, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

ED 81

ED Emergency Department OR ALS 81

St. Emlyn's

NOVEMBER 19, 2024

St.Emlyn's - Emergency Medicine #FOAMed Traditionally, large-bore chest tubes have been standard for managing hemothorax, but smaller tubes are now proving just as effective in stable patients. Dive in to explore the latest evidence in trauma management and see if small-bore thoracostomy is suitable for your practice’s patient population. The post Small Bore vs Large Bore Thoracostomy for Traumatic Haemothorax. appeared first on St.Emlyn's.

82

82

ESO

NOVEMBER 20, 2024

 “Integrating community paramedicine into our community has helped give a voice to people that have historically been marginalized.” James McLaughlin Community Paramedic Director at Ute Pass Regional Health Service District Covering over 500 square miles of rural territory surrounding Pikes Peak, the Ute Pass Regional Health Service team is tasked with providing outstanding care for a widely underserved population in often remote mountainous terrain.

MIH 52

MIH Mobile Integrated Health Community Paramedicine Paramedicine 52

Stem EMS

NOVEMBER 18, 2024

Florida Hurricane Milton caused devastation, but swift rescues saved thousand, raising concerns over climate change and prevention L'articolo Florida Hurricane Milton: Timely Rescues Save Thousands of Lives proviene da Stem Ems.

EMS 52

EMS 52

REBEL EM

NOVEMBER 21, 2024

A parent presents to the ED with their 6-week-old infant for evaluation of a fever. The infant was born full term and has no other symptoms. Physical exam is normal and vital signs are HR is 150 bpm, SpO2 is 99%, and a rectal T is 101.4°F (38.6°C). Blood cultures are sent and lab results from a CBC, procalcitonin, and urinalysis are as follows: WBC: 5,300/µL Hemoglobin: 12.2 g/dL Platelets: 205,000/µL Absolute neutrophil count: 2,600/µL Procalcitonin: 0.14 ng/mL Urinalysis WBC: 50–100/hpf RBC: 0

ALS 59

ALS ED EMS 59

St. Emlyn's

NOVEMBER 22, 2024

St.Emlyn's - Emergency Medicine #FOAMed This retrospective study explores the link between intra-arrest arterial blood pressure (IBP) and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). The post Intra-Arrest Arterial Blood Pressure and Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest. appeared first on St.Emlyn's.

52

52

Broome Docs

NOVEMBER 17, 2024

Palatinus HN, Johnson MA, Wang HE, Hoareau GL, Youngquist ST. Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. Resuscitation. 2024 Aug;201:110266. doi: 10.1016/j.resuscitation.2024.110266. Epub 2024 Jun 9. PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest.

Epinephrine 62

Epinephrine Emergency Department Critical Care ICU 62

EMT City

NOVEMBER 20, 2024

Hello! I was wondering if anyone on this forum would be able to help me out : ). I am from Australia and am interested in training as an EMT in the US and would further like to work as an EMT for 6 months. However, I’m finding it difficult to determine what visa this is possible on/if it is possible. I understand that I would probably need a student visa for the training, it is the work visa that I am struggling to understand.

EMT 40

EMT EMT 40

Paramedic Chiefs of Canada

NOVEMBER 18, 2024

CACP – Public Safety Interoperability Workshop – February 2nd-5th, Toronto, ON

Public Safety 40

Public Safety 40

The Bottom Line

NOVEMBER 22, 2024

Quetiapine Versus Haloperidol in the Management of Hyperactive Delirium: Randomized Controlled Trial Zakhary et al. Neurocritical Care; Oct;41(2):550-557. doi:10.1007/s12028-024-01948-w Clinical Question In critically ill patients with delirium, does quetiapine in comparison to haloperidol, reduce the severity of delirium?

ICU 88

ICU ALS 88

St. Emlyn's

NOVEMBER 19, 2024

St.Emlyn's - Emergency Medicine #FOAMed All the best from the blog from August 2024, in our easy to digest podcast. The post September 2024 Round-Up – Patient Experience in the ED, Dirty Adrenaline, and More! appeared first on St.Emlyn's.

ED 70

ED Emergency Department 70

EMDocs

NOVEMBER 16, 2024

Authors: Steven Wright, MD (EM Resident Physician, UTSW – Dallas, TX); Samia Farooqi, MD (Assistant Professor of EM/Attending Physician, UTSW – Dallas, 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.

EMS 77

EMS E-9-1-1 Operating Room Emergency Department 77

EMOttawa

NOVEMBER 21, 2024

A common Emergency Department (ED) presentation, vaginal bleeding in pregnancy affects approximately 30% of pregnancies in the 1st trimester and 1-2% in the 2nd trimester. About half of these result in pregnancy loss. Here we will use cases to highlight an ED approach to stable vaginal bleeding in pregnancy with an emphasis on: Management of […] The post Stable Vaginal Bleeding in Pregnancy appeared first on EMOttawa Blog.

Emergency Department 118

Emergency Department ED 118

Chicago EMT Training

NOVEMBER 16, 2024

Our third annual graduation ceremony was a success. We hosted around 250 people at the SkyDeck of the Sears Tower. We had Chief Deborah Sommer and Dr. Dave Nayak speak some wisdom and inspiration to some newly minted EMTs and their families. We also hosted various agencies where our new grads could be utilized. Agencies like CFD, CPD, OEMC, IL state police, cook county sheriff's office, and various private ambulance companies.

EMT 130

EMT EMT Ambulance 130

FOAMfrat

NOVEMBER 21, 2024

Halloween may have come and gone, but for trauma patients, some true horrors linger year-round. Still lurking in the shadows are silent killers—hypothermia, acidosis, and coagulopathy—the dreaded ‘Trauma Triad of Death.' Just when things seem like they couldn't get any worse, hypocalcemia and hypotension creep in, presenting their own sinister twist.

ICU 118

ICU Emergency Department OR Ambulance 118

Dr. Smith's ECG Blog

NOVEMBER 19, 2024

These ECGs were texted to me by one of our previous ultrasound fellows, Will Smoot An elderly male arrived via EMS for acute substernal chest pain with radiation to left shoulder and arm that awakened him from sleep at 0030. He took two full strength aspirin prior to EMS arrival. The pain was relieved by one prehospital NTG spray. He arrived at the ED just shy of two hours after onset, pain free.

OR 111

OR STEMI Coronary CAD 111

SSCOR

NOVEMBER 21, 2024

Suction plays a critical role in numerous medical procedures. It’s also a key component of every tactical medical kit. Yet many first responders and other medical professionals are familiar with only one or two suction aspirators. In an emergency or when you collaborate with another agency, your familiarity with a wide range of suction equipment may be the most important factor in patient outcomes.

First Responder 105

First Responder OR 105