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

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 154

ICU Emergency Department ALS EMS 154

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

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

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 161

Emergency Department ALS OR ED 161

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

EMergucate

NOVEMBER 17, 2024

A 60yr old female presents to ED with 3hrs of pleuritic chest pain radiating to the back associated with diaphoresis.

ED 130

ED EMS 130

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 130

OR 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 111

ICU Emergency Department OR Ambulance 111

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

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 104

First Responder OR 104

NVFC

NOVEMBER 19, 2024

Safe and adequate personal protective equipment is essential to firefighters performing at their best. However, many volunteer fire departments lack the resources to purchase new gear, leaving them to function with old, torn, and non-compliant equipment. To help combat this issue, the National Volunteer Fire Council (NVFC) has partnered with MSA Safety and DuPont Personal Protection to award 13 volunteer fire departments with new turnout gear and helmets in 2024.

Firefighter 105

Firefighter First Responder Emergency Response EMS 105

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 100

OR 100

This Podcast Will Kill You

NOVEMBER 19, 2024

We really don’t give fungi the credit they deserve. Over the years of this podcast, we’ve covered only a handful of fungal pathogens, and pathogenic fungi themselves represent a teeny tiny proportion of the incredible diversity of fungal life on this planet. But with this book club episode, we’re attempting to correct this oversight, at least a little bit.

98

98

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 87

ICU ALS 87

Dr. Smith's ECG Blog

NOVEMBER 21, 2024

Written by Pendell Meyers A woman in her 40s presented with acute chest pain and shortness of breath. Vitals were within normal limits. Here is her triage ECG: What do you think? Smith : This is classic for pulmonary embolism (PE). There are 2 key points to making this diagnosis on the ECG: 1) There is T-wave inversion which you might think is due to Wellens' waves, but the patient has active symptoms, so it is not Wellens' sydrome 2) The T-wave inversion in V1-V4 is accompanied by T-wave invers

ACS 88

ACS OR 88

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 78

ED Emergency Department OR ALS 78

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 83

Ambulance Firefighter EMS 83

The Bottom Line

NOVEMBER 22, 2024

Long-term effects of flexible visitation in the intensive care unit on family members’ mental health: 12-month results from a randomized clinical trial JMB de Souza et al. Intensive Care Med (2024); 50:1614–1621. DOI: 10.

ICU 73

ICU ALS 73

Dr. Smith's ECG Blog

NOVEMBER 17, 2024

Written by Willy Frick A 51 year old man with hypertension presented with three hours of acute onset, severe midsternal chest pain associated with two episodes of nausea and vomiting. ECG 1 What do you think? Smith : Inferior leads have subtle ST Elevation with reciprocal STD in aVL. The end of the T-wave in all of II, III, aVF has a rapid downturn, suggesting early T-wave inversion.

OR 91

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.

92

92

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 77

Overdose EMS Emergency Medical Services OR 77

The Bottom Line

NOVEMBER 22, 2024

Validating quantitative pupillometry thresholds for neuroprognostication after out‑of‑hospital cardiac arrest. A predefined substudy of the Blood Pressure and Oxygenations Targets After Cardiac Arrest (BOX)‑trial Nyholm. Intensive Care Med 2024; 50:1484–1495. doi.org/10.

73

73

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 74

OR STEMI Coronary CAD 74

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 69

Emergency Department ED OR 69

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 69

Firefighter EMS OR 69

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 69

Critical Care EMS OR 69

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

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 64

ED Emergency Department 64

The Bottom Line

NOVEMBER 16, 2024

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

Critical Care 117

Critical Care 117

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

FirstNet Authority

NOVEMBER 19, 2024

Baltimore on broadband: Improving public safety with data-based technologies Blog joseph.rey@fir… Tue, 11/19/2024 - 09:47 By Lori Stone, 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 64

Public Safety First Responder OR 64

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.

65

65

First 10 EM

NOVEMBER 18, 2024

Back for another month of interesting, arcane, important, or baffling articles. As we enter the winter in the Northern hemisphere, and I have little interest in heading outside, I will probably spend more time reading, so these write ups might get longer for the next few months. For now, the weather remains fine, golf season […] The post The November 2024 Research Roundup appeared first on First10EM.

OR 62

OR Epinephrine 62

First Responder Wellness

NOVEMBER 22, 2024

Contributing credit: Chief Sam Digiovanna and Michael Berk As the holiday season approaches, the lives of First Responders grow busier. Between shifts at work and home life, there are many commitments to balance. Many have been thinking about their plans, who’s cooking, if they will be on duty, if they should eat both the turkey and ham, take a vacation instead, or how to best avoid certain family members.

Public Safety 52

Public Safety First Responder Firefighter OR 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

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