Sat.Jul 20, 2024 - Fri.Jul 26, 2024

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What The Guardian Missed About US Ambulance Balance Billing

American Ambulance Association

To the Editor of The Guardian, On July 21, The Guardian published Jessica Glenza’s “Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress.” The inflammatory title and lack of […] The post What The Guardian Missed About US Ambulance Balance Billing appeared first on American Ambulance Association.

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Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

We have discussed many causes of encephalitis and encephalopathy previously (ex, Eastern Equine Encephalitis , Posterior Reversible Encephalopathy , FIRES , Reye’s Syndrome ) and have highlighted the fact that they can be challenging to diagnose early. An irritated brain can lead to such a wide array of symptoms. It is even more challenging when the initial symptoms seem to align with what we perceive as psychiatric concerns.

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Episode 197: Acute Agitation

Core EM

We discuss an approach to the acutely agitated patient and review medications commonly used. Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.

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SGEM#447: Just What I Needed – Preoxygenation Prior To Intubation

The Skeptics' Guide to EM

Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of clinical practice has been largely devoted to health care policy.

ALS 227
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EMS Profiles | Meet Tamara Moss

American Ambulance Association

Tamara Annette Robinson Moss Paramedic & Field Training Officer Richmond Ambulance Authority Richmond, VA Share on Facebook | LinkedIn | Instagram | X How did you come to be in […] The post EMS Profiles | Meet Tamara Moss appeared first on American Ambulance Association.

EMS 147
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Episode 77: Mastering APRV with Rory Spiegel

Critical Care Scenarios

We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessons We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr.

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Better Watch Your Back… Finding the Needle in the Haystack.

Core EM

The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway. The following ECG is obtained upon arrival to the emergency department.

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National EMS Advisory Council Meeting August 7-8, 2024

American Ambulance Association

Register Now: National EMS Advisory Council Meeting August 7-8, 2024 The National EMS Advisory Council (NEMSAC) will host a hybrid meeting on Wednesday, August 7, 2024, at 1:00 pm ET, […] The post National EMS Advisory Council Meeting August 7-8, 2024 appeared first on American Ambulance Association.

EMS 130
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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

Written By Magnus Nossen — with edits by Ken Grauer and Smith. The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The below ECG was recorded. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion.

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The Intervals Aren’t Alright!

Core EM

The Case An elderly male with a past medical history of hypertension and diabetes presents to the emergency department with a chief complaint of diarrhea and shortness of breath. His vital signs are: HR 60, BP 105/65, RR 30, O2 100% on room air, oral T 98.6 F, and FSG 120. EKG Show Details EKG Characteristics Rate 60 BPM Rhythm Regular, no discernible P-waves Intervals PR na; QRS complex > 160 ms; QT Prolonged Axis LAD ST Segments Wide QRS complexes slurring into very large pointed T waves Diagn

Plasma 130
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Quantifying Threat or Challenge Response of Undergraduate Paramedicine Students During High-Stress Clinical Scenarios

International Journal of Paramedicine

Paramedic work can be stressful. Encountering clinically unwell patients, long shift hours and dealing with the unknown expose paramedics to mental, physical and emotional stress. In the learning environment, these types of stresses are difficult for educators to replicate. Traditionally, students have been tested under pressure in scenario-based situations as a means of stress inoculation.

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RAND Corporation issues two reports on ground ambulance industry

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post RAND Corporation issues two reports on ground ambulance industry appeared first on American Ambulance Association.

Ambulance 130
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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

This patient was witnessed by bystanders to collapse. They started CPR. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% sodium bicarbonate.

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Acute Radiation Exposure

Core EM

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. Due to their availability, iridium-192, Cesium-137, and Cobalt-60 are often viewed as the substances posing the greatest threat for intentional radiation exposure.

ALS 130
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Steroids in preschool wheeze

Don't Forget the Bubbles

Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. Unfortunately, the number of acute wheeze exacerbations coming through the doors is still rising , but are we equipped to manage these children? In the UK, national guidance advises giving oral prednisolone early when treating paediatric asthma attacks.

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Speak at Annual 2025 in Lexington!

American Ambulance Association

Share your insights with fellow EMS leaders surrounded by the charm and excitement of Lexington’s iconic hospitality featuring world-class dining, bourbon, and horseracing. The post Speak at Annual 2025 in Lexington! appeared first on American Ambulance Association.

Ambulance 130
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A prehospital ECG in a patient with chest pain. The paramedics tell me it is normal.

Dr. Smith's ECG Blog

I was working at triage when the medics brought this patient who is 65 yo and has had chest pain for 12 hours. They recorded a prehospital ECG at 2112 and said that it was “normal”. It had already been crumpled up and put in the waste basket. So I uncrumpled it: What do you think? You need to click on it to enlarge it to view it well I was suspicious for inferior and posterior OMI (Large T-wave in aVF, slight STE in lead III with inverted T-wave in aVL, and a slightly downsloping ST with negativ

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Episode 195: ARDS

Core EM

We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure. Berlin criteria for diagnosis include acute onset within 7 days, bilateral pulmonary infiltrates on imaging, not fully explained by cardiac failure or fluid overload, and impaired oxygenation with PaO2/FiO2 ratio <300 mmHg, even wi

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The Busy Nurse's Guide to Organizing Crash Cart Supplies

SSCOR

During a code, knowing where your supplies are located on your crash cart is just as important as having everything necessary. Navigating your way through a hectic code is much easier when you have the right items and an organized system for your crash cart. Here are some tips.

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CMS Schedules ODF for August 1, 2024 | CY 2025 PFS

American Ambulance Association

The next CMS Ambulance Open Door Forum scheduled for: Date: Thursday, August 1, 2024 Start Time: 2:00pm-3:00pm PM Eastern Time (ET); Please log in at least 15 minutes before call […] The post CMS Schedules ODF for August 1, 2024 | CY 2025 PFS appeared first on American Ambulance Association.

Ambulance 130
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JC: Evaluation of Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Background As I think I have mentioned before, I spend some of my time as a major trauma consultant on the major trauma ward (MTW). You may be shocked to […] The post JC: Evaluation of Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study appeared first on St.Emlyn's.

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Classic EM: High risk and low prevalence diseases: Blast injuries

Core EM

High risk and low prevalence diseases: Blast injuries American Journal of Emergency Medicine, 2023 Background Blast injuries stem from the instantaneous transformation of a substance from solid or liquid to gas, releasing energy in the form of heat, light, pressure, and sound. While rare, blast injuries carry a high rate of morbidity and mortality. Blast injuries commonly have a mixed presentation of blunt and penetrating trauma.

EMS 100
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Anatomical Landmarks For Intubation

SSCOR

Few EMS procedures are as important as tracheal intubation. However, this procedure can also be challenging, and not just for novice providers. If skills are not initially mastered and frequently practiced, intubation success rates plummet, and placement of an advanced airway doesn't occur.

EMS 100
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CMS Schedules ODF for August 1, 2024 | CY 2025 PFS

American Ambulance Association

Dear Ground Ambulance Providers and Suppliers, We wanted you to be aware that we posted the following announcement on our Ambulance Events website: August 1, 2024 2:00 PM-3:00 PM ET Ambulance Open […] The post CMS Schedules ODF for August 1, 2024 | CY 2025 PFS appeared first on American Ambulance Association.

Ambulance 130
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How to Choose Between ACLS vs BLS

NHCPS Save a Life

When comparing ACLS vs BLS certifications, there’s one important thing to keep in mind: both courses are accredited. The American Nurses Credentialing Center, American Medical Association, and other leading medical organizations accept both types of certification. What’s more, you don’t necessarily have to pick between the ACLS vs BLS.

BLS 98
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Optimizing Trauma Resuscitation Education: A Year-Long In-Situ Simulation Curriculum

Core EM

Optimizing Trauma Resuscitation Education: A Year-Long In-Situ Simulation Curriculum Ashika Jain, MD, Nelly Parisot, MD, Michael J. Klein, MD, Janice Shin-Kim, MD, Brian Lin, MD, Julia Paris, MD, Shannon McNamara, MD, Jessica Strauss, MD, Soma Pathak, MD Delivering optimal care in a trauma resuscitation requires a highly coordinated and skilled team.

ALS 100
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Episode 146 Celiac Disease: Rootin tootin gluten

This Podcast Will Kill You

CW: discussion of disordered eating, eating disorders Did the word gluten manifest in everyone’s consciousness one day in 2010? Suddenly, grocery stores were filled with gluten-free crackers, cookies, buns, you name it. Everyone went on gluten-free diets or knew someone with a gluten intolerance or sensitivity. For some, it might seem that gluten-related disorders went from 0 to 60 overnight, but those who had lived with these illnesses for decades knew better.

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CMS Publishes Two New Reports on GADCS Website

American Ambulance Association

Dear Ground Ambulance Providers and Suppliers, We wanted you to be aware that we posted 2 reports on our Medicare Ground Ambulance Data Collection System website under Reports: Ground Ambulance Industry Trends, […] The post CMS Publishes Two New Reports on GADCS Website appeared first on American Ambulance Association.

Ambulance 130
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Rural vs. Urban: Differences in EMT Responses and Resources

Unitek EMT

Comparing the unique challenges and capabilities. Emergency medical services (EMS) are a crucial component of the healthcare system, providing immediate medical care and transportation for individuals experiencing medical emergencies. Whether in bustling urban centers or remote rural areas, EMS plays a vital role in saving lives and improving health outcomes.

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The REBEL Lit Distillery at ResusX

REBEL EM

Do you know what the latest evidence in critical care/resuscitation? If this question makes you uncomfortable or you just don’t have time to keep up with the literature, you should sign up for the REBEL Lit Distillery at the ResusX Conference in Philly. Let us help you keep up to date. -Workshop: Sept 17 th , 2024 -Location: Philadelphia, PA -20 to 25 Critical Care/Resuscitation Papers Reviewed -Direct Link: [link] The post The REBEL Lit Distillery at ResusX appeared first on REBEL EM - Emergen

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Medical Malpractice Insights: The challenge of suicide evaluation in the ED

EMDocs

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.

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Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Background I spend some of my time as a major trauma consultant on the major trauma ward (MTW). You may be shocked to hear that an Emergency Medicine doctor such […] The post Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study appeared first on St.Emlyn's.

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Reinventing Emergency Response: ESO’s Acquisition of Logis

ESO

“The ability for us to link data from the 9-1-1 call through the hospital visit and post-acute care for the very first time is exciting and will help us improve community health and safety.” – Erica Holland, ESO’s Vice President of Corporate Development A partnership ten years in the making, the Logis and ESO teams are officially joining forces.

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Saving Your Smile: How An Oral Surgeon Can Prevent Future Health Issues

Paramedics World

Oral health matters—not just for a nice smile, but for your whole body’s longevity. Here in Morristown, oral surgeons like us at Ridge Oral Surgery do more than fix dental… The post Saving Your Smile: How An Oral Surgeon Can Prevent Future Health Issues appeared first on Paramedics World.

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Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Does Stress Ulcer Prophylaxis with a PPI Work? Spoon Feed An international, multi-center RCT found that administering pantoprazole to intubated ICU patients lowered the rate of upper GI bleeding compared to placebo.

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Podcast – Positive and Negative Predictive Values: Critical Appraisal Nugget

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Welcome back to another instalment of our Critical Appraisal Nugget series with Rick Body and Greg Yates here at St Emlyn’s. In our previous podcast, we delved into the concepts […] The post Podcast – Positive and Negative Predictive Values: Critical Appraisal Nugget appeared first on St.Emlyn's.

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How to Choose Between ACLS vs BLS

NHCPS Save a Life

When comparing ACLS vs BLS certifications, there’s one important thing to keep in mind: both courses are accredited. The American Nurses Credentialing Center, American Medical Association, and other leading medical organizations accept both types of certification. What’s more, you don’t necessarily have to pick between the ACLS vs BLS.

BLS 52