The Skeptics' Guide to EM

JULY 2, 2023

Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma. NEJM 2023. Guest Skeptic: Dr. Salim Rezaie is a community emergency physician in San Antonio, TX. He is the Creator and founder of REBEL EM, a free, critical appraisal blog that tries to cut down knowledge translation gaps of […] The post SGEM#408: Hey, I, Oh I’m Still Alive – Is it due to TXA?

Emergency Medical Services 302

Emergency Medical Services EMS Paramedic 302

Pediatric EM Morsels

JULY 7, 2023

In the past, we have discussed several causes of Knee Pain in children. Some of those causes are benign (ex, Osgood Schlatter’s Disease ) while others are scary (ex, osteosarcoma ). Evaluating the limping child , though, requires us to ponder not only the common (ex, Toddler’s Fracture ), but also to be vigilant for the severe (ex, Septic Arthritis ).

OR 141

OR EMS 141

American Ambulance Association

JULY 6, 2023

This content is for AAA members only. Please either Log In or Join! The post SCOTUS Decision Changes Religious Accommodation Standard appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

REBEL EM

JULY 5, 2023

Take Home Points Provider assessment of how the patient looks is extremely important. If it looks and feels like a STEMI clinically, get serial ECGs and consult Cardiology immediately. POCUS has been a phenomenal tool in the management and early diagnosis of a lot of abnormal ECG and chest pain presentations. Isolated elevation in aVR with diffuse ST depressions can be a sign of Left Main occlusion.

Coronary 144

Coronary STEMI EMS ED 144

Don't Forget the Bubbles

JULY 5, 2023

Topic Sickle Cell Disease Author Beatrice Zanetti Duration Up to 2 Hours Facilitator Level ST4+ Learner Level Most useful for those in experience seeing paediatric patients regularly. From FY1 + and 5+ nurses on Equipment Required None Outline Pre-reading Basics Case 1: Salmonella osteomyelitis Case 1: Discussion Case 2: Acute painful crisis and Priapism Case 2: Discussion Advanced Case 1: Acute chest syndrome Advanced Case 1: Discussion Advanced Case 2: Stroke in sickle cell disease patient Adv

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

Critical Care Scenarios

JULY 5, 2023

We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles for doing it right. Bluejacket_headshot Download We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles f

100

100

American Ambulance Association

JULY 6, 2023

Thank you to Rob Lawrence of Pro EMS, EMS1, and the California Ambulance Association for connecting with #Ambucon23 keynote Anna Liotta and Royal Ambulance’s Steve Grau! The post EMS1 Stop | Anna Liotta, AAA 2023 Keynote Speaker appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. 2,3 In general, patients who develop cardiac arrest with an initial r

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

REBEL EM

JULY 3, 2023

Background: Atrial fibrillation and atrial flutter with rapid ventricular rate (AF/AFL with RVR) are the most common subtypes of SVT, comprising a large number of ED visits in aging populations. Currently, rhythm and rate control are the mainstays of therapy in acute settings. One common strategy for rate control in stable patients is the use of non-dihydropyridine calcium channel blockers.

E-9-1-1 98

E-9-1-1 EMR Emergency Department ED 98

American Ambulance Association

JULY 6, 2023

Nominations Are Due January 1, 2024! Nominations are open for the second annual American Ambulance Association Vanguard Awards! The Vanguards honor those who blazed the trail for fellow women EMS […] The post 2024 Vanguard Nominations Open Through January 1 appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

EMergucate

JULY 4, 2023

The following chest x-ray is from an elderly patient.

EMS 130

EMS 130

ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. She notes that the wound has been present for greater than a year and it becomes malodorous and painful and oozes intermittently. She reports fevers up to 103 degrees Fahrenheit. She endorses a one-year history of near-syncopal episodes associated with shortness of breath, headache, and neck pain.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

The Bottom Line

JULY 1, 2023

In critically ill adults undergoing tracheal intubation, does the use of a videolaryngoscope (VL) compared to a direct laryngoscope (DL) improve the first-pass success rate?

98

98

American Ambulance Association

JULY 6, 2023

EMSNext Nominations Due January 1, 2024! Know a wonderful rising leader you’d like to recognize as the future of EMS? Nominations are open for EMSNext (formerly Mobile Healthcare 40 Under […] The post 2024 EMSNext Nominations Now Open! appeared first on American Ambulance Association.

Ambulance 130

Ambulance EMS 130

Emergency Medicine Ireland

JULY 3, 2023

Welcome back to the tasty morsels of critical care podcast. Today we tackle a somewhat nebulous syndrome. Something we throw around with a few hand wavy explanations but often light on detail. Hopefully in a few minutes you’ll at least have a few morsels more of information to stave off all the trainees who are undoubtedly much smarter than you on the ward round.

Critical Care 96

Critical Care ACS OR ALS 96

Medgadget

JULY 6, 2023

Researchers at Harvard University have developed a technique that lets them create biomaterial heart valves in a matter of minutes. The approach, called ‘Focused Rotary Jet Spinning’, has been described by the researchers as ‘a cotton-candy machine with a hair dryer behind it.’ Essentially, the technique involves using jets of air to direct polymer strands onto a heart valve shaped frame.

OR 94

OR 94

First 10 EM

JULY 3, 2023

The pace of these literature summaries has decreased over the years, but perhaps that means that quality has increased? I think there is an interesting variety of papers this time around, from sepsis, to b t, to patient access to their own results online. A few huge papers dropped in the past few weeks, including RCTs […] The post Research Roundup (July 2023) appeared first on First10EM.

EMS 97

EMS 97

American Ambulance Association

JULY 5, 2023

This content is for AAA members only. Please either Log In or Join! The post EEOC Weighs in on SCOTUS Decision On Affirmative Action Programs in Education appeared first on American Ambulance Association.

Ambulance 130

Ambulance OR 130

ACEP Now

JULY 7, 2023

Question: A 67-year-old man presents to the emergency department (ED) following syncope. He denies any antecedent symptoms. He has a witnessed episode of syncope in the ED, and the following ECG, is obtained What is the likely diagnosis? Left bundle branch block Supraventricular tachycardia with aberrancy Wolff-Parkinson-White syndrome Ventricular tachycardia See the answer here.

Emergency Department 90

Emergency Department ED 90

EMergucate

JULY 3, 2023

40-year-old man was brought to ED with low GCS after and ingestion of unknown substance.

ED 100

ED 100

Medgadget

JULY 6, 2023

Scientists at the Swiss Federal Laboratories for Materials Science and Technology (EMPA) have developed an advanced surgical sealant that can alert clinicians to the presence of an intestinal leak after gastrointestinal surgery. Such leaks can be very dangerous, but until now clinicians had few ways to detect them before they start causing symptoms.

OR 77

OR 77

American Ambulance Association

JULY 6, 2023

The post 2024 Annual Conference Speakers Wanted! appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

EMDocs

JULY 5, 2023

Author: Walid Malki, MD ( @Wandering_ER ) // Reviewed by: Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK); Manny Singh, MD (@MPrizzleER) Welcome the Visual Wednesdays, a series that provides focused EM updates with infographics. Please follow us on Instagram to see past, current and future infographics! Share this: The post Visual Wednesdays: Neurocritical Care appeared first on emDOCs.net - Emergency Medicine Education.

EMS 69

EMS 69

The Bottom Line

JULY 1, 2023

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

Critical Care 107

Critical Care 107

University of Maryland Department of Emergency Med

JULY 1, 2023

Shock index (heart rate/systolic blood pressure) has been used to predict trauma outcomes. This study from American Journal of Emergency Medici.

71

71

ACEP Now

JULY 7, 2023

Answer: The correct answer is ventricular tachycardia (d). Ventricular tachycardia (VT) is more common in men and in individuals older than 65 years. The most common risk factors include structural heart disease (i.e., cardiomyopathies), and ion-channel mutations (i.e., catecholaminergic polymorphic VT). Idiopathic VT occurs in a structurally normal heart and is very rare.

Defibrillator 52

Defibrillator ALS OR 52

EMDocs

JULY 1, 2023

Authors: Maha Khalid, MD (EM Resident Physician, Advocate Christ Medical Center); Thaer Ahmad, MD (EM Attending Physician, Advocate Christ Medical Center) // Reviewed by: Sophia Görgens, MD (EM Resident Physician, Zucker-Northwell NS/LIJ, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School) ; Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited

EMS 66

EMS Coronary ED OR 66

The Bottom Line

JULY 1, 2023

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

Critical Care 97

Critical Care 97

Dr. Smith's ECG Blog

JULY 7, 2023

This was texted to me. An 80-something woman who presented with chest pain and dyspnea. What do you think? The rhythm appears to be atrial fibrillation. In any case, it is clearly a supraventricular rhythm. There is significant ST depression in V2-V4. Is this posterior OMI? Before jumping to any conclusions about the significance of ST-T abnormalities, you must first be certain that they are not a result of (secondary to) any QRS abnormalities.

OR 52

OR 52

ACEP Now

JULY 7, 2023

This is the second in a multi-part ACEP Now series focused on mental health emergencies. Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Future articles will highlight solutions and success stories. This month, we are discussing the medical management of patients with mild to moderate agitation.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

FOAMfrat

JULY 1, 2023

Rocuronium > Succinylcholine, in my opinion — All day, every day! But with that being said, I have used Succinylcholine (and occasionally still do), and I won't "knock" anyone who chooses to use it. Pending, they have identified that no contraindications likely exist, and their "rationale" seems rational. Below is my “Quick Look” infographic, which looks at both Succinylcholine and Rocuronium, the benefits, considerations, and adverse effects.

E-9-1-1 52

E-9-1-1 Emergency Department OR ALS 52

University of Maryland Department of Emergency Med

JULY 2, 2023

POCUS can be used to screen for appendicitis. A recent study showed a sensitivity of 66.7% (CI 95% 47.1–82.7), and a specificity of 96.8%.

59

59

Dr. Smith's ECG Blog

JULY 5, 2023

This was texted to me in real time. The patient has acute chest pain. What do you think? Here was my answer: "Not ischemia. Chronic. Maybe HOCM or another form of LVH. I would not activate cath lab. Get serial troponins" It is a scary ECG, with a lot of ST Elevation and what appear to be hyperacute T-waves in inferior leads, and profound reciprocal ST Depression in aVL.

STEMI 52

STEMI OR 52

ACEP Now

JULY 6, 2023

Emergency medicine (EM) has evolved over time and has long passed a crossroads where previously unachievable capabilities should be celebrated and shared. Emergency physicians have become leaders in achieving cost efficiency in health care, predominantly through implementation of new processes and research findings, enabling us to achieve significant financial savings.

ALS 52

ALS Emergency Department STEMI ED 52

EMCrit Project

JULY 6, 2023

So much lit goodness!!! EMCrit Project by Scott Weingart, MD FCCM.

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68

University of Maryland Department of Emergency Med

JULY 6, 2023

Burns are common pediatric injuries and usually represent preventable unintentional trauma. Approximately 10% of children hospitalized with burns.

61

61

Dr. Smith's ECG Blog

JULY 2, 2023

This was texted to me from a former resident, while working at a small rural hospital, with the statement: "I can’t convince myself of anything here, but he’s a 63-year-old guy with prior stents and a good story for ACS." (Chest pain or discomfort) What do you think? Here was my response: "Suspicious for inferior posterior OMI. Get serial ECGs" He then sent a previous from 4 years prior: "This is totally normal, which confirms that the first EKG does indeed represent OMI" Then the patient's ches

ACS 52

ACS Coronary OR 52