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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?
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 ).
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.
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.
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
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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
Answers: PH = 7.56, that is moderate alkalaemia We have low pCO2 (34 mmHg) and high HCO3 (30 mmol/L), both these values can lead to alkalosis. Most likely combined alkalosis.
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
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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
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