Critical Care Scenarios

JANUARY 31, 2024

We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon here! Buy your merch here! Takeaway lessons References We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr.

OR 286

OR 286

ALiEM

FEBRUARY 2, 2024

An 18-year-old-female with no known past medical history presented with a lesion on her back that had been present and enlarging for five months. It was not painful unless she touched it, and then only mildly tender. She denied any known cause, wound, prior rash, or other lesions. Her review of systems and past medical history were negative. Additional Images Physical Exam Vitals : Normal Skin : An erythematous lenticular, or biconvex, lesion with distinct borders is noted at the left posterior

Emergency Department 169

Emergency Department OR 169

Pediatric EM Morsels

FEBRUARY 2, 2024

There have been many times I have encountered a triage note which states “ patient recently returned from … (insert awesome foreign country) … ” Not only does this leave me daydreaming about my future travel adventures, but has often caused me to take pause. Thoughts of what endemic illnesses could this child potentially have been exposed to in their travels?

E-9-1-1 161

E-9-1-1 ED OR Emergency Department 161

EMergucate

JANUARY 31, 2024

Simulation report 1/2/24 In situ sim ED JHC Hi everyone, Thank you so much for participating and helping … Continue reading →

ED 130

ED 130

REBEL EM

JANUARY 29, 2024

Background: Massive pulmonary embolism defined as sustained hypotension (SBP <90mmHg) has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) [1]. However, full-dose thrombolytic therapy (Alteplase 100mg (IV) is associated with an increase in bleeding [2]. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety

ALS 137

ALS ACS OR CPR 137

ALiEM

JANUARY 29, 2024

A 59-year-old male with no known past medical history other than an incidental abdominal aortic aneurysm presented with sudden onset, painless vision loss in his left eye. The patient was watching TV two days prior when he saw a “brightness” in his left eye and then progressive blurriness until his vision faded away, all occurring within the span of a minute.

ALS 161

ALS ED OR 161

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. These are Osborn waves usually associated with hypothermia. There is also large T wave inversion and long QT.

ICU 132

ICU OR ALS ED 132

Don't Forget the Bubbles

JANUARY 29, 2024

A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Of those patients admitted with RSE, a subset will go on to develop super-refractory status epilepticus (SRSE).

ALS 122

ALS Critical Care OR 122

NVFC

JANUARY 30, 2024

The National Volunteer Fire Council (NVFC), in cooperation with the U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration, launched a new hazmat train-the-trainer program, Partners in Training (PIT) Crew, in early 2023. This program provided in-person courses to hundreds of first responders across the country in its first year.

First Responder 119

First Responder Firefighter Emergency Response EMS 119

FirstNet Authority

JANUARY 29, 2024

FirstNet Authority Board Approves Investment for Network Evolution Press Releases michelle.fordi… Mon, 01/29/2024 - 13:53 The First Responder Network Authority (FirstNet Authority) is an independent authority within the U.S. Department of Commerce. Created in 2012, its mission is to ensure the building, deployment, and operation of the nationwide broadband network that equips first responders to save lives and protect U.S. communities.

First Responder 118

First Responder 118

EMergucate

JANUARY 29, 2024

The wrist x-rays show multiple fractures but the main injury is trans scaphoid perilunate dislocation.

EMS 130

EMS 130

Paramedic Chiefs of Canada

FEBRUARY 1, 2024

We are pleased to inform you that registration for the CIPSRT Symposium (March 19-20, 2024), is now live. Access link and registration through QR code Please Share! Download: EN Social Register NOW Symposium 2024.jpg Download: Social graphic Symposium 2024 EN.jpg Download: Symposium 2024 EN Poster.pdf Download: CIPSRT Symposium 2024 FR.jpg Download: Social graphic Symposium 2024 FR.jpg Download: Symposium 2024 FR Poster.

116

116

The Curious Clinicians

JANUARY 31, 2024

The history and science behind a drug that harmed thousands in-utero On the Curious Clinicians, we like to often discuss more lighthearted topics, such as why some people think cilantro tastes like soap or whether the post-Thanksgiving turkey coma is a real thing. This episode deals with something whose pathophysiology and history are considerably darker, but important to talk about nonetheless: How thalidomide was heavily, irresponsibly marketed and prescribed to pregnant women in the 1950’s an

ACS 111

ACS OR 111

ESO

JANUARY 31, 2024

January is Firefighter Cancer Awareness Month, a time to shine a spotlight on the critical issue of increased cancer risk among firefighters, along with the importance of effective safety and preventive measures to reduce exposure to cancer-causing carcinogens. It’s no secret that firefighters face many health and safety risks in their line of work, which is why it’s of the utmost importance for both the fire services industry and individual departments to do everything in their power to keep th

Firefighter 105

Firefighter OR 105

EMOttawa

JANUARY 29, 2024

Methodology: 4/5 Usefulness: 3.5/5 Thiele H, et al. N Engl J Med. 2023 Oct 5;389(14):1286-1297. Editorial: Routine Early ECLS in Infarct-Related Cardiogenic Shock? Question: Does early ECLS therapy confer a mortality benefit in patients with MI complicated by cardiogenic shock? Methods: Open label RCT with 417 patients comparing 30-day all-cause mortality between ECLS versus standard […] The post Extracorporeal Life Support in Infarct-Related Cardiogenic Shock appeared first on EMOttawa B

Life Support 102

Life Support ALS Critical Care 102

Dr. Smith's ECG Blog

JANUARY 27, 2024

Written by Jesse McLaren, comments by Smith A 55 year old with a history of NSTEMI presented with two hours of exertional chest pain, with normal vitals. Below is the triage ECG, with a computer interpretation (Marquette 12 SL) of “normal” which was confirmed by the over-reading cardiologist. What do you think? Should this patient continue to stay in the waiting room, without interruption of the physician to interpret the ECG, because the computer interpretation is normal?

STEMI 101

STEMI Coronary ACS ED 101

NVFC

JANUARY 30, 2024

As we begin a new year, now is a great time for your department to show its commitment to the health and well-being of your members. The NVFC is recognizing departments that are taking the steps needed to create a psychologically healthy fire department. This means focusing on areas relating to member involvement, health and safety, member growth and development, work-life balance, member recognition, and effective communication.

102

102

This Podcast Will Kill You

JANUARY 30, 2024

Raise your hand if you or someone you know has had their tonsils removed. If your hand is sky-high, there’s a pretty good chance that you (or that person you know) are from the US and were born before 1980. Of course, maybe that’s not the case, but tonsillectomies certainly fit in the category of 20th century fads, along with Tamagotchis and the Atkins diet.

OR 98

OR 98

Life in the Fastlane

JANUARY 29, 2024

Sheralyn Guilleminot and Mike Cadogan Using Artificial Intelligence in the Medical Field Full interview with critical care clinician and AI enthusiast, Dr Sameer Shaikh, on the many ways to use AI to save time and increase efficiency in healthcare

Critical Care 98

Critical Care 98

Dr. Smith's ECG Blog

JANUARY 31, 2024

A 60-something male presented stating that he had had chest pain that morning which awoke him from sleep but then resolved after several minutes. He has had similar pain in the past which he attributed to acid reflux. He has a history of untreated hypertension. He is pain free now. His systolic BP was 200. The patient is pain free at the time of this ECG: What do you think?

OR 99

OR ED 99

NVFC

JANUARY 30, 2024

Practical tips for diversity, equity, and inclusion in your community According to the 2020 U.S. Census , about 25 percent of the United States population is aged 65 years or older. It’s critical that fire and EMS departments take this large population into consideration when planning fire and life safety community education – and recruitment and retention initiatives.

NFPA 98

NFPA OR EMS 98

First Responders Foundation

JANUARY 29, 2024

First responders are our everyday heroes, facing challenging situations to keep our communities safe. Beyond the essential emergency services they provide, many first responders are deeply involved in community-building activities like Jiu-Jitsu, anti-bullying, and women’s self-defense classes. Supporting these initiatives not only benefits first responders but also strengthens community bonds.

First Responder 98

First Responder Public Safety Firefighter OR 98

EMCrit Project

JANUARY 30, 2024

Polypharmacy is technically defined as taking five or more medications on a daily basis. Polypharmacy is increasingly becoming the norm among adults, due to several factors (an aging population, increasing numbers of medical problems, and increasingly complex regimens available to treat chronic disorders such as heart failure). Indeed, the term “polypharmacy” is arguably antiquated now […] EMCrit Project by Josh Farkas.

ICU 97

ICU OR 97

Life in the Fastlane

JANUARY 30, 2024

Chris Nickson Critical Care Reviews… Down Under! Expressions of interest are open to attend the "Critical Care Reviews Down Under" meeting in Melbourne, December 10th & 11th 2024.

Critical Care 95

Critical Care 95

Pulsara

FEBRUARY 1, 2024

January Recap With four trade shows — NAEMSP, Florida Fire Conference, Arrowhead EMS Conference, and the MHCA Statewide Symposium — under our belts, January 2024 was our busiest January since 2019! Pictured: Brandon Means, Kate Leatherby, and Tim Hakamaki set up the booth at NAEMSP. We're also excited to announce that we published our first pediatric and behavioral-health-focused case study!

Emergency Medical Services 95

Emergency Medical Services ED EMS 95

EM Literature of Note

JANUARY 27, 2024

A brief post collating a few bits of my various work published across the interwebs … The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Apple Podcasts Google Podcasts Soundcloud Naturally, there are continuing Journal Club features, covering the following articles: Zone 1 endovascular balloon occlusion of the aorta vs resuscitative thoracotomy for patient resuscitation after severe hemorrha

Emergency Department 94

Emergency Department 94

First 10 EM

JANUARY 29, 2024

REBOA (resuscitative endovascular balloon occlusion of the aorta) has been discussed in the emergency medicine world for quite some time now, but always with very limited data. There have been some observational studies that suggested REBOA was associated with worse outcomes, but the outcomes were largely assumed to be the result of confounders. (Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM.

EMS 89

EMS 89

Dr. Smith's ECG Blog

JANUARY 29, 2024

This was sent by Sam Ghali @EM_RESUS A 44 year old man presented with chest pain The tech came running with the ECG as the computer called "STEMI!" What do you think? Sam sent this to me and asked: "What do you think, Steve?" My answer: --Tough one! --But I'm going to stick my neck out and say "Not OMI" --STE in V2 has a near "saddleback" configuration, and that is a sign of false positive STE.

STEMI 79

STEMI OR 79

Unitek EMT

JANUARY 31, 2024

Combine your love for the outdoors with a career in saving lives. Wilderness Emergency Medical Technicians (EMTs) are specialized healthcare providers trained for emergency response in remote, rugged areas with limited medical resources. The responsibilities of Wilderness EMTs are unique and demanding. They must possess not only the medical knowledge and skills of a standard […] The post How to Become a Wilderness EMT appeared first on Unitek EMT.

EMT 75

EMT EMT Emergency Medical Technician Emergency Response 75

EMOttawa

FEBRUARY 1, 2024

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we’ve learned. If you haven’t read part one – check it out here! […] The post Lung Protective Ventilation appeared first on EMOttawa Blog.

ED 74

ED Critical Care ICU 74

First 10 EM

JANUARY 31, 2024

The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the focus is on content I have found, but I hope the community gets engaged […] The post The First10EM monthly wrap-up for January 2024 appeared first on First10EM.

77

77

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

This case was sent by Dr. Jean-christophe Reiters, an interventionalist in Belgium. He has been following the blog for 4 years. He has now implemented the Queen of Hearts in his hospital. He wanted to share one of the first cases. A 55 year old with no previous cardiac history presented with 3 hours of chest pain. The pain was persistent and reportedly still present at the time of the ECG.

STEMI 102

STEMI ACS OR 102

The Bottom Line

JANUARY 31, 2024

In patients with aneurysmal subarachnoid haemorrhage (aSAH), does lumbar CSF drainage compared to standard therapy improve clinical outcomes as measured by the modified Rankin Scale (mRS) score at 6 months?

73

73

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. Louis); Marina Boushra, MD (EM-CCM Attending Physician, Cleveland Clinic Foundation); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case: A 39-year-old male is brought in by EMS with a sudden-onset severe headache

ALS 73

ALS Critical Care OR EMS 73

FirstNet Authority

JANUARY 31, 2024

3GPP begins Release 19 work for public safety as Release 18 progress continues Blog joseph.rey@fir… Wed, 01/31/2024 - 09:46 By Dean Prochaska, Senior Director of Standards, 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 72

Public Safety First Responder OR 72

Don't Forget the Bubbles

JANUARY 31, 2024

With millions of journal articles published yearly, it is impossible to keep up. Our team have scoured the literature, so you don’t have to… or it might spark an interest to go and have a look at the full article. We have teamed up with the team from Wexham Park ED which has been coordinated by Dr Mohomed Ashraf Vahedna ST6 A&E. As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties.

Emergency Department 72

Emergency Department ED ALS OR 72

EMCrit Project

JANUARY 27, 2024

a ton of hemodynamic stuff. EMCrit Project by Scott Weingart, MD FCCM.

110

110