Emergency Medicine Cases
JULY 8, 2024
In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages?
The Skeptics' Guide to EM
JULY 6, 2024
Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She co-founded FOAMcast and is a pulmonary embolism and implementation science researcher.
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Critical Care Scenarios
JULY 10, 2024
We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here! We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital.
St. Emlyn's
JULY 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed A podcast with Steve Smith ECG educator extraordinaire where we discuss occlusive myocardial infarction and the future of AI and ECG interpretation. The post Podcast – Occlusive Myocardial Infarction, ECGs and Artificial Intelligence with Steve Smith appeared first on St.Emlyn's.
Emergency Medicine Cases
JULY 9, 2024
The decision of whether or not to order a CT head for an older patient who falls is one I need to make on almost every shift. The Canadian CT Head Rule does not apply to older patients. Does the recently derived Falls Decision Rule give us an answer to the question of which older patients can safely forego a CT head after a fall? Dr. Rohit Mohindra reviews the latest evidence in this EM Cases Journal Club.
American Ambulance Association
JULY 11, 2024
The Centers for Medicare & Medicaid Services (CMS) has released the Calendar Year (CY) 2025 proposed rule that proposes changes to the CY 2025 definitions of ALS-2 services to include […] The post CMS Proposed Expansion of ALS-2 to include Low-Tier O+ Whole Blood Transfusions Fails to Include Additional Funding for the Services appeared first on American Ambulance Association.
EMergucate
JULY 9, 2024
75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55.
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Dr. Smith's ECG Blog
JULY 9, 2024
Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. He arrived to the ED with severe hypotension, heart rate in the 70s, unable to follow commands but moving all extremities requiring restraint and sedation, respiratory rate around 24/min being supporte
The Bottom Line
JULY 11, 2024
Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation (REVISE) D. Cook. NEJM 2024. DOI: 10.1056/NEJMoa2404245 Clinical Question In mechanically ventilated adults, does stress ulcer prophylaxis with intravenous pantoprazole (40 mg daily), compared with placebo (0.9% saline), reduce the occurrence of clinically important upper gastrointestinal bleeding at 90 days?
EMergucate
JULY 9, 2024
The following ECG is from a 74-year-old man with one hour of chest pain. He has no cardiac risk factors and denies any significant medical history.
SSCOR
JULY 11, 2024
Asthma is a common affliction, affecting 8% to 10% e of the population. Many childhood asthmatics grow out of the disorder in adulthood, so a disproportionate percentage of people with asthma are children. For most people, asthma is a minor inconvenience akin to – and often associated with – seasonal allergies. An unlucky fraction of asthmatics, however, have a more severe form of the illness.
Dr. Smith's ECG Blog
JULY 11, 2024
This is another case sent by the undergraduate (who is applying to med school) who works as an EKG tech. How is it possible that a kid who has not even started medical school can know so much about EKGs and cardiology? Because: 1) He has been reading this blog for a long time. 2) He is curious This is how Pendell got started. Case A 43 year old male with a history of DM II, hyperlipidemia, and a family history of myocardial infarction presented to a family clinic with two days of epigastric pain
EMCrit Project
JULY 12, 2024
How do you sedate a critically ill patient for a procedure? EMCrit Project by Scott Weingart, MD FCCM.
Firefighters and EMS Fund
JULY 11, 2024
On June 18th, 2024, firefighters across America earned a powerful reason to celebrate: by a landslide vote of 88 to 2, the U.S. Senate approved S.870, also known as the Fire Grants and Safety Act. As one of the final acts of the current legislative term, this bill will secure significant funds for fire and […] The post MAJOR Legislative Victory: AFG and SAFER Signed Into Law appeared first on Firefighters and EMS Fund.
SSCOR
JULY 6, 2024
As an EMS professional, one of the most critical decisions you will make is when to secure an advanced airway. Airway decisions are crucial: they must be expedient, effective, and appropriate.
ACEP Now
JULY 11, 2024
It’s 7 a.m. and before you’ve even taken the first sips of your morning coffee, you’ve already received sign out. The last person on your list is the young man resting in a hallway bed recovering from a drunken fight. Thankfully he has no major injuries and by the time you get around to evaluating him, he’s clinically sober come up and eager to leave.
International Journal of Paramedicine
JULY 8, 2024
Objective: Acute severe agitation often requires pharmacologic sedation. While benzodiazepines and antipsychotics are traditional first-line medications for this purpose, recent evidence has shown that prehospital intramuscular (IM) administration of ketamine results in rapid, effective sedation. However, ketamine may be associated with adverse clinical events including a higher intubation rate.
NVFC
JULY 8, 2024
Eligible responders can enter for a chance to receive two cases of DripDrop electrolyte drink mix for their volunteer fire department Summer brings outdoor adventures, water activities, and barbecues, but it also can bring danger to firefighters, who exert themselves in heavy gear and high temperatures. To help prevent firefighter dehydration and heat-related injuries, especially during long incidents and wildfire response, DripDrop Hydration, PBC, has partnered with the National Volunteer Fire
Unitek EMT
JULY 8, 2024
From emergencies to empowerment: how EMTs lead community health education. Emergency Medical Technicians (EMTs) serve as the frontline responders in Emergency Medical Services (EMS), playing a critical role in delivering immediate medical care during emergencies. Their swift actions—often the first point of contact in life-threatening situations—are essential in stabilizing patients and preparing them for further […] The post Community Outreach: EMTs Educating and Engaging with the Public
ACEP Now
JULY 7, 2024
I have learned more from my failures than my successes. My current practice is a hybrid of academic and community sites, and I have worked in myriad community hospitals from busy ones to single coverage critical access hospitals. Each has its own challenges and lessons. Emergency medicine residencies focus heavily on foundational knowledge, procedural competency, and professionalism.
International Journal of Paramedicine
JULY 8, 2024
Background : In the United States, research has found that emergency medical service (EMS) clinicians contemplate and attempt suicide at a rate approximately 10 times higher than the general population. However, prior to this study, no comprehensive data existed on the mental health status and needs of Virginia’s EMS clinicians. Objective: To evaluate mental health conditions, substance use, COVID-19 stress, and job satisfaction among Virginia’s EMS clinicians and to assess the perceived mental
CanadiEM
JULY 11, 2024
Clinical scenario A 27-year old female presents to the emergency department (ED) after a fall onto her hand from amotorized scooter. She has pain on the radial aspect of her left wrist and anatomical snuffbox.However, the X-rays do not indicate an obvious scaphoid fracture. Clinical question: What are the predictive clinical features for occult scaphoid fractures in patients with normal initial radiographs in the ED?
EMOttawa
JULY 11, 2024
In Fall 2023, I was working an evening shift at a community hospital when we got a patch. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. We prepared the ED for the patient’s arrival. According to EMS, the patient had […] The post Invasive Group A Strep (iGAS).
EMDocs
JULY 9, 2024
The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Today on we have our two renowned experts, Dr.
International Journal of Paramedicine
JULY 8, 2024
Purpose: Buprenorphine is a lifesaving medication in opioid use disorder (OUD). Emergency Medical Services (EMS) play a crucial role in responding to opioid overdoses. The pre-hospital use of buprenorphine by EMS can expand access to this important medication. This article aims to provide a narrative review of the use of buprenorphine in the pre-hospital setting.
The Bottom Line
JULY 7, 2024
In adult patients scheduled for cardiac surgery with cardiopulmonary bypass does infusion of a balanced solution of amino acids, commencing at the time of surgery, compared with balanced crystalloid alone (Ringer's Lactate) reduce the incidence of acute kidney injury (AKI)?
Dr. Smith's ECG Blog
JULY 7, 2024
Written by Jesse McLaren A previously healthy 60 year old developed exertional chest pain with diaphoresis, and called EMS. Here’s the EMS ECG, digitized with PM cardio. What do you think? There’s sinus arrhythmia with normal conduction, normal axis and normal voltages. There’s loss of R waves in V2-3 with hyperacute waves V1-5. There’s no significant ST elevation but there are two forms of ST depression: deWinter T wave V3-5 and precordial swirl with ST depression V6 reciprocal to subtle STE in
ACEP Now
JULY 7, 2024
A 40-year-old woman with a history of untreated hypertension presented by ambulance after she was thrown from an ATV at unknown speeds and then crushed by the vehicle. The vehicle had no seatbelt or airbags, she was not helmeted, and she did not hit her head or lose consciousness. She reported 10/10 pain localized to her right arm and right flank, with no other complaints.
International Journal of Paramedicine
JULY 8, 2024
Out-of-hospital cardiac arrest (OHCA) can have significant adverse sequelae for both the patient’s families, as well as the responding EMS clinicians. Despite advances in medicine, 90% of OHCA result in death. The sudden and unexpected nature of these events, adds to the complexity of grief for the surviving family members. OHCA specifically has been shown to have deleterious mental health impacts on EMS clinicians who have self-reported experiencing negative emotions after delivering bad news t
The Bottom Line
JULY 10, 2024
In patients who have recently taken factor Xa inhibitors with an intracerebral haemorrhage (ICH) did the administration of Andexanet result in better haemostatic efficacy compared to standard care?
REBEL EM
JULY 10, 2024
Take Home Points Early administration of antibiotics (within 60 min) in patients with fever and neutropenia is life saving. Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well. Avoid sedation and lying supine and steroids in patients with mediastinal masses. Red flags in patients with headaches that may suggest a brain tumor include signs of increased intracranial pressure, focal neurological signs, seizures or ataxia.
FirstNet Authority
JULY 11, 2024
FirstNet at the Cow Creek Umpqua Pow Wow Blog joseph.rey@fir… Thu, 07/11/2024 - 13:08 By Jasper Bruner, National Tribal Government Liaison, 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.
NVFC
JULY 11, 2024
The National Volunteer Fire Council (NVFC) recently hosted two train-the-trainer events for instructors who will teach about key issues in the fire service across the U.S. One session addressed electric vehicle/alternative fueled vehicle (EV/AFV) incidents, while the other focused on recruitment and retention (R&R). Both trainings took place in Buffalo, NY, immediately following the NVFC Training Summit.
Dr. Smith's ECG Blog
JULY 10, 2024
Our latest @stemlyns podcast is an absolute cracker. A chat with @smithECGBlog about all things OMI and artificial intelligence for ECG interpretation. Could be a game changer for many.
Life in the Fastlane
JULY 8, 2024
Kane Guthrie and Mike Cadogan LITFL Update 031 Update 029. Sending you FOAMed content from around the globe. Latest trends and best articles so that you stay top of your field.
FirstNet Authority
JULY 9, 2024
Getting the Most Out of FirstNet Blog joseph.rey@fir… Tue, 07/09/2024 - 09:22 By 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. Follow us on Twitter , Facebook , Instagram , and LinkedIn for the latest FirstNet Authority updates.
ACEP Now
JULY 8, 2024
Virtually everyone has experimented with large language models (LLMs) in some fashion. Whether a person is conducting such parlor tricks as generating “Choose Your Own Adventure” children’s stories, looking for recipes in order to utilize a strange assortment of leftover ingredients, or composing eloquent poetry, the list of non-serious uses is vast.
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