ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. On hospital day 2, he was taken to the operating room for surgical rib fixation. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.)

EMS 52

EMS Operating Room ICU Emergency Department 52

Handtevy

SEPTEMBER 20, 2022

The standard care in North America for post-traumatic EDH involves decompressive craniotomy or trepanation via a burr hole, typically performed in an operating room by neurosurgery teams. Initially refusing emergency medical services, she was brought to the ED via a private vehicle.

Operating Room 52

Operating Room Emergency Medical Services ED Emergency Department 52

EMDocs

JULY 17, 2023

In these cases, CT may not be feasible and a plain radiograph showing free air or bedside US showing free fluid may be useful to confirm serious abdominal pathology prior to transfer to the operating room. He describes the pain as a gradually worsening pressure-like discomfort distributed across his entire abdomen.

E-9-1-1 77

E-9-1-1 ED ALS Operating Room 77

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. N Engl J Med. 2000 May 4; PMID: 10793162 Harvey CE, et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

ACEP Now

MARCH 14, 2024

A 24-year-old male with history of quadriplegia and traumatic brain injury presents to the emergency department with hemorrhage in his oral cavity and blood from his tracheostomy tube. He has had a tracheostomy for approximately 15 months since his injury. Blood is spurting from the orifice of the tube.

E-9-1-1 52

E-9-1-1 ALS Operating Room OR 52

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 0.41), p < 0.001.

E-9-1-1 183

E-9-1-1 Operating Room Emergency Department ALS 183

ALiEM

FEBRUARY 12, 2024

A 28-year-old female G3P2002 presented to the emergency department for one month of vaginal bleeding. The patient was seen in the emergency department one month earlier for vaginal bleeding in the first trimester of pregnancy. Her estimated gestational age was six weeks by last menstrual period.

Operating Room 161

Operating Room Emergency Department ALS OR 161

EMDocs

JUNE 3, 2023

C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. This is less critical in ED management of the unstable pelvic fracture, as the optimal site for identification of rectal or vaginal tears is the operating room. An x-ray in the trauma bay demonstrated an AP grade III fracture.

ED 54

ED Operating Room ALS Frozen Plasma 54

FOAMfrat

DECEMBER 28, 2023

During Orientations, new crew members must do a minimum of 10 live intubations in the operating room before being cleared to intubate in the field. From experience, some emergency departments would not even allow the nurse to administer a paralytic. The conclusion of this article…drum roll….

Emergency Medical Services 52

Emergency Medical Services Paramedic Operating Room OR 52

REBEL EM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

Epinephrine 95

Epinephrine Emergency Department ALS Critical Care 95

ACEP Now

JANUARY 12, 2024

Case A 40-year-old female at 11 weeks, five days gestation presented to the emergency department (ED) with concern for lower abdominal pressure and inability to fully empty her bladder. The patient was admitted to the obstetrics service and underwent spinal anesthesia in the operating room to manually reduce the uterus.

Operating Room 52

Operating Room Emergency Department OR ED 52

ACEP Now

APRIL 4, 2024

3 The majority of those who arrive to the emergency department (ED) live for 2 hours or more, leaving a small window for surgical intervention. Other exceptions are patient refusal, patient death or immediate transfer to the operating room. About 35 percent of individuals with rAAA will die at home.

Operating Room 40

Operating Room ALS ED Emergency Department 40

AAEM RSA

DECEMBER 3, 2020

A thorough physical exam, imaging, and laboratory studies can assist, but definitive diagnosis can only be made in the operating room. West J Emerg Med. Inadequate Sensitivity of Laboratory Risk Indicator to Rule Out Necrotizing Fasciitis in the Emergency Department. West J Emerg Med. 2014;15(1):111-113.

Emergency Department 52

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

Don't Forget the Bubbles

FEBRUARY 7, 2024

My first real encounter with the healthcare system took place when I was about seven years old and had to go into hospital for an orchidopexy, so I can empathize with all the young people who come through our emergency department with acute testicular pain. This dropped to 79.3%

Operating Room 111

Operating Room Emergency Department ALS OR 111