Don't Forget the Bubbles

JUNE 19, 2024

In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR). What is the problem? What did previous studies show?

CPR 124

CPR Operating Room OR Emergency Department 124

REBEL EM

NOVEMBER 25, 2024

Included patients from out-of-hospital, emergency department, intensive care unit, and operating-room intubations. Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Exclusion criteria: Manikin and cadaver studies. airway scope). to 1.36).

Operating Room 79

Operating Room Emergency Department ICU ALS 79

REBEL EM

JUNE 8, 2023

Epinephrine – 10ug/mL, 10mL syringe Phenylephrine – 100ug/mL, 10mL syringe Phenylephrine bolus doses from 100-200ug and epinephrine 10-20ug administered every 2-5 minutes pursuant to provider order Inclusion Criteria: Adults age >18 years old Received at least one bolus dose of phenylephrine or epinephrine pre-filled syringes Exclusion (..)

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. The literature suggests that approximately 85 percent of these cases require procedural source control in the operating room, highlighting the importance of expediting transport arrangements. CREDIT: Dr. P.

Operating Room 52

Operating Room Epinephrine ALS ED 52

GEDC

APRIL 12, 2024

Thanks to the American College of Surgeons and the Institute for Healthcare Improvement, who, along with the American College of Emergency Physicians (ACEP), spearheaded the rule development, the new measure will encourage hospital systems to change the way they approach care for older patients.

Operating Room 52

Operating Room Emergency Department ED OR 52

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm.

Operating Room 52

Operating Room ACS Critical Care Coronary 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. The Journal of Emergency Medicine.

Operating Room 52

Operating Room Emergency Medical Services ED Emergency Department 52

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. His vital signs were within normal limits except for a respiratory rate of 23 with a room air pulse oxygen in the upper 90s. Click to enlarge.)

EMS 52

EMS Operating Room ICU Emergency Department 52

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. 7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. He reports distension and the sensation of fullness. Small bowel dilation may also be seen.

E-9-1-1 78

E-9-1-1 ED ALS Operating Room 78

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. Let’s start with what this study is This study is of a single service with three (3) bases in southeastern Wisconsin and northern Illinois. Data was pulled from June 2013 to June 2018.

Paramedic 52

Paramedic Emergency Medical Services Operating Room OR 52

EMDocs

JUNE 3, 2023

C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. 4 This is the framework the ED resuscitationist should be operating under, as hemodynamically unstable pelvic trauma patients require a different approach compared to stable patients who will undergo CT, routine pelvic fixation, and definitive surgical repair.

ED 54

ED Operating Room ALS Frozen Plasma 54

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. 7,8 The significance of this is clear: bronchoscopy or angiography may not suffice to make the diagnosis in the emergency setting.

E-9-1-1 52

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

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 77

EMS E-9-1-1 Operating Room Emergency Department 77

AAEM RSA

DECEMBER 3, 2020

Diagnosis is clinical and challenged by overlap with more superficial skin infections (i.e. cellulitis) and the need for thorough examination of the genital region. 1 His description of cases of life-threatening infections in the perineal, genital or perianal regions were thought to be idiopathic in previously healthy men.

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% How do you diagnose torsion? Where does this leave us?

Operating Room 111

Operating Room Emergency Department ALS OR 111

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. 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.

Operating Room 40

Operating Room ALS ED Emergency Department 40

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

REBEL EM

DECEMBER 18, 2024

Diagnosis: Diagnosis can be made based on clinical exam alone Physical exam Inability to close the mouth Garbled speech Drooling. Anterior dislocations: palpation of the TMJ can reveal one or both of the condyles to be anteriorly displaced in front of the articular eminence.

Operating Room 52

Operating Room ALS ED Emergency Department 52

FOAMfrat

NOVEMBER 25, 2024

Epidemiology Amniotic fluid embolism (AFE) is an incredibly rare yet catastrophic pathology during which fetal debris and/or amniotic fluid enters the maternal central circulation in the third trimester of pregnancy or, most commonly, during the labor process. Regardless, she complains of sudden and severe shortness of breath.

Epinephrine 105

Epinephrine CPR Operating Room Plasma 105