EMDocs

AUGUST 7, 2023

7 The American College of Emergency Physicians (ACEP) clinical policy supports the use of age-adjusted D-dimer testing when evaluating for VTE in older patients. The chest pain started suddenly today while at rest, is located on the right side, and radiates to her back. She denies other symptoms, including leg pain or swelling.

E-9-1-1 97

E-9-1-1 ALS Plasma OR 97

Core EM

JANUARY 25, 2024

link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. Patients should undergo comprehensive work-up to rule out alternative causes of thrombocytopenia, evaluate for end-organ damage, and identify underlying infectious or autoimmune etiologies.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

EMDocs

MARCH 4, 2024

Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.

Emergency Department 106

Emergency Department E-9-1-1 ALS OR 106

The Skeptics' Guide to EM

DECEMBER 17, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

EMDocs

JULY 11, 2023

HIV, hep C status Do they have an emergency plan from their hematologist? Today on the emDOCs cast, Brit Long, MD ( @long_brit) covers hemophilia, including background, severity, evaluation, and management. Episode 81: Hemophilia What is hemophilia? Other presenting bleeds were post-circumcision (27%) and heel-stick bleeds (17%).

Plasma 75

Plasma ALS OR Emergency Department 75

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

E-9-1-1 154

E-9-1-1 Plasma Emergency Department OR 154

EMDocs

DECEMBER 18, 2023

In addition to clinical screening methods, many biomarkers have emerged over the years as potential adjuncts for early diagnosis of sepsis. The patient currently resides at a skilled nursing facility. Per staff, she has been acting progressively more tired, confused, and less interactive over the last three days.

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E-9-1-1 ALS Emergency Department Plasma 94

Don't Forget the Bubbles

JUNE 30, 2023

You ask your anaesthetist to get ready to sedate or intubate depending on their status – Significant risk to the department – you make sure security is aware And your patient arrives. Ranulf is quite a sweet, round-faced boy, accompanied by his traumatised-looking mother as he is wheeled to your trauma bay.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

Don't Forget the Bubbles

AUGUST 12, 2024

What neuroprotective measures can we undertake in the emergency department? This can be from the brain hitting the skull, shear forces from sudden acceleration and deceleration, or direct injury at the point of impact. The severity of head injuries can be classified according to the GCS. This insult to the brain is often irreversible.

ALS 75

ALS Emergency Department Plasma OR 75

ACEP Now

APRIL 5, 2024

2 TTP often presents abruptly, and most patients that develop it first visit the emergency department (ED) as their symptoms worsen. It is thus imperative that emergency physicians be able to recognize and properly treat this disease, especially in the absence of its classical presentation. creatinine less than 2.0

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. 2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department.

E-9-1-1 95

E-9-1-1 ALS Emergency Department Plasma 95

FOAMfrat

AUGUST 15, 2024

I can only speak for me, but I don’t ever remember anyone talking about that, and I would venture to guess most readers don’t either. I love this definition because it is simple and to the point: bleeding post birth accompanied by shock. Perfusion in your body is much the same. In the case of our patient, she is experiencing the latter.

Plasma 69

Plasma Ambulance ALS Emergency Department 69

ACEP Now

NOVEMBER 16, 2023

Fresh frozen plasma, or FFP, should only be given to cirrhotic patients as part of the massive transfusion protocol in cases of profound hypotension, as “patients with cirrhosis rarely have true enzymatic hypocoagulability, and FFP may worsen bleeding due to over-resuscitation and dilution of coagulation factors.” 6 Balloon tamponade (i.e.,

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

EMDocs

JUNE 12, 2024

Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. Why is calcium important in trauma or critical illness?

ALS 106

ALS FFP Plasma Emergency Department 106

ACEP Now

APRIL 2, 2024

An 18-year-old woman presented to the emergency department (ED) with symptoms of nausea, vomiting, diarrhea, and abdominal pain. Ann Emerg Med. Quantification of hypoglycin A and methylenecyclopropylglycine in human plasma by HPLC-MS/MS. Since the onset of illness, she had been unable to tolerate any oral intake.

Plasma 40

Plasma ALS Emergency Department ED 40

Don't Forget the Bubbles

OCTOBER 28, 2024

doi: 10.1136/archdischild-2024-327224 Six-year-old Rhaenyra is brought into the emergency department after being hit by a car. Major haemorrhage protocols typically include a mixture of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Published Online First: 24 June 2024.

FFP 72

FFP Frozen Plasma Plasma ALS 72

FOAMfrat

SEPTEMBER 19, 2024

The patient, bystanders, and emergency personnel should avoid approaching or handling the snake. Background and Epidemiology In the United States, roughly 9,000 snake bites are reported annually, with approximately 3,000 being attributed to venomous species and less than 10 resulting in death. 's robust healthcare infrastructure.

Emergency Department 95

Emergency Department Epinephrine OR Plasma 95

EMDocs

JUNE 3, 2023

In fact, the World Society of Emergency Surgery (WSES) classification assigns grades I-III depending on their Young-Burgess classification, but any patient hemodynamically unstable from their pelvic fracture is automatically WSES grade IV regardless of their fracture pattern. of pelvic fractures to be open.

ED 67

ED Operating Room ALS Frozen Plasma 67

ACEP Now

FEBRUARY 11, 2025

A 33-year-old male with a history of drug use presented to the emergency department (ED) for extreme agitation after receiving two doses of 2 mg naloxone by EMS for respiratory depression. Upon arrival, his vitals were as follows: heart rate of 132 bpm, respiratory rate of 27, blood pressure of 134/75 mm Hg, and a SpO 2 of 100 percent.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89

Don't Forget the Bubbles

MARCH 24, 2025

Later phase : As plasma levels fall, vasoconstriction decreases. Dexmedetomidine (Dexmed) is a highly selective alpha-adrenoreceptor agonist that can provide anxiolysis, sedation , and analgesia. Alpha-adrenoreceptors are found all over the body and reduce the fight-or-flight (sympathetic) response. How is Dexmedetomidine used in the ED?

E-9-1-1 59

E-9-1-1 Emergency Department ALS Critical Care 59

EMDocs

JUNE 14, 2023

He has been having difficulty walking and is having trouble manipulating tools he uses for work with his hands. He has a glove and stocking pattern of numbness to his extremities. Motor and sensory findings are symmetrical. Patellar reflexes are 1+. Paraquat Influenza vaccine Methanol Organophosphate Are his symptoms reversible?

E-9-1-1 97

E-9-1-1 Emergency Department Plasma ED 97

EMDocs

FEBRUARY 3, 2025

She also reports a fever (maximum 101F), photosensitivity, and mild abdominal discomfort radiating to both flanks, accompanied by some shortness of breath. However, she denies chest pain or any recent infections. Physical examination reveals a fatigued-appearing female with a malar rash across her face. What are common manifestations of SLE flares?

ED 72

ED E-9-1-1 ALS OR 72

EMDocs

DECEMBER 6, 2024

A partner at bedside reports recent depressed mood, abdominal pain, and vomiting yesterday. The patient woke up confused this morning, and has had a worsening mental status throughout the day today. Children without vomiting within 6 hours of iron ingestion will almost never have significant toxic effects. Be wary of this stage. 2 L/hr in adults.

E-9-1-1 98

E-9-1-1 Frozen Plasma Plasma Overdose 98

FOAMfrat

NOVEMBER 25, 2024

Resuscitating patients with low titer O whole blood or with component therapy in a ratio of 1:1:1, with packed red blood cells, platelets, and plasma, is impactful as it will help promote the restoration of circulation and add platelets and hemoglobin to the depleted store. Regardless, she complains of sudden and severe shortness of breath.

Epinephrine 105

Epinephrine CPR Operating Room Plasma 105

EMDocs

JANUARY 22, 2025

Is there an ideal observation period in the emergency department after reversal with naloxone? What are the pharmacokinetics of naloxone and how do they vary by route of administration? When should a naloxone infusion be considered? Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years.

Naloxone 98

Naloxone E-9-1-1 Overdose NARCAN 98

EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. 7 May lead to respiratory failure.

E-9-1-1 98

E-9-1-1 ICU Emergency Department ED 98

Emergency Medicine Ireland

MARCH 4, 2021

GBS is a clinically important diagnosis for both the emergency department and the ICU. GBS is a clinically important diagnosis for both the emergency department and the ICU. Its rareish but common enough that you. Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 40

Critical Care ICU Plasma Emergency Department 40

Core EM

JANUARY 16, 2025

Success at intubation likely takes more time and practice than other procedures, as shown in recent research on ED residents and their success rate at intubating, measured as a function of their total number of intubations (See Figure 1). Practice may not achieve perfection, but it will make you better. fiber optic through the nose).

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E-9-1-1 EMS ALS OR 130

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. In addition, free haem and haemoglobin contribute to the vascular damage. Blood film shows sickle cells and a further sample was sent for confirmation of diagnosis.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. Her facial features were flattened, and her eyes were sunken deep into their sockets. cholerae bacteria.

ED 111

ED OR ALS Plasma 111

EMDocs

JANUARY 6, 2025

History of Present Illness The collateral history indicates that her symptoms began one week into her journey, but medical care was inaccessible at the time. The family reports no history of food allergies, insect bites, or contact with sick individuals. The patient did not receive pre-travel prophylaxis for malaria, hepatitis A, or yellow fever.

ED 75

ED E-9-1-1 ALS Emergency Department 75