EMDocs

OCTOBER 19, 2024

We’ll keep it short, while you keep that EM brain sharp. link] The post EM@3AM: Bacterial Tracheitis appeared first on emDOCs.net - Emergency Medicine Education. A 3-year-old male with no previous past medical history, born full term, and unvaccinated presents after 6 days of cough, fever, myalgias, and rhinorrhea. 1983;137(8):764.

EMS 109

EMS E-9-1-1 Epinephrine OR 109

EMDocs

SEPTEMBER 7, 2024

We’ll keep it short, while you keep that EM brain sharp. Disposition: Consider ICU for many patients, especially if any signs of instability or repeatedly requiring blood products. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank. Vital signs include BP 90/48, HR 122, T 98.3

EMS 97

EMS E-9-1-1 Operating Room OR 97

REBEL EM

AUGUST 7, 2023

Background Information: Delirium is a common and serious condition in patients in the intensive care unit (ICU). It is estimated to affect 30-50% of patients in the ICU and haloperidol is the most frequently used agent in treatment (3). Paper: Andersen-Ranberg NC,et al; AID-ICU Trial Group. N Engl J Med. 2022 Dec 29.

ICU 52

ICU ALS OR EMS 52

EMOttawa

JANUARY 25, 2024

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. With both ER and ICU experience, this post acts as a quick […] The post Mechanical Ventilation Basics appeared first on EMOttawa Blog.

ICU 143

ICU ED OR Critical Care 143

REBEL EM

FEBRUARY 15, 2024

PMID: 38019968 Clinical Question: In patients with suspected acute poisoning and GCS <9, is a conservative airway strategy of withholding intubation associated with a reduction in death, ICU LOS, and hospital LOS compared with routine practice of intubation? References: Freund Y et al.

ICU 139

ICU ALS ED OR 139

EMDocs

JUNE 3, 2023

We’ll keep it short, while you keep that EM brain sharp. Patients receiving thrombolysis will require ICU admission for neurologic monitoring. 29.8.1550 The post EM@3AM: Cerebellar Stroke appeared first on emDOCs.net - Emergency Medicine Education. Her symptoms have been constant over the last two weeks. 1998; 29(8):1550-1555.

EMS 96

EMS ALS OR ED 96

Emergency Medicine Cases

SEPTEMBER 25, 2019

While community acquired pneumonia (CAP) is 'bread and butter' emergency medicine, and the diagnosis is often a 'slam dunk', it turns out that up one third of the time, we are wrong about the diagnosis; that x-rays are not perfect; that blood work is seldom helpful; that not all antibiotics are created equal and that deciding who can go home and who (..)

Emergency Management 130

Emergency Management Emergency Manager ICU EMS 130

REBEL EM

FEBRUARY 19, 2024

PMID: 37611862 Clinical Question: In patients treated in the ICU, can a protocol of peripheral IV catheter vasopressors safely reduce the number of days of CVC use and frequency of placement? REBEL EM: Peripheral Vasopressors – Safe or Dangerous? Crit Care Med 2021.

ICU 134

ICU EMS ALS OR 134

Emergency Medicine Cases

AUGUST 25, 2020

Barbara Tatham, EM colleague and educator, died of metastatic sarcoma at the age of 32 in October 2019. During her last year of life, in between surgeries, ICU stays and rounds of chemotherapy and radiation, she gave lectures on compassionate care inspired by her journey as a patient.

ICU 130

ICU EMS 130

ACEP Now

OCTOBER 13, 2023

“We want important community leaders to be aware that we are highly concerned about this announcement and the dire impacts that this could have on our community and our patients,” said on a post by Texas A&M/Spohn EM on X. “We We fear that this decision will negatively impact patient safety and quality of care.”

ICU 132

ICU Emergency Department EMS 132

REBEL EM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Below you will find some of the points we discussed.

CPR 144

CPR ICU EMS ALS 144

Core EM

FEBRUARY 9, 2024

Population 18+-year-old patients admitted with septic shock to a Medical ICU in an academic hospital in Mexico. Length of ICU stay: 1.5 Clinical Question Does early and repeated administration of methylene blue in patients with septic shock achieve the following outcomes? sodium chloride over 6 hrs once daily for 3 days. p<0.001.

ICU 100

ICU EMS OR 100

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. All patients who receive thrombolytics for ischemic stroke should be admitted to a neurosurgical, neurologic, or medical ICU for management and monitoring, as this is shown to decrease mortality and length of stay. Lancet Neurol 2009; 8:724-730.

EMS 96

EMS ALS OR ACS 96

REBEL EM

JANUARY 18, 2024

PMID: 35387313 Clinical Question: Do prehospital antibiotics impact 28 day mortality, length of stay in the hospital and ICU length of stay for patients triggering sepsis compared to usual care (No prehospital antibiotics)? appeared first on REBEL EM - Emergency Medicine Blog. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

ICU 130

ICU ALS EMS 130

REBEL EM

MAY 29, 2024

The idea behind abx is to prevent things like AOM and TSS but neither should be much of an issue with short term placement ICU Admission? Traditional teaching is that these patients are at risk for life-threatening bradydysrhythmias and should go to the ICU Literature here is non-existent. PMID: 7741333 Corrales CE, Goode RL.

ICU 96

ICU ALS ACS EMS 96

REBEL EM

APRIL 9, 2024

She’s helped to redesign the built environment of a Harvard ICU and an infectious diseases unit in Malawi. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL EM Book Club – MicroSkills appeared first on REBEL EM - Emergency Medicine Blog. Post Peer Reviewed By: Salim R.

EMS 58

EMS ICU 58

REBEL EM

MAY 29, 2023

What They Did: Single-center, parallel, double blind, randomized controlled trial performed in a medical-surgical ICU (Mexico) Both groups received: Adjunctive vasopressin initiated at a dose of 0.03 It also reduced length of stay in ICU and hospital without adverse effects. appeared first on REBEL EM - Emergency Medicine Blog.

ICU 145

ICU ALS Epinephrine OR 145

The Skeptics' Guide to EM

JULY 16, 2022

Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice. She is admitted to the intensive care unit (ICU) for septic shock. The ICU team is considering using Vitamin C therapy for this patient.

ICU 100

ICU ALS Critical Care Emergency Department 100

REBEL EM

FEBRUARY 8, 2024

PMID: 38215002 Clinical Question: In critically ill adults in the ICU is noninvasive blood pressure (NIBP) monitoring similar (≤10% difference) to invasive arterial blood pressure (IABP) monitoring? PMID: 32109843 For More Thoughts on This Topic Checkout: REBEL EM: Is ATLS Wrong About Palpable Blood Pressure Estimates?

MICU 117

MICU ICU ALS EMS 117

The Skeptics' Guide to EM

OCTOBER 3, 2021

Case: A 66-year-old woman is brought in by EMS from home with lethargy and hypotension. Clinical Question: Does administration of a balanced solution (Plasma-Lyte 148) during intensive care unit (ICU) stay, compared with saline solution, result in improved 90-day survival in critically ill patients? Reference: Zampieri et al.

OR 130

OR Critical Care ICU Plasma 130

ALiEM

MAY 19, 2023

Esophageal Balloon Tamponade Devices – Linton-Nachlas, Sengstaken-Blakemore, Minnesota Tubes (image courtesy of Dr. Mark Ramzy at REBEL EM) What are esophageal balloon tamponade devices? It is time to MacGyver a method that allows you to know the esophageal balloon pressure that you are generating to avoid an esophageal rupture.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

REBEL EM

OCTOBER 2, 2023

Mild to moderate DKA represents a subgroup of patients that often require admission to the ICU due to hospital policies not allowing insulin infusions outside of this clinical setting. to 19.3hrs); Reduction by 3.6hrs ED LOS was shorter for the SQuID cohort ICU Admissions: SQuID & Traditional (Post Intervention): 42.9%

ICU 97

ICU ED ALS OR 97

Critical Care Scenarios

NOVEMBER 15, 2020

” is always, ultimately, the main question of the EM provider. ICU time and ED time are different. In the ICU, we have a useful (albeit sometimes flexible) cap: our total number of beds.* This differs from the main questions of many of their consulting and admitting specialties.*

ICU 100

ICU Life Support Emergency Department ED 100

Dr. Smith's ECG Blog

JANUARY 2, 2025

Dodd KW, Elm KD, Dodd EM, Smith SW. CASE CONTINUED She was admitted to the ICU. New formula for evaluation of the QT interval in patients with left bundle branch block. Heart Rhythm [Internet]. 2014;11:22732277. Available from: [link] 2. 2017;236:14. LBBB, ventricular pacing, etc.)."

Coronary 116

Coronary OR Defibrillator ALS 116

REBEL EM

FEBRUARY 29, 2024

3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. The low incidence could be a result of the systematic implementation of bundles known to decrease VAP incidence in the ICU. 4, 8 Paper: Dahyot-Fizelier, C.,

E-9-1-1 111

E-9-1-1 ICU ALS OR 111

REBEL EM

AUGUST 14, 2023

They consecutively enrolled 1,817 ICU patients from 45 sites across China. Population: Inclusion Criteria: Age 18-75 years old SOFA score 2-13 Admitted to the ICU with a diagnosis of sepsis 3.0, “ Life-threatening organ dysfunction caused by a dysregulated host response to infection.” 002) ICU-free days: Placebo 12.4%

ICU 97

ICU EMS OR ALS 97

The Skeptics' Guide to EM

JUNE 6, 2020

Max is then going to Georgetown to be an attending in both EM and ICU. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Case: It’s another day in your emergency department (ED).

EMR 130

EMR ALS ICU Emergency Department 130

EMS 12-Lead

MAY 8, 2022

EMS found her acutely ill, mottled, dry mucous membranes, modestly hypotensive, and lethargic. This is critical for the EMS provider, or ED clinician, as identification of Grade I ischemia (aka, HATW’s) addresses the culprit lesion at the earliest opportunity with excellent downstream prognosis for the patient. [2] An ECG is recorded.

STEMI 130

STEMI ED EMS Firefighter 130

REBEL EM

APRIL 22, 2024

Population: Adult patients ( > 18 years of age) admitted to the ICU with COVID-19 and severe hypoxemia (defined as receiving supplemental O2 with a flow rate of at least 10L/min or receiving mechanical ventilation or non-invasive ventilation. appeared first on REBEL EM - Emergency Medicine Blog.

Life Support 74

Life Support ICU EMS OR 74

The Skeptics' Guide to EM

MARCH 27, 2021

He has a passion for FOAMed and is the creator of the Danish EM platform www.akutmedicineren.dk. Recent guidelines recommend admitting the patient to the intensive care unit (ICU), but the patient is eager to return home to her husband who is also well, and whom she claims will be able to help her. Reference: Schuster et al.

ICU 100

ICU ALS Emergency Department ED 100

REBEL EM

OCTOBER 5, 2023

ClinicalTrials.gov: NCT02517489 7 Clinical Question: In adult patients with severe community-acquired pneumonia admitted to the ICU, does early hydrocortisone treatment, compared to standard therapy, reduce mortality at 28 days? ICU-acquired infections were observed in: 9.8% Patients enrolled from 31 Intensive Care Units in France.

Critical Care 94

Critical Care ICU E-9-1-1 ALS 94

The Skeptics' Guide to EM

NOVEMBER 16, 2019

NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest.

CPR 100

CPR ALS ICU EMS 100

AAEM RSA

JUNE 30, 2021

A combined Emergency Medicine (EM)/Internal Medicine (IM) residency program may allow for the best of both worlds. 2] The most popular fellowship pursued by combined training candidates is critical care (CC), and there are five all-inclusive combined EM/IM/CC programs in the United States. Welcome to LIJ EM/IM and EM/IM+CC.

EMS 52

EMS Critical Care ICU ED 52

The Overrun

MAY 18, 2020

This week is EMS Week. Usually, if you’re in EMS; this means some type of free meal, water bottle, bag, or other gift that symbolizes their respective agencies, hospitals, and healthcare systems thanking them for their service. Since the entry of COVID-19, EMS has noticed a difference. People wave. And that’s wrong.

EMS 52

EMS Firefighter Paramedicine Paramedicine 52

EMDocs

SEPTEMBER 6, 2023

Removed from cooling at 102 and admitted to ICU. Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints. Cooling blanket placed, but temperature increases to 107F. Immersion cooling completed with ice between body bags. Temperature starts to decrease. ROS unremarkable.

ACS 95

ACS ICU EMS ALS 95

Emergency Medicine Ireland

SEPTEMBER 20, 2021

There’s not a huge amount of notes on procedural stuff that I accumulated for the exams but I did collect some interesting bits on bronchoscopy, particularly because it was so novel to me as an EM trainee who really had no experience with bronchoscopy prior to starting to my critical care fellowship.

Critical Care 40

Critical Care ICU EMS OR 40

Critical Care Scenarios

OCTOBER 31, 2021

Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. An overview of VV ECMO with a focus on COVID-19, with Dr. Kimberly A. Data remains slim,

Interfacility Transport 100

Interfacility Transport Plasma ICU EMS 100