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EM@3AM: Retroperitoneal Hematoma

EMDocs

We’ll keep it short, while you keep that EM brain sharp. F, RR 16, SpO2 97% on room air. A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness.

EMS 75
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SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections

The Skeptics' Guide to EM

He will need to be transferred to the tertiary care center which is 35 minutes away by ground EMS if it is a dissection. Type A AoDs generally require an emergent trip to the operating room as soon as they are identified to reduce the likelihood of a terrible outcome. You suspect an acute aortic dissection (AoD).

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Ep 164 Cardiogenic Shock Simplified

Emergency Medicine Cases

What are the best strategies to efficiently get the patient in cardiogenic shock to definitive care, whether that be the cath lab or the operating room? How can we best pick up occult cardiogenic shock before it floured shock kicks in? Which patients with acute heart are safe to send home in general?

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Case Report: EMS Says Flail Chest, But Is It?

ACEP Now

EMS recognized a chest wall deformity with movement of the chest wall, and a splint was devised and taped around his chest for what was suspected to be a 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. A chest tube was placed at that time.

EMS 52
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Cervical Spine Imaging in Kids – the PECARN rule

Don't Forget the Bubbles

Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. A proportion of the patients who were initially missed using the CDR were found to actually have risk factors documented in EMS reports or the medical record. What is the problem?

CPR 124
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Case Report: a High-Voltage Victim

ACEP Now

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.

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SGEM#186: Apneic and the O, O, O2 for Rapid Sequence Intubation

The Skeptics' Guide to EM

He writes an excellent blog called EM Nerd , which he describes as nihilistic ramblings. There have been some studies in various clinical settings (operating room, critical care and pre-hospital) that have demonstration benefit of apneic oxygenation. Case: A 68-year-old female presents with shortness of breath.