Dr. Smith's ECG Blog

OCTOBER 21, 2023

Here is a subsequent rhythm strip: This confirms sinus rhythm == MY Comment , by K EN G RAUER, MD ( 10/21 /2023 ): == It is often challenging to review the charts of complex cases when you lack a detailed sequential account of events that transpired. From a purely ECG interpretation standpoint — How would you interpret today's rhythm ?

OR 139

OR 139

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Patient # 1: Assessment of the Initial ECG in the ED … The History for Patient #1 — is clearly concerning for a higher -risk likelihood of having an acute event. Patient # 2: Assessment of the Initial ECG in the ED … While still of concern — I found the history for Patient #2 of a lower likelihood for an acute event.

OR 116

OR STEMI Coronary ED 116

REBEL EM

MAY 27, 2024

What they did: Prospective randomized controlled trial, unblinded, multicenter study Conducted from January 2017 to December 2022 Patients with confirmed PSVT were randomly assigned to receive MVM, IV Adenosine, or combined therapy. This absence of detail leaves the study open to bias. Evidence suggests that a weight-based dosing approach (0.1

OR 137

OR E-9-1-1 ED ALS 137

Unitek EMT

MAY 28, 2024

Event Medical Services Emergency Medical Technicians (EMTs) play a crucial role in ensuring the safety and well-being of attendees at various events and gatherings. Your comprehensive guide: roles, responsibilities, and pathways to success.

EMT 75

EMT EMT Emergency Medical Technician OR 75

High Performance EMS

OCTOBER 11, 2024

Participating public safety agencies recommend more than 1,000 nearby AEDs for approximately 800 cardiac arrest events every day! ( Spoiler alert, we have a pretty good idea of that number through the existing use of the Emergency AED Registry. View live stats for the registry here. View live stats for the registry here. What can you do?

Public Safety 317

Public Safety Defibrillator EMD CPR 317

American Burn Association

JANUARY 10, 2025

10, 2025] As wildfires rage across California, the American Burn Association (ABA) is prepared to assist burn centers and healthcare providers in responding to burn injuries resulting from these devastating events. The ABA continues to mobilize resources and expertise to support communities and healthcare systems facing these challenges.

First Responder 119

First Responder Life Support OR 119

FirstNet Authority

AUGUST 1, 2024

Don’t miss events at APCO 2024 Blog joseph.rey@fir… Thu, 08/01/2024 - 09:48 By Jennifer McIntyre, Senior Public Safety Advisor, First Responder Network Authority Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters.

Public Safety 72

Public Safety First Responder OR 72

The Skeptics' Guide to EM

OCTOBER 3, 2021

In the two large trials, this benefit was seen as a reduction in a composite outcome of major adverse kidney events within 30 days (MAKE-30). Date: September 28th, 2021 Reference: Zampieri et al. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Lactated Ringer’s or Plasmalyte 148) over 0.9%

OR 130

OR Critical Care ICU Plasma 130

Pediatric EM Morsels

JULY 19, 2024

If bleeding has completely stopped, most of these children still come into the hospital for observation so access will likely be necessary and helpful should patient have rebleed event. Resolved Bleeding on Arrival Nebulized TXA: Even in the setting of bleeding that has stopped, nebulized TXA has been shown to reduce rebleeding events.

E-9-1-1 290

E-9-1-1 Epinephrine Emergency Department OR 290

Dr. Smith's ECG Blog

OCTOBER 1, 2023

This history immediately places this patient in a high -prevalence population for having an acute event. Thus, the role of the emergency provider has to be proving that an acute event is not happening — rather than the other way around. It's OK not to be certain from the initial ECG as to whether or not an acute event is occurring.

OR 127

OR STEMI CAD Coronary 127

ALiEM

OCTOBER 30, 2024

The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Along the same time, a veterinary sedative, xylazine , became popular in Puerto Rico in individuals who used injection drugs [3]. We treat with wound care and reserve surgical management only for limbs that are no longer viable.

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

EMOttawa

NOVEMBER 7, 2024

These injuries can arise from various sources, including thermal injuries from fires, recreational activities such as smoke exposure during camping or outdoor events, and chemical inhalation in both industrial and household settings.

OR 86

OR 86

American Burn Association

JANUARY 14, 2025

The recent event highlights this long-standing partnership in the western region, readiness and disaster preparation. The collaboration between burn centers and the ABA is what makes it possible to manage events of this magnitude, said Pomerantz. According to Jain, the Arizona Burn Centers team includes ABA members such as Drs.

OR 105

OR 105

High Performance EMS

MARCH 8, 2024

It may be better to account for the coverage of recommended demand maintained based on a measured forecast for evaluation of performance, for instance, than simply reviewing specific results at the end of an event. It is also important that the decision criteria be flexible to adjust quickly to any changes in the business environment.

Public Safety 278

Public Safety OR 278

The Skeptics' Guide to EM

JULY 6, 2024

Conflicts in the ED often stem from clinical decision-making and actions, leading to potential adverse patient events and exacerbating access block issues. An abdominal pelvic CT scan demonstrates uncomplicated left-sided diverticulitis. Background: We have discussed agitation in the ED on the SGEM several times.

ED 242

ED ALS Emergency Department OR 242

The Skeptics' Guide to EM

AUGUST 17, 2024

Networking Opportunities: The conference provides a unique platform to connect with peers, thought leaders, and industry professionals from around the world, fostering collaborations that can continue long after the event. Five Questions about IncrEMentuM Listen to the podcast to hear Francisco and Carmen answer the five questions.

EMS 260

EMS OR 260

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

As discussed above in Dr. Smith's excellent discussion — serial ECGs, correlated to severity of patient symptoms soon confirmed the acute event in today's patient. This is diagnostic of full reperfusion.] An old ECG was found: As you can see, this patient has zero baseline STE, and normal T-waves. 90% of normals have some STE in V2 and V3.

OR 131

OR STEMI Coronary 131

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

Furthermore, if this occurs at all, it is a rare event. It is not small but rather large plaques, which may not be producing significant stenosis, that undergo rupture with acute occlusive thrombosis, resulting in myocardial infarction and other ischemic events. years, with the interval as long as 12 or 18 years in some studies.

Coronary 122

Coronary ACS OR EMR 122

NVFC

MARCH 12, 2024

However, departments that protect fewer than 2,500 people, which are almost all volunteer, have the highest percentage of firefighters over the age of 50 (34%). In many rural areas it is not uncommon to find volunteers in their 60s or 70s. The post Is Volunteerism Dying Or Has Your Marketing Flatlined?

OR 116

OR Firefighter NFPA EMT 116

First Responder Wellness

FEBRUARY 25, 2025

Given the high propensity for police officers to be exposed to such events, it is not surprising that we see a higher rate of PTSD in officers than in the general population (Lewis-Schroeder et al., PTSD is a unique mental health condition as it is one of the only disorders that specifically requires a precipitating event.

First Responder 78

First Responder Public Safety ALS OR 78

First Responders Foundation

NOVEMBER 25, 2024

Veterans and first responders, who often experience multiple traumatic events over their careers, benefit from the calming presence of a service dog. Whether it’s helping a firefighter cope with trauma or aiding a police officer with mobility issues, these specially trained dogs provide a level of support that can be life-changing.

First Responder 90

First Responder Public Safety Firefighter OR 90

Core EM

JANUARY 25, 2024

Consider these medications if there are signs of end-organ dysfunction, there is a considerable delta in baseline BP, systolic is less than 90 and/or MAP is less than 65 Norepinephrine is a good pressor for a lot of the situations that we encounter in the emergency department, such as septic shock, undifferentiated shock and hypovolemic shock.

Epinephrine 246

Epinephrine Critical Care Emergency Department ED 246

Don't Forget the Bubbles

NOVEMBER 11, 2024

Target temperature management in traumatic brain injury with a focus on adverse events, recognition, and prevention. One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. Should we aim to prevent fever, or should we cool patients?

ALS 117

ALS Life Support Critical Care OR 117

FOAMfrat

DECEMBER 26, 2024

TRIGGER WARNING: TOPICS OF SUICIDE MAY BE HARD FOR SOME PEOPLE TO READ ABOUT. THIS ARTICLE IS COVERING THE MEDICAL ASPECTS OF CHEMICAL SUICIDES. IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCY DEPARTMENT. REMEMBER, IF YOU ARE TREATING A SUICIDE ATTEMPT SURVIVOR, DO NOT PASS JUDGMENT.

Epinephrine 116

Epinephrine First Responder OR Emergency Management 116

EMDocs

DECEMBER 23, 2024

Major adverse cardiac events 40 minutes after giving the antiarrhythmic. Major adverse cardiac events 40 minutes after giving the antiarrhythmic. The following table shows their results, take a look: Note that procainamide leads with less adverse cardiac events. This was based on 11, thats not a typo, ELEVEN patients.

ALS 75

ALS OR STEMI EMS 75

First Responder Wellness

APRIL 4, 2025

Trauma Exposure: Frequent, Cumulative, and Unique Vulnerability: Traumatic incidents are not one-off events for first respondersthey are part of the job description. Rather than casting blame, we must recognize how easily a coping mechanism like alcohol can turn into a deeper struggle. screening positive for problem drinking (Haddock et al.,

First Responder 81

First Responder Firefighter ALS Paramedic 81

Pediatric EM Morsels

SEPTEMBER 22, 2023

Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. Spinal shock is a phenomenon of transient, physiologic (rather than anatomic) complete loss of spinal cord function inferior to an injury. Thought to be a “stunning” of the spinal cord. Basics are the Best!

E-9-1-1 304

E-9-1-1 Epinephrine ALS EMS 304

REBEL EM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. 2 Despite these recommendations there are no randomized clinical trials to help guide practice until now.

OR 91

OR Emergency Medical Technician CPR Emergency Medical Services 91

EMDocs

FEBRUARY 15, 2025

1: New Meta-analysis Metoprolol vs Diltiazem for A-Fib with RVR Spoon Feed This systematic review of 13 studies found slightly higher rates of adverse events after administration of diltiazem versus metoprolol, when treating atrial fibrillation (a-fib) with RVR. . #1: Am J Emerg Med. 2024 Dec 27;89:230-240. doi: 10.1016/j.ajem.2024.12.070.

OR 58

OR 58

EMDocs

NOVEMBER 13, 2024

Guidelines also recommend against routinely transfusing blood products to correct coagulation panel abnormalities; transfusion is associated with adverse events and does not reduce the risk of bleeding. Literature concerning risk with PPIs is controversial. Literature suggests 10-33% of patients are asymptomatic or only have mild symptoms.

E-9-1-1 105

E-9-1-1 ALS OR ED 105

ACEP Now

APRIL 5, 2024

Techniques, success, and adverse events of emergency department adult intubations [published correction appears in Ann Emerg Med. A study in the February issue of Annals conducted a meta-analysis of 18 studies and concluded that bougie use was associated with increased first-attempt intubation success. percent with use of a bougie and 83.0

OR 73

OR ALS Emergency Department Critical Care 73

Core EM

JANUARY 25, 2024

mEq/L Effect starts 10-20 mins after administration and can last 4-6 hours Albuterol 10-20 mg over 10 mins (NB: higher dose than for asthma) Peak effect at 90 mins Decreases by 0.5 – 1.0 mEq/L alone With insulin, ~1.2 mEq/L, additive effect Bicarbonate Controversy. mEq/L alone With insulin, ~1.2

Epinephrine 246

Epinephrine ED OR 246

Chicago EMT Training

AUGUST 6, 2021

Standby EMS for events The company that comes to mind in Chicago is Event Medical Solutions. Standby EMS for events The company that comes to mind in Chicago is Event Medical Solutions. The biggest event they provide EMS for recently is Lollapalooza. It opens many doors in various industries.

EMT 130

EMT EMT Paramedic Plasma 130

The Skeptics' Guide to EM

JULY 22, 2023

Intubation FPS is associated with fewer adverse events, most importantly hypoxia, hypotension, and cardiac arrest. Your assessment is that the patient will likely be a physiologically, but not anatomically, difficult airway. You’ve assured appropriate physiologic optimization and pharmacologic preparation and are ready to intubate.

Emergency Medical Services 245

Emergency Medical Services Defibrillator CPR EMS 245

NVFC

SEPTEMBER 10, 2024

The impact was significant: about half of the departments that hosted a screening during a recruitment event enlisted new volunteer firefighters or received strong inquiries, and one station received a $350,000 grant after screening it for state representatives. Want to host a watch party or hold your own FREE recruitment event?

Firefighter 122

Firefighter First Responder OR 122

ESO

JANUARY 30, 2025

Critical incident reporting metrics are designed to measure the events that have the most potential to be psychologically traumatizing for first responders and are closest linked to PTSD and suicide. Enable incident tracking and take action when any events are reported. Documenting exposure to critical incidents is key.

First Responder 52

First Responder Public Safety EMS First Response 52

REBEL EM

JUNE 26, 2023

This could potentially help improve thrombin generation, reduce blood product consumption, but also could increase the risk of thromboembolic events. Some clinicians have advocated for early administration of 4-factor prothrombin complex concentrate (4F-PCC) based on limited observational data. to 3.33; P = 0.72 to 2.10; P = 0.03

FFP 145

FFP Frozen Plasma ALS Plasma 145