The Skeptics' Guide to EM

FEBRUARY 2, 2018

Might his examination be enough to convince the urologists to take him straight to the operating room without a preceding diagnostic ultrasound? Melissa is passionate about clinical and translational research and focuses most of her work on the use of capnography or end-tidal carbon dioxide monitoring.

Operating Room 100

Operating Room Emergency Department ALS ED 100

Critical Care Scenarios

JULY 11, 2021

Takeaway lessons * Trauma patients who are hypotensive or otherwise unstable should be assumed to be bleeding, bleeding, bleeding until proven otherwise, and should have a very low threshold to proceed directly to the operating room for exploration.* Operative prep for exploratory laparotomy is usually from the chin to the knees.

Operating Room 100

Operating Room ICU ED OR 100

ESO

MARCH 7, 2024

Surgical Repair of Hip Fractures: Demonstrating effective care prioritization, 94% of older adults with hip fractures were moved to the operating room within 24 hours. This rapid intervention reduced complications and highlights the need for maintaining and improving such protocols.

Operating Room 106

Operating Room ICU OR ED 106

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). Randomized controlled trials or comparative non-randomized observational studies. airway scope).

Operating Room 91

Operating Room Emergency Department ICU ALS 91

Don't Forget the Bubbles

NOVEMBER 22, 2023

They concluded that propofol is safe, particularly in short-term sedation, but should be used with caution outside of the operating room, given some of the potentially severe adverse events (including PRIS) seen. Mortality associated with PRIS has been estimated to be around 33% and becomes even higher if the diagnosis is delayed.

E-9-1-1 126

E-9-1-1 Critical Care Operating Room ALS 126

EMDocs

SEPTEMBER 7, 2024

Patients may arrive with other concomitant injuries such as head or spine injuries and may be critically ill. Imaging CT scan of the abdomen and pelvis with IV contrast or CT angiogram of the abdomen is the imaging modality of choice. Majority of RPH will stabilize on their own and not require intervention. Mortality can varies between 5-20%.

EMS 75

EMS E-9-1-1 Operating Room OR 75

Broome Docs

APRIL 30, 2024

Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in the Operating Room: A Cluster Randomized Clinical Trial. PMID: 36895888 Yeah, we get it, video is better Ruetzler K, Bustamante S, Schmidt MT, Almonacid-Cardenas F, Duncan A, Bauer A, Turan A, Skubas NJ, Sessler DI; Collaborative VLS Trial Group. N Engl J Med.

Operating Room 70

Operating Room Critical Care ED OR 70

GEDC

APRIL 12, 2024

IPPS Proposed Rule by the Centers for Medicare & Medicaid Services The Age-Friendly Hospital measure assesses hospital commitment to improving care for patients 65 years or older receiving services in the hospital, operating room, or emergency department (pg.

Operating Room 52

Operating Room Emergency Department ED OR 52

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

REBEL EM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

ICU 81

ICU Operating Room Critical Care ALS 81

ACEP Now

MARCH 14, 2024

Thick, dry, and calloused skin of a construction worker can have as much as 100 times more resistance than the previous example. 4 This may lead to more heat dissipated at the skin with impressive burns to skin, but less transmission of electricity to deeper tissues. High voltage” is defined by texts as 600 V and 1,000 V. Click to enlarge.)

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. EDH accompanies up to 4% of adult head injuries, leading to 10% mortality in adults and 5% mortality in children. What are the key takeaways? (1)

Operating Room 52

Operating Room Emergency Medical Services ED Emergency Department 52

ACEP Now

MAY 4, 2023

His vital signs were within normal limits except for a respiratory rate of 23 with a room air pulse oxygen in the upper 90s. On hospital day 2, he was taken to the operating room for surgical rib fixation. The splint consisted of a folded blanket placed over the mobile segment and held in place with tape.

EMS 52

EMS Operating Room ICU Emergency Department 52

EMDocs

JUNE 3, 2023

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. Conceptually, pelvic ring fractures are similar to breaking a hard pretzel.

ED 54

ED Operating Room ALS Frozen Plasma 54

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

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. 2-3 Risk Factors CRC is the most common underlying etiology of LBO.

E-9-1-1 78

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

ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. The University of Virginia (UVA) School of Medicine was founded in 1819 by Thomas Jefferson and is one of the oldest medical schools in the United States. This volume and variation presented challenges when attempting to staff the ED appropriately.

Emergency Department 52

Emergency Department Operating Room ED OR 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. Or Helly Larson describing the first week after her Miami BBL as “absolute hell” to a Vox reporter.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

Emergency Medicine Ireland

APRIL 26, 2021

This is certainly outside the realm of intensive care but remains a somewhat magical act that my surgical and anaesthetistic colleagues perform in the operating room. These are now recently developed for the lungs which allows donor lungs to be perfused and even optimised prior to implantation.

Critical Care 40

Critical Care Operating Room OR 40

ACEP Now

MARCH 14, 2024

18 The finger is inserted through the stoma alongside the endotracheal tube and, while 90 percent success rate has been reported with this method in controlling bleeding, the pressure must be maintained until the patient is transferred to the operating room. In one case series of seven patients, the average patient age was 15.7

E-9-1-1 52

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

REBEL EM

MARCH 27, 2023

First ED-based study to evaluate how operational effects such as crowding can affect patient care in the form of LPV Included ARDS criteria relating to the usage of LPV in the ED allowing evaluation as to whether patients with ARDS were more likely to receive LPV settings. of patients left the ED on TV settings of 450 mL and 36.1%

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

Paramedic Training Spot

JANUARY 20, 2022

Some states and programs also require EMT students to complete 24 to 48 hours of clinical time working in an emergency room and/or ambulance under the supervision of a certified EMT, paramedic, or registered nurse. The CPR course typically takes 4 to 8 hours to complete.

Paramedic 52

Paramedic Emergency Medical Technician Emergency Medical Services EMT 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

Don't Forget the Bubbles

FEBRUARY 7, 2024

One systematic review of 1283 patients showed that if you got to the operating room within 6 hours, you had a 97% chance of saving the testicle. The gold standard – the only way you will really know if there is a torsion or not – is to take a look in the operating theatre. How do you diagnose torsion?

Operating Room 111

Operating Room Emergency Department ALS OR 111

ACEP Now

JANUARY 12, 2024

The patient was admitted to the obstetrics service and underwent spinal anesthesia in the operating room to manually reduce the uterus. She had urinary dribbling when standing and leaning forward. She denied fevers, back pain, saddle anesthesia, numbness, or weakness in the extremities. A pessary was inserted during that procedure.

Operating Room 52

Operating Room Emergency Department OR ED 52

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

ACEP Now

APRIL 4, 2024

Other exceptions are patient refusal, patient death or immediate transfer to the operating room. The classic triad of abdominal pain, hypotension and pulsatile abdominal mass is present in less than 25 percent of patients. 2 Patients can present with back pain, or with focal neurologic signs such as numbness of the lower extremity.

Operating Room 40

Operating Room ALS ED Emergency Department 40

FOAMfrat

MARCH 11, 2024

However, we may need to temporize the patient before they can get to an operating room. The placenta wants to connect to the uterine wall at a location that allows good communication between the two. This causes the placenta to look elsewhere for an attachment site with better circulation. volume resuscitation is necessary.

Operating Room 65

Operating Room ALS OR Ambulance 65

ALiEM

FEBRUARY 12, 2024

The patient was taken to the operating room for dilation and curettage and was discharged the following day. She endorsed worsening nausea and vomiting over the past two weeks. She has been sexually active since her last encounter. She denied abdominal pain, pelvic pain, cramping, dizziness, shortness of breath, or fevers.

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 106

Epinephrine CPR Operating Room Plasma 106