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 CAD 116

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

E-9-1-1 105

E-9-1-1 Emergency Department ICU ED 105

ALiEM

JUNE 10, 2024

Emergency physicians often face the challenge of deciding whether to proceed with imaging, given the potential risks associated with ionizing radiation from CT scans. High Risk (>12.1% sensitivity and 99.9% High Risk (>12.1% sensitivity and 99.9%

Emergency Department 317

Emergency Department ED OR 317

The Skeptics' Guide to EM

APRIL 13, 2024

When she arrives in your ED, her family tells you she was last seen normal about 12 hours ago. A code stroke is activated, and the initial CT head shows no signs of hemorrhage or early ischemic changes. A CT angiogram shows a proximal middle cerebral artery occlusion. CT perfusion showed a 10 mL core and 189 mL penumbra.

ALS 343

ALS Emergency Department EMS OR 343

Don't Forget the Bubbles

DECEMBER 31, 2024

Communication is as Visual as it is Verbal Communication is not just about speaking words; its about connecting, understanding, and being understood. Whether interacting with children, young people, or even colleagues, the nuances of communication turn exchanges into meaningful dialogue. The tone of their voice, even when the words seem neutral.

Emergency Department 140

Emergency Department OR 140

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Reference: Snelling et al. Ultrasonography or radiography for suspected pediatric distal forearm fractures. New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. He is also a fully-fledged ultrasonographer.

Critical Care 345

Critical Care ALS ED Emergency Department 345

Don't Forget the Bubbles

MARCH 21, 2025

Children under 16 undergoing emergency intubation between May 2017 and October 2022 were eligible for inclusion if consent could be obtained from their parent or legal guardian either prospectively or retrospectively. Patients were randomised in a 1:1 ratio to receive either nasal high-flow or standard care.

ICU 103

ICU Critical Care ED OR 103

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post ECG Cases 45 ECG in Weakness and Neurological Symptoms appeared first on Emergency Medicine Cases.

Coronary 321

Coronary OR EMS 321

EMS 12-Lead

APRIL 9, 2024

No 12 Lead ECG was captured, but telemetry did reveal the following: The spouse offers a pertinent medical history to include HTN and HLD, and furthermore states that he hasn’t previously complained of any chest discomfort, or shortness of breath. He awoke earlier that morning in his usual state of health. The CXR demonstrated no pulmonary edema.

Coronary 290

Coronary ACS CAD ED 290

Dr. Smith's ECG Blog

JANUARY 2, 2025

T-waves are quite tall and possibly peaked (HyperK?), but potassium returned normal. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis. What is the QT interval? In LBBB, the QT interval is partly prolonged by the wide QRS. Bogossian et al. (1)

Coronary 116

Coronary OR Defibrillator ALS 116

The Skeptics' Guide to EM

NOVEMBER 16, 2024

A promising application of AI is the development of early warning systems to detect patient deterioration. These systems use real-time data from electronic health records (EHRs) and other sources to predict which patients are at risk of adverse outcomes, such as cardiac arrest or transfer to an intensive care unit (ICU) [1.2].

ICU 275

ICU Emergency Department ALS EMS 275

Critical Care Scenarios

JANUARY 31, 2024

We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon here! Buy your merch here! Find us on Patreon here!

OR 283

OR 283

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

E-9-1-1 107

E-9-1-1 ACS OR Emergency Department 107

Pediatric EM Morsels

AUGUST 23, 2024

It does NOT have structural brain damage visible on standard neuroimaging. In the research setting, abnormalities can be found via functional, blood flow, or metabolic imaging. Mild traumatic brain injury also includes a larger group of injuries that may have evidence of structural injury.

Emergency Department 281

Emergency Department OR ED EMS 281

Emergency Medicine Cases

APRIL 2, 2024

In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain.

Emergency Department 329

Emergency Department OR STEMI EMS 329

Pediatric EM Morsels

MARCH 29, 2024

Let’s consider Inborn Errors of Metabolism Presenting in the ED : Inborn Errors of Metabolism: Basics Common Presentations, Uncommon Kiddos For the child with lethargy, vomiting, acidosis, hypoglycemia , organomegaly, or cardiopulmonary arrest remember to consider Inborn Errors of Metabolism (IEM) on your DDx. Kid with Known diagnosis?

ED 297

ED Plasma OR EMS 297

Pediatric EM Morsels

APRIL 19, 2024

Pediatric Buckle and Greenstick Forearm Fractures: Basics The junction of the metaphysis and diaphysis in pediatric long bones is an area of biomechanical transition (Light, 1984) Thin metaphyseal cortex meets the thick cortex of the diaphysis Or in Emergency Medicine terms, “ Thick bone meet thin bone.”

ALS 290

ALS ACS Emergency Department ED 290

Dr. Smith's ECG Blog

MARCH 10, 2025

Here's the PMCardio AI OMI Model Queen of Hearts interpretation: This confirms that computer normal ECGs are neither safe nor accurate, that physicians can identify subtle OMI in real time (enhanced by AI), and that the gold standard should be patient outcome. Take home 1. Computer normal ECGs are not safe or accurate. CJEM 2025 March 10 3.

STEMI 90

STEMI OR Coronary Emergency Department 90

ALiEM

OCTOBER 27, 2023

He denied vomiting, dizziness, diplopia, loss of consciousness, or seizures. Nothing made it better or worse. Additional Images Physical Exam Vitals : BP 101/63; HR 76; RR 14; T 36.7°C Most cases of MCM are found during prenatal ultrasonography. Adults with isolated MCM are typically asymptomatic and found incidentally on radiographic imaging.

OR 278

OR ED 278

ALiEM

FEBRUARY 9, 2024

Low-risk patients do not routinely require stress testing in the ED. Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. That’s because these values are assay specific. She does not smoke.

E-9-1-1 276

E-9-1-1 ED Coronary ALS 276

Pediatric EM Morsels

MAY 10, 2024

Ask about suicidal ideation : Let’s not miss a caustic ingestion… Ask about birth control : Teens may be on OCPs and at increased risk for PE and their parents don’t know it Ask about drugs : Does your patient smoke, vape, or use cocaine? Have you ever had chest pain or shortness of breath in exercise? Cardiac Murmurs, gallops or rubs? Equal pulses?

E-9-1-1 271

E-9-1-1 OR EMS 271

EMDocs

DECEMBER 1, 2024

typhi infection if treatment is refractory to supportive measures or conventional community-acquired pneumonia antibiotics Treat with atypical bacterial coverage (doxycycline, azithromycin, chloramphenicol, or fluoroquinolones) A 32-year-old woman presents to the ED with a fever and rash after returning from a trip to Southeast Asia. .:

EMS 104

EMS E-9-1-1 OR ED 104

EMDocs

NOVEMBER 19, 2024

Second-generation antipsychotics (see Table 1 below) improve both positive and negative symptoms of schizophrenia and are less likely to be associated with EPS. 1,2 Most second-generation antipsychotics act as D 2 antagonists and inhibit the 5-HT 2A receptor. Atypical antipsychotics come in daily and long-acting forms.

Overdose 111

Overdose EMS Emergency Medical Services ALS 111

American Ambulance Association

MARCH 3, 2025

This content is for AAA members only. Please either Log In or Join! The post Joint Position Statement on Criminal Liability for Alleged Deviations from Clinical Standards of Care in Emergency Medical Services appeared first on American Ambulance Association.

Emergency Medical Services 130

Emergency Medical Services Ambulance Emergency Medical Technician OR 130

Don't Forget the Bubbles

NOVEMBER 11, 2024

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? A 12-year-old boy presents with a significant head injury following a road traffic accident. Fever is common among patients with TBI.

ALS 117

ALS Life Support Critical Care OR 117

ACEP Now

JANUARY 5, 2025

Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. A patient’s mouth packed with gauze after tonsillectomy surgery. CREDIT: Dr. P.

Operating Room 98

Operating Room Epinephrine ALS ED 98

EMDocs

NOVEMBER 13, 2024

Literature concerning risk with PPIs is controversial. Presentation: Classic presentation is abdominal pain or tenderness, fever, and altered mental status. Literature suggests 10-33% of patients are asymptomatic or only have mild symptoms. Clinician sensitivity for SBP based on bedside assessment is between 40-75%. increase in mortality.

E-9-1-1 105

E-9-1-1 ALS OR ED 105

Pediatric EM Morsels

JULY 26, 2024

While it is important for us to maintain a safe work environment for our patients and our team, managing the agitated patient requires more of us than administering Droperidol or Ketamine. Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! The prevalence ranges from 12.5%-61%

Plasma 271

Plasma OR ED Critical Care 271

ACEP Now

NOVEMBER 7, 2024

Poorly healing wounds are primarily the result of chronic venous insufficiency, peripheral (arterial) vascular disease, prolonged pressure-point skin injury, or neuropathy secondary to vascular disease or diabetes. Once identified, they must protect the skin from further injury. Examples include Adaptic, Xeroform, Telfa, and Dermagen.

ED 97

ED OR Emergency Department Ambulance 97

The Skeptics' Guide to EM

MARCH 2, 2024

It’s more common and more dangerous than Type B, as it can lead to serious complications like rupture into the pericardial space leading to cardiac tamponade, aortic valve insufficiency, or myocardial infarction. Symptoms can include sudden onset of pain in the back or abdomen, depending on the exact location and extent of the dissection.

Operating Room 329

Operating Room Emergency Department ALS ED 329

The Skeptics' Guide to EM

DECEMBER 16, 2023

Background: Patient experiences of care are associated with health outcomes and may impact perspectives of ED care and the patient recovery process.(1-5) 1-5) Perceptions of discrimination in healthcare are linked to delays in seeking medical treatment, nonadherence to clinician recommendations, and mistrust of clinicians and the healthcare system.(6-7)

Emergency Department 319

Emergency Department ED ALS OR 319

Medic Mindset

NOVEMBER 13, 2024

He wants paramedics to ask the same question he asks: Is the rapid A-fib the primary problem or secondary to another critical condition like sepsis, PE, DKA, hypovolemia, etc? He shares with listeners how he came to the decision to remove Diltiazem from his service. “ – Dr. Casey Patrick Thank you, iSimulate.

Paramedic 98

Paramedic Emergency Department EMS ED 98

Pediatric EM Morsels

JANUARY 19, 2024

[CDC 2023] In 2021, there were over 2800 cases of congenital syphilis, tripled from 2017. CDC 2023] Pseudoparalysis of Parrot – Presentation and Exam Infant presents with lack of movement of one or both upper extremities, and will cry with palpation. However , the musculoskeletal complaints may be the first presenting symptom !

Plasma 271

Plasma OR EMS ED 271

Pediatric EM Morsels

JULY 19, 2024

Your support staff…depending on the amount of bleeding, you are about to have your hands full and may need IV access, medications, airway management, etc. Get a hold of ENT early as OR management and/or admission are common. Set up suction x2 in the room! Using a Mac Laryngoscope as a tongue blade can be helpful! Headlamps can also be helpful!

E-9-1-1 290

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

EMDocs

JANUARY 27, 2025

Variety of classes and types of ICIs: Anti-CTLA-4:Ipilimumab/Yervoy, Tremelimumab/Imjudo Anti-PD-1: Pembrolizumab/Keytruda, Nivolumab/Opdivo, Cemiplimab/Libtayo Anti-PD-L1: Avelumab/Bavencio, Atezolizumab/Tecentriq, Durvalumab/Imfinzi Anti-LAG-3/Anti-PD-1: Relatlimab and Nivolumab 20-90% of patients receiving ICIs will experience an adverse event; (..)

ACS 97

ACS OR 97

Core EM

JANUARY 25, 2024

Written By: Kaitlynn Tracy, MD Edited By: Sean Schnarr, MD and Gregg Chesney, MD Definition/Background: Burns are classified as being major, moderate, or minor in severity. 4 Survival rate for all burn injuries is around 97%, which is a notable increase from 75% in the 1960’s.

ED 246

ED E-9-1-1 First Aid OR 246

The Skeptics' Guide to EM

SEPTEMBER 28, 2024

Case: You are working a busy shift in a rural emergency department (ED) and your excellent Family Medicine trainee presents a case of a 63-year-old woman with chest pain and some intermittent radiation into the inter-scapular region. The patient has no specific risk factors for acute coronary syndrome (ACS) or dissection.

Emergency Department 234

Emergency Department ACS Coronary ALS 234