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A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.
We discuss the recognition and treatment of necrotizing fasciitis. Hosts: Aurnee Rahman, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , General Surgery Show Notes Table of Contents 0:00 – Introduction 0:41 – Overview 1:10 – Types of Necrotizing Fasciitis 2:21 – Pathophysiology & Risk Factors 3:16 – Clinical Presentation 4:06 – Diagnosis 5:37 – Treatment 7:09 – Prognosis and Recovery 7:37 – Take Home points Int
By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.
St.Emlyn's - Emergency Medicine #FOAMed This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. Drawing on a systematic review and meta-analysis, it examines the evidence, evaluates key benefits, and critically appraises the limitations. The discussion highlights the potential of this model to enhance pre-hospital emergency care while addressing challenges in implementation across dive
National Rural Health Association December 2024 Policy Paper Bridging the gap: A policy framework for sustainable community paramedicine in rural America Authors: Katie Gorndt, Kimberly Haverly, Tom Syverson The post NRHA | Community Paramedicine Framework appeared first on American Ambulance Association.
Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. 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.
Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 14, 2025] In the aftermath of the devastating New Years Eve fireworks explosion in Honolulus Salt Lake neighborhood, which overwhelmed Hawaiis burn care capacity, and the ongoing challenges posed by the recent California wildfires, the American Burn Association (ABA) recognizes the extraordinary efforts of burn care
When you think about strokes, you probably picture a slurred speech, middle-aged hypertensive smoker with half their face drooping. You dont picture atoddler in a car seat or a baby in a crib. But the reality is that strokes happen to kids, too.As paramedics, we thrive on pattern recognition, but pediatric strokes are theultimate zebra in the room. They dont present like adult strokes; theyre incredibly rare,and the clock is still ticking as fast.
When you think about strokes, you probably picture a slurred speech, middle-aged hypertensive smoker with half their face drooping. You dont picture atoddler in a car seat or a baby in a crib. But the reality is that strokes happen to kids, too.As paramedics, we thrive on pattern recognition, but pediatric strokes are theultimate zebra in the room. They dont present like adult strokes; theyre incredibly rare,and the clock is still ticking as fast.
When I started as a paramedic in Hartford in January of 1995, I was given a 100-page protocol book to memorize. There were fewer than 50 protocols in the book, along with pages for 24 medications and 8 procedures. The book was approved by the two largest hospitals in Hartford. Looking through the book today, it is truly an antiquated. For instance, there was no protocol for stroke or STEMI.
Author: Christopher Blanton, MD, MBA (EM Resident, UTSW / Dallas, TX); Joslin Gilley-Avramis, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
Happy New Year, and w elcome back to another edition of ESO product updates. Thanks to our new and improved feedback process, our customers have been more involved than ever in our Product Roadmap. Your input is invaluable to our team and integral to the improvements and enhancements you’ll find below. So, without further ado, here are the latest updates from ESO in Q4 2024 and whats just ahead on the horizon , all of which h as been made possible by our incredible ESO community : Content
Okay everyone, think about your tongue. Maybe move it around a bit, check in with it, consider what it means to you. Now imagine that your tongue suddenly shriveled up and fell off and that in its place is a tongue-sized isopod aka rollie pollie aka pillbug. Just there, hanging out, forever. How are you feeling? Horrified? Disgusted? Hey, we get it.
Welcome to the first episode of the Broomedocs podcast for 2025. Justin and I are back for more nerdy goodness to make you smarter in the Resus room, or at a pub trivia night more likley… wether it is about salt correction, dissection or infection we can help you out! Listen in and learn! Or if you don’t have enough Youtube content featuring aging bearded men – you can watch over on Justin’s channel here: Airway, breathing, cellphone: a new vital sign?
Introduction Out-of-hospital cardiac arrest remains a global health problem. There is emerging evidence that the use of extra-corporeal membrane oxygenation during resuscitation [ECPR], may help to improve outcomes. Several prehospital services around the world are now able to provide on-scene ECPR. However, the early identification of patients is a key factor in enabling this level of response to OOHCA.
We all know the key to a thorough patient assessment is to approach it systematically so that we dont become distracted (by that bleeding scalp wound) or skip steps that may yield valuable information (like listening to breath sounds). Theres a reason we are all taught head-to-toe surveys: so that we work our way through essential assessment points, avoiding a haphazard exam where key signs are missed.
Yesterday evening, March 14, the United States Senate by a vote of 54 to 46 passed the Full-Year Continuining Appropriations and Extensions Act, 2025 (H.R. 1968) to fund the federal […] The post Congress Extends Ambulance Add-On Payments Through September 30 appeared first on American Ambulance Association.
Methodology 3/5 Usefulness 3/5 Connolly SJ, et al. N Engl J Med. 2024 May 16;390(19):1745-1755. Editorial: Reversing Oral Anticoagulation in Intracerebral Hemorrhage. Question and Methods: This unblinded, multicentre randomized controlled trial studied whether Andexanet improved hemostatic efficacy compared to usual care in patients with acute intracerebral hemorrhage using factor Xa inhibitors.
Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 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.
In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy.
PCC Members, Further to the bulletin issued on March 6, 2025 Member Messages regarding the impact of tariffs and counter-tariffs on equipment, supplies and services used to provide paramedic services across Canada, we want to provide an update on our advocacy activities and share resources to members as our messaging is expanding across government and the public.
Authors: Lloyd Tannenbaum, MD (EM Attending Physician, APD, Geisinger Wyoming Valley, PA) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations. This week, we feature a post from Dr. Tannenbaums ECG Teaching Cases , a free ECG resource. Please check it out.
The Congressional Fire Services Institute (CFSI) will hold its annual Fire and Emergency Services Symposium and Dinner on February 12-13 in Washington, DC. CFSI is a consensus organization for the nations fires service that advocates for policies that have been approved by its National Advisory Committee, which consists of over 30 national fire service organizations including the National Volunteer Fire Council (NVFC).
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections BALANCE Investigators. NEJM 2024; DOI: 10.1056/NEJMoa2404991 Clinical Question In hospitalised patients with bloodstream infections (BSI), is antibiotic treatment for 7 days, compared to treatment for 14 days, non-inferior with respect to mortality at 90 days?
Alex (Sandy) MacQuarrie , PhD and Paramedic, reflects on his move from Canada to Australia, principles of simulation in medical education & his personal experience with cardiac arrest. Topics discussed: Constructivism in education Organic versus mechanistic approach to learning Difference between feedback and debriefing Socratic method versus Advocacy-Inquiry model Peer-to-peer feedback Psychological safety in the classroom Emotional Seriousness in simulation NHET-SIM Certification Prebriefi
St.Emlyn's - Emergency Medicine #FOAMed This blog post provides concise summaries of recent critical care trials, including HEMOTION, PREOXI, BLING III, CLASSIC, EVIDENCE, VICTOR, and PARAMEDIC-3. Each trial is examined for its key findings, strengths, limitations, and practical implications for clinical practice. The post aims to inform healthcare professionals about the latest evidence-based practices in critical care.
Instructions to join are below description and speakers. February 6th, 2025 | 9:00 am PST (12:00 pm EST) Join us for an in-depth exploration of the innovative Preburn Project: Preventing Burnout by Predicting Compromised Wellness in EMS Workers. This session is designed for EMS directors, EMS administrators, paramedics, dispatchers, mental health professionals and researchers who are committed to improving the well-being of frontline EMS workers.
Medicare Ambulance Extender Bill Introduced in House Yesterday, March 18, Representatives Claudia Tenney (R-NY), Terry Sewell (D-AL), Cliff Bentz (R-OR), Paul Tonko (D-NY), Mike Carey (R-OH), Danny Davis (D-IL), Carol […] The post House Reintroduces Vital Medicare Extender and EMS Workforce Bills appeared first on American Ambulance Association.
In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED). However, their use is far from straightforwardbalancing […] The post These are the ‘Roids you are looking for – Steroids in the ED appeared first on EMOttawa
Cleveland Clinic’s Geriatric Emergency Department (GED) model has significantly reduced hospital admissions and improved care for older emergency department (ED) patients. The GED model involves dedicated units, specialized practitioners, and a focus on early delirium detection, care transitions, and geriatric education. It operates in all 13 Cleveland Clinic EDs, with positive results: 17% admission rate for those seen by the geriatric team, compared to 55% for those not seen.
Understanding this vital tool for EMTs in diagnosing and monitoring heart conditions An Electrocardiogram, commonly known as an EKG or ECG, is a medical test that measures the electrical activity of the heart. For Emergency Medical Technicians (EMTs), understanding EKGs is a critical skill. In the fast-paced environment of emergency medical services (EMS), EMTs are […] The post What is an EKG?
PCC Members, As Canadians face the disruption and uncertainty of our countrys financial stability as a result of the trade war initiated earlier this week, we collectively have concerns impacting our personal situations as well as our professional role as leaders delivering critical health services to Canadians. With the true impact of the current and any future tariffs and counter-tariffs notyetclearly understood, what is certain is that the downstream effect will significantly challengeparamed
As you approach your patient, you hear him snoring and notice the familiar sound of gurgling coming from his mouth. You immediately know you will be working to manage his airwayall within seconds of looking at, listening to, speaking with, and touching the patient. Remember: The first few seconds when you approach your patient will likely give you the most clinical information about your patients condition, bombarding you with information rapidly, sometimes instantaneously.
The Senate Committee on Health, Education, Labor, and Pensions will hold a confirmation hearing for Secretary of Labor nominee Lori Chavez-DeRemer on February 19 starting at 10am ET. If confirmed by the Senate, Chavez-DeRemer would oversee the Occupational Safety and Health Administration (OSHA) and the ongoing development of their proposed Emergency Response Standard.
Originally published at The Pediatric EMS Podcast on March 5, 2035. Reposted with permission. Please visit their site HERE to see all the amazing podcasts or subscribe to their RSS HERE. This is the Pediatric EMS Podcast with the mission to provide case-based discussion with evidence-based recommendations by content experts in prehospital pediatric medicine in order to advance the care of children outside the hospital.
Do you change your practice when new evidence is published? Will these articles change your practice? Will you read them? Does anyone read them? I dont know, but here is another month of my reading summarized. For the regular readers, you will have noticed I have taken a few weeks off. February is also likely […] The post Research Roundup for January 2025 appeared first on First10EM.
St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). The post Prehospital Emergency Anaesthesia (PHEA) vs. Emergency Department RSI: A Comparative Study on Trauma Care Timelines and Outcomes appeared first on St.Emlyn's.
Author : Katie Stuart MD; Washington University Emergency Medicine Residency Editors : Sarah Fabiano MD, FACEP, FAAEM & Michael DeFilippo DO You are a second-year emergency medicine resident physician doing a ride along with a helicopter-based EMS (HEMS) agency. You are dispatched to the scene of a golf cart versus tree. The air crew successfully identifies a safe landing place near where the ambulance is staged.
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.
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