Trending Articles

article thumbnail

SGEM#447: Just What I Needed – Preoxygenation Prior To Intubation

The Skeptics' Guide to EM

Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of clinical practice has been largely devoted to health care policy.

article thumbnail

Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.

E-9-1-1 230
professionals

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

OSHA Proposed Emergency Response Rule Comment Deadline This Monday

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post OSHA Proposed Emergency Response Rule Comment Deadline This Monday appeared first on American Ambulance Association.

article thumbnail

Ep 196 Pediatric Meningitis Recognition, Workup and Management

Emergency Medicine Cases

In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages?

EMS 239
article thumbnail

Better Watch Your Back… Finding the Needle in the Haystack.

Core EM

The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway. The following ECG is obtained upon arrival to the emergency department.

STEMI 147
article thumbnail

What The Guardian Missed About US Ambulance Balance Billing

American Ambulance Association

To the Editor of The Guardian, On July 21, The Guardian published Jessica Glenza’s “Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress.” The inflammatory title and lack of […] The post What The Guardian Missed About US Ambulance Balance Billing appeared first on American Ambulance Association.

Ambulance 147
article thumbnail

Lightning rounds 42: Hospital chaplains, with Christine V. Davies

Critical Care Scenarios

We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here! We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital.

152
152

More Trending

article thumbnail

Journal Club 6 Which Older Patients Can Safely Forgo CT Head After a Fall? The Falls Decision Rule

Emergency Medicine Cases

The decision of whether or not to order a CT head for an older patient who falls is one I need to make on almost every shift. The Canadian CT Head Rule does not apply to older patients. Does the recently derived Falls Decision Rule give us an answer to the question of which older patients can safely forego a CT head after a fall? Dr. Rohit Mohindra reviews the latest evidence in this EM Cases Journal Club.

EMS 222
article thumbnail

Episode 197: Acute Agitation

Core EM

We discuss an approach to the acutely agitated patient and review medications commonly used. Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.

article thumbnail

EMS Profiles | Meet Tamara Moss

American Ambulance Association

Tamara Annette Robinson Moss Paramedic & Field Training Officer Richmond Ambulance Authority Richmond, VA Share on Facebook | LinkedIn | Instagram | X How did you come to be in […] The post EMS Profiles | Meet Tamara Moss appeared first on American Ambulance Association.

EMS 147
article thumbnail

Intensive Ambulance-Delivered Blood Pressure Reduction in Hyperacute Stroke.

EMergucate

Intensive Ambulance-Delivered Blood- Pressure Reduction in Hyperacute Stroke Li, Y. Lin, J. Yang, C.S. Anderson, C. Chen, F. Liu, L.

Ambulance 130
article thumbnail

Episode 77: Mastering APRV with Rory Spiegel

Critical Care Scenarios

We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessons We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr.

OR 100
article thumbnail

EM Cases Summit ’24 Registration Now Open!

Emergency Medicine Cases

Registration is now open for the 2024 International EM Cases Summit November 21-23. Registration includes 3 days of talks, panel discussions, interactive discussions, procedural demos, an ebook and access to all the talks for 3 months after the conference. We also offer small group virtual simulation sessions, symposiums on EM Flow, Rural EM and Global EM plus a pre-conference HEARTS ECG course!

EMS 130
article thumbnail

The Intervals Aren’t Alright!

Core EM

The Case An elderly male with a past medical history of hypertension and diabetes presents to the emergency department with a chief complaint of diarrhea and shortness of breath. His vital signs are: HR 60, BP 105/65, RR 30, O2 100% on room air, oral T 98.6 F, and FSG 120. EKG Show Details EKG Characteristics Rate 60 BPM Rhythm Regular, no discernible P-waves Intervals PR na; QRS complex > 160 ms; QT Prolonged Axis LAD ST Segments Wide QRS complexes slurring into very large pointed T waves Diagn

Plasma 130
article thumbnail

CMS Publishes Two New Reports on GADCS Website

American Ambulance Association

Dear Ground Ambulance Providers and Suppliers, We wanted you to be aware that we posted 2 reports on our Medicare Ground Ambulance Data Collection System website under Reports: Ground Ambulance Industry Trends, […] The post CMS Publishes Two New Reports on GADCS Website appeared first on American Ambulance Association.

Ambulance 130
article thumbnail

ECG of the Week – 10th July

EMergucate

The following ECG is from a 74-year-old man with one hour of chest pain. He has no cardiac risk factors and denies any significant medical history.

130
130
article thumbnail

Podcast – Occlusive Myocardial Infarction, ECGs and Artificial Intelligence with Steve Smith

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed A podcast with Steve Smith ECG educator extraordinaire where we discuss occlusive myocardial infarction and the future of AI and ECG interpretation. The post Podcast – Occlusive Myocardial Infarction, ECGs and Artificial Intelligence with Steve Smith appeared first on St.Emlyn's.

134
134
article thumbnail

A prehospital ECG in a patient with chest pain. The paramedics tell me it is normal.

Dr. Smith's ECG Blog

I was working at triage when the medics brought this patient who is 65 yo and has had chest pain for 12 hours. They recorded a prehospital ECG at 2112 and said that it was “normal”. It had already been crumpled up and put in the waste basket. So I uncrumpled it: What do you think? You need to click on it to enlarge it to view it well I was suspicious for inferior and posterior OMI (Large T-wave in aVF, slight STE in lead III with inverted T-wave in aVL, and a slightly downsloping ST with negativ

Paramedic 104
article thumbnail

Episode 193: Threatened Abortion

Core EM

We review threatened abortion and the complexities in its care. Hosts: Stacey Frisch, MD Brian Gilberti, MD [link] Download One Comment Tags: OBGYN Show Notes Background Defined as vaginal bleeding during early pregnancy (before 20 weeks) with a closed cervical os, no passage of fetal tissue, and IUP on ultrasound Occurs in 20-25% of all pregnancies.

OR 130
article thumbnail

AAA Board Nominations Open Through August 16

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post AAA Board Nominations Open Through August 16 appeared first on American Ambulance Association.

Ambulance 130
article thumbnail

Lab case 448 Interpretation

EMergucate

Question 1: We should consider ascending cholangitis in any patient with fever and features of obstructive jaundice till prove otherwise.

130
130
article thumbnail

JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Background – What do we already know about REBOA? In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.

article thumbnail

What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

Written By Magnus Nossen — with edits by Ken Grauer and Smith. The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The below ECG was recorded. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion.

article thumbnail

Acute Radiation Exposure

Core EM

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. Due to their availability, iridium-192, Cesium-137, and Cobalt-60 are often viewed as the substances posing the greatest threat for intentional radiation exposure.

ALS 130
article thumbnail

Treatment In Place Bill Introduced in House

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Treatment In Place Bill Introduced in House appeared first on American Ambulance Association.

Ambulance 130
article thumbnail

Lab Case 448

EMergucate

75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55.

article thumbnail

Non-fatal strangulation

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed The Faculty of Forensic & Legal Medicine's guidelines for managing non-fatal strangulation (NFS). These guidelines advocate a trauma-informed, multidisciplinary approach to improve outcomes for patients who have experienced NFS. @stemlyns #FOAMed The post Non-fatal strangulation appeared first on St.Emlyn's.

126
126
article thumbnail

REVISE – Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation

The Bottom Line

Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation (REVISE) D. Cook. NEJM 2024. DOI: 10.1056/NEJMoa2404245 Clinical Question In mechanically ventilated adults, does stress ulcer prophylaxis with intravenous pantoprazole (40 mg daily), compared with placebo (0.9% saline), reduce the occurrence of clinically important upper gastrointestinal bleeding at 90 days?

110
110
article thumbnail

Episode 195: ARDS

Core EM

We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure. Berlin criteria for diagnosis include acute onset within 7 days, bilateral pulmonary infiltrates on imaging, not fully explained by cardiac failure or fluid overload, and impaired oxygenation with PaO2/FiO2 ratio <300 mmHg, even wi

article thumbnail

CMS Proposed Expansion of ALS-2 to include Low-Tier O+ Whole Blood Transfusions Fails to Include Additional Funding for the Services

American Ambulance Association

The Centers for Medicare & Medicaid Services (CMS) has released the Calendar Year (CY) 2025 proposed rule that proposes changes to the CY 2025 definitions of ALS-2 services to include […] The post CMS Proposed Expansion of ALS-2 to include Low-Tier O+ Whole Blood Transfusions Fails to Include Additional Funding for the Services appeared first on American Ambulance Association.

ALS 130
article thumbnail

Imaging Case of the Week 597

EMergucate

The chest x-ray is from an adolescent with high fever, productive cough and pleuritic chest pain. What can be seen?

EMS 130
article thumbnail

Inspiring the Next Generation of First Responders

First Responders Foundation

The safety and well-being of our communities rely heavily on the dedication and courage of first responders—firefighters, police officers, EMTs, and paramedics—who are on the front lines during emergencies. As the current generation of first responders approaches retirement, it becomes crucial to inspire and prepare the next generation to take up this noble and vital role.

article thumbnail

A man in his 50s with unwitnessed VF arrest, defibrillated to ROSC, and no STEMI criteria on post ROSC ECG. Should he get emergent angiogram?

Dr. Smith's ECG Blog

Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. He arrived to the ED with severe hypotension, heart rate in the 70s, unable to follow commands but moving all extremities requiring restraint and sedation, respiratory rate around 24/min being supporte

article thumbnail

Classic EM: High risk and low prevalence diseases: Blast injuries

Core EM

High risk and low prevalence diseases: Blast injuries American Journal of Emergency Medicine, 2023 Background Blast injuries stem from the instantaneous transformation of a substance from solid or liquid to gas, releasing energy in the form of heat, light, pressure, and sound. While rare, blast injuries carry a high rate of morbidity and mortality. Blast injuries commonly have a mixed presentation of blunt and penetrating trauma.

EMS 100
article thumbnail

2024 Ambulance Ride-Along Toolkit

American Ambulance Association

Government Affairs Update View this email in your browser 2024 Ambulance Ride-Along Toolkit Educating your members of Congress about ambulance industry issues makes them much more likely to support your efforts. […] The post 2024 Ambulance Ride-Along Toolkit appeared first on American Ambulance Association.

Ambulance 130
article thumbnail

Imaging Case of the Week 598

EMergucate

The following chest x-ray is from a child with cough & fever. What can be seen?

EMS 130
article thumbnail

State Farm® is Giving $500,000 in Grants to Volunteer Fire Departments Through the Good Neighbor Firefighter Safety Program

NVFC

Get ready for the application period, which opens August 1 State Farm® is teaming up with the National Volunteer Fire Council (NVFC) to award $500,000 in grants to local volunteer fire departments – the ultimate good neighbors. Through the State Farm Good Neighbor Firefighter Safety Program, 50 fire departments will receive $10,000 grants to help them obtain the equipment they need to increase responder safety and improve service to the community.