JEMS

JUNE 23, 2025

1 EMS has always been described as the canary in the coal mine and the tip of the spear simultaneously. 1 Yet, despite its critical function, EMS remains an underfunded outlier in the Medicaid landscape, excluded from mandatory federal benefits, inconsistently reimbursed, and perennially subject to the whims of state fiscal policy.

EMS 116

EMS E-9-1-1 Community Paramedicine Emergency Medical Services 116

JEMS

JULY 23, 2025

2 Only 1% of those studied actively attempted to solicit information from the patient with a suspected Autism Spectrum Disorder (ASD), instead electing to question bystanders. The DSM-5 splits Autism Spectrum Disorder into three levels on this basis: Level 1. References 1. & Stuart, E. 2012, December 28).

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E-9-1-1 EMT EMT Public Safety 98

Don't Forget the Bubbles

DECEMBER 16, 2024

Coverage of the 6-in-1 vaccine measured at 12 months of age in England for Q4 2023 to 2024 Source: ONS under the Open Government License v3.0 Young infants and immunosuppressed individuals are particularly at risk of severe disease, resulting in significant morbidity and associated mortality rates of 1-3 per 1,000 cases.

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E-9-1-1 OR ALS Emergency Department 57

Pediatric EM Morsels

MARCH 7, 2025

Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H,Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA,Meja-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR,Yutthakasemsunt S. 2012 Feb;147(2):113-9. J Emerg Med.

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E-9-1-1 ALS OR ED 231

EMDocs

DECEMBER 6, 2024

1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Commercially available formulations of iron have varying elemental components. 1 Table 1: Iron content of various preparations. 1 Obtain a single view abdominal x-ray.

E-9-1-1 95

E-9-1-1 Frozen Plasma Plasma Overdose 95

REBEL EM

FEBRUARY 24, 2025

1 They noticed how spontaneously breathing patients had their IVC collapse with inspiration; and ventilated patients had their IVC dilate during positive pressure ventilation. Oct 2012; PMID: 23043910 Kumar A, et al. Oct 2013; PMID: 24079262 Gohar E, et al. Nov 2020; PMID: 33140173 Hanson J, et al.

ALS 64

ALS E-9-1-1 Critical Care OR 64

This Podcast Will Kill You

JUNE 16, 2025

The Lancet Infectious Diseases, 19(9), pp.e313-e321. The Lancet infectious diseases, 9(5), pp.281-290. ” New England Journal of Medicine Atchade, E., ” New England Journal of Medicine Atchade, E., Antibiotics, 13(1), p.96. Wasmuth, S., and Brügger, J., Morbid Mortal Weekly Rep 29:229-230, May 23, 1980.

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E-9-1-1 ALS OR 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2017

Repost this one A 30-something with 8 hours of chest pain and an e. Computer says. huge inf right lateral RV afib block vfib What is lurking underneath this new right bundle b. QT Correction Formulas Compared to The Rule of Thu. A 30-something with It is not a STEMI; it is an opportunity to save my. A male in his 50s with chest pain.

E-9-1-1 52

E-9-1-1 STEMI Coronary CPR 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2017

Repost this one A 30-something with 8 hours of chest pain and an e. Computer says. huge inf right lateral RV afib block vfib What is lurking underneath this new right bundle b. QT Correction Formulas Compared to The Rule of Thu. A 30-something with It is not a STEMI; it is an opportunity to save my. A male in his 50s with chest pain.

E-9-1-1 52

E-9-1-1 STEMI Coronary CPR 52

This Podcast Will Kill You

JULY 1, 2025

2012): 599-609. Scientific Opinion on the re‐evaluation of Sunset Yellow FCF (E 110) as a food additive. Scientific Opinion on the re‐evaluation of Allura Red AC (E 129) as a food additive. Scientific Opinion on the re‐evaluation Tartrazine (E 102). Refined exposure assessment for Allura Red AC (E 129). Kitchin, E.,

E-9-1-1 52

E-9-1-1 ACS ALS OR 52

Dr. Smith's ECG Blog

JANUARY 16, 2020

A man in his early sixties with palpitations An elderly patient with a fall, QS-waves, and ST E. And have you ever. great EKG of heart block, RBBB, TIMI-3 flow in LAD A 40-something with sharp chest pain, worse with l. Viral symptoms, then acute chest pain and this ECG. A young woman with epigastric pain. ECG Crochetag. Atrial fibrillation?

E-9-1-1 52

E-9-1-1 STEMI Coronary CPR 52

Pediatric EM Morsels

OCTOBER 27, 2023

Rosenburg 2010] B-L system is designed for 12yo and younger, patients up to 80 lbs, height 46-143 cm [Meguerdichian 2012] Estimates the 50%ile weight for height (Length vs Ideal Body Weight). Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. 2020;13(1):9.

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E-9-1-1 Emergency Medical Services Life Support ALS 274

Pediatric EM Morsels

JULY 19, 2024

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. Tranexamic Acid (TXA) IV TXA 15 mg/kg for a child 1 g for adult (that’s right…this isn’t just a presentation seen in children.

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E-9-1-1 Epinephrine Emergency Department OR 293

ALiEM

MAY 19, 2023

The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Apply traction to the tube by tying a roller bandage to the end of it and then the other end to a 1 L bag of IV fluids. Pearl 1: Check the units of pressure being used. The conversion rate is: 1 cmH2O = 0.74 1950 May;131(5):781-9.

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E-9-1-1 Emergency Department ICU OR 245

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. ECG 1 What do you think? Grines, C.

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E-9-1-1 OR Coronary ACS 137

REBEL EM

SEPTEMBER 13, 2023

Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation. Both conditions can range in severity from benign to life threatening (Wilkerson 2012).

Frozen Plasma 99

Frozen Plasma Allergic Reaction FFP Plasma 99

EMDocs

SEPTEMBER 7, 2024

1 Risk Factors: 1-4 Spontaneous Anticoagulants (Apixaban, Rivaroxaban, etc.) Older Age (median age of 70 years) 1 Abnormal vasculature/neoplasm of the kidney (e.g., 5 Clinical Presentation: 1-3 Variable presentation but may present with dropping hemoglobin/hematocrit without other findings in spontaneous cases.

EMS 95

EMS E-9-1-1 Operating Room ICU 95

REBEL EM

AUGUST 30, 2023

Epidemiology 1 to 2.4 cases per 100,000 people ( Zimmerli 2010 ) More common in males with M:F of 3:1 Rate is also increasing due to increased number of spinal procedures Typically affects adults, with most cases occurring in patients over 50 years old. Other pathogens include: E. Often used interchangeably with osteomyelitis.

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E-9-1-1 ALS ED OR 86

EMDocs

JULY 13, 2024

1997 Mar;11(1):203-22. 2012 May;27(5):1368-74. Epub 2012 Mar 14. 1985 Dec 1;153(7):737-9. 1985 Dec 1;153(7):737-9. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. 2024, [link] Mackeen AD, Packard RE, Ota E, Speer L. Infect Dis Obstet Gynecol. 2000;8(2):77-82. PMID: 10805361; PMCID: PMC1784665.

EMS 83

EMS E-9-1-1 Plasma OR 83

FOAMfrat

MAY 19, 2024

While transporting to the emergency department, the patient’s mother informed me that PDCD affects less than 1 in 50,000 individuals and is more common in males than females. The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. 2012 Jan.

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E-9-1-1 ALS Emergency Department EMT 98

EMDocs

MAY 11, 2024

CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis? Updated November 9, 2023. Epub 2019 Dec 9. On exam, the patient opens eyes to voice, has extraocular movements intact, is unable to speak, and has 0/5 strength in all extremities. Available from: [link] Guy-Evans, Olivia.

EMS 101

EMS E-9-1-1 ALS OR 101

ACEP Now

FEBRUARY 13, 2024

A radiograph is shown (see figure 1). LEARN MORE The most common nerve blocks in this study are shown in Table 1. 1–4 Emergency physicians commonly prescribe opioid pain medications, and there is significant variability among prescribing patterns. 2023 Sep 2;15(9):e44583. 2024 Jan;83(1):14-21. 2016;129(2):221.e21–221.e30.

E-9-1-1 52

E-9-1-1 Emergency Department ED ALS 52

Don't Forget the Bubbles

MAY 29, 2023

A study of teams over a 1-year period highlights that people witnessing incivility are also affected, which could lead to individuals feeling unsupported in their teams. 2021:36:1–2, NP448–NP473 Available at. Review of Cultivating Communities of Practice: A Guide to Managing Knowledge, by Wenger E, McDermott R, Snyder WM].

Critical Care 98

Critical Care E-9-1-1 Emergency Medical Services ALS 98

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

To me, it was clearly atrial flutter with 1:1 conduction. Continue Eliquis 5mg BID, should be continued for 3 months == MY Comment , by K EN G RAUER, MD ( 9/18 /2024 ): == I found the following aspects of today's case of special interest. Why did Dr. Smith immediately say the rhythm was AFlutter with 1:1 AV conduction?

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E-9-1-1 ALS OR ED 69

EMDocs

AUGUST 22, 2024

1 However, we recognize that many patients prefer to speak a language other than English regardless of their English proficiency, and this does not indicate a deficiency. 9 Less likely to be satisfied with their care and have a lower understanding of their discharge instructions. Karliner L, Jacobs E, et al. Lion KC, et al.

Emergency Department 98

Emergency Department ALS E-9-1-1 ED 98

NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. 1] Table from Hamam et al. 9] Figure from Clemency et al. 1] References 1. Fowler R, Gallagher JV, Isaacs SM, Ossman E, Pepe P, Wayne M. Resuscitation.

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E-9-1-1 Advanced Life Support Epinephrine Life Support 52

NAEMSP

APRIL 19, 2023

This CI does include 1; and further and further analysis of the data showed that the likelihood that calcium has a beneficial effect (e.g. The overall conclusion was that as less than 1% of cardiac arrest etiologies fall into a group that would potentially benefit from calcium, that routine use should be avoided (Padrao, et.

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E-9-1-1 Advanced Life Support Overdose Defibrillator 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

There are two main etiologies of ischemic ST-depression: 1) subendocardial ischemia 2) reciprocal to ST-elevation in an opposite wall Here there are distinct R-waves with marked ST-depression throughout most of the precordium. Tips for recognizing Acute Posterior STEMI: 1. References: 1. This can help in confirmation.

STEMI 52

STEMI E-9-1-1 Coronary ALS 52

REBEL EM

JANUARY 19, 2023

Patients were randomly assigned 1:1 to treatment with either an ambulatory device or standard guideline-based management (aspiration, standard chest tube insertion, or both). Patients were observed for 1-2 hours for clinical stability, and placement was confirmed with a chest x-ray. 2013 Jul;68(7):664-9. Epub 2013 Mar 20.

E-9-1-1 52

E-9-1-1 OR ALS ED 52

REBEL EM

DECEMBER 28, 2022

Conducted at 2 US Veterans Affairs medical centers from 2012–2019. Approx 1 in 4 (23%) patients with a urine culture had no bacterial growth, which may dilute any effect of treatment duration or choice of agent. Approx 1 in 4 patients (23%) with a urine culture had no growth. 2016;57(9):485-490. 2017;15(1):70.

E-9-1-1 52

E-9-1-1 ALS OR EMS 52

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. For clarity in Figure-1 — I've reproduced the initial ECG in today's case.

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E-9-1-1 ALS Defibrillator OR 118

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al.

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E-9-1-1 Plasma ALS OR 145

Don't Forget the Bubbles

JANUARY 17, 2024

Around 80% of those reported pass spontaneously, with another 10-20% requiring endoscopic removal and only 1% requiring surgical intervention. Mirza and Sheikh reported perhaps the first unfortunate case in 2012. In 2012, one brand of SAP beads – Water Balz – was recalled by the U.S. 2012 Jan;3(1):6.

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E-9-1-1 ALS Emergency Department OR 109

EMDocs

OCTOBER 5, 2024

Answer : ESBL-producing organisms Background 1-3 Extended spectrum beta-lactamases (ESBL) are enzymes produced by certain bacteria that can break down a broad range of beta-lactam antibiotics. 3 Epidemiology 4-8 ESBL-producing Enterobacteriaceae (ESBL-E) have been reported worldwide. ceftriaxone, cefepime).

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E-9-1-1 EMS ALS OR 94

Dr. Smith's ECG Blog

JULY 22, 2023

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year incidence of SCD in this cohort [1].

E-9-1-1 92

E-9-1-1 CAD STEMI OR 92

EMDocs

FEBRUARY 7, 2024

Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. 2023 October 9. 2012 Feb 1;4(1):127-57. Essex R, Weldon SM, Thompson T, Kalocsányiová E, McCrone P, Deb S. 2013 Dec;14:1-0. 2022 Nov 9. January 23, 2024. Retrieved from: [link] Fischer S.

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E-9-1-1 OR Ambulance 96

Don't Forget the Bubbles

NOVEMBER 29, 2023

Intensive Care Research , 1 (3-4), pp.60-64. A 2012 study on paediatric patients showed that approximately 42% were intubated without medications, and 2% were intubated with paralysis only in the ED. Pediatric Emergency Care 28(11): p 1129-1131, November 2012. | Epub 2014 Sep 9. 2013 Jan;31(1):222-6. Burgart, A.M.

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E-9-1-1 Emergency Department ED CPR 135