JEMS

AUGUST 7, 2025

1-6 They were strictly designed to reimburse services for the cost associated with transport to a medical facility. The Economic and Clinical Infrastructure of EMS Is Under Siege These proposed reforms, if implemented, would have devastating, systemic consequences for emergency care in the United States. Prehosp Emerg Care.

EMS

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. RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Crit Care Med. Critical Care Medicine.

ALS

EMDocs

MARCH 18, 2025

Episode 116: Massive Hemoptysis Definition: Hemoptysis is expectoration of blood from the respiratory tract; ranges from mild with small streaks of blood to cardiopulmonary compromise (1-5). Massive hemoptysis: no clear definition, ranges from 50 mL in a single expectoration to 100 mL in 24 hours to over 1 L in 48 hours.

E-9-1-1

Pediatric EM Morsels

OCTOBER 27, 2023

Initially tested in Johannesburg, South Africa: 1 month old to 12 years old Broselow predicted within 10% of weight in 63.6% Prehosp Emerg Care. doi:10.3109/10903127.2012.664247 Committee on Pediatric Emergency Medicine, American Academy of Pediatrics, Krug SE, Frush K. Int J Emerg Med. 2020;13(1):9.

E-9-1-1

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Pearl 1: Check the units of pressure being used. The conversion rate is: 1 cmH2O = 0.74

E-9-1-1

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. If bleeding, the only lab that is needed in the Emergency Department is a type and cross. Am J Emerg Med.

E-9-1-1

ALiEM

APRIL 12, 2024

Traditionally large-bore tube thoracostomy has been the standard of care for treating many acute intrathoracic pathologies [1]. Pigtails provide a less invasive and often better tolerated alternative to traditional chest tubes and allow for adequate treatment of pneumothoraces and uncomplicated pleural effusions [1-5].

E-9-1-1

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

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Acad Emerg Med. Cuffed endotracheal tubes in pediatric intensive care. 1994 Jul;125(1):57-62. 2019 Sep;74(9):1186-1190.

E-9-1-1

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ).

E-9-1-1

Don't Forget the Bubbles

AUGUST 28, 2023

Management must be multidisciplinary involving anaesthetics, paediatric retrieval service/paediatric intensive care, ENT and oncology teams (as well as the cardiothoracic surgery team – not always available). Five-year-old Ginny presents to the Emergency Department with a syncopal episode. 2014;9(9):S102-S109.

Emergency Manager

ACEP Now

OCTOBER 11, 2024

Introduction Pediatric intubations in the emergency department (ED) occur at only a tenth the frequency of adult intubations. 1 Pediatric rapid sequence intubation (RSI) in the ED is associated with a higher frequency of failed first attempts and adverse effects than in adult patients. References Long E, Sabato S, Babl FE.

E-9-1-1

Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures Without Pyuria. 2024;24(1):111-118. Giannoni, E., Pediatric Critical Care Medicine , 25 (3), pp.e117-e128. Acad Pediatr. doi:10.1016/j.acap.2023.06.023

E-9-1-1

Broome Docs

OCTOBER 31, 2022

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Intensive Care Med. 2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Anaesth Crit Care Pain Med.

E-9-1-1

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.

E-9-1-1

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. Out-of-hospital cardiac arrest unfortunately occurs relatively commonly and emergency physicians must be equipped to diagnose and treat this rapidly. 2018;13(9):e0204169. Margey R, Browne L, Murphy E, et al. Resuscitation. Resuscitation.

Defibrillator

REBEL EM

OCTOBER 5, 2023

1-6 We now have the Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial. Patients enrolled from 31 Intensive Care Units in France. Patients admitted to the ICU with severe community-acquired pneumonia were randomized in a 1:1 ratio to receive hydrocortisone or a placebo.

Critical Care

EMDocs

JANUARY 4, 2024

1 In addition to intentional overdoses, there are multiple case studies of abuse (ingestion, insufflation, injection). QRS > 100 msec can give sodium bicarbonate 1-2 mEq/kg IV boluses. 9-12 Do not use this prophylactically in bupropion overdoses. 2014;52(9):969-72. Critical Care Toxicology. Eds (2017).

Overdose

FOAMfrat

JULY 1, 2023

titled "The Association of Rocuronium Dosing and First-Attempt Intubation Success in Adult Emergency Department Patients" revealed that first-attempt intubation success was the highest when more than 1.4 mg/kg Rocuronium versus 1 to 1.5 mg/kg Rocuronium versus 1 to 1.5 mg/kg of Rocuronium was used [4]. This dose is: 1.0

E-9-1-1

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. The study asked TWO questions: 1. Eligible participants were randomised in an acceptable manner ( 1:1) using a computer-generated randomisation sequence. Br J Haematol.

E-9-1-1

AAEM RSA

AUGUST 27, 2020

Interventions during the acute phase of treatment post return of spontaneous circulation (ROSC) are therefore critical. 1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC.

E-9-1-1

EMDocs

FEBRUARY 12, 2024

Introduction Arterial blood gas (ABG) or venous blood gas (VBG) testing is used to assess the pH and systemic carbon dioxide tension in patients, and, therefore, provide a more complete picture of their acid-base status than an isolated basic metabolic panel (BMP) (1). However, ABGs have many drawbacks compared to VBGs.

Emergency Department

EMDocs

OCTOBER 7, 2023

1-3 Common causes: Natural disasters such as tornadoes or earthquakes 4,5 Structure or building collapses from home fires or bombings. Critical Care. 2016;20(1):135. J Emerg Med. Stahl K, Rastelli E, Schoser B. Clinical spectrum of rhabdomyolysis presented to pediatric emergency department.

EMS

EMDocs

MAY 29, 2023

Louis); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 54-year-old female with a past medical history of rheumatoid arthritis presents to the emergency department (ED) with generalized fatigue. ESR and CRP are widely used in monitoring and detecting multiple inflammatory conditions.

ED

EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? 2022 Jul 5;328(1):57-68. 2020 Feb 12;10(1):2470.

E-9-1-1

Don't Forget the Bubbles

MARCH 24, 2025

Emerging evidence from animal studies also suggests that Dexmed may have neuroprotective properties. While no paediatric studies have confirmed this, the DICE trial ( D exmedetomidine in I nfants undergoing C ooling for Neonatal E ncephalopathy) is underway. Adv Emerg Nurs J. 2014;55(1):209-215. 2021;43(4):293-302.

E-9-1-1

Don't Forget the Bubbles

MARCH 31, 2025

Article 1: Should we rely on WBC to predict serious bacterial infection in children? The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. 2023 Nov;7(1):e002094.

E-9-1-1

Core EM

JANUARY 16, 2025

Introduction Airway management is a critical ED skill to master. Success at intubation likely takes more time and practice than other procedures, as shown in recent research on ED residents and their success rate at intubating, measured as a function of their total number of intubations (See Figure 1).

E-9-1-1