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. Crit Care Med. Critical Care Medicine. Oct 2013; PMID: 24079262 Gohar E, et al. Mar 2004; PMID: 15090949. Marik P, et al.

ALS

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% 2020) The Times & Tapes Are a-Changin’: The Latest Broselow-Luten Tape for EMS , EMS World. Prehosp Emerg Care. Patient safety in the pediatric emergency care setting. 2020;13(1):9.

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Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Alpha 1 agonists are necessary to maintain appropriate blood pressure. 2011;46(9):1771. Never fear. J Pediatr Surg.

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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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ALiEM

MAY 19, 2023

Esophageal Balloon Tamponade Devices – Linton-Nachlas, Sengstaken-Blakemore, Minnesota Tubes (image courtesy of Dr. Mark Ramzy at REBEL EM) What are esophageal balloon tamponade devices? The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Pearl 1: Check the units of pressure being used.

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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

Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Cuffed endotracheal tubes in pediatric intensive care. 1994 Jul;125(1):57-62. 2019 Sep;74(9):1186-1190. 2016 Feb;30(1):3-11. The post Cuffed Endotracheal Tubes for Children: ReBaked Morsel appeared first on Pediatric EM Morsels.

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Don't Forget the Bubbles

NOVEMBER 22, 2023

Of these signs, mortality in children is associated with hepatomegaly and fever; meanwhile, mortality in adults is associated with hyperkalaemia, traumatic brain injury, propofol infusion rates >5mg kg -1 h -1 and ECG changes. 1998;8(6):491-9. Filho EM, Riechelmann MB. Critical care (London, England).

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FOAMfrat

APRIL 22, 2024

Simulation allows EMS clinicians to train for scenarios they may encounter in the field. Depending on the EMS providers, these scenarios may be ones that they have already encountered or those that they have yet to see in real life. Prehosp Emerg Care. 2024 Mar 15:1-9. Prehosp Emerg Care. 2016;20(1):76-81.

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Don't Forget the Bubbles

AUGUST 28, 2023

The median age at diagnosis was 47 months (range 1-173 months). About PICSTAR PICSTAR is a trainee-led research network open to all doctors, nurses and allied health trainees within Paediatric Intensive Care. See their website for more: [link] References Carter BW, Marom EM, Detterbeck FC. 2014;9(9):S102-S109.

Emergency Manager

Broome Docs

OCTOBER 31, 2022

Intensive Care Med. 2022 Jan;48(1):78-91. PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. 2022 Sep;21(9):781-791. Anaesth Crit Care Pain Med. Epub 2021 Dec 14. 2022.101096.

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ACEP Now

OCTOBER 11, 2024

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. Paralytic agents include rocuronium at 1 mg/kg IV and succinylcholine at 1-2 mg/kg IV. References Long E, Sabato S, Babl FE. mg/kg IV, ketamine at 1.5–2

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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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REBEL EM

MAY 8, 2023

Paper: Smith JA, Secombe P, Aromataris E. J Trauma Acute Care Surg. Only 1 RCT and 1 cohort study had only mechanically ventilated patients. References: Smith JA, Secombe P, Aromataris E. J Trauma Acute Care Surg. appeared first on REBEL EM - Emergency Medicine Blog. 2021 Dec 1;91(6):1025-1040.

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ACEP Now

NOVEMBER 7, 2023

EMS physicians report he was found in ventricular fibrillation. 1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). 2018;13(9):e0204169. Margey R, Browne L, Murphy E, et al.

Defibrillator

Pediatric EM Morsels

JULY 28, 2023

Rates of type 1 diabetes have increased since the COVID-19 pandemic. A critical MORSEL is that every child you treat for DKA needs to have an initial thorough neuro exam including cranial nerves and then frequent neuro reassessments … and document it ( so your colleagues who take over care for the kid can know if there has been a change )!

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REBEL EM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 5 Onset of VAP has been repeatedly shown to increase the number of ventilator days, intensive care length of stay, use of antimicrobials, medical costs, and mortality risk. 4, 8 Paper: Dahyot-Fizelier, C.,

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REBEL EM

NOVEMBER 30, 2023

Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis [published online ahead of print, 2023 Aug 9]. References: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM.

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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

REBEL EM

AUGUST 21, 2023

Figure 2 : Extended Glasgow Outcome Scale (GOS-E) (credit: Doc_HG ) Secondary Modified Rankin Score Secondary outcomes included death within 6 months. Monitoring cerebral pressures is crucial in assessing the impact of interventions, especially in critical care scenarios.

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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

In fact, Herbstritt 2012, identified that there was "no significant difference to time to intubate, intubating conditions, or intubating success rate when using 1 to 1.2 mg/kg Rocuronium versus 1 to 1.5 mg/kg Rocuronium versus 1 to 1.5 Updated 2021 Oct 1]. mg/kg of Succinylcholine during RSI in an ED setting." [1]

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Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. Figure-1: I've reproduced the initial ECG in today's case.

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EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. However, ABGs have many drawbacks compared to VBGs.

Emergency Department

EMDocs

OCTOBER 7, 2023

We’ll keep it short, while you keep that EM brain sharp. A 17-year-old girl, in moderate distress, is brought in by EMS after a motor vehicle collision. EMS reports that she was “pinned” underneath the dashboard, and it took several hours to extricate her. Critical Care. 2016;20(1):135. Genthon A, Wilcox SR.

EMS

EMDocs

MAY 29, 2023

Authors: Rachel Kelly, MD (EM Resident Physician, Stony Brook University Hospital) and Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St.

ED

Don't Forget the Bubbles

DECEMBER 6, 2023

Their analyses revealed an association between social media use and e-cigarette and tobacco use. Abrams EM, et al. Rodríguez-Gutiérrez E et al. Venturini E, et al.Eur J Pediatr. 2023 Nov 1:e2023063289. Future research should incorporate longitudinal analyses to test these associations robustly. Eur J Pediatr.

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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. C or 100.4 mg/kg, max 0.4

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EMDocs

OCTOBER 29, 2024

Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA), Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

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EMDocs

MAY 6, 2025

Chu CK, Delia E, Mograder A, Dwyer EM. Anaesth Intensive Care. 2017;45(1):12-20. 2015;7(9):E365-E369. Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. 2018;12(1). J Saudi Hear Assoc. 2018;30(4):336.

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FOAMfrat

NOVEMBER 28, 2024

Hoffman is the editor-in-chief of PulmCCM, a blog that frequently updates its readers on evidence and best practices in critical care medicine. I have always wondered how our work in the field affects a patient's care downstream. The key is ensuring the patient gets individualized care based on their unique physiology."

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Core EM

JANUARY 16, 2025

An EM Residents Guide to Basic Airway Management Authors: Justin Rice, MD Sagar Desai, MD Eunice Monge, MD William Chiang, MD Preface: Airway management is one of the most critical skills in emergency medicine, yet it can be one of the most challenging to master. Introduction Airway management is a critical ED skill to master.

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