EMDocs

NOVEMBER 16, 2024

1-3 Despite its commonality it retains a relatively high rate of complications overall and patients frequently present to the ED for evaluation. 10% of patient’s have an ED visit within 30 or 90 days following THA. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. of adults over the age of 55).

EMS 96

EMS E-9-1-1 Operating Room Emergency Department 96

Don't Forget the Bubbles

JUNE 10, 2025

A recent study highlighted the gap in confidence surrounding paediatric assessment and management, and recommended a combined approach of targeted training and follow-up feedback from emergency departments after handover. The SWAST Feedback Project uses REDCap ( R esearch E lectronic D ata CAP ture) as its data collection platform.

E-9-1-1 62

E-9-1-1 Emergency Department Paramedic Ambulance 62

JEMS

JUNE 23, 2025

1 EMS has always been described as the canary in the coal mine and the tip of the spear simultaneously. While EMS forms the first line of clinical response in time-sensitive crises, ranging from cardiac arrests and strokes to traumatic injuries and behavioral health emergencies, it occupies a paradoxical place in our funding architecture.

EMS 116

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

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.

E-9-1-1 57

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

REBEL EM

NOVEMBER 11, 2024

What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. Comorbidity Index : Higher in the cefepime group (median 2 vs. 1). 9 Instrumental Variable Analysis? vs. 52.2%). vs. 15.3%). vs. 22.3%).

E-9-1-1 93

E-9-1-1 ALS ICU Critical Care 93

EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. Labs Laboratory workup in the ED is notable for a leukocytosis of 41,000/L, hemoglobin of 6.5 g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 1 By the end of 2023, 117.3 of the global population.

ED 74

ED E-9-1-1 ALS Frozen Plasma 74

EMDocs

JULY 21, 2025

SCAPE defining features: 1) rapid onset of respiratory distress (<4-6 hours); 2) pulmonary edema with severe dyspnea; 3) abdominal vital signs with SBP > 160 and/or > 120, hypoxic, tachypneic, tachycardic; 4) critically ill, evidence of pulmonary edema. In ED population, diuretics have not demonstrated clear benefit in mortality.

E-9-1-1 88

E-9-1-1 ALS Emergency Department OR 88

JEMS

JUNE 12, 2025

1 Many of these approvals represent entirely new drug classes or treatment approaches. Emerging platforms use AI to personalize learning, simulate high-risk cases, and adapt instruction to individual needs. 9 Still, some educators worry that reliance on technology could erode hands-on problem-solving. References 1.

Mobile Integrated Health 98

Mobile Integrated Health E-9-1-1 EMS Community Paramedicine 98

Broome Docs

DECEMBER 22, 2024

2024 Oct 9. There were no differences in survival (12% with IO vs 10% with IV) or neurologically intact survival (9% vs 8%). Acad Emerg Med. 2024 Nov 1. Piroxicam and paracetamol in the prevention of early recurrent pain and emergency department readmission after renal colic: Randomized placebo-controlled trial.

E-9-1-1 52

E-9-1-1 ACS Paramedic Emergency Department 52

EMDocs

NOVEMBER 25, 2024

Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. 1 Life Cycle and Pathophysiology Life Cycle Humans are the only hosts for O. 13 Figure 1. PLoS Med 3(9): e371.

E-9-1-1 71

E-9-1-1 ALS Emergency Department OR 71

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. 1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent.

ALS 40

ALS E-9-1-1 ED Emergency Department 40

EMDocs

JULY 2, 2025

What are the important considerations for management in the ED? Background: Tianeptine is an atypical tricyclic antidepressant (Image 1 displays the structure of Tianeptine) primarily used in some European, Asian, and Latin American countries for the treatment of major depressive disorder, and is sold under the name; Coaxil TM or Tatinol TM.

E-9-1-1 74

E-9-1-1 Naloxone Overdose ED 74

Don't Forget the Bubbles

NOVEMBER 27, 2024

C presents to your emergency department. FIDO was designed to assess the management of young febrile infants presenting to emergency departments in the UK and Ireland , report risk factors for IBI, and apply CDAs that do not exclusively rely on PCT testing. An additional 1 ml of blood was taken for PCT from some infants.

E-9-1-1 80

E-9-1-1 Emergency Department ED Ambulance 80

REBEL EM

JULY 14, 2025

🤕 Case A 26-year-old woman presents to the ED after falling onto her outstretched right hand while rollerblading. About 1 in 10 patients will have an occult fracture, and roughly 1 in 10 scaphoid fractures result in nonunion. 2025;26(1):14. 7 🧾 Paper Cohen A, Reijman M, Kraan GA, et al. J Orthop Traumatol.

E-9-1-1 103

E-9-1-1 ALS OR ED 103

EMDocs

JUNE 28, 2025

Vital signs revealed a BP of 136/76, HR of 88, RR of 9, SpO2 of 94% on room air, and a temperature of 97.6 Answer : Bradypnea Background: Bradypnea is defined as a decreased respiratory rate and varies by age (Table 1) 1 Hypopnea is shallow breathing that occurs during sleep 2 Etiology: Secondary to a number of causes.

EMS 78

EMS E-9-1-1 Overdose ALS 78

EMDocs

DECEMBER 6, 2024

On arrival to the ED the patient’s initial vital signs are temperature 38.5C, BP 102/48, HR 106, RR 20. 1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Table 1: Iron content of various preparations.

E-9-1-1 96

E-9-1-1 Frozen Plasma Plasma Overdose 96

EMDocs

MAY 17, 2025

Case: A 32-year-old female presents to the ED with chief complaint of abdominal pain. 1 These values can be difficult to quickly assess and measure in a fast-paced clinical scenario. See Figure 1. 9 Current best practice suggests a 1:1:1 administration of PRBC, Platelets, and FFP.

E-9-1-1 104

E-9-1-1 EMS FFP Frozen Plasma 104

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 70

E-9-1-1 FFP ALS Critical Care 70

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. Oct 2013; PMID: 24079262 Gohar E, et al.

ALS 64

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

EMDocs

MARCH 24, 2025

The syphilis and trichomonas tests come back negative in the ED, but his rapid HIV test is positive. How should clinicians approach the diagnosis and management of HIV in the ED? 9 Historically, the management of HIV and its complications was primarily the domain of primary care and infectious disease (ID) specialists.

E-9-1-1 81

E-9-1-1 ALS ED OR 81

EMDocs

JUNE 14, 2025

A 23-year-old female presents to the ED with slurred speech, left lower leg weakness, and confusion. We’ll keep it short, while you keep that EM brain sharp. A friend is with her and states that the patient does not take any medications, has no past medical history, but has been complaining of various symptoms over the past year.

E-9-1-1 99

E-9-1-1 EMS ALS ED 99

EMDocs

MAY 31, 2025

Physical exam: Appears thin with dry mucous membranes Abdomen is soft, nondistended, and mildly tender diffusely Ulcers present on the uvula and soft palate Labs: WBC 21 10 9 /L, HGB 7.1 Vital signs reveal normothermia, normotension, borderline tachycardia, O2 saturation of 100% on RA, normal respiratory rate, and a weight of 48kg.

E-9-1-1 74

E-9-1-1 EMS ALS Emergency Department 74

EMDocs

APRIL 12, 2025

Answer : Pediatric Aural Foreign Body Background: Foreign bodies are a common presenting complaint in pediatric emergency departments. Typically begin after development of the pincer grip (9 months). 1 ADHD is considered an important risk factor for auricular foreign bodies due to increased impulsivity and inatentiveness.

E-9-1-1 79

E-9-1-1 EMS Emergency Department ED 79

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Emergency Medical Services for Children] “Red to Head.” One end of the tape is red with an arrow. Prehosp Emerg Care. Patient safety in the pediatric emergency care setting. Int J Emerg Med.

E-9-1-1 274

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

ALiEM

MARCH 7, 2024

Ultrasound probes from left to right: linear (nenoates), phased array (infants/younger children), and curvilinear (older children/adolescents) Pro tips for performing renal/bladder POCUS on a child [1] Addressing potential anxiety leads to a more efficient and comfortable examination. Estimated volume = 39.2

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. Technique Positioning and Probe Figure 1: Younger children can sit in their parent’s lap and give a hug for lateral and posterior lung scanning.

E-9-1-1 246

E-9-1-1 ALS Emergency Department OR 246

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]. 1999;3(1):57-61.

E-9-1-1 184

E-9-1-1 ALS Critical Care Emergency Department 184

REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

ED 116

ED E-9-1-1 Emergency Department ALS 116

Don't Forget the Bubbles

AUGUST 30, 2023

The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of Emergency Department attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.

E-9-1-1 130

E-9-1-1 Emergency Department ALS OR 130

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Her symptoms started 1 week ago as a scratch which progressively got more red and painful. Pediatric Soft Tissue POCUS Ultrasound Technique Figure 1.

E-9-1-1 161

E-9-1-1 ALS Emergency Department OR 161

Broome Docs

SEPTEMBER 3, 2024

In a surprise to no one who reads First10EM, clinical judgment is better than all decision tools for sepsis Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.

E-9-1-1 94

E-9-1-1 Emergency Department ICU ALS 94

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the Emergency Department with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergency departments.

E-9-1-1 133

E-9-1-1 Emergency Department ALS ED 133

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?

E-9-1-1 137

E-9-1-1 OR Coronary ACS 137

EMDocs

JULY 29, 2023

A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E. RR 18, SpO2 97% on RA.

E-9-1-1 94

E-9-1-1 EMS Emergency Department OR 94

EMDocs

OCTOBER 30, 2023

Belcher, MD (EM Attending Physician, University of Kentucky, Department of Emergency Medicine) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) “What do you call an IV contrast shortage? 11 Table 1.

E-9-1-1 92

E-9-1-1 Emergency Department ALS ED 92

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. Orthopedic Emergencies 2015 May; 33(2) 311-26.

E-9-1-1 86

E-9-1-1 ALS ED OR 86

REBEL EM

SEPTEMBER 13, 2023

patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01

Frozen Plasma 99

Frozen Plasma Allergic Reaction FFP Plasma 99