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1 Self-driving ambulances represent another emerging technology. Autonomous EMS delivery systems offer exciting possibilities to transform emergency medical respons e. References 1. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 25(1), 43. Cost efficiency is another significant benefit. Fredman, D.,
Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)
Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2].
typhi infection if treatment is refractory to supportive measures or conventional community-acquired pneumonia antibiotics Treat with atypical bacterial coverage (doxycycline, azithromycin, chloramphenicol, or fluoroquinolones) A 32-year-old woman presents to the ED with a fever and rash after returning from a trip to Southeast Asia. .:
1 Even beyond the assessment of volume tolerance, there is suggestion that the VEXUS scan can be used to guide decongestion from heart failure, 2 guide the decision for dialysis 3 , and identify different venous congestion as it mimics different pathologic states such as cardiogenic shock or cholecystitis. Adapted from Pocus101.com
3, 9, 11, 12 The average age tends to be greater than 60 years old. Up to 1/3 of adults over 60 suffer from chronic constipation. Clinical exam: 2, 3, 9 Abdominal distension and tenderness Nausea and vomiting Stool present in the rectal vault Peritonitis may be accompanied by hemodynamic instability in the case of sepsis.
The ECG shows sinus rhythm with a rate of about 78 and 2:1 AV conduction along with right bundle branch block and left anterior fascicular block. 2:1 block is a special case, because the tracing lacks successive PR intervals. I have labeled the P waves below for ease of reference: P waves 8 and 9 both conduct to the ventricles.
1 Notably, these statistics don’t include the substantial increase in behavioral health visits to pediatric emergency departments since the COVID-19 pandemic occurred. One of the hardest communication challenges in pediatric patients is the fact that their wide age range is accompanied by a variety of developmental stages. million in 2020.
1 Push-dose pressors can come in handy in three situations: Anticipated transient hypotension. A pure a 1 – agonist, phenylephrine gives you peripheral vasoconstriction but no increase in cardiac output. However, because of the b 1 effect, tachydysrhythmias are a common side effect. What is a Push-Dose Pressor?
1 In the ED, the most important consideration in management of these toxicities involves decontamination, evaluating for airway protection, and managing any hemodynamic instability. mg/kg-1 mg/kg with maximum dose of 50 mg in children. The dose is 25 mg- 100 mg for adults and 0.5 It also has opioid receptor agonism.
1 Prehospital endotracheal intubation and EGAs are typically placed without paralytics and are reserved for unconscious, apneic, and out-of-hospital cardiac arrest patients. 9 LMAs use an inflatable mask expanded using a similar technique to the endotracheal tube cuff. 2014;4(1):77-87. 2014;18(1):106-115.
Journal of Zoological Systematics and Evolutionary Research, 46(1), pp.19-23. Anais da Academia Brasileira de Cincias, 96(1), p.e20230706. Gompper, Matthew E., Diseases of Aquatic Organisms, 66(1), pp.87-90. Just there, hanging out, forever. How are you feeling? Hey, we get it. But at least youll never be alone again.
1 According to the ACEP Code of Ethics: The physician-patient relationship is the moral center of medicine and the defining element in clinical ethics. 2018;13(9):e0204113. 2017;17(1):136. 2020;20(1):52. 2023;23(1):270. Winter R, Issa E, Roberts N, et al. 2020;10(9):e036471. 2020;103(9):1866-1867.
His wife tells us he's a long-term alcoholic who drinks several pints of vodka every day, and 3 days ago tried to start weaning himself off by drinking less than 1 pint. Journal of Clinical Medicine , 9 (6), 1901. 2023, October 1). Ben-Menachem, E., Brodtkorb, E., Acta Neurologica Scandinavica , 135 (1), 416.
What is the next step in evaluation and treatment? fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold
Commonly a monomicrobial infection with gram-negative bacteria like E. Paracentesis is a safe procedure with a low complication rate (< 1%). For the remaining fluid inject 1 mL into a purple top EDTA blood tube for cell count; send 2-3 mL for Gram stain in a red-top tube or sterile urine container. coli (50-90% of cases).
Nature Reviews Gastroenterology & Hepatology , 20 (9), pp.615-624. 2016): 1-9. Conficconi, E., BioMed research international , 2017 (1), p.9784565. Thieme, E. Surgeons performed appendectomies like it was spring cleaning – when in doubt, cut it out. JAMA network open , 4 (8), pp.e2122248-e2122248.
1-3 Despite its commonality it retains a relatively high rate of complications overall and patients frequently present to the ED for evaluation. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. of adults over the age of 55). 10% of patients.
1 The reason is understandablethrombolytics in stroke is a high-risk, higher-reward treatment. Acceptance of thrombolytics in stroke is exemplified in the results from a survey of EDs participating in ACEPs Emergency Quality Network (E-QUAL) Stroke Collaborative. In the setting of regular patient care, the debate is over.
Perkins ZB, Greenhalgh R, Avest E, et al. International Prehospital Medicine Institute Literature Review, June 2025 1. Perkins ZB, Greenhalgh R, Avest E, et al. Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest. 2025;160:432-440 2. Baker PO, Karim SR, Smith SW, et al. Prehospital Emergency Care, 2025;29:218-226.
Step 1: Conversion to Formaldehyde Methanol is broken down in the liver by an enzyme called alcohol dehydrogenase at a fixed rate. This zero-order elimination occurs at about ~8–9 mg/dL/hour. Let’s break down the science, signs, and solutions for managing this stealthy poison—especially in children. What is Methanol?
1 A wide spectrum of severity exists in PE presentations, ranging from mild shortness of breath to cardiac arrest. Approximately 60,000 to 100,000 patients die from pulmonary embolism (PE) each year in the United States, and PE is the third leading cause of cardiovascular mortality.
The SWAST Feedback Project uses REDCap ( R esearch E lectronic D ata CAP ture) as its data collection platform. Other prehospital clinicians included Emergency care assistants ( 7% ) and student paramedics ( 8% ) (see Figure 1 ). REDCap is a secure, web-based tool designed to support high-quality data capture and management.
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.
1 The author’s employer, a Michigan-based life support agency, further represents clinician shortages, experiencing only a 70% retention rate of EMTs and a 77% retention rate of paramedics. Here’s a closer look at each topic: 1. This can include role-playing simulations, physical simulations, and computer-based simulations.
Follow our step-by-step guide below: 1) Build your project group and delegate roles Assembling your project group The project group should have a range of emergency medicine clinicians, including: Senior clinicians (minimum of 2) Consultants. Tier 1 doctors (minimum of 2) Junior grade resident doctors. e.g., ST3 + (UK equivalent).
The Queen of Hearts also knows which large T-waves are hyperacute and which are not: She knows that it is not OMI (Unfortunately, most providers no longer have access to the Queen of Hearts because 1) it is not yet FDA approved and 2) thus a provider can only use it in the context of research.) Here are 9 cases that involve re-occlusion.
In 2025, some systems are running 1 EMS call every 45 seconds in urban centers, with the majority of those calls for non-life-threatening issues. 1 Yet the industry response has been predictable; “We need more medics.” Introduction The EMS workforce is burning out, not just from trauma and long hours, but from sheer volume.
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.
Patients can lose up to 2 million brain cells every minute of a stroke; every hour without treatment, the brain ages 3 1/2 years. 21—It was just after 2 p.m. on Monday, Sept. 17, 2017, and Chris Cartier was sitting at his computer at Quest Diagnostics, working. Every 40 seconds in the U.S., That’s why a swift response is imperative.
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. 2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. In 2021, Buckley et.
ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 History of Present Illness The collateral history indicates that her symptoms began one week into her journey, but medical care was inaccessible at the time. Bowel sounds are normal.
Barnhard By Roy Danks, DO It’s time to decommission the long spine board. These may be fighting words to the hardcore EMS provider who has seen the decades-old spine splint go through its many iterations. , taping the head to the board and applying straps to the body. I don’t want to brag (or complain), but this was my idea. That’s it.
1 Many of these approvals represent entirely new drug classes or treatment approaches. 9 Still, some educators worry that reliance on technology could erode hands-on problem-solving. Since beginning my EMS career in 1993, the U.S. It would be a great display in training centers, simulation labs and EMS stations.]
1 Obviously, this is an extreme case; however, it illustrates that field amputations can be successful even in the most primitive conditions. The Gigli saw technique had an instrument malfunction on 3/9 trials which was distinct from the other techniques. Differences in cleanliness of cut were nonsignificant.
2024 Oct 9. There were no differences in survival (12% with IO vs 10% with IV) or neurologically intact survival (9% vs 8%). There is a bunch more – so have a listen or watch us on Youtube feed below. You can read all the papers on the links in the show notes right here. doi: 10.1001/jama.2024.20424. 2024.20424. of the IV group).
Kids get hurt. And they get sick. Its inevitable. Whether their fingers get caught accidentally in a car door or bedroom door slamming closed, or they trip and fall while running on their uncooperative little toddler legs , or catching all the germs as their immune systems slowly struggle to fight off every known virus to mankind.
1 Life Cycle and Pathophysiology Life Cycle Humans are the only hosts for O. 1 The parasite has a 5-stage life cycle in which the blackfly acts as an obligate intermediate host. 1 Life Cycle and Pathophysiology Life Cycle Humans are the only hosts for O. 13 Figure 1. PLoS Med 3(9): e371. 7 Approximately 14.6
1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent. Then, it was video laryngoscopy versus direct … bougie or stylet. Now, the next debate to be settled is the ideal method for preoxygenation before intubation. The brain is an entirely different organ system, however.
Margin: Allowed up to 1 in 25 more deathsthough stricter than past trials. REBEL Rundown Key Points Generalizability: Mostly Canadian patients with gram-negative UTIs or abdominal infections. Bias: Multiple biases may have made 7 days look better than it is. Gram-Positive? Still not enough data for other bugs or sources. Community-onset: 75.4%
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. Questions: What is tianeptine?
1 His tragic loss underscores the urgent need for mental health support for residents and fellows. Accessed December 9, 2024. Accessed 9 December 2024. Other demands included increased time for parental leave and childcare, clean resident call rooms, reimbursement for board exam fees, and improved medical benefits coverage.
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