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From the ED to the edge: How Dr. Darria Long found her rhythm — and how EMS can find theirs For many of us in EMS, the term “crazy busy” […] The post EMS1 | From the ED to the edge: How Dr. Darria Long found her rhythm — and how EMS can find theirs appeared first on American Ambulance Association.
She is passionate about paediatric EM, wellbeing and medical education. Case: A ten-year-old boy presents to your emergency department (ED) after being involved in a motor vehicle collision at high speed. Emergency Medical Service (EMS) tells you that he was properly restrained.
We’ll keep it short, while you keep that EM brain sharp. A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities. .: Infect Dis Rep.
This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He came to the ED at the urging of his wife.
Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department and Program Director of the EM residency program at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County. AEM Oct 2024. AEM Oct 2024.
Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. 10.1007/s00384-021-03971-1.
Howard Ovens, on leading from the inside out, we cover foundational principles, practical habits, and transformative insights that can make any member of an ED team a more effective, compassionate, and adaptive leader.
A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. Hemoptysis ED approach and management. Its going to take time to get her to a tertiary center.
Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ Our experience: Traditionally, ED physicians do not like ordering urine drug screens (UDS).
Dr. Casey Patrick is the EMS medical director of Montgomery County Hospital District (Texas). As an EM physician, he shares how he decides to care for his own patients in the ED who present with rapid atrial fibrillation. Want CE for listening? Here’s how.
Remember, from the ED point of view, if you are confronted with a wide complex regular tachydysrhythmia, assume VTach until proven otherwise! Academic EM. References Tannenbaum L, Bridwell R, Inman B. EKG Teaching Rounds. Current algorithms for the diagnosis of wide QRS complex tachycardias. Curr Cardiol Rev. 2014 Aug;10(3):262-76.
Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration. Background: There are many ways to define artificial intelligence.
Emergency medical services (EMS) scope of practice is governed by the state, but national scope of practice guidelines are available for the four different EMS provider levels. Conclusion EGAs offer multiple benefits in managing patient airways and have found generally wide acceptance in the protocols of numerous EMS provider levels.
As emergency departments (EDs) have become the focus of bottlenecks in the entire health care systemfrom insufficient inpatient beds leading to hospital boarding to dwindling access to primary carea siege atmosphere has developed. This leads to a vicious circle of more and more professionals exiting the EMS workforce.
Clinical Application in the ED Incorporating VTI into sepsis management requires minimal additional equipment beyond the ultrasound already present in many emergency departments. This assumption expedites the evaluation of a patient’s volume responsiveness and facilitates implementation in the ED setting. F, and SpO₂ 92% on room air.
Many of these patients will be agitated, posing a management challenge for EMS practitioners. ED-based protocols have already been created to aid in the treatment of patients with this condition.
A 55-year-old woman with medical history of well-controlled hypertension and renal cell carcinoma, status post-partial nephrectomy, presented to the emergency department (ED) with sudden-onset, 10-out-of-10 chest pain and pressure. Screening, evaluation, and early management of acute aortic dissection in the ED. Curr Cardiol Rev.
What could you achieve if you had a patient’s prearrival care information in hand when they arrived at the emergency department (ED)? What would change if you could see timely EMS input? Read on to find the latest ESO HDE enhancements that provide hospitals with actionable insights into EMS activity and collaboration.
Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. A 36-year-old male presents to the emergency department after being found down at home by his spouse. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.
Reference: Bourke EM, et al. Case: A 14-year-old girl with no known medical or psychiatric history presents to the emergency department (ED) with her family for aggression. In the ED setting, pediatric agitation presents unique challenges. Annals of Emergency Medicine.
These findings raise an important question: if the OFC, in its current form, doesnt meaningfully impact outcomes but does extend ED stays, is it time to rethink how (or if) we use it? For those working in EMS and community healthcare, ongoing education and professional development in paediatric emergency care are often insufficient.
I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr. Clarke said. The specialty, he said, spoke to his interest in surgery and EMS in a way that family medicine did not. ED resident Dr. Steve Hui doing a pericardiocentesis on a trauma patient.
We’ll keep it short, while you keep that EM brain sharp. 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. Initial vital signs include T 36.8, J Orthop Trauma.
In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. His roommate found an empty pill bottle on the floor next to him. The bottle contained 100 mg quetiapine tablets, and 50 tablets were unaccounted for. Management of atypical antipsychotic overdose is mainly supportive. References: N. Juurlink D. Antipsychotics.
Applicability to Emergency Medicine: For emergency medicine providers, the greatest challenge with this study is that it did not include or account for ED care. Only fluids administered after admission were considered and only in the subset of patients whose pain could not be controlled adequately in the ED to discharge without an admission.
Light The primary goal of EMS, is to always do the best for our patients. It is common in EMS to use an initial volume of 500 ml for an adult. Gastric distention also directly correlates to duration of prehospital care; the longer the patient is with EMS, the higher the incidence of gastric distention. By Brian M.
Gerard, MS, RN 35 min read Share To: Shutterstock/RozenskiP In the fragile, complex ecosystem of the American healthcare system, few services are as mission-critical and chronically underfunded as EMS. 1 EMS has always been described as the canary in the coal mine and the tip of the spear simultaneously.
Timeline for Repeat EMS Encounters Resulting in Transport Following “Lift Assist” in a Suburban EMS System. In conclusion, this is an interesting study from the LAA, one of the most advanced EMS agencies in the world. Prehospital emergency finger thoracostomy in compensated obstructive shock: Benefits and outcomes.
After reviewing over 12 million EMS incidents that took place in 2023 , the 2024 ESO EMS Index highlights two critical areas that demand attention: Early CPR and Opioid Use Disorder (OUD). Bystander CPR has been shown to double survival rates compared to cases where no CPR is performed prior to EMS arrival.
The ED staff quickly checks vital signs and a blood glucose, starts an IV, then wheels the patient to the CT scanner, where you perform a brief exam. According to the patient’s wife, his symptoms started suddenly, approximately one hour before they arrived at the ED. Authors: Justin Doroshenko, DO, M.Ed. (EM
In an effort to support flight workflows, GundersenAIR has adopted OneDose by Hinckley Medical, becoming the first air EMS provider to implement the OneDose system into its clinical operations. Our work involves some of the most high-stress situations in medicine,” said Dr. Ed Rodenkirch, Medical Director of GundersenAIR.
Literature Review Few case studies have touched on the subject of terminal extubation performed by EMS providers during the initial patient contact. More commonly, patients are transported to the Emergency Department (ED), where extensive conversations between ED providers and family occur.
4 The 2023 ACORN Trial ( covered here on REBEL EM ) randomized 2,511 patients requiring antipseudomonal coverage to receive either cefepime or piperacillin-tazobactam. In this case, a piperacillin-tazobactam shortage influenced antibiotic usage based on when patients presented to the ED, creating a “randomization” effect.
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 She is sent to the medical ward after three days in the ED with the diagnoses of resolving septic shock, severe malaria, and AKI.
Advocating for the Addressing Boarding and Crowding in the ED (ABC-ED) Act was a central part of this year’s Leadership and AdvocacyConference (LAC). Urge Your Legislator to Support the ABC-ED Act. Now is the time to build off the LAC momentum and call for the prompt passage of this bill into law. Read more about the bill here.
Duration of intubation: Nine of thirteen studies reported slightly longer intubation times with a bougie, with a maximum average increase of 13 seconds in ED–based studies. Clinically Diverse Patient Population : The study included patients from varied clinical settings (ED, ICU, OR, and pre-hospital). in another study). N Engl J Med.
Here in Connecticut, in addition to being a street paramedic (admittedly working less shifts than I used to), working in an ED, and helping manage the state’s EMS opioid reporting initiative, I can tell you, EMS reported overdoses have increased each month on a per-day average since last December, with June having the largest increase.
Figure-1: Comparison of today's initial EMS ECG — with the repeat ECG on arrival in the ED. That said — I'd add 2 important points related to ECG #2 : Point #1: There has been improvement in the ECG findings that were seen in the initial EMS tracing. Download now for iOS or Android. (Dr.
Authors: Noah Kronk, MS-4 (University of Missouri-Columbia); Jessica Pelletier, DO, MHPE (APD, EM Attending Physician, University of Missouri-Columbia, USA) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 30-year-old female presents to the emergency department (ED) with fever, fatigue, and an extensive rash.
Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 131.0 – Traumatic Arthrotomy appeared first on REBEL EM - Emergency Medicine Blog. cefazolin or cefuroxime) If risk factors for MRSA present, use agent with activity against MRSA (i.e. gentamycin) If concern for fecal or clostridial infection, add high dose penicillin (i.e.
Since beginning my EMS career in 1993, the U.S. For EMS clinicians and educators, this relentless pace of innovation demands a constant recalibration of knowledge and skills to address the shifting realities of prehospital care. Adapted from J. 2010 , 87 , 1348.
These may be fighting words to the hardcore EMS provider who has seen the decades-old spine splint go through its many iterations. These may be fighting words to the hardcore EMS provider who has seen the decades-old spine splint go through its many iterations. Barnhard By Roy Danks, DO It’s time to decommission the long spine board.
One thing to toss around that ends up effecting fluid resus in our ED – I see lots of providers ordering NS because Ceftriaxone – frequently used – isn’t compatible with LR. Questions Before Joining (FAQ) Join Now! Future Show: Upping your IV Game Fluids Get dinged for 4, rectal temps on elderly, etc.
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