Critical Care Scenarios

JULY 11, 2021

Takeaway lessons * Trauma patients who are hypotensive or otherwise unstable should be assumed to be bleeding, bleeding, bleeding until proven otherwise, and should have a very low threshold to proceed directly to the operating room for exploration.* Traction splinting is usually not done in the ED.

Operating Room 100

Operating Room ICU ED OR 100

EMDocs

SEPTEMBER 7, 2024

A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness. F, RR 16, SpO2 97% on room air. Vital signs include BP 90/48, HR 122, T 98.3

EMS 96

EMS E-9-1-1 Operating Room ICU 96

Don't Forget the Bubbles

JUNE 19, 2024

Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. A proportion of participants were missed because the ED provider refused enrollment or said “Other,” but this is not well described.

CPR 122

CPR Operating Room OR Emergency Department 122

ESO

MARCH 7, 2024

of patients with open long bone fractures receive antibiotics within the critical first 60 minutes of ED arrival. Surgical Repair of Hip Fractures: Demonstrating effective care prioritization, 94% of older adults with hip fractures were moved to the operating room within 24 hours.

Operating Room 105

Operating Room ICU OR ED 105

Handtevy

SEPTEMBER 20, 2022

The standard care in North America for post-traumatic EDH involves decompressive craniotomy or trepanation via a burr hole, typically performed in an operating room by neurosurgery teams. Initially refusing emergency medical services, she was brought to the ED via a private vehicle. What are the key takeaways? (1)

Operating Room 52

Operating Room Emergency Medical Services ED Emergency Department 52

REBEL EM

JUNE 8, 2023

This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. The impact of push-dose phenylephrine use on subsequent preload expansion in the ED setting. 2015;10(3):e0119331. PMID: 25789927 Schwartz MB, et al. Am J Emerg Med.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. Following the pandemic, the ED saw a surge in its volume as it raced through 60,000 to 80,000 visits per year.

Emergency Department 52

Emergency Department Operating Room ED OR 52

GEDC

APRIL 12, 2024

IPPS Proposed Rule by the Centers for Medicare & Medicaid Services The Age-Friendly Hospital measure assesses hospital commitment to improving care for patients 65 years or older receiving services in the hospital, operating room, or emergency department (pg. This is a proposed measure, not to be set in place until Fall 2024.

Operating Room 52

Operating Room Emergency Department ED OR 52

ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. On hospital day 2, he was taken to the operating room for surgical rib fixation. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.)

Operating Room 52

Operating Room EMS ICU Emergency Department 52

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. Paper: Owyang CG, et al. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

The Skeptics' Guide to EM

MARCH 2, 2024

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.

Operating Room 328

Operating Room Emergency Department ALS ED 328

EMDocs

JULY 17, 2023

and is poorly tolerated by patients with obstruction, it should not be a routine part of the ED evaluation for LBO unless it is critical for another diagnosis on the differential. Bowel Perforation: ED Presentations, evaluation and management. He reports distension and the sensation of fullness. Adv Cancer Res. 2021;151:1-37.

E-9-1-1 97

E-9-1-1 ED ALS Operating Room 97

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. In the operating room, there was minimal urinary output and the bladder pressures were 35 mmHg under sedation and analgesia.

Operating Room 52

Operating Room ACS Critical Care Coronary 52

ACEP Now

JANUARY 12, 2024

Case A 40-year-old female at 11 weeks, five days gestation presented to the emergency department (ED) with concern for lower abdominal pressure and inability to fully empty her bladder. The patient was admitted to the obstetrics service and underwent spinal anesthesia in the operating room to manually reduce the uterus.

Operating Room 52

Operating Room Emergency Department ED OR 52

AAEM RSA

DECEMBER 3, 2020

The sensitivity of these scores range, but they cannot exclude FG diagnosis and may have lower sensitivity when used for prediction in ED patient populations. A thorough physical exam, imaging, and laboratory studies can assist, but definitive diagnosis can only be made in the operating room.

Emergency Department 52

Emergency Department E-9-1-1 ALS Operating Room 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. The data that are available come largely based on voluntary reporting, physician surveys, or autopsies.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

EMDocs

JUNE 3, 2023

C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients.

ED 62

ED Operating Room ALS Frozen Plasma 62

Don't Forget the Bubbles

FEBRUARY 7, 2024

One systematic review of 1283 patients showed that if you got to the operating room within 6 hours, you had a 97% chance of saving the testicle. Clinical predictors for testicular torsion as seen in the pediatric ED. This dropped to 79.3% The Journal of Urology , 189 (5), pp.1859-1864. Beni-Israel, T., Goldman, M., Chaim, S.B.

Operating Room 109

Operating Room Emergency Department ALS OR 109

ACEP Now

APRIL 4, 2024

3 The majority of those who arrive to the emergency department (ED) live for 2 hours or more, leaving a small window for surgical intervention. Other exceptions are patient refusal, patient death or immediate transfer to the operating room. Bailey & Love’s short practice of surgery, 26th ed. Br J Surg 2012;99:655-665.

Operating Room 40

Operating Room ALS ED Emergency Department 40

Broome Docs

APRIL 30, 2024

Join Justin and I for a sold 80 minutes of nerdy evidence-based ED care. Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in the Operating Room: A Cluster Randomized Clinical Trial. Join Justin and I for a sold 80 minutes of nerdy evidence-based ED care. 2024 Mar 18:e240762. doi: 10.1001/jama.2024.0762.

Operating Room 67

Operating Room Critical Care ED OR 67

REBEL EM

DECEMBER 18, 2024

Rosens Emergency Medicine: Concepts and Clinical Practice, 7 ed. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. Louis, Mosby, Inc., 2010, (Ch) 70: p 895-909. GorchynskiJ et al. The “syringe” technique: a hands-free approach for the reduction of acute nontraumatictemporomandibulardislocations in the emergency department.

Operating Room 52

Operating Room ALS ED Emergency Department 52

Core EM

JANUARY 16, 2025

While this guide isnt exhaustive, its designed by residents, for residents, to provide practical tips and foundational knowledge thats crucial in the fast-paced, high-stakes environment of the ED. Introduction Airway management is a critical ED skill to master. So the actual benefit for most ED patients is unclear.

E-9-1-1 130

E-9-1-1 EMS ALS OR 130