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2475908 50-something male with PMH of hypertension and tobacco use who presented to triage with chest pain, which has been stuttering for a few days but constant since 6pm last night. It is worse and "sharp" with inspiration, but a constant dullness. He states for the past few weeks he has had cough and cold symptoms, productive of thick phlegm and some occasional chest pain with coughing.
Is 15 lead ECG better than 12 lead for diagnosing posterior MI or right ventricular infarction? When do you need a 15 lead ECG? Jesse McLaren guides us through 8 cases to highlight the steps and pitfalls in diagnosing posterior MI and RVMI in light of recent ECG literature. The post ECG Cases 31 Is a 15 lead ECG better than 12? Diagnosing Posterior MI and RVMI appeared first on Emergency Medicine Cases.
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith [link] @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. A 59 y/o Female calls 911 for crushing chest discomfort and difficulty breathing. Fire/EMS personnel find her laying supine on the kitchen floor, awake and verbal, although acutely ill.
Date: May 13th, 2022 Reference: Abril et al. The Relative Efficacy of Seven Skeletal Muscle Relaxants. An Analysis of Data From Randomized Studies. J Emerg Med 2022 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading […] The post SGEM#366: Relax, Don’t Do It – Skeletal Muscle Relaxants for Low Back Pain first appeared on The Skeptics Guide to Emergency Medicine.
Elsewhere on social media this week I have seen a call to “protest EMS Week 2023” The logic suggests that the free meals and cheap trinkets are far less than the long-suffering and under-paid providers deserve. While I whole-heartedly agree, “we” have made EMS Week what it has become, not what it was intended. The EMS Week 2022 proclamation reads “I call upon public officials, doctors, nurses, paramedics, EMS providers, and all the people of the United States to obs
In this first part of our 2-part series on Cardiac Arrest Controversies Rob Simard, Bourke Tillman, Sara Gray and Scott Weingart discuss with Anton how best to ensure high quality chest compressions, the pros and cons of mechanical CPR, the literature on dual sequential defibrillation and optimizing pad placement, epinephrine vs vasopressin, amiodarone vs lidocaine, when to consider IV calcium and sodium bicarbonate, esmolol, airway considerations, sedation in cardiac arrest, the pros and cons o
Date: May 24th, 2022 Reference: Broder et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE) 2: Low-Risk, Recurrent Abdominal Pain in the Emergency Department. AEM May 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 33-year-old male presents to […] The post SGEM#367: GRACE2 – Low-Risk, Recurrent Abdominal Pain first appeared on The Skeptics Guide to Emergency Medicine.
Discussing ICU triage, risk stratification, and patient disposition with intensivist Eddy Joe Gutierrez (@eddyjoemd) of the Saving Lives Podcast. For 20% off the upcoming Resuscitative TEE courses (through July 23, 2022), listen to the show for a promo code for CCS listeners! Takeaway lessons When a patient has borderline indications for requiring the ICU, generally, … Continue reading "Episode 47: ICU triage with Eddy Gutierrez" Discussing ICU triage, risk stratification, and patient dispositio
Welcome back to the tasty morsels of critical care podcast. Today we’re going to talk about some of the basics of some of our favorite drugs intensive care – the diuretics. As always this is planned to be a brief overview of the essentials rather than the deep dive. Click for source As a starter pretty much all diuresis is conducted by convincing the kidney to lose more Na.
A 79 year old male presents to ED after a syncope. The patient has had diarrhoea and vomiting over the past week. He has a background of hypertension, atrial fibrillation and CCF.
On this month's EM Quick Hits: Christina Shenvi on ACS in older people, Nour Khatib on rural NRP, Jess McLaren on how not to get fooled by ECG computer interpretation, Brit Long on hemophilia recognition and workup, Maria Ivankovic on persistent and intractable hiccups from EM Cases Summit 2021. The post EM Quick Hits 38 ACS in Older Patients, Rural Neonatal Resuscitation, Hemophilia, Hiccups, ECG Computer Interpretation appeared first on Emergency Medicine Cases.
Hey all. This week I am making a guest appearance on the excellent ABCS of Anaesthesia podcast with Dr Lahiru Amaratunge. Specifically we are discussing the way that we can approach Obstetric Anaesthesia in rural hospitals. We discuss how we can manage risk, a lot about our paranoia and pessimism when it comes to higher risk Obstetric scenarios. It is a great topic that illustrates the way that GPAs need to balance the medical, social and logistical considerations in discussion with our team and
Image by Mohamed Hassan Knowing our audience of advisors well, we here at ASC-EM won’t bother hunting for citations to adorn this sentence: We are all suffering from burnout of historic proportions. Whatever one’s politics, beliefs, position and physical capacity, the last two and a half years have been hard in a way that might (if one were prone to such thoughts) seem almost specifically targeted to make life difficult for ER doctors and educators.
Applicants to our nationally renowned EMT training courses often ask us if they can take their new EMT credentials to the state where they live, and the answer is mostly yes. The National Center for Outdoor and Adventure Education’s (NCOAE) campus is located in North Carolina, where we offer 21-day “Intensive” EMT-Basic and 23-day “Intensive” Advanced EMT training courses among others.
Movement disorders are encountered more frequently in the critical care unit than one might realize. For example Parkinson's disease alone affects ~1% of patients over sixty years old (often requiring careful consideration in medication management, to avoid either psychosis or Parkinsonism-hyperpyrexia syndrome). Other disorders are less common, but their recognition may be critical (e.g., propofol […].
Bryan and Brand talk about night shifts, how to handle them, managing the disruption of your circadian rhythm, and more. For 20% off the upcoming Resuscitative TEE courses (through July 23, 2022), listen to the show for a promo code for CCS listeners! Bryan and Brand talk about night shifts, how to handle them, managing the disruption of your circadian rhythm, and more.
EMS Week: Rising to the challenge As EMS week comes to a close, NAEMSP, the PEC podcast , and the But Why EMS podcast would like to highlight a NAEMSP member who has Risen to the Challenge of the war in Ukraine. Dr. Kasia Hampton ( @kasiahamptonmd ) & her medical student daughter Livia Van Humbeeck ( @doclivia ) have been helping their home country Poland and their neighbor Ukraine during this horrendous time in history.
History Behind Tactical Combat Casualty Care (TCCC) Tactical Combat Casualty Care (TCCC) is a combat lifesaver course that outlines the priorities of medical care for casualties in combat-related situations as faced in military and law enforcement applications. Initially, it was developed developed for U.S. Special Operations Forces in 1996 but has become an international standard […] The post Introduction to Tactical Combat Casualty Care (TCCC) appeared first on SaveaLife.com.
I don’t have favorite episodes but if I did, this would be one of them. With my girlfriend Cassi by my side, I caught up with Kris and Sara Kaull at a conference. It’s the first ever double-date on Medic Mindset! Cassi & Kris are both paramedics. Sara and I have the perspective of the significant-other to a paramedic. We swap stories while Cassi and Kris offer ideas about what medics need from their spouses/partners.
A 30-something male presented in the middle of the night with several hours of sharp, non-radiating, left sided chest pain. It was there earlier, went away, and then returned approximately 1 hour prior to arrival. He is a smoker and has some family history of early MI. Exam and vital signs were normal. Here was the triage ECG: There appears to be diffuse ST Elevation (II, III, aVF with reciprocal STD in aVL, V3-V6, and lead I, with T-waves that appear to be hyperacute (broad and fat, but on the
The relationship between skin warmth and color, cardiac output, and systemic vascular resistance. For 20% off the upcoming Resuscitative TEE courses (through July 23, 2022), listen to the show for a promo code for CCS listeners! The relationship between skin warmth and color, cardiac output, and systemic vascular resistance. For 20% off the upcoming Resuscitative TEE courses (through July 23, 2022), listen to the show for a promo code for CCS listeners!
Carotid or vertebral artery dissection are important considerations in trauma and also common causes of ischemic stroke among younger patients. Variable presentations and a plethora of different diagnostic modalities can make this tricky. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes. EMCrit Project by Josh Farkas.
Ouch-less Pediatrics For CAPCE Credit click here! Happy EMS Week: Pediatrics Day! The PEC Podcast team would like to highlight NAEMSP's newest podcast to our family The Pediatric EMS Podcast In their first episode, hosts Dr. Joseph Finney and Dr. Joelle Donofrio Odmann talk about Safely and effectively managing pain in our pediatric patients. Medical directors and prehospital clinicians must be able to identify gaps in pediatric pain management and provide the necessary QA/QI to close those gap
This is a special cross-post with the brand new pediatric podcast from NAEMSP: The Pediatric EMS Podcast created by Drs. Joelle Donofrio-Odmann and Dr. Joseph Finney. Dr. Donofrio-Odmann has been a guest on the show previously in Thinking: Pediatric Respiratory. Other guests in this episode are Drs. Maia Dorsett , Jeff Jarvis and Jeremiah Escajeda They’ve created these show notes.
Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode of chest pain and shortness of breath after finishing a 4-mile run. He typically runs 4 to 8 miles per day. This episode was unusual to him because he was still "huffing and puffing" about 30 minutes after finishing his strenuous run in the outdoor heat.
Hilary gates is a real life educator at American University who happened to join EMS and fall in love with it. The program she works with, Prodigy EMS , is at the forefront of EMS education. As we move forward out of our collective nightmare that has been the past two years, Ed and Anna discuss how EMS education can grow from here. Hilary speaks with focus and passion about expanding the role of EMTs and medics moving forward and what we can do as educators and providers in the classroom to take
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