ACEP Now
JANUARY 5, 2025
Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.
The EMS Educator
JANUARY 3, 2025
How do EMS clincians process the trauma they witness dailyand how can they be better supported? In this episode of The EMS Educator podcast, hosts Rob Lawrence, Hilary Gates and Maia Dorsett explore the critical topic of trauma stewardship with guest Ronit Reguer, the first behavioral health coordinator for DC Fire and EMS. Together, they unpack the challenges of emotional resilience, the importance of proactive mental health care, and the cultural shifts shaping the future of first responder su
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Dr. Smith's ECG Blog
JANUARY 2, 2025
By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.
St. Emlyn's
JANUARY 27, 2025
St.Emlyn's - Emergency Medicine #FOAMed This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. Drawing on a systematic review and meta-analysis, it examines the evidence, evaluates key benefits, and critically appraises the limitations. The discussion highlights the potential of this model to enhance pre-hospital emergency care while addressing challenges in implementation across dive
EMDocs
JANUARY 8, 2025
Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.
International Journal of Paramedicine
JANUARY 15, 2025
Approximately 10% of geriatric patients (adults over the age of 65) transported via ambulance will have a mental status altered from baseline, otherwise known as delirium. Many of these patients will be agitated, posing a management challenge for EMS practitioners. Existing protocols for delirium in the pre-hospital setting were designed for younger adults, who have different etiologies and different levels of tolerance for medications than most older adults.
Peter Canning
JANUARY 27, 2025
When I started as a paramedic in Hartford in January of 1995, I was given a 100-page protocol book to memorize. There were fewer than 50 protocols in the book, along with pages for 24 medications and 8 procedures. The book was approved by the two largest hospitals in Hartford. Looking through the book today, it is truly an antiquated. For instance, there was no protocol for stroke or STEMI.
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
ALiEM
JANUARY 13, 2025
A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.
St. Emlyn's
JANUARY 13, 2025
St.Emlyn's - Emergency Medicine #FOAMed Explore the variability in maintaining prehospital anaesthesia for trauma patients in this comprehensive summary of a multinational survey. With insights into drug protocols, administration methods, and governance, the article highlights challenges and opportunities for standardisation in prehospital care.
EMDocs
JANUARY 27, 2025
Today on the emDOCs cast with Brit Long ( @long_brit) , we cover immune checkpoint inhibitors and adverse events. Episode 113: Immune Checkpoint Inhibitor Adverse Events Several cancers (melanoma, non-small cell lung cancer, renal cell carcinoma, hepatocellular carcinoma, others) suppress the innate T-lymphocyte function by activating checkpoint signals.
FirstWatch
JANUARY 2, 2025
Instructions to join are below description and speakers. February 6th, 2025 | 9:00 am PST (12:00 pm EST) Join us for an in-depth exploration of the innovative Preburn Project: Preventing Burnout by Predicting Compromised Wellness in EMS Workers. This session is designed for EMS directors, EMS administrators, paramedics, dispatchers, mental health professionals and researchers who are committed to improving the well-being of frontline EMS workers.
American Burn Association
JANUARY 14, 2025
Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 14, 2025] In the aftermath of the devastating New Years Eve fireworks explosion in Honolulus Salt Lake neighborhood, which overwhelmed Hawaiis burn care capacity, and the ongoing challenges posed by the recent California wildfires, the American Burn Association (ABA) recognizes the extraordinary efforts of burn care
NAEMSP
JANUARY 19, 2025
Authors: Rebecca Dupree, DO and Emerson Franke, MD FAEMS FAAEM Case The dreaded scenario: youre performing high quality CPR in the field, youve successfully intubated the patient, and suddenly you hear, I found their DNR form! just as youve gotten ROSC. You manage to get in contact with family and determine the patient is enrolled in hospice. The family does not want the patient transported to the hospital.
ALiEM
JANUARY 10, 2025
A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. The infant appeared to be asymptomatic per parents, without any behavior changes or associated symptoms noted. The patients mother noticed her sons left pupil was dilated and unresponsive to light the morning of presentation.
GEDC
JANUARY 30, 2025
GEDCs Spotlight Series shares the great work that member organizations are doing in the field of geriatric emergency medicine. Through the pursuit of GEDA accreditation, implementation of meaningful QI initiatives, and provision of educational resources for clinicians, health systems that take advantage of GEDC membership are setting the standard for outstanding geriatric emergency medicine.
EMDocs
JANUARY 6, 2025
Authors: Paul Omagor, MD (EM Resident Physician, Makerere University, Uganda); Tracy Walczynski, MD (EM Attending Physician, SEED Global Health, Mbarara University of Science and Technology, Uganda ); Jessica Pelletier, DO, MHPE (APD, EM Attending Physician, University of Missouri-Columbia, USA) // Reviewed by: Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic, USA); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 16-year-old female with no remarkable past medical history is
Dr. Smith's ECG Blog
JANUARY 15, 2025
From Nick Hoffman in Two Harbors in hcmed email Hello Dr. Smith, I attempted to have the receiving hospital activate the cath lab when I transmitted the initial ECG. Our transport time to the ED was 30 min. Unfortunately, the ED declined as it was viewed as an NSTE. I am still working to better identify OIM / NOIM and use the Queen of Hearts as a tool.
ACEP Now
JANUARY 4, 2025
Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. 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.
ESO
JANUARY 27, 2025
Happy New Year, and w elcome back to another edition of ESO product updates. Thanks to our new and improved feedback process, our customers have been more involved than ever in our Product Roadmap. Your input is invaluable to our team and integral to the improvements and enhancements you’ll find below. So, without further ado, here are the latest updates from ESO in Q4 2024 and whats just ahead on the horizon , all of which h as been made possible by our incredible ESO community : Content
ALiEM
JANUARY 27, 2025
A 20-year-old previously healthy student-athlete female presented with a 2-week history of bilateral periorbital swelling unresponsive to steroids and anti-histamines prescribed by her PCP. The edema had been worsening, and there was a new development of throat tightening and discomfort. She denied rash, allergies, fever, URI symptoms, urinary symptoms, or new medications.
FOAMfrat
JANUARY 7, 2025
From my first discussion with Alcohol Withdrawal I talked about my personal experience that's now become a driving motivation to improve the care we render for patients suffering Alcohol Withdrawal Syndrome in my state, but how exactly can we do that? How do we reduce a number as high as a 37% mortality rate, to an incredible 5%? Let's briefly discuss a case.
EMDocs
JANUARY 11, 2025
Author: Christopher Blanton, MD, MBA (EM Resident, UTSW / Dallas, TX); Joslin Gilley-Avramis, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
Dr. Smith's ECG Blog
JANUARY 31, 2025
Written by Magnus Nossen The ECG below was obtained from 50-something male with a history of hypertension and tobacco use. The patient contacted the ambulance service after he experienced sudden onset chest pain and diaphoresis that had started 20 minutes prior. The ECG below ECG was recorded on the scene. What is the cause of the ECG changes here? How will you manage this patient?
International Journal of Paramedicine
JANUARY 15, 2025
Body-worn cameras (BWCs) were introduced for ambulance crews in England in 2021 in response to rising rates of abuse targeted towards ambulance crews by members of the public. As part of an evaluation of the effectiveness of BWCs as a tool for reducing occupational violence, we produced a non-systematic literature review to examine the real-world outcomes and cost-effectiveness of BWCs in a variety of settings and countries.
ACEP Now
JANUARY 5, 2025
Every year, the hopeless task of keeping up with the medical literature grows even more unattainable. Will our Sisyphean burden be replaced with AI? ( Read this months Skeptics Guide to Emergency Medicine for that answer.) Will we be microchipped with peripheral PubMed brains? Will we finally wake up from the Matrix and be freed? Not yet! So, in the meantime, heres a host of articles of more than just passing interest from the past year, not already covered in ACEP Now.
ESO
JANUARY 30, 2025
Long, physically demanding hours coupled with life-and-death decision-making can lead to more than just burnout for first responders. Nearly 22% of all fire service members are expected to experience PTSD at some point in their careers. Due to this, protecting your team members wellbeing should be a top priority for EMS agencies and fire departments alike, right up there with their physical safety.
Peter Canning
JANUARY 19, 2025
I was talking to a doctor friend about the movie Asphalt City. He mentioned the scene where the old crackhead lady was relentlessly berating the young paramedic who just sat there saying nothing, looking all burnt to hell already, not two months into the job. We talked about burnout. Burnout comes in waves, I said. When you are new and getting beat to s**t every night, it can come on hard.
Broome Docs
JANUARY 27, 2025
Welcome to the first episode of the Broomedocs podcast for 2025. Justin and I are back for more nerdy goodness to make you smarter in the Resus room, or at a pub trivia night more likley… wether it is about salt correction, dissection or infection we can help you out! Listen in and learn! Or if you don’t have enough Youtube content featuring aging bearded men – you can watch over on Justin’s channel here: Airway, breathing, cellphone: a new vital sign?
FOAMfrat
JANUARY 10, 2025
In this episode of Good Reads, we look into the early stages of STEMI progression and how to identify critical ECG changes before obvious ST segment elevations appear. Using a 61-year-old male patient as a case study, we explore the significance of reciprocal lead changes, specifically in lead aVL, during early injury and ischemia phases. Learn to recognize early signs such as ST segment depression, T wave inversion, and checkmark T waves to improve early STMEI detection.
International Journal of Paramedicine
JANUARY 15, 2025
Unresponsive patients with no family or friends can be particularly challenging for EMS providers, especially if they rapidly deteriorate or arrest on scene. Although the Hs & Ts are taught in ACLS, hyperkalemia is an infrequent cause of cardiac arrest and can be easily overlooked in patients not on dialysis. However, recognition is crucial as the standard approach to cardiac arrest will not work and specific medications are indicated.
EMOttawa
JANUARY 27, 2025
Methodology 3/5 Usefulness 3/5 Connolly SJ, et al. N Engl J Med. 2024 May 16;390(19):1745-1755. Editorial: Reversing Oral Anticoagulation in Intracerebral Hemorrhage. Question and Methods: This unblinded, multicentre randomized controlled trial studied whether Andexanet improved hemostatic efficacy compared to usual care in patients with acute intracerebral hemorrhage using factor Xa inhibitors.
SSCOR
JANUARY 25, 2025
We all know the key to a thorough patient assessment is to approach it systematically so that we dont become distracted (by that bleeding scalp wound) or skip steps that may yield valuable information (like listening to breath sounds). Theres a reason we are all taught head-to-toe surveys: so that we work our way through essential assessment points, avoiding a haphazard exam where key signs are missed.
ACEP Now
JANUARY 4, 2025
Effectively negotiating your employment contract may be as important as the actual choice of position itself. Although most emergency doctors focus primarily on money paid and hours worked, career quality and longevity are optimized by good contract negotiation. I am often asked: What are the most important contract provisions to consider? First, one must carefully study the more general, descriptive contract provisions beyond just compensation.
ALiEM
JANUARY 6, 2025
A 32 year-old male with PMH significant for opioid use disorder, a prior admission in 2021 for left-sided empyema s/p thoracotomy and decortication, gas bacteremia, and tricuspid endocarditis presented for a left leg wound. The patient reported a wound to his left leg that had become larger over the past 5 months. The pain worsened today, prompting him to come to the emergency department for evaluation.
FOAMfrat
JANUARY 21, 2025
In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy.
First 10 EM
JANUARY 27, 2025
Do you change your practice when new evidence is published? Will these articles change your practice? Will you read them? Does anyone read them? I dont know, but here is another month of my reading summarized. For the regular readers, you will have noticed I have taken a few weeks off. February is also likely […] The post Research Roundup for January 2025 appeared first on First10EM.
EMOttawa
JANUARY 13, 2025
Methodology: 4/5 Usefulness: 4/5 Vallentin MF, et al. N Engl J Med. 2024 Oct 31. doi: 10.1056/NEJMoa2407616. Editorial: The Way to a Patient’s Heart – Vascular Access in Cardiac Arrest Question and Methods: This RCT compared IO vs. IV vascular access in adults with OHCA, using ROSC as a primary outcome. Findings: No significant difference […] The post Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest appeared first on EMOttawa Blog.
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