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On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG.
Date: September 18, 2024 Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Before attending medical school, he was a New York City Paramedic.
We discuss a new class of medications, Immune Checkpoint Inhibitors, and their side effects. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Oncology Show Notes Overview of Immune Checkpoint Inhibitors (ICIs) ICIs are a relatively new class of oncologic drugs that have revolutionized cancer treatment. Unlike chemotherapy, ICIs help the immune system develop memory against cancer cells and adapt as the cancer mutates.
Complete Heart Block with Altered Mental Status Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the third installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using information from different cases where paramedics attempted TCP in the field.
A 50-year-old male with insulin-dependent Type 2 Diabetes presented to the emergency department with three days of pain and swelling on the right side of his neck. He endorsed progression of his symptoms, reporting that he was now having fevers, myalgias, and intermittent difficulty swallowing solid foods. Additional Images Physical Exam Vitals : BP 153/96; HR 110; T 100.0°F; RR 16; O2 sat 97% General : Appears uncomfortable HEENT : Mild right-sided facial swelling.
Video Transcript Hello, I’m Shawn Baird, past president of the American Ambulance Association. Together with my fellow ambulance profession representatives Ted Van Horne, Regina Crawford, and Rhonda Holden, I was […] The post GAPBAC Balance Billing Report Released to Congress appeared first on American Ambulance Association.
We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr. Joe Chaffin (@bloodbankguy), the “Blood Bank Guy” and transfusion medicine specialist. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Takeaway lessons We discuss transfusion reactions, risks, and management, including infection, consent, TRALI, TACO, and hemolytic reactions—with Dr.
St.Emlyn's - Emergency Medicine #FOAMed The diagnosis of subarachnoid haemorrhage in the emergency department is a constant source of anxiety. How do we make sure we pick up everyone with a bleed, but not overinvestigate […] The post The Subarachnoid Haemorrhage in the Emergency Department (SHED) Study appeared first on St.Emlyn's.
Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. AEM August 2024. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: It’s another day, another dollar in the emergency department (ED). The next patient is a 63-year-old woman with a cough and fever.
A 23-year-old healthy male presented to the emergency department with left eye pain, soreness, and blurry vision after being hit in the left eye with a Nerf gun bullet two days prior. He had no prior ophthalmologic history and does not wear corrective lenses. Physical Exam Left eye : Visual acuity 20/30. Intraocular Pressure 17. Pupil 3mm, irregular, minimally reactive.
Press Contact Tristan North Senior Vice President American Ambulance Association tnorth@ambulance.org FOR IMMEDIATE RELEASE Congressman Brad Finstad Honored as 2024 Legislator of the Year by the American Ambulance Association Washington, […] The post Press Release: Congressman Brad Finstad Honored as Legislator of the Year appeared first on American Ambulance Association.
Experts in critical care share their approach to post-intubation sedation. Contributors: Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! Experts in critical care share their approach to post-intubation sedation. Contributors: * Jason Wieland * Casey Albin * Jace Mullen * Kali Dayton * Nick Ghionni * Emily Fridenmaker Check out the Intensive Care Academy here!
St.Emlyn's - Emergency Medicine #FOAMed This blog post reviews a study comparing non-invasive blood pressure (NIBP) and invasive blood pressure (IBP) monitoring in pre-hospital critical care. Using a retrospective cohort design, the study found that NIBP measurements are often inaccurate in patients with haemodynamic instability, particularly in hypotensive and hypertensive states.
A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. The patient presented to an outside “eye doctor” and was told to go to the nearest hospital for evaluation.
Press Contact Tristan North Senior Vice President American Ambulance Association tnorth@ambulance.org FOR IMMEDIATE RELEASE Congresswoman Gluesenkamp Perez Awarded 2024 Legislator of the Year by the American Ambulance Association Washington, […] The post Press Release: Congresswoman Gluesenkamp Perez Honored as Legislator of the Year appeared first on American Ambulance Association.
The Case A 96-year-old female with a history of coronary artery disease, hypertension, and complete heart block status post dual-chamber pacemaker (remote) presents to the ED by EMS with generalized weakness and lethargy. EKG Show Details EKG Characteristics Rate 130 Rhythm Wide Complex Tachycardia, Paced Intervals QRS 180, QT/QTc 406/596 Axis Left axis deviation ST Segments Non-specific Additional Features Paced Rhythm with LBBB morphology Diagnosis Pacemaker-Mediated Tachycardia Questions What
Written by Willy Frick with edits by Ken Grauer A woman in her 70s with a history of hypertension presented with acute onset shortness of breath. She was out walking her dog when she developed sudden dizziness and light-headedness. When EMS found her, she was dyspneic and diaphoretic. Her ECG is shown below: What do you think? The conventional machine algorithm interpreted this ECG as STEMI.
St.Emlyn's - Emergency Medicine #FOAMed Case series of dirty epi drips in Australia. A potentially useful tool in austere/remote settings, but lots of caveats and cautions before we all start doing this! Be careful, but do learn about this potential therapy. #FOAMed @stemlyns The post The Dirty Adrenaline (Epi) drip. appeared first on St.Emlyn's.
A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Associated symptoms included nausea and a mild headache for one day, and one episode of vomiting prior to arrival.
This content is for AAA members only. Please either Log In or Join! The post OSHA Statement on Volunteer Agency Impact appeared first on American Ambulance Association.
The Case A 96-year-old female with a history of coronary artery disease, hypertension, and complete heart block status post dual-chamber pacemaker (remote) presents to the ED by EMS with generalized weakness and lethargy. EKG Show Details EKG Characteristics Rate 130 Rhythm Wide Complex Tachycardia, Paced Intervals QRS 180, QT/QTc 406/596 Axis Left axis deviation ST Segments Non-specific Additional Features Paced Rhythm with LBBB morphology Diagnosis Pacemaker-Mediated Tachycardia Questions What
Some topics come up over and over again, and it may seem somewhat repetitive or wasteful to spend so much time on them, but seeing as so many people are still using outpatient IV antibiotics despite overwhelming evidence that oral antibiotics are just as good, if not better, I will continue to cover papers as […] The post Oral antibiotics are noninferior to IV in pediatric bone and joint infections (obviously) appeared first on First10EM.
By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. The pain radiated to both shoulders. He arrived to the ED at around 6:45am, and stated the pain has persisted. He has had similar pain in recent weeks that has occurred at rest, but it typically goes away after about an hour.
A 24-year-old male with a history of microscopic hematuria presented to the emergency department (ED) with left lower quadrant abdominal pain. His pain started about two weeks ago and has been intermittent. He describes the pain as stabbing. He decided to come to the ED today because of the persistent nature of the pain. He denies chest pain, cough, shortness of breath, fevers, nausea, vomiting, diarrhea, constipation, rectal bleeding, dysuria, and increased urinary frequency.
The Department of Veterans Affairs (VA) has notified Senate Committee on Veterans Affairs Chairman Jon Tester (D-MT) and Ranking Member Jerry Moran (R-KS) that the Department will be delaying implementation […] The post VA Notifies Tester/Moran of Delay of Final Rule until 2029 appeared first on American Ambulance Association.
We discuss a new class of medications, Immune Checkpoint Inhibitors, and their side effects. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Oncology Show Notes Overview of Immune Checkpoint Inhibitors (ICIs) ICIs are a relatively new class of oncologic drugs that have revolutionized cancer treatment. Unlike chemotherapy, ICIs help the immune system develop memory against cancer cells and adapt as the cancer mutates.
Acclaimed volunteer fire service documentary Odd Hours, No Pay, Cool Hat is hitting TVs across the nation this fall. Over 180 PBS stations will air a one-hour version of the film in September and October in conjunction with the 9/11 anniversary, October’s Fire Prevention Week, and National First Responders Day (Oct. 28). The documentary takes audiences behind the lines of America’s volunteer fire service community by sharing the stories of volunteer responders as they face challenges and triumph
This is another case sent by the undergraduate (who is applying to med school) who works as an EKG tech. The undergraduate is now willing to identify himself: Hans Helseth. A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion.
This content is for AAA members only. Please either Log In or Join! The post Federal Departments Issue Final Report and Recommendations of the GAPB Advisory Committee appeared first on American Ambulance Association.
Readers of First10EM will know that I spend way too much time on PubMed searching the medical literature. I use the website daily. It is probably the most used link on my computer. Despite that, I am more than willing to admit that PubMed – and specifically the search function – sort of sucks. It […] The post Using AI to improve scientific literature search results appeared first on First10EM.
Practical tips for diversity, equity, and inclusion in your community Intergeneration Month is held worldwide each September. First launched in 2000, Intergeneration Month is a time to examine, strengthen, and celebrate the connections between generations of people. Like all industries, fire and emergency services organizations can experience challenges and opportunities by having first responders from several generations working together.
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