Sat.May 25, 2024 - Fri.May 31, 2024

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Ep 195 Management of Subarachnoid Hemorrhage

Emergency Medicine Cases

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr.

ED 305
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SGEM#440: I’m Gonna Need Someone To Help Me – GRACE4 AUD and CHS Management in the ED

The Skeptics' Guide to EM

Reference: Borgundvaag et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. AEM May 2024 Date: May 22, 2024 Dr. Bjug Borgundvaag Guest Skeptic: Dr. Bjug Borgundvaag is the Founding Director of the Schwartz/Reisman Emergency Medicine Institute (SREMI), at Sinai Health System.

ED 233
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Optimizing Trauma Resuscitation Education: A Year-Long In-Situ Simulation Curriculum

Core EM

Optimizing Trauma Resuscitation Education: A Year-Long In-Situ Simulation Curriculum Ashika Jain, MD, Nelly Parisot, MD, Michael J. Klein, MD, Janice Shin-Kim, MD, Brian Lin, MD, Julia Paris, MD, Shannon McNamara, MD, Jessica Strauss, MD, Soma Pathak, MD Delivering optimal care in a trauma resuscitation requires a highly coordinated and skilled team.

ALS 203
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Episode 75: Automatic tube compensation, with Ben Fabry

Critical Care Scenarios

We discuss the principles and application of automatic tube compensation (ATC) on modern ventilators, with its creator Ben Fabry. Dr. Fabry is a professor and chair of biophysics at University of Erlangen-Nuremberg, originally trained as an electrical engineer, who originally developed ATC as part of his PhD program. Find us on Patreon here! Buy your … Continue reading "Episode 75: Automatic tube compensation, with Ben Fabry" We discuss the principles and application of automatic tube compensati

OR 161
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WTBS 30 Lessons on Emergency Medicine Leadership: The Role of The Leader

Emergency Medicine Cases

Dr. Howard Ovens reflects on the role of leader in the EM in this 2nd part of a 2-part Waiting to Be Seen blog series on EM leadership. He touches on mentoring, being committed, aligning with patients' interests, being a role model and a few quick takes on some controversial issues in EM. The post WTBS 30 Lessons on Emergency Medicine Leadership: The Role of The Leader appeared first on Emergency Medicine Cases.

EMS 173
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AAA Submits Paramedic Expedited Visa Comments in Line with PARA-EMT Act

American Ambulance Association

On May 13, the AAA submitted a Comment Letter to the Department of Labor (DOL) in response to their Request for Information (RFI) on modernizing the process and updating the occupations […] The post AAA Submits Paramedic Expedited Visa Comments in Line with PARA-EMT Act appeared first on American Ambulance Association.

EMT 130
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Lab case 445

EMergucate

85 year-old-woman with fracture of right neck of femur. Her blood gases showed the following: PH = 7.51 pCO2 = 59.5 mmHg pO2 = 70 mmHg HCO3 = 47.

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Ep 195 ED Management of Spontaneous Subarachnoid Hemorrhage

Emergency Medicine Cases

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr.

ED 130
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EMS.gov | On-Demand: EMS Harm Reduction and SUD Treatment

American Ambulance Association

Webinar Recap & Materials: EMS Harm Reduction and SUD Treatment Thank you to everyone who attended our recent EMS Focus Webinar on EMS Harm Reduction and SUD Treatment. If you […] The post EMS.gov | On-Demand: EMS Harm Reduction and SUD Treatment appeared first on American Ambulance Association.

EMS 130
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Imaging Case of the Week 594

EMergucate

The lateral neck x-ray is from a patient with dysphagia. What can be seen? Answer will be posted later.

EMS 130
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Andexanet alfa: expensive and harmful?

First 10 EM

We have previously discussed the many pharmaceutical advertisements published by the New England Journal of Medicine, thinly disguised as science, such as the original open label uncontrolled look at andexanet alfa. (Connolly 2019) At that point, I concluded that andexanet alfa should clearly not be used (although our pharmacies didn’t listen and wasted a lot […] The post Andexanet alfa: expensive and harmful?

EMS 103
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Chest pain: Are these really "Nonspecific ST-T wave abnormalities", as the cardiologist interpretation states?

Dr. Smith's ECG Blog

Written by Jesse McLaren, with a very few edits by Smith A 60-year-old presented with chest pain. The ECG did not meet STEMI criteria, and the final cardiology interpretation was “ST and T wave abnormality, consider anterior ischemia”. But are there any other signs of Occlusion MI? There’s only minimal ST elevation in III, which does not meet STEMI criteria of 1mm in two contiguous leads.

STEMI 101
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FEMA & USFA | Weekly Infectious Disease Update

American Ambulance Association

May 21, 2024 Edition The post FEMA & USFA | Weekly Infectious Disease Update appeared first on American Ambulance Association.

Ambulance 130
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Lab case 444 interpretation

EMergucate

Answers: Ph = 7.25, that is moderate acidaemia. pCO2 = 58 mmHg, so we have respiratory acidosis.

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JC: Is First Pass Success an important outcome in PHEA research? St Emlyn’s

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed This JC from St Emlyn's looks at a paper from SJTRM and explores the association between first-pass success (FPS) during pre-hospital intubation and 30-day mortality in patients treated by Finnish helicopter emergency medical services (HEMS). The post JC: Is First Pass Success an important outcome in PHEA research?

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Wide complex tachycardia, resistant to cardioversion. Some fascinating features here.

Dr. Smith's ECG Blog

An elderly dialysis patient presented with chest pain. She has poor LV function. Previous echo 4 months ago (confirmed with ED bedside echo): The estimated left ventricular ejection fraction is 30%. Severely decreased LV function. Regional wall motion abnormality-inferior, inferolateral, septum, anterolateral, anterior and apex, lateral. Here is her ECG: Regular Wide Complex Tachycardia.

OR 99
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Pulsara Around the World - June 2024

Pulsara

May Recap Our teams didn't lose steam after an incredibly busy April. They hit the ground running and exhibited at ten events, including the NASEMSO Annual Meeting, where our team spoke to councils and committees about the importance of using the same tool every day, regardless of event. The Evolution of Patient Load Balancing During the height of the COVID-19 pandemic, Texas, like many other states, struggled to load balance patients, with some hospitals reaching capacity.

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ECG of the Week 29th May

EMergucate

The following ECG is from a 64-year-old man who presents with severe abdominal pain.

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Measles – An Ancient Foe in Modern Times

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Measles is a highly contagious viral disease making a resurgence due to declining vaccination rates. It presents with initial symptoms like high fever and coryza, followed by a rash. Rapid isolation and appropriate use of PPE are critical for suspected cases. The post Measles – An Ancient Foe in Modern Times appeared first on St.Emlyn's.

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Cancer Clinical Trials Don’t Benefit Patients

EM Literature of Note

Hearkening back to my former life as the chair of an Institutional Review Board: you do not promise or imply a potential for benefit to clinical trial participants. Why? Because clinical trials aren’t designed to benefit participants. Participants may be randomized to the “standard of care” arm. The trial drug may not have any improvement in efficacy over the “standard of care” Worse, the trial drug may, in fact, have greater toxicity than the current options.

OR 86
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Quiz post: two patients with chest pain. Do either, both, or neither have OMI?

Dr. Smith's ECG Blog

Written by Pendell Meyers Two patients with acute chest pain. Do either, neither, or both have OMI and need reperfusion? Patient 1: Patient 2: Patient 1: A man in his 40s with minimal medical history presented with acute chest pain radiating to his R shoulder. Triage ECG: Click here to sign up for Queen of Hearts Access Three serial troponins were all undetectable.

CAD 83
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REBEL Core Cast 123.0 – Posterior Epistaxis

REBEL EM

Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit to a place with a higher level of monitoring. REBEL Core Cast 123.0 – Posterior Epistaxis Click here for Direct Download of the Podcast.

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How to Become an Event Medical Services EMT

Unitek EMT

Your comprehensive guide: roles, responsibilities, and pathways to success. Event Medical Services Emergency Medical Technicians (EMTs) play a crucial role in ensuring the safety and well-being of attendees at various events and gatherings. Whether it’s a concert, sporting event, or large public festival, Event Medical Services EMTs are on the front lines, ready to respond […] The post How to Become an Event Medical Services EMT appeared first on Unitek EMT.

EMT 82
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Dangerous Chest Tube Complications to Avoid During Transport

SSCOR

Although the placement of chest tubes usually falls to physicians, many healthcare workers have had to care for patients with chest tubes in place, either in a hospital setting or during transport. Chest tubes are a critical factor in certain respiratory emergencies , so let’s review the indications for placement and some of the dangerous complications you can avoid when caring for such patients.

OR 78
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EM@3AM: Sialadenitis

EMDocs

Authors: Alena Hoover, MD (EM Resident Physician, ACMC/Oak Lawn, IL); Thaer Ahmad, MD (EM Attending Physician, Oak Lawn, IL) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); 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.

EMS 79
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The First10EM monthly wrap-up for May 2024

First 10 EM

The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the format means the focus is mostly on content I have found, but I hope […] The post The First10EM monthly wrap-up for May 2024 appeared first on First10EM.

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Proposed OSHA Standard: Join Us for a Day of Action on June 12

NVFC

The National Volunteer Fire Council (NVFC) is announcing a Day of Action on June 12 for members of the volunteer fire service to learn more about the proposed OSHA Emergency Response Standard and formulate comments on how the standard would impact your department. The Emergency Response Standard will replace the existing Fire Brigades Standard. While many of the proposed provisions would be helpful and improve health and safety, the standard as currently written would issue numerous new requirem

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Hurt

EMS 20/20

EMS can be dangerous. Though incidents that truly threaten the lives of responding crews are not common, his leadership responds and supports those on the front lines matters. EMS can be dangerous. Though incidents that truly threaten the lives of responding crews are not common, his leadership responds and supports those on the front lines matters.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover part 2 of acute chest syndrome. Episode 101: Acute Chest Syndrome Part 2 Background SCD is an autosomal recessive condition that results in the formation of hemoglobin S (HbS). HbS has reduced solubility in the setting of hypoxia, leading to sickling of the RBCs. Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis.

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Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia

EMOttawa

Methodology: 4/5 Usefulness: 3.5/5 Carson JL, et al. N Engl J Med. 2023 Dec 28;389(26):2446-2456. doi: 10.1056/NEJMoa2307983. Questions and methods: This multicenter, open-label, RCT of 3604 patients with MI with anemia compared 30-day all-cause mortality and recurrent nonfatal MI between liberal vs restrictive transfusion thresholds. Findings: There was no significant difference in 30-day all-cause mortality […] The post Restrictive or Liberal Transfusion Strategy in Myocardial Infarctio

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CV-EMCrit – Cardiovascular Intensivist Series: Post Cardiopulmonary Bypass (CABG) Care with Trina Augustin

EMCrit Project

Management of the Post-CABG pt in the ICU EMCrit Project by Katrina Augustin.

ICU 100
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Volunteer Fire Service Takes Center Stage on ‘The Way I Heard It with Mike Rowe’ Podcast

NVFC

Firefighters serve their communities in a unique and impactful way – going into the emergency when everyone else is going out. But what many people don’t realize is that the majority of firefighters in the U.S. are volunteers. These are neighbors helping neighbors when they need it most. It is this commitment to service and giving back that Mike Rowe highlights on the May 28 episode of The Way I Heard It podcast.

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Is all this "ST Depression" due to ischemia?

Dr. Smith's ECG Blog

Written by Magnus Nossen, with some edits by Smith This ECG was transmitted electronically by EMS for evaluation. The patient is a 70 something female with chest discomfort and dyspnea. How would you interpret the ST changes seen in this ECG? Will you accept this patient for emergent coronary angiogram based on the ECG changes? Does the ECG represent STEMI-negative OMI findings?

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PTM Journal Club Recap: Glucocorticoid and Hemodynamics

EMOttawa

At this month’s PTM Journal Club, we explored the use of high-dose glucocorticoid on hemodynamics in the prehospital setting; in particular, the STEROHCA trial conducted in Denmark. Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial Background and Objectives Out-of-hospital cardiac arrest (OHCA) carries […] The post PTM Journal Club Recap: Glucocorticoid and Hemodynamics appe

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EMCrit 376 – Do We Need ETCO2 (Capnography) for Procedural Sedation in the ED? with Sam Campbell (Procedural Sedation 4)

EMCrit Project

Do we need ETCO2 for PSA in the ED? EMCrit Project by Scott Weingart, MD FCCM.

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How to Become a Paramedic: Complete Guide Answers All Your Questions

NHCPS Save a Life

Are you looking to learn how to become a paramedic? I’ve created this go-to guide to help you explore paramedic requirements, what to expect, and the specific steps to take to pursue a rewarding paramedic career. Depending on what you’ve done so far, becoming a paramedic can take one to three years. So, now’s the […] The post How to Become a Paramedic: Complete Guide Answers All Your Questions appeared first on SaveaLife.com.

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RETTmobil 2024: Here’s How It Went at the STEM Stand

Stem EMS

With over 30,000 visitors from 50 countries and 480 exhibitors, the 22nd edition of RETTmobil, Europe’s leading trade fair for rescue, safety, and emergency medical transport, concluded in Fulda, Germany. […] L'articolo RETTmobil 2024: Here’s How It Went at the STEM Stand proviene da Stem Ems.