Sat.Mar 16, 2024 - Fri.Mar 22, 2024

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SAEM Clinical Images Series: Purple Finger

ALiEM

A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. She stated she was typing on a computer keyboard approximately 10 minutes prior to presentation and she noticed a sudden popping sensation at the base of her right ring finger. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger.

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Ep 192 ED Adult Asthma Management Strategies For Improved Prognosis – A Stepwise Approach

Emergency Medicine Cases

In this part 1 of our 2-part podcast series on Asthma Management we explore a systematic approach to managing patients presenting to the ED with asthma exacerbations. Our discussion will emphasize the critical role of a thorough history and physical examination in effectively stratifying patient risk and guiding treatment/disposition decisions. Additionally, we'll examine the importance of providing comprehensive discharge medications and instructions to mitigate both mortality and morbidity ass

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EMS.gov | New Resources Address Important EMS Issues

American Ambulance Association

New Resources Address Important EMS Issues The Latest Updates on Highway Safety Regulations, Rural EMS Education and Special Pathogens Updating the Highway Safety Improvement Program The Federal Highway Administration has […] The post EMS.gov | New Resources Address Important EMS Issues appeared first on American Ambulance Association.

EMS 130
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ECG of the Week March 20th

EMergucate

The following ECG is from a 65 year old lady who has presented with two hours of central chest pain. She has a history of hypertension and is a current smoker. What are the key features on her ECG?

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SAEM Clinical Images Series: Seeing Double

ALiEM

A 53-year-old woman with no significant past medical history presented to the emergency department with a 3-day history of double vision on leftward gaze. She initially presented to urgent care with a chief complaint of chest heaviness and concern that her blood pressure was too high, but was sent to the emergency department for further cardiac and neurological evaluation after her urgent care provider noticed abnormal eye movement.

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WTBS 29 Four Key Learnings from a Career in Emergency Medicine Leadership

Emergency Medicine Cases

In this Waiting to Be Seen blog Dr. Howard Ovens outlines 4 key learnings from his extensive career in EM leadership: Be a good clinician, get substantial real-world experience, take a long-term view of benefits and risks and get along with your counterparts in the leadership dyad. The post WTBS 29 Four Key Learnings from a Career in Emergency Medicine Leadership appeared first on Emergency Medicine Cases.

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EMS Testifies at House Ways & Means Field Hearing

American Ambulance Association

Yesterday was a proud day for EMS! Yesterday, Dr. @ed_racht of @AMR_social and former @NAEMT_ President @mattzavadsky provided testimony at a House Ways & Means field hearing on the challenges […] The post EMS Testifies at House Ways & Means Field Hearing appeared first on American Ambulance Association.

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SGEM Xtra: The Matrix – Social Media for Knowledge Translation

The Skeptics' Guide to EM

Date: March 16, 2024 This is an SGEM Xtra episode. Yes, that is two back-to-back SGEM Xtra episodes. The critical appraisal that was lined up for this week’s episode got delayed due to some scheduling problems with clinical responsibilities. You can access all the slides for this episode from this LINK and see the presentation […] The post SGEM Xtra: The Matrix – Social Media for Knowledge Translation first appeared on The Skeptics Guide to Emergency Medicine.

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TIRBO 57: Volume vs pressure control

Critical Care Scenarios

Should you use volume or pressure control ventilation? Find us on Patreon here! Buy your merch here! Should you use volume or pressure control ventilation? Find us on Patreon here! Buy your merch here!

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JEMS | Remembering Mike Touchstone

American Ambulance Association

Jonathon Feit eulogizes Mike Touchstone for making significant contributions to advance EMS and fire leadership. Mike Touchstone’s Joie de Vivre: Obituary to Everyone’s Friend, Mentor and Muse by Jonathon S. […] The post JEMS | Remembering Mike Touchstone appeared first on American Ambulance Association.

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T1 Hacks - 5 Tips You Should Know

FOAMfrat

The Hamilton T1 is quickly becoming one of the most prominent ventilators in the transport environment. While initially, all the bells and whistles can be intimidating, some high points make the learning curve slightly less steep. My goal for this blog is to highlight some "hacks" that are actually just strategies you should know and common misconceptions.

OR 131
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Imaging Case of the Week 585 Answer

EMergucate

The ankle x-ray shows a faint lucent line running vertically involving the distal tibial epiphysis.

EMS 130
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High dose nitroglycerin is correct dose nitroglycerin

First 10 EM

Looking back, I am somewhat surprised I never published a First10 approach to sympathetic crashing pulmonary edema. I guess it never felt necessary, as it was the first ever EMCrit post, and therefore felt well covered in the FOAMed community. However, a full 15 years after that first EMCrit podcast (congrats on the decade and […] The post High dose nitroglycerin is correct dose nitroglycerin appeared first on First10EM.

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SURVEY | 2024 Ambulance Industry Employee Turnover Study

American Ambulance Association

The American Ambulance Association is partnering with Newton 360, an ambulance industry partner and Human Resource support firm, to conduct our sixth annual industry turnover study. Our intent is to […] The post SURVEY | 2024 Ambulance Industry Employee Turnover Study appeared first on American Ambulance Association.

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PulmCrit Wee: Propofol induced eyelid opening apraxia – the struggle is real

EMCrit Project

Eyelid opening apraxia refers to a specific inability to open the eyelids. This may result from non-dominant hemispheric strokes. On superficial examination it will mimic unconsciousness, but upon further examination the patient is awake and able to respond to stimuli with their extremities. I've seen a similar phenomena of eyelid opening apraxia a few times […] EMCrit Project by Josh Farkas.

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Imaging Case of the Week 587

EMergucate

The abdominal x-ray is from a neonate with vomiting. What can be seen? Answer will be posted later.

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A 50-something with chest pain. Is there OMI? And what is the rhythm?

Dr. Smith's ECG Blog

Written by Willy Frick A man in his 50s with history of hypertension, hyperlipidemia, and a 30 pack-year smoking history presented to the ER with 1 hour of acute onset, severe chest pain and diaphoresis. His ECG is shown: What do you think? The history thus far is highly suggestive of OMI, so we must study the ECG very closely to see if we can confirm this.

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NVFC Holds Wildland Fire Assessment Program Training for New Advocate Network

NVFC

The National Volunteer Fire Council (NVFC) recently hosted its first Wildland Fire Assessment Program (WFAP) Advocate train-the-trainer event for a new network of regional representatives that will teach the WFAP curriculum and advocate for mitigation and safety in wildfire-prone areas across the U.S. The WFAP is a joint effort by the U.S. Forest Service and the NVFC to provide fire service volunteers with training and resources to conduct safety assessments for homes located in the wildland-urb

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emDOCs Podcast – Episode 97: Spontaneous Cervical Artery Dissection

EMDocs

Today on the emDOCs cast with Jess Pelletier and Brit Long, we discuss the challenging diagnosis of spontaneous cervical artery dissection (sCAD). Episode 97: Spontaneous Cervical Artery Dissection Definition/pathophysiology: sCAD refers to a tear or separation of arterial wall layers involving either the carotid or vertebral arteries. Creates a false lumen where blood may enter the vessel wall between the intima and the media or between the media and the adventitia.

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Imaging Case of the Week 584 Answer

EMergucate

The lateral neck x-ray shows a foreign body in the hypopharynx (chicken bone).

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An 80 year old woman with Left Bundle Branch Block (LBBB) and pleuritic chest pain

Dr. Smith's ECG Blog

This case was sent by Amandeep (Deep) Singh at Highland Hospital, part of Alameda Health System. The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. HPI: Abrupt onset of substernal chest pain associated with nausea/vomiting 30 min PTA.

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Texas A&M Students Lead Disaster Day Simulation

Pulsara

On March 1st, 2024, Pulsara was honored to participate in the largest student-led disaster drill in the world at Texas A&M’s Disaster Day in College Station, Texas. The team, comprised of students in various healthcare disciplines, used the Pulsara communication platform to manage the incident, including triaging and tracking around 300 patients, documenting treatments, and ordering and delivering meds from the field pharmacy.

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Medical Malpractice Insights: Speaking in “Code”

EMDocs

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

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Imaging Case of the Week 587 Answer

EMergucate

The supine abdominal x-ray shows dilated small bowel loops located centrally.

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Are You Prepared for Pediatric Trauma?

SSCOR

The call came in as a “child down.” No other information was available. As your unit races to the scene, you do a quick mental inventory of the equipment you may need: pedi bag, airway bag, spinal immobilization, trauma bag. As with any emergency, your pulse is racing, but when the call involves a child, there is always an added layer of stress. Is your equipment ready?

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Why is the angiogram normal?

Dr. Smith's ECG Blog

Written by Willy Frick A man in his 50s with a 15 pack-year smoking history presented to his primary care physician's office complaining of intermittent headache. He also complained of intermittent mild chest pain radiating into into both shoulders and his back, as well as occasional unexplained sweating. (Although radiation into the left arm is most classic for coronary ischemia, radiation into both arms is actually modestly more predictive ).

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Critical Care Evidence Updates – February 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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ACETECH Free Live Webinar ‘Safety Insanity: Addressing Ambulance Safety Paradigms’

Paramedic Chiefs of Canada

Join ACETECH Senior Consultant, David McGowan, on Thurs. March 28th at 11AM EST for this must-attend FREE webinar where he will identify the true root causes of why EMS providers are in harm’s way and what culturally needs to be addressed to make EMS safer.

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Haemolytic Uraemic Syndrome

Don't Forget the Bubbles

4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. She appears pale and dehydrated , and her level of alertness fluctuates. She is apyrexial, tachycardic and normotensive. She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Her urine dip is positive for erythrocytes, protein, and leukocytes and negative for nitrates.

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Coping Strategies for Trauma Among First Responders: Navigating the Aftermath of Crisis

First Responders Foundation

First responders are the unsung heroes of our communities, facing life-threatening situations with courage and determination. However, the very nature of their work exposes them to traumatic events that can leave lasting emotional scars. Recognizing and addressing the impact of these experiences is crucial for their mental health and overall well-being.

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Emergency Evidence Updates – February 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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The Common Treatment Options for Charley Horses

Paramedics World

Oh no! That searing pain that shoots through your leg, leaving you wincing and grabbing your calf – that’s a charley horse or a sudden involuntary muscle cramp. These surprise… The post The Common Treatment Options for Charley Horses appeared first on Paramedics World.

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The Silent Crisis: The impact of paediatric hospital social admissions

Don't Forget the Bubbles

There has been a notable shift in paediatric admissions in Ireland. This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. Whilst paediatric social admissions (PSA) are not a novel concept, they have gained increased attention and significance in recent years.

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Clinical Question: How do I measure frailty in the Emergency Department?

CanadiEM

Mrs. Vivianne Dubois is an 84-year-old female presenting to your Emergency Department with her daughter. She tells you that she is here because she has been feeling weak and has had a fall. You speak to her daughter and find out that in the past year since her husband’s death, Vivienne has been struggling to take care of herself, requiring assistance with bathing and cooking.

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Validation of the MIRACLE 2 Score for Prognostication After OOHCA

The Bottom Line

In patient with out-of-hospital cardiac arrest, how does the MIRACLE2 score compare with previously reporting scoring systems, for predicting poor neurological outcome at hospital discharge?

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This Month in Emergency Preparedness News: The 5 Most Common School Emergencies

SSCOR

Here's what you need to know about the five most common school emergencies.

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Analgesic dose of Ibuprofen

Emergency Medicine Education

Ibuprofen has analgesic, anti-inflammatory, and fever-reducing effects. Although studies have investigated the proper dosage of ibuprofen as a pain reliever, the optimal dose for each specific effect is not thoroughly studied. In a study published in Annals of Emergency Medicine, Motov et al. examined various dosages of ibuprofen as a pain reliever.

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