Sat.Apr 27, 2024 - Fri.May 03, 2024

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SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?

The Skeptics' Guide to EM

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. February 2024. Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community College paramedic program.

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CMS Begins Notifications to Ground Ambulance Providers that Failed to Submit Cost Data

American Ambulance Association

The American Ambulance Association (AAA) has learned that the Centers for Medicare and Medicaid Services (CMS) has started to send notices to ground ambulance providers that missed their deadline to […] The post CMS Begins Notifications to Ground Ambulance Providers that Failed to Submit Cost Data appeared first on American Ambulance Association.

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TIRBO 60: They don’t care about you

Critical Care Scenarios

The difference between people and institutions. Find us on Patreon here! Buy your merch here! The difference between people and institutions. Find us on Patreon here! Buy your merch here!

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Lab case 444

EMergucate

18 year-old-girl presented to ED with reduced level of consciousness. She is known to by drugs online.

ED 130
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Don’t Forget About the IO in the Critically Ill Patient

REBEL EM

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line. If you are not familiar with this term, it’s the act of rapidly trying to place a central line (usually femoral), placing the needle for access over strict sterile pr

ALS 104
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OSHA Proposed Rule Impact Survey

American Ambulance Association

Attention EMS Leaders! We are reaching out to gather your insights on the potential financial impact of the recent OSHA Proposed Rule concerning health and safety requirements in the EMS […] The post OSHA Proposed Rule Impact Survey appeared first on American Ambulance Association.

Ambulance 130
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Choosing with Intention. Liz Crowe

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed What you don’t do, determines what you can do Tim Ferris One of the most powerful personal lessons I have learned in recent years is every time I say YES […] The post Choosing with Intention. Liz Crowe appeared first on St.Emlyn's.

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GCS 8 obviously doesn’t mean intubate (in tox or otherwise)

First 10 EM

Although it made a bit of a splash when published, this article really didn’t interest me. Obviously, GCS 8 doesn’t mean intubate. I didn’t think anyone was simplistic enough to practice medicine based on a jingle. Clearly trajectory matters. If a patient’s GCS hit 8 and they are on a clinical course where you expect […] The post GCS 8 obviously doesn’t mean intubate (in tox or otherwise) appeared first on First10EM.

OR 101
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NAEMSP Survey on Drug Shortages: Impact on Fire Departments and EMS Agencies

American Ambulance Association

NAEMSP is currently conducting a vital survey aimed at understanding the effects of drug shortages on Emergency Medical Services (EMS) agencies. As esteemed leaders in the field of EMS, your […] The post NAEMSP Survey on Drug Shortages: Impact on Fire Departments and EMS Agencies appeared first on American Ambulance Association.

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What Are the Most Common Causes of Upper Airway Obstruction?

SSCOR

Airway obstructions are common. The prevalence and type of airway obstruction varies with age. Children younger than four are more vulnerable to choking-related upper airway obstructions, while adults commonly experience airway obstruction caused by complications from smoking. First responders will inevitably encounter a wide variety of airway obstructions and must be prepared to promptly respond to each with appropriate medical care.

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Lab case 443 interpretation

EMergucate

Answers: PH = 6.9, that is severe acidaemia/ pCO2 = 72 mmHg. o, we have respiratory acidosis.

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Tonics, Tinctures and Toxicology: Naturopathy

EMOttawa

In the pursuit of holistic health and wellness, individuals often turn to naturopathy as a beacon of alternative medicine, seeking relief and healing outside the realm of conventional treatments. Yet, amidst the allure of natural remedies and lifestyle adjustments, there is a concerning degree of possible iatrogenic harm. This post seeks to address the use […] The post Tonics, Tinctures and Toxicology: Naturopathy appeared first on EMOttawa Blog.

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FTC Publishes Final Rule Banning Employee Non-Compete Agreements

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post FTC Publishes Final Rule Banning Employee Non-Compete Agreements appeared first on American Ambulance Association.

Ambulance 130
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What is the rhythm?

Dr. Smith's ECG Blog

A patient was found down approximately 30 minutes after taking methamphetamine. Bystander CPR. Medics found patient in PEA arrest. He was resuscitated into a perfusing rhythm. He went in and out of arrest until arrival at the ED. Here is the only prehospital 12-lead: Sinus tachycardia, somewhat wide QRS, Ischemia Here is the first ED ECG: What is the rhythm here?

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First10EM Journal Club: May 2024

Broome Docs

Another month and another batch of fascinating papers from the Morgenstern vaults. This month is heavy on dermatology for some reason… but still plenty of EBM, Crit care and laughs. Join Justin and I for a sold 80 minutes of nerdy evidence-based ED care. As always, the free PDF version of each of the papers discussed is linked below – so you can check it out for yourself.

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The First10EM monthly wrap-up for April 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 April 2024 appeared first on First10EM.

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U.S. DOL Issues Final Rule to Increasing the FLSA Overtime Exemption Salary Levels

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post U.S. DOL Issues Final Rule to Increasing the FLSA Overtime Exemption Salary Levels appeared first on American Ambulance Association.

Ambulance 130
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Tasty Morsels of Critical Care 079 | Hyponatraemia – management

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Last time i was butchering my way through a diagnostic approach to hyponatraemia, particularly the forms likely to end up in the critical care end of the hospital. This time we’ll take a punt at how you might approach management. In an ideal world of course you would have all of the diagnostic tests back and you’ve been able to make a very solid diagnosis of the cause of hyponatraemia and you would institute a bespoke treatm

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SVT in infants

Don't Forget the Bubbles

Carly is a 9-month-old who was brought in by her parents because she had been unsettled and not feeding well for a day. At triage, she has a pulse of 277 and is brought straight to resus. What happens in a normal heart? The sino-atrial ( SA ) node is the pacemaker of the heart. It is situated in the right atrium and generates an electrical impulse that conducts through the whole heart and causes it to contract.

OR 59
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Preparing Your People for Pediatric Patients

The EMS Educator

How, where, when and why should we be training our EMS clinicians to take care of tiny humans? Look no further for the answers, as we have subject matter expert Stephanie Ashford, Division Chief of Clinical Practice at the Saint Charles County (MO) Ambulance District. Stephanie has proven advice on how to successfully integrate pediatric readiness and skills training for your agency.

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EMS Visionary Award – Mike Taigman

FirstWatch

EMS Visionary Award – Mike Taigman Mike Taigman ran his first emergency medical services (EMS) call on November 4, 1974. In the following 50 years, he has demonstrated a lifelong dedication to the improvement of EMS and healthcare that has left an indelible mark on the industry. That dedication was recently recognized with the American Ambulance Association’s (AAA) EMS Visionary Award.

EMS 52
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Medicare Part D Price Negotiations - Clinical Correlations

Clinical Correlations

By Alison Cline Peer Reviewed Let’s Start with a Case… A 79-year-old man with a history of atrial fibrillation and stroke presents to the emergency department with new focal neurologic deficits in the setting of a recent upper.

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EMCrit 374 – ShadowBoxing – An AMAXimally Sick Patient

EMCrit Project

An AMAX4 shadowboxing case EMCrit Project by Scott Weingart, MD FCCM.

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Sudden shock with a Nasty looking ECG. What is it?

Dr. Smith's ECG Blog

A 60-something woman complained of sudden severe abd pain. She was found by medics agitated, hypotensive, diaphoretic, and in shock. There were 2 prehospital ECGs: What do you think? Smith : Uncertain supraventricular rhythm with PVCs. (See Ken Grauer's analysis below). There is "shark fin" in I and aVL, which is due to a combination of a large R-wave due to left anterior fascicular block plus downsloping ST elevation due to OMI.

ACS 95
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EMS Visionary Award – Mike Taigman

FirstWatch

EMS Visionary Award – Mike Taigman Mike Taigman ran his first emergency medical services (EMS) call on November 4, 1974. In the following 50 years, he has demonstrated a lifelong dedication to the improvement of EMS and healthcare that has left an indelible mark on the industry. That dedication was recently recognized with the American Ambulance Association’s (AAA) EMS Visionary Award.

EMS 52
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EM@3AM: Malignant/Necrotizing Otitis Externa

EMDocs

Authors: Russ Burgin (MS4, Bethesda, MD); Rachel Bridwell, MD (EM Attending Physician, WA) // 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 83