ALiEM

OCTOBER 30, 2024

‘Dope’ is no longer heroin in an increasing number of our communities. The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2].

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

First 10 EM

OCTOBER 28, 2024

As with everything that comes out of the PECARN group, this is a huge study, and is therefore one that everyone needs to know about. That being said, despite working in two very busy community hospitals with a high percentage of pediatrics visits, c-spine injuries are just not an issue I struggle with. I have […] The post The PECARN c-spine rule could cause a lot of harm appeared first on First10EM.

EMS 122

EMS 122

ACEP Now

OCTOBER 29, 2024

On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? His vitals are fine…”. Seemingly unsure, she pauses, “I’m getting an interpreter, and I think he has belly pain, but something just doesn’t seem right.” Coming into triage, I see a young man—Georgian-speaking—bracing himself with a hand against the wall and holding his lower abdomen.

Emergency Department 59

Emergency Department ALS Emergency Medical Services OR 59

EMergucate

OCTOBER 29, 2024

The following chest x-ray is from an elderly patient with cough & dyspnoea.

EMS 130

EMS 130

St. Emlyn's

OCTOBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed This article reviews a recent study on the use of Tranexamic Acid (TXA) in traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH), focusing on prehospital care. The study, a subgroup analysis from the Prehospital TXA for TBI Trial, compared different TXA dosing regimens and found that a 2-g TXA bolus significantly reduced 28-day mortality compared to placebo.

OR 120

OR Critical Care 120

Life in the Fastlane

OCTOBER 30, 2024

Casey Parker and James Rippey Ultrasound Case 112 A 30 year old woman who is currently 30 weeks gestation presents to the ED with abrupt, severe right loin pain.

ED 111

ED 111

First Responders Wellness Center

OCTOBER 27, 2024

Too often I see first responders who are not checked for a concussion at an emergency after a OIS, traffic crash or fall. Please start demanding to have all first responders checked for this when at the hospital. Here is a new easy way to be checked. New testing options could change the way concussions are assessed, and that could have big implications for the future.

First Responder 52

First Responder OR 52

Emergency Medicine Education

OCTOBER 31, 2024

Epinephrine and cardiac arrest: what’s the question? How much epinephrine is enough? Garcia et al. published a retrospective study in AJEM discussing cumulative epinephrine dosage in cardiac arrest. Although the study includes a variety of patient settings, such as CT surgery and cath lab patients, which may not be directly applicable to ED patients, it’s certainly worth a read.

Epinephrine 40

Epinephrine ALS ED 40

The Bottom Line

OCTOBER 26, 2024

Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury @fabio_taccone. JAMA. 2024. PMID: 39382241 Clinical Question In patients with acute brain injury, does a liberal, compared to a restrictive strategy of blood transfusion, improve neurological outcomes at 180 days?

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99

St. Emlyn's

OCTOBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed This article reviews a recent study on the use of Tranexamic Acid (TXA) in traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH), focusing on prehospital care. The study, a subgroup analysis from the Prehospital TXA for TBI Trial, compared different TXA dosing regimens and found that a 2-g TXA bolus significantly reduced 28-day mortality compared to placebo.

OR 98

OR Critical Care 98

EMergucate

OCTOBER 28, 2024

This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days. PH = 7.52, that is moderate alkalaemia. pCO2 = 21 mmHg. So, we have respiratory alkalosis.

130

130

EMCrit Project

NOVEMBER 1, 2024

Chart to protect yourself and your patients! EMCrit Project by Scott Weingart, MD FCCM.

Emergency Department 62

Emergency Department 62

SSCOR

OCTOBER 31, 2024

Chronic obstructive pulmonary disease (COPD) affects almost 12 million people in the United States. Though people of widely varying health profiles can develop this disorder, it is more common among people who smoke. Suctioning these patients demands skill and compassion. Here’s what you need to know about suctioning a patient with COPD.

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Clinical Correlations

NOVEMBER 1, 2024

By Chloe Fong Peer Reviewed The correlation between vitamin deficiency and alcohol use disorder (AUD) has been well documented in the literature, with a study from 1963 finding that 70% of patients admitted to the hospital.

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EMergucate

OCTOBER 27, 2024

Today’s ECG is a 45yr male who presents to ED with a 12hr history of epigastric pain and diaphoresis. He is an ex smoker, no other cardiac risk factors.

ED 130

ED EMS 130

The FllightBridge ED

OCTOBER 31, 2024

A Story: A colleague of mine jogged up to me before a course once, rather excitedly, he grabbed my arm and jogged me into the…

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52

SSCOR

OCTOBER 26, 2024

With the advent of minimally invasive in-office procedures, patients are increasingly choosing sedation instead of general anesthesia. Sedation exists on a continuum, ranging from very mild sedation to deep sedation, but it is generally safer than anesthesia and requires a shorter recovery time. Patients also may require sedation in some emergency medicine scenarios.

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GEDC

OCTOBER 30, 2024

Throughout his storied 30-year career as a geriatrician, Dr. Michael Malone has been a pioneer in the care of older adult patients. Malone, who plans to retire from his roles as Medical Director of Senior Services and Director of Home Care for Advocate Health Midwest in December, was recognized with the 2024 Silver Birch Award by the American College of Emergency Physicians at its Scientific Assembly in September.

Emergency Department 52

Emergency Department 52

FirstNet Authority

OCTOBER 30, 2024

CEO, NetAesthetics Rasheid Scarlett brings over 25 years of telecommunications and network infrastructure expertise to the FirstNet Authority Board. His extensive experience in mission-critical communications and proven track record of implementing innovative technology solutions make him uniquely qualified to help shape the future of public safety communications.

Public Safety 52

Public Safety 52

The FllightBridge ED

OCTOBER 31, 2024

A Story: A colleague of mine jogged up to me before a course once, rather excitedly, he grabbed my arm and jogged me into the…

52

52

EMS 20/20

OCTOBER 30, 2024

We're back for another Master Your Medics Special Edition! Spencer tosses Chris a hot hot potato and Chris. well Chris tries. Does he need a thermometer or a calculator? Find out! We're back for another Master Your Medics Special Edition! Spencer tosses Chris a hot hot potato and Chris. well Chris tries. Does he need a thermometer or a calculator? Find out!

OR 40

OR 40

FOAMfrat

OCTOBER 28, 2024

In this episode of FOAMfrat, Tyler speaks with paramedic Kyle Rice to discuss a deeply personal and eye-opening experience—rolling his ambulance after running a red light. Kyle shares the lessons he learned about complacency, crew resource management, and the often-overlooked dangers of driving with lights and sirens. Together, they explore how EMS providers can stay vigilant behind the wheel, adopt safer driving practices, and shift their mindset when responding to emergencies.

Ambulance 52

Ambulance Paramedic EMS 52

FirstNet Authority

OCTOBER 30, 2024

Chief Trisha L. Wolford michelle.

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52

The FllightBridge ED

OCTOBER 26, 2024

Instructors must be well read and prepared before they begin teaching something as dangerous (and litigious) as airway management skills. Intubation is a singular skill within the larger system of airway management. The focus should be on teaching approaches that reduce the likelihood of multiple attempts, desaturation, and peri/post intubation hypotension.

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52

Don't Forget the Bubbles

OCTOBER 28, 2024

Karageorgos S, Ren D, Ranaweera M, et al. Fifteen-minute consultation: a guide to paediatric major haemorrhage Archives of Disease in Childhood – Education and Practice. Published Online First: 24 June 2024. doi: 10.1136/archdischild-2024-327224 Six-year-old Rhaenyra is brought into the emergency department after being hit by a car. On primary survey, she is found to be tachycardic and hypotensive, with bruising over her abdomen.

Frozen Plasma 70

Frozen Plasma FFP Plasma ALS 70

ACEP Now

OCTOBER 28, 2024

Holy Foley A Rare Case of Iatrogenic Obstruction by Adam Heilmann, MD; Jessica Pelletier, DO; Jennifer Reyes Lin, MD, MPH Our patient is a 33-year-old male with spastic quadriparesis due to cerebral palsy with chronic indwelling suprapubic catheter (SPC) who presented to the emergency department (ED) due to concern for Foley catheter obstruction. The patients’ mother has attempted to flush the SPC multiple times unsuccessfully at home.

Emergency Department 52

Emergency Department Defibrillator Epinephrine EMS 52

FirstNet Authority

OCTOBER 30, 2024

Medical Director, Mississippi Department of Public Safety | CEO, Paladin Emergency Services Consulting

Public Safety 52

Public Safety 52

The FllightBridge ED

OCTOBER 26, 2024

Instructors must be well read and prepared before they begin teaching something as dangerous (and litigious) as airway management skills. Intubation is a singular skill within the larger system of airway management. The focus should be on teaching approaches that reduce the likelihood of multiple attempts, desaturation, and peri/post intubation hypotension.

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Critical Care Scenarios

OCTOBER 30, 2024

We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! We chat with Nick Ghionni, pulm/crit attending at MedStar Baltimore Hospital, about identifying and combating cognitive biases in our clinical decision-making.

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177

ALiEM

NOVEMBER 1, 2024

A 67-year-old male with a past medical history of CHF, MI, hypertension, and diabetes presented to the ED with complaints of headache, chest pain, and dyspnea for the past four days. He stated that he has been without his medications for the past few months due to cost. He denied any past surgical history. He stated that he primarily presented because he felt like “my blood pressure is high” Additional Images Physical Exam Cardiovascular : Tachycardic, 2+ pedal edema bilaterally Re

ED 161

ED OR 161

FirstNet Authority

OCTOBER 30, 2024

Emergency Manager, First Responder, Technology Consultant

First Responder 52

First Responder Emergency Management Emergency Manager 52

Core EM

NOVEMBER 1, 2024

We review Sexually Transmitted Infections and pertinent updates in diagnosis and management. Hosts: Avir Mitra, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: gynecology , Infectious Diseases , Urology Show Notes Table of Contents (1:49) Chlamydia (3:31) Gonorrhea (4:50) PID (6:14) Syphilis (8:08) Neurosyphilis (9:13) Tertiary Syphilis (10:06) Trichomoniasis (11:13) Herpes (12:49) HIV (14:10) PEP (15:13) Mycoplasma Genitalium (18:00) Take Home Points Chlamydia: Prevalence: M

OR 130

OR 130

American Ambulance Association

OCTOBER 29, 2024

The American Ambulance Association is proud to announce the winners of the 2024 AAA Legislative Awards. Each Member of Congress is being recognized for their strong advocacy for emergency medical […] The post 2024 AAA Legislative Awards appeared first on American Ambulance Association.

Ambulance 130

Ambulance ALS 130

ALiEM

OCTOBER 28, 2024

A 2-year, 11-month-old female with a history of constipation was brought to the ED by her mother for abdominal pain. The mother noticed that the patient’s abdomen had been enlarging for months. When they visited the pediatrician several months ago, the pediatrician also noticed a mildly enlarged abdomen but the patient was asymptomatic at that time.

ED 161

ED OR 161

FirstNet Authority

OCTOBER 30, 2024

Keisha Lance Bottoms michelle.

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EMOttawa

OCTOBER 31, 2024

Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever, tachypnea, tachycardia, or hypoxia. There is an ED prevalence ranging from 7-24%, with increased mortality rates […] The post Delirium revisited appeared first on EMOttawa Blog.

ED 122

ED OR EMS 122

Dr. Smith's ECG Blog

OCTOBER 31, 2024

This case was sent by an old residency friend, Kirk Lufkin. He works in a small hospital in Northern Michigan. Case A 61 year old female. hypertension no other past history presented with 30 minutes of fluctuating non-radiating heaviness in chest, with diaphoresis and nausea. VS normal. No cardiac past history. Here is her ECG: What do you think? There are inferior hyperacute T-waves (diagnostic of inferior OMI), with 1) reciprocal ST depression in aVL, 2) a reciprocally inverted hyperacute T-wa

STEMI 117

STEMI Coronary 117