Sat.Jan 11, 2025 - Fri.Jan 17, 2025

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A prehospital protocol for geriatric agitation

International Journal of Paramedicine

Approximately 10% of geriatric patients (adults over the age of 65) transported via ambulance will have a mental status altered from baseline, otherwise known as delirium. Many of these patients will be agitated, posing a management challenge for EMS practitioners. Existing protocols for delirium in the pre-hospital setting were designed for younger adults, who have different etiologies and different levels of tolerance for medications than most older adults.

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Maintenance of Prehospital Anaesthesia in Trauma Patients: Variability in Practice

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Explore the variability in maintaining prehospital anaesthesia for trauma patients in this comprehensive summary of a multinational survey. With insights into drug protocols, administration methods, and governance, the article highlights challenges and opportunities for standardisation in prehospital care.

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SAEM Clinical Images Series: Spontaneous Eye Luxation

ALiEM

A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.

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American Burn Association Provides Essential Expertise in Times of Burn Disasters

American Burn Association

Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 14, 2025] In the aftermath of the devastating New Years Eve fireworks explosion in Honolulus Salt Lake neighborhood, which overwhelmed Hawaiis burn care capacity, and the ongoing challenges posed by the recent California wildfires, the American Burn Association (ABA) recognizes the extraordinary efforts of burn care

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40 year old woman with acute chest pain and prehospital activation that was cancelled!

Dr. Smith's ECG Blog

From Nick Hoffman in Two Harbors in hcmed email Hello Dr. Smith, I attempted to have the receiving hospital activate the cath lab when I transmitted the initial ECG. Our transport time to the ED was 30 min. Unfortunately, the ED declined as it was viewed as an NSTE. I am still working to better identify OIM / NOIM and use the Queen of Hearts as a tool.

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EM@3AM: Stercoral Colitis

EMDocs

Author: Christopher Blanton, MD, MBA (EM Resident, UTSW / Dallas, TX); Joslin Gilley-Avramis, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); 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.

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Making sense of body-worn cameras as a violence prevention tool for ambulance staff

International Journal of Paramedicine

Body-worn cameras (BWCs) were introduced for ambulance crews in England in 2021 in response to rising rates of abuse targeted towards ambulance crews by members of the public. As part of an evaluation of the effectiveness of BWCs as a tool for reducing occupational violence, we produced a non-systematic literature review to examine the real-world outcomes and cost-effectiveness of BWCs in a variety of settings and countries.

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What is an EKG?

Unitek EMT

Understanding this vital tool for EMTs in diagnosing and monitoring heart conditions An Electrocardiogram, commonly known as an EKG or ECG, is a medical test that measures the electrical activity of the heart. For Emergency Medical Technicians (EMTs), understanding EKGs is a critical skill. In the fast-paced environment of emergency medical services (EMS), EMTs are […] The post What is an EKG?

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Elderly woman with 12 hours of chest pain and dyspnea.

Dr. Smith's ECG Blog

Pulmonary embolism looks like LV aneurysm except for TWI in lead III 1974642 121/65, 37.2, 88, 94%, RR 20 I thought is looked like a subacute anterior OMI (which can look a lot like LV aneurysm) On closer look, with TWI in lead III, PE is likely. But not always. I took her to the critical care area. My partners did a bedside US as we do on all patients with chest pain or dysnpea.

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Field Presentation of Hyperkalemia and Cardiac Arrest

International Journal of Paramedicine

Unresponsive patients with no family or friends can be particularly challenging for EMS providers, especially if they rapidly deteriorate or arrest on scene. Although the Hs & Ts are taught in ACLS, hyperkalemia is an infrequent cause of cardiac arrest and can be easily overlooked in patients not on dialysis. However, recognition is crucial as the standard approach to cardiac arrest will not work and specific medications are indicated.

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Podcast – Monthly Round Up November 2024 – Learning culture, chest drains, arterial lines and more

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed The monthly update podcast from November 2024, including learning culture, chest drains in haemothorax, arterial lines in cardiac arrest and bad behaviour. The post Podcast – Monthly Round Up November 2024 – Learning culture, chest drains, arterial lines and more appeared first on St.Emlyn's.

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Notice of Proposed Rule Making HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Notice of Proposed Rule Making HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information appeared first on American Ambulance Association.

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A 50-something man with Chest pain at triage

Dr. Smith's ECG Blog

A 50-something male presented to triage with chest pain for one day. An ECG was recorded quickly before any further history or physical exam: What do you think? When I saw this (presented at a conference), I immediately thought it looked like Thype 1 Brugada phenocopy (in other words, Type 1 Brugada ECG pattern ). There is an rSR' in lead V1 without any spike of the R'-wave.

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Fluid Resuscitation in the Prehospital Setting

International Journal of Paramedicine

Urban Emergency Medical Services benefit from an increased number of higher-level personnel (Advanced Emergency Medical Technicians and Paramedics) responding to all calls that are trained to obtain intravenous access. Current Advanced Trauma Life Support guidelines require all trauma patients to receive intravenous access, and as such it is essential for EMS clinicians to be conversant with situations which may require fluid resuscitation.

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Driving Tips for Senior Drivers

California Casualty

Age may bring wisdom, but it also comes with new challenges behind the wheel. From adapting to changing reflexes to navigating the latest technology in cars, senior drivers face unique hurdles. If you are a senior driver, or know one, here are simple tips to help stay safe and confident on the road.

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Fundraising Efforts for EMSers

American Ambulance Association

The 9 Line Company (www.the9linecompany.com) has launched a campaign to support EMS professionals who have lost their homes and are facing significant hardships due to the recent fires. As […] The post Fundraising Efforts for EMSers appeared first on American Ambulance Association.

Ambulance 130
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ECG of the Week – 15th January

EMergucate

The following ECG is from a 60-year-old male who has presented with 5 days of central chest pain and epigastric pain which radiates between his shoulder blades.

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A Systematic Review of the Evidence for Using Simulation to Replace Clinical Experience for Paramedic Students

International Journal of Paramedicine

Background In health professions education there is a shortage of clinical training opportunities and an increasing demand for workers, creating a need for alternative methods to clinical placements. One alternative method to replace clinical experience is simulation-based education. Currently, the efficacy of simulation as a clinical replacement in paramedicine is unknown.

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Emergency Evidence Updates – December 2024

The Bottom Line

Whats new in the Critical Care literature monthly updates

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👀 What’s New at Savvik This Week?

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post What’s New at Savvik This Week? appeared first on American Ambulance Association.

Ambulance 130
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Finding the Gaps in Your Hospital's Disaster Preparedness Plan

SSCOR

Foreseeable disasters can come in all shapes and sizes, from a power failure that affects only your facility to an earthquake that sends hundreds of casualties to your emergency department.

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EMCrit Wee (392.5) – Naughty or Nice? Bad Behavior in Healthcare with Liz Crowe, PhD

EMCrit Project

More amazing discussion with Liz Crowe EMCrit Project by Scott Weingart, MD FCCM.

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Critical Care Evidence Updates – December 2024

The Bottom Line

Whats new in the Critical Care literature monthly updates

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State Snap Shots to Support EMS Advocacy

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post State Snap Shots to Support EMS Advocacy appeared first on American Ambulance Association.

EMS 130
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It’s the People You Meet Along the Way

Ambulance Driver Files

The best… and worst… boss I ever had. I’m gonna miss her. I had been an EMT perhaps two weeks when I met her. The big EMS agency in my town wouldnt have anything to do with me; I showed up at their headquarters and asked the receptionist for an application, and then cooled my.

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Clear the Airway with SALAD

SSCOR

A growing group of people are passionate about airway management and minimizing the risks of aspiration and its subsequent effects. Dr. James DuCanto identified an improved technique called suction-assisted laryngoscopy and airway decontamination (SALAD).

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CT Case 097

Life in the Fastlane

Jennifer Davidson, Parvathy Suresh Kochath, Georgina Beech and Leon Lam CT Case 097 An 85-year-old woman presents with anterior pelvic pain following a mechanical fall.

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ESO Trauma Index: Inside the 2024 Report

ESO

In the busy world of trauma care, how do you measure how well you’re doing? The ESO Trauma Index helps provide answers. Using de-identified data from 975,433 trauma patient records collected between January 1 and December 31, 2023, and focusing on nine key metrics, the new 2024 ESO Trauma Index offers an in-depth look at national trends in trauma care.

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New Review Article in Annals of Emergency Medicine: ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review

Dr. Smith's ECG Blog

ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review

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Left-Sided Pain, Right-Sided Action: Tackling Diverticulitis

EM Board Bombs

-Case- A 55-year-old female who is an every-day smoker arrives at the emergency department clutching her left lower abdomen. She describes two days of progressively worsening pain along with nausea, a low-grade fever, and constipation. While she denies actively having blood in her stool, she mentions having these same symptoms a long time ago.

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Adult Ortho Cases 004

Life in the Fastlane

Michael Gibbs MD Adult Ortho Cases 004 Shoulder Dislocations. Adult Orthopedic case interpretation.

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Steady Progress

Ambulance Driver Files

Haven’t updated this in a while… but the weight has steadily been coming down. Weighed in at 272.6 today, down 3.4 pounds since Wednesday. Not bad, considering I ate whatever I wanted during the holidays and haven’t been in the pool in two months. For those keeping score at home, that’s 127.4 pounds less than.

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DeMeester case

Dr. Smith's ECG Blog

This was sent to me by Susy DeMeester. [link] 66 yo female with squeezing cp, ho meth use. Was transferred to our ED for emergent PCI, clean cath. I thought the ECG was pretty convincing. I put it into Queen of Hearts (I just signed up for the trial) and said high prob STEMI. What are your thoughts? Outside ED (no cath lab) 66 yo female with past ho polysubstance use and htn c/o dhest tightness lasting for seconds.

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Left-Sided Pain, Right-Sided Action: Tackling Diverticulitis

EM Board Bombs

-Case- A 55-year-old female who is an every-day smoker arrives at the emergency department clutching her left lower abdomen. She describes two days of progressively worsening pain along with nausea, a low-grade fever, and constipation. While she denies actively having blood in her stool, she mentions having this a long time ago.

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Mitochondrial Uncouplers: The Future of Weight Loss Medications?

Clinical Correlations

By Ella Feiner Peer Reviewed In a world abundant with food and sedentary lifestyles, the global prevalence of cardiometabolic disease has reached alarming levels.

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SGEM#465: Not A Second Time – Single Center RCTs Fail To Replicate In Multi-Center RCTs

The Skeptics' Guide to EM

Date: December 2o, 2024 Reference: Kotani et al. Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review. Crit Care. 2023 Guest Skeptic: Dr. Scott Weingart is an ED Intensivist from New York. He did fellowships in Trauma, Surgical Critical Care, and ECMO. He is a physician coach concentrating on the promotion of eudaimonia and optimal performance.

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SAEM Clinical Images Series: Painful Weeping Scalp

ALiEM

An otherwise healthy 11-year-old female presented to the Emergency Department (ED) with one week of scalp pain and discharge. Her symptoms began as a dry and itchy rash in the scalp area that was unresponsive to triamcinolone 0.1% ointment. She was initially seen in clinic and was diagnosed with an abscess of the scalp and treated with Trimethoprim/ Sulfamethoxazole (TMP-SMX) for seven days.

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