ACEP Now

APRIL 5, 2024

A study in the February issue of Annals conducted a meta-analysis of 18 studies and concluded that bougie use was associated with increased first-attempt intubation success. The authors conclude, “despite the certainty of evidence being low, these data suggest that a bougie should probably be used first and not as a rescue device.” 2021;40(2).

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NVFC

MARCH 12, 2024

However, departments that protect fewer than 2,500 people, which are almost all volunteer, have the highest percentage of firefighters over the age of 50 (34%). In many rural areas it is not uncommon to find volunteers in their 60s or 70s. The post Is Volunteerism Dying Or Has Your Marketing Flatlined?

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Emergency Medicine Cases

JULY 18, 2023

He lives with autism spectrum disorder and is uncomfortable in X-ray rooms, and you wonder if there is a role for PoCUS to help exclude a fracture. With expert clinical commentary by Dr. Arun Sayal and Research Methodology Hot Take by Dr. Shelley Mcleod.

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First 10 EM

DECEMBER 25, 2023

Throughout the length of my career, we have consistently heard that less is more when it comes to blood transfusions (outside of the critically ill requiring massive transfusion, where the message, correct or not, has been the exact opposite).

OR 100

OR Coronary EMS 100

Dr. Smith's ECG Blog

MAY 29, 2024

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.

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OR CAD STEMI 109

EMS 20/20

JULY 24, 2024

For the first time ever, Chris and Spencer will be squaring off to see who can pass the test the best as the guys test one another using the 100 Patient Scenarios book by Master Your Medics! In this episode, Chris serves up a trauma call to see if Spencer can manage.

OR 40

OR 40

EMOttawa

MAY 31, 2024

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.

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OR ALS 65

ALiEM

FEBRUARY 28, 2024

Clinical photograph for: Ludwig Angina. CorePendium. For Media Without an Associated Publication: This type of citation may be helpful if the image is used in multiple places within a publication, or if it is not tied to a particular publication. In the example below, there is no specified date of publication for the image. Last Name First Initial.

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Critical Care Scenarios

MAY 31, 2023

A brief overview and call to arms around the key concepts of ICU liberation. A brief overview and call to arms around the key concepts of ICU liberation.

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OR ICU 100

EMOttawa

MAY 6, 2024

Question and Methods: This multi-centre, triple-blind, double dummy RCT in China aimed to evaluate the functional outcomes and safety of intravenous tirofiban as compared to aspirin in moderate to severe strokes […] The post Tirofiban for Stroke without Large or Medium-Sized Vessel Occlusion appeared first on EMOttawa Blog.

OR 65

OR ALS 65

Medgadget

SEPTEMBER 14, 2023

Researchers at the National University of Singapore have developed a highly sensitive pressure sensor that can provide haptic feedback for surgeons using laparoscopic tools or for use in robotic grippers as part of robotic surgical systems.

OR 94

OR 94

The Skeptics' Guide to EM

OCTOBER 3, 2021

Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in […] The post SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline first appeared on The Skeptics Guide to Emergency Medicine. Date: September 28th, 2021 Reference: Zampieri et al.

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OR Critical Care ICU Plasma 130

International Journal of Paramedicine

JULY 22, 2024

Traditionally, students have been tested under pressure in scenario-based situations as a means of stress inoculation. However, the literature is unclear as to whether this enhances or hinders learning. A recent scoping review identified an acceptable level of stress during simulation can be beneficial, although a level of a balance is required.

Paramedicine 52

Paramedicine Paramedicine OR Paramedic 52

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

This is diagnostic of full reperfusion.] An old ECG was found: As you can see, this patient has zero baseline STE, and normal T-waves. You never know if a patient's baseline has normal large STE or complete absence of STE, or somewhere in between. 90% of normals have some STE in V2 and V3. I focus my comment on this initial ECG in today's case.

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The Skeptics' Guide to EM

FEBRUARY 11, 2023

first appeared on The Skeptics Guide to Emergency Medicine. Date: February 7, 2023 Reference: Cheskes et al. One issue that has not been covered on the SGEM is pad placement and double sequential external defibrillation. Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation.

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The Skeptics' Guide to EM

FEBRUARY 13, 2021

Pediatrics 2020 Case: A 4-year-old immunized girl presents to the emergency department (ED) with a fever and rhinorrhea for the […] The post SGEM#319: Is it Aseptic Meningitis or More Than This? first appeared on The Skeptics Guide to Emergency Medicine. On exam, she is febrile to 38.5 She does not have any petechiae or purpura on skin exam.

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OR Emergency Department ALS ED 130

Emergency Medicine Cases

DECEMBER 16, 2019

In this ECG Cases blog we look at seven patients with potentially ischemic symptoms and subtle ECG changes in the lateral leads. Which had acute coronary occlusion? Introducing the concept of Occlusion MI - a paradigm shift in ECG diagnosis of MI. The post ECG Cases 4: Lateral STEMI or Occlusion MI? appeared first on Emergency Medicine Cases.

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STEMI OR Coronary 130

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. amiodarone or lidocaine).

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EMDocs

NOVEMBER 6, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. Top 10 Take Home Pearls 1.

Naloxone 94

Naloxone OR Overdose BLS 94

Emergency Medicine Cases

OCTOBER 22, 2019

In this ECG Cases blog we present ECGs from 7 patients who presented with chest pain and mild anterior ST elevation. Can you identify which were early repolarization and which were anterior STEMI? The post ECG Cases 2: Early Repolarization or Anterior STEMI? appeared first on Emergency Medicine Cases.

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STEMI OR EMS 130

Paramedics World

JANUARY 3, 2024

Feeling tired, weary, or exhausted? These sensations of fatigue seem to be an inevitable part of modern life. We blame fatigue on lack of sleep, overwork, stress, not enough exercise,… The post Fatigue: Is It Simple Tiredness or an Underlying Illness? appeared first on Paramedics World.

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OR Paramedic 52

The Skeptics' Guide to EM

MAY 23, 2020

Endovascular thrombectomy with or without intravenous alteplase in acute stroke. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. Joseph’s Regional Medical Center in Paterson, NJ. Managing editor of EM:RAP and Associate Editor at REBEL EM. Date: May 19th, 2020 Reference: Yang P et al.

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OR ALS EMS 100

NAEMSP

APRIL 15, 2024

Article Summary by Sarah Fabiano, MD, FACEP, FAAEM Kupas DF, Wydro GC, Tan DK, Kamin R, Harrell AJ 4th, Wang A. Clinical care and restraint of agitated or combative patients by emergency medical services practitioners. Prehosp Emerg Care 2021 Sep-Oct;25(5):721-3. doi: 10.1080/10903127.2021.1917736. Epub 2021 Jun 7. PMID: 33877949.

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OR Emergency Medical Technician Emergency Medical Services EMS 52

The Skeptics' Guide to EM

DECEMBER 21, 2019

Mathew Reeves is a Professor and Interim Chair of the Department of Epidemiology and Biostatistics at the College of Human Medicine at MSU. Dr. Joshua Reynolds is […] The post SGEM Xtra: NNT – WET or DRI first appeared on The Skeptics Guide to Emergency Medicine. Date: December 17th, 2019 Reference: Reeves and Reynolds.

OR 100

OR ALS ED 100

The Skeptics' Guide to EM

JANUARY 30, 2021

Steve is currently an Assistant Professor in the Department of Family Medicine at Western University (London, Ontario) […] The post SGEM#317: Dese Bones Gonna Heal Again – With or Without a Non-Selective NSAID first appeared on The Skeptics Guide to Emergency Medicine. Date: January 22nd, 2021 Guest Skeptic: Dr. Steve Joseph. J Bone Joint Surg Am.

OR 130

OR ALS 130

EMergucate

AUGUST 15, 2023

Comparison of intravenous paracetamol (acetaminophen) to intravenously or intramuscularly administered non-steroidal anti-inflammatory drugs( NSAIDs) or opioids for patients presenting with … Continue reading →

OR 130

OR ED 130

NCOAE

DECEMBER 11, 2023

Spinal immobilization involves the use of various devices, including a long spine board (LSB) and a cervical collar to stabilize the spine and prevent further injury. However, recent research has called this practice into question. For this reason, the term “spinal motion restriction (SMR)” has gained favor over “spinal immobilization.”

OR 52

OR Emergency Medical Technician Emergency Department Emergency Medical Services 52

University of Maryland Department of Emergency Med

JUNE 3, 2023

Bottom Line: Lack of pericardial fluid or cardiac motion on FAST exam leads to no intact survivors for ED RT for trauma. Zone 1 REBOA. Click to view the rest

ED 74

ED OR 74

The Skeptics' Guide to EM

AUGUST 10, 2019

Alyssa Stroud (@TheBlondeMD) is a PGY2 surgery resident who is trying to survive the hardships of residency and dating, one glass of wine at a time. Date: August 6th, 2019 Guest Skeptic: Dr. Alyssa Stroud ( @TheBlondeMD ) is a PGY2 surgery resident who is trying to survive the hardships of residency and dating, one glass of wine at a time.

OR 100

OR EMS 100

Dr. Smith's ECG Blog

OCTOBER 1, 2023

Elevated troponin" After hours of misdiagnosis and ongoing pain, the patient finally gets to go to the cath lab 6 hours after arrival ( could have been an immediate ECG diagnosis of LAD OMI using human expertise OR the Queen ), where they of course find a complete 100% thrombotic occlusion of the mid LAD, at the site of his prior LAD stent.

OR 128

OR STEMI Coronary CAD 128

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Smith : this ECG is definitely not OMI, but could be mistaken for Swirl pattern, which is a septal OMI with STE in V1 and STD in V6. See these cases: Precordial Swirl -- 20 cases of Swirl or Look-Alikes Subsequent serial high sensitivity troponin I measurements were all below the level of detection. AMI was ruled out altogether.

OR 123

OR STEMI EMS ED 123

EMS 20/20

DECEMBER 1, 2021

A crew has to make a hard choice. stay and play or load and go? With a rapidly closing window to make a hard decision does the crew make the right choice? Spence and Chris give their opinions and ask for yours in this weeks episode! LISTENER FEEDBACK WANTED! A crew has to make a hard choice. stay and play or load and go?

OR 40

OR 40

Emergency Medicine Cases

FEBRUARY 11, 2020

What is the preferred first line reduction technique for posterior shoulder dislocation? What are the most common and consequential pitfalls in the management of anterior shoulder dislocations? and many more.

OR 130

OR EMS 130

University of Maryland Department of Emergency Med

SEPTEMBER 30, 2023

"The main findings were the following: (1) there was no evidence of an effect of HTS compared with other agents (mainly mannitol) on long-term n. Click to view the rest

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OR 71

Dr. Smith's ECG Blog

DECEMBER 12, 2022

Here is the OMI progression of ECG findings for review: You can see that OMI ECG findings must "deflate" and pass through normal or near-normal in order to get to reperfusion findings. In other words, to get from hyperacute T waves and STE to terminal T wave inversion, the ST and T wave must pass transiently through a state of near-normal.

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OR ACS STEMI Coronary 52

The Good, The Bad & The Ugly Paramedic

JULY 1, 2020

As paramedics, whilst we often take great offence at being called ambulance drivers, the question is, when it’s our turn to drive, what exactly is it that we are providing? Do we fully engage in shared patient care with our attending partner, or do we switch off so that we can simply drive the ambulance and take it easy?

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Ambulance Driver Paramedic Ambulance OR 52

Dr. Smith's ECG Blog

AUGUST 6, 2023

NOTE: There are 2 reasons to watch this video while stopping to freeze the screen each time that a new tracing is shown: i ) To hone your skill in making a “quick read” — in which you force yourself to commit to a diagnosis of OMI or no - OMI; — and — ii ) To give yourself an extra moment to look at all 12 leads of each ECG — so that you can practice (..)

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