article thumbnail

SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

Most EMS providers are choosing the proximal tibial as their go-to IO access. The current evidence has not given a definitive answer as to which type of access is best for OHCAs. Clinical Question: Should we use an IV first or an IO first approach to deliver epinephrine to adult patients with an OHCA? Reference: Couper et al.

article thumbnail

SGEM#457: Inhale – Nebulized or IV Ketamine for Acute Pain?

The Skeptics' Guide to EM

His allergies to acetaminophen, non-steroidal anti-inflammatories (NSAIDs), and opioids limit your pain management options. A bedside sonogram shows no significant hydronephrosis. You’re considering ketamine for pain relief but wonder if you should choose IV sub-dissociative ketamine or nebulized ketamine? mg/kg nebulized or 0.3 mg/kg intravenously?

OR 197
professionals

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Non-Compete and “Stay or Pay” Agreements

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Non-Compete and “Stay or Pay” Agreements appeared first on American Ambulance Association.

OR 130
article thumbnail

Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest

EMOttawa

Editorial: The Way to a Patient’s Heart – Vascular Access in Cardiac Arrest Question and Methods: This RCT compared IO vs. IV vascular access in adults with OHCA, using ROSC as a primary outcome.

OR 109
article thumbnail

Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

Thus, the lumen observed may actually still be the same size as the original, normal lumen. Furthermore, in studies reporting progression of insignificant lesions to total thrombotic occlusions, the mean interval between angiography and acute myocardial infarction is 2.5 years, with the interval as long as 12 or 18 years in some studies.

Coronary 125
article thumbnail

ECG Cases 50 – STEMI: A Failed Paradigm, Enter Occlusion MI

Emergency Medicine Cases

Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg.

STEMI 314
article thumbnail

ECG Cases 45 ECG in Weakness and Neurological Symptoms

Emergency Medicine Cases

The post ECG Cases 45 ECG in Weakness and Neurological Symptoms appeared first on Emergency Medicine Cases.

Coronary 321