American Ambulance Association
JULY 23, 2024
To the Editor of The Guardian, On July 21, The Guardian published Jessica Glenza’s “Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress.” The inflammatory title and lack of […] The post What The Guardian Missed About US Ambulance Balance Billing appeared first on American Ambulance Association.
Pediatric EM Morsels
JULY 19, 2024
Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.
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The Skeptics' Guide to EM
JULY 20, 2024
Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of clinical practice has been largely devoted to health care policy.
Emergency Medicine Cases
JULY 8, 2024
In this episode: recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick on performing LPs in children, and ED management of pediatric meningitis. We answer such questions as: what are the test characteristics of the various clinical features of meningitis across various ages?
Core EM
JULY 23, 2024
We discuss an approach to the acutely agitated patient and review medications commonly used. Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.
Critical Care Scenarios
JULY 10, 2024
We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital. Find us on Patreon here! Buy your merch here! We learn about the training, role, and benefits of hospital chaplains, with Christine V. Davies, MDiv, MSW, Director of Chaplaincy at Robert Wood Johnson University Hospital.
American Ambulance Association
JULY 18, 2024
This content is for AAA members only. Please either Log In or Join! The post OSHA Proposed Emergency Response Rule Comment Deadline This Monday appeared first on American Ambulance Association.
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
The Skeptics' Guide to EM
JULY 6, 2024
Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She co-founded FOAMcast and is a pulmonary embolism and implementation science researcher.
Emergency Medicine Cases
JULY 9, 2024
The decision of whether or not to order a CT head for an older patient who falls is one I need to make on almost every shift. The Canadian CT Head Rule does not apply to older patients. Does the recently derived Falls Decision Rule give us an answer to the question of which older patients can safely forego a CT head after a fall? Dr. Rohit Mohindra reviews the latest evidence in this EM Cases Journal Club.
Core EM
JULY 23, 2024
The Case A 71-year-old male with a history of chronic obstructive pulmonary disease, hyperlipidemia, and peptic ulcer disease presents to the emergency department with substernal chest pain radiating down the right arm and dyspnea that began acutely while “running” up the stairs from the subway. The following ECG is obtained upon arrival to the emergency department.
Critical Care Scenarios
JULY 24, 2024
We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr. Rory Spiegel (@EMnerd_), emergency physician and intensivist at MedStar Washington Hospital Center (and EMNerd at Emcrit). Find us on Patreon here! Buy your merch here! Takeaway lessons We discuss the practicalities of using airway pressure release ventilation (APRV) with Dr.
American Ambulance Association
JULY 23, 2024
Tamara Annette Robinson Moss Paramedic & Field Training Officer Richmond Ambulance Authority Richmond, VA Share on Facebook | LinkedIn | Instagram | X How did you come to be in […] The post EMS Profiles | Meet Tamara Moss appeared first on American Ambulance Association.
Pediatric EM Morsels
JULY 5, 2024
It seems like just yesterday ( or maybe ~ a month ago ) when we served up a tasty morsel on the PECARN decision rule for intra-abdominal traumatic injuries in children. Our friends at the PECARN injury group have remained busy this spring with generating more externally validated clinical decision rules. In addition to the recently published low risk intra-abdominal injury validation, we have another new tool to use this summer as school breaks, underdeveloped frontal lobes, and high speeds leav
EMergucate
JULY 1, 2024
Question 1: • Hb = 76 (between 7 and 9.9) = moderate anaemia. Normal MCH and MCV so we have normochromic anaemia. • WBC = 1.5 (N = 0.9) = mild leukopenia with moderate neutropenia.
Emergency Medicine Cases
JULY 16, 2024
Registration is now open for the 2024 International EM Cases Summit November 21-23. Registration includes 3 days of talks, panel discussions, interactive discussions, procedural demos, an ebook and access to all the talks for 3 months after the conference. We also offer small group virtual simulation sessions, symposiums on EM Flow, Rural EM and Global EM plus a pre-conference HEARTS ECG course!
Core EM
JULY 23, 2024
The Case An elderly male with a past medical history of hypertension and diabetes presents to the emergency department with a chief complaint of diarrhea and shortness of breath. His vital signs are: HR 60, BP 105/65, RR 30, O2 100% on room air, oral T 98.6 F, and FSG 120. EKG Show Details EKG Characteristics Rate 60 BPM Rhythm Regular, no discernible P-waves Intervals PR na; QRS complex > 160 ms; QT Prolonged Axis LAD ST Segments Wide QRS complexes slurring into very large pointed T waves Diagn
St. Emlyn's
JULY 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed A podcast with Steve Smith ECG educator extraordinaire where we discuss occlusive myocardial infarction and the future of AI and ECG interpretation. The post Podcast – Occlusive Myocardial Infarction, ECGs and Artificial Intelligence with Steve Smith appeared first on St.Emlyn's.
American Ambulance Association
JULY 26, 2024
Register Now: National EMS Advisory Council Meeting August 7-8, 2024 The National EMS Advisory Council (NEMSAC) will host a hybrid meeting on Wednesday, August 7, 2024, at 1:00 pm ET, […] The post National EMS Advisory Council Meeting August 7-8, 2024 appeared first on American Ambulance Association.
Dr. Smith's ECG Blog
JULY 21, 2024
Written By Magnus Nossen — with edits by Ken Grauer and Smith. The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The below ECG was recorded. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion.
EMergucate
JULY 2, 2024
The forearm x-ray is from a child with pain & swelling in the elbow & forearm following a FOOSH injury. Only 1 view could be obtained due to patient being in distress. What can be seen?
The Bottom Line
JULY 19, 2024
In critically ill patients undergoing tracheal intubation does pre-oxygenation with non-invasive ventilation compared with pre-oxygenation with an oxygen mask reduce the incidence of hypoxemia during intubation?
Core EM
JULY 23, 2024
We review threatened abortion and the complexities in its care. Hosts: Stacey Frisch, MD Brian Gilberti, MD [link] Download One Comment Tags: OBGYN Show Notes Background Defined as vaginal bleeding during early pregnancy (before 20 weeks) with a closed cervical os, no passage of fetal tissue, and IUP on ultrasound Occurs in 20-25% of all pregnancies.
St. Emlyn's
JULY 14, 2024
St.Emlyn's - Emergency Medicine #FOAMed Background – What do we already know about REBOA? In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.
American Ambulance Association
JULY 26, 2024
This content is for AAA members only. Please either Log In or Join! The post RAND Corporation issues two reports on ground ambulance industry appeared first on American Ambulance Association.
Dr. Smith's ECG Blog
JULY 23, 2024
I was working at triage when the medics brought this patient who is 65 yo and has had chest pain for 12 hours. They recorded a prehospital ECG at 2112 and said that it was “normal”. It had already been crumpled up and put in the waste basket. So I uncrumpled it: What do you think? You need to click on it to enlarge it to view it well I was suspicious for inferior and posterior OMI (Large T-wave in aVF, slight STE in lead III with inverted T-wave in aVL, and a slightly downsloping ST with negativ
EMergucate
JULY 9, 2024
The following ECG is from a 74-year-old man with one hour of chest pain. He has no cardiac risk factors and denies any significant medical history.
NVFC
JULY 2, 2024
The National Volunteer Fire Council (NVFC) has received $100,000 from Tractor Supply Company, the largest rural lifestyle retailer in the United States, and the Tractor Supply Company Foundation. The donation comes as part of the retailer’s launch of its Hometown Heroes program and its $1 million donation to charity organizations supporting our nation’s military service members, veterans, and first responders.
Core EM
JULY 23, 2024
Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. Due to their availability, iridium-192, Cesium-137, and Cobalt-60 are often viewed as the substances posing the greatest threat for intentional radiation exposure.
St. Emlyn's
JULY 11, 2024
St.Emlyn's - Emergency Medicine #FOAMed The Faculty of Forensic & Legal Medicine's guidelines for managing non-fatal strangulation (NFS). These guidelines advocate a trauma-informed, multidisciplinary approach to improve outcomes for patients who have experienced NFS. @stemlyns #FOAMed The post Non-fatal strangulation appeared first on St.Emlyn's.
American Ambulance Association
JULY 25, 2024
Share your insights with fellow EMS leaders surrounded by the charm and excitement of Lexington’s iconic hospitality featuring world-class dining, bourbon, and horseracing. The post Speak at Annual 2025 in Lexington! appeared first on American Ambulance Association.
The Bottom Line
JULY 11, 2024
Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation (REVISE) D. Cook. NEJM 2024. DOI: 10.1056/NEJMoa2404245 Clinical Question In mechanically ventilated adults, does stress ulcer prophylaxis with intravenous pantoprazole (40 mg daily), compared with placebo (0.9% saline), reduce the occurrence of clinically important upper gastrointestinal bleeding at 90 days?
EMergucate
JULY 18, 2024
Intensive Ambulance-Delivered Blood- Pressure Reduction in Hyperacute Stroke Li, Y. Lin, J. Yang, C.S. Anderson, C. Chen, F. Liu, L.
Dr. Smith's ECG Blog
JULY 9, 2024
Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration. His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. He arrived to the ED with severe hypotension, heart rate in the 70s, unable to follow commands but moving all extremities requiring restraint and sedation, respiratory rate around 24/min being supporte
Core EM
JULY 23, 2024
We review Acute Respiratory Distress Syndrome Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , Pulmonary Show Notes Definition of ARDS: Non-cardiogenic pulmonary edema characterized by acute respiratory failure. Berlin criteria for diagnosis include acute onset within 7 days, bilateral pulmonary infiltrates on imaging, not fully explained by cardiac failure or fluid overload, and impaired oxygenation with PaO2/FiO2 ratio <300 mmHg, even wi
First Responders Foundation
JULY 15, 2024
The safety and well-being of our communities rely heavily on the dedication and courage of first responders—firefighters, police officers, EMTs, and paramedics—who are on the front lines during emergencies. As the current generation of first responders approaches retirement, it becomes crucial to inspire and prepare the next generation to take up this noble and vital role.
American Ambulance Association
JULY 24, 2024
The next CMS Ambulance Open Door Forum scheduled for: Date: Thursday, August 1, 2024 Start Time: 2:00pm-3:00pm PM Eastern Time (ET); Please log in at least 15 minutes before call […] The post CMS Schedules ODF for August 1, 2024 | CY 2025 PFS appeared first on American Ambulance Association.
NVFC
JULY 2, 2024
$25,000 in grants and 100 pancake breakfast kits donated through the Nutella® “Stacks for Giving Back” program Volunteer first responders are there when their community needs them – whatever the emergency. However, they often face significant obstacles as departments struggle to keep up with the rising costs of equipment and increasing call volume. To help volunteer fire departments secure some of the necessities they need to best serve their communities, Nutella® partnered with the National Vol
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