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Reference: Muldowney et al. A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting. Ann Emerg Med. 2025 Date: April 24, 2025 Guest Skeptic: Dr. Howie Mell received his Medical Doctorate (MD) from the University of Illinois at Chicago, College of Medicine at Rockford. Prior to that, he received a Master of Public Health (MPH) degree emphasizing Environmental and Occupational Health from the University of Illinois at Chicago, School
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.
We dive into the recognition and management of blast crisis. Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Hematology , Oncology Show Notes Topic Overview Blast crisis is an oncologic emergency, most commonly seen in chronic myeloid leukemia (CML). Defined by: >20% blasts in peripheral blood or bone marrow.
By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.
This content is for AAA members only. Please either Log In or Join! The post AAA Advocates for Student Loan Forgiveness for All EMS Personnel appeared first on American Ambulance Association.
St.Emlyn's - Emergency Medicine #FOAMed This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. Drawing on a systematic review and meta-analysis, it examines the evidence, evaluates key benefits, and critically appraises the limitations. The discussion highlights the potential of this model to enhance pre-hospital emergency care while addressing challenges in implementation across dive
In this video, Dr. Jailyn Avila walks you through how to diagnose thoracic aortic aneurysms and thoracic aortic dissection using bedside ultrasound. While the abdominal aorta often gets the most attention, aortic disease above the diaphragm is just as criticaland often harder to recognize. Early detection of thoracic aortic pathology can be life-saving, and ultrasound can play a key role in raising suspicion quickly.
Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.
Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.
I think most clinicians enjoy getting as much information as possible before getting on scene. It gives your mind time to start working through various scenarios, cross-check guidelines, and develop a game plan with your partner. I want you to read the following dispatch information and let your brain do a little premature future-telling.
Reference: Umana E, et al. Performance of clinical decision aids for the care of young febrile infants: A multicenter prospective cohort study.eClinicalMedicine Lancet December 2024 Date: March 6, 2025 Dr. Demetris Athanasiou Guest Skeptic: Dr. Demetris Athanasiou is a paediatric registrar based in London and enrolled in the PEM MSc program through Queen Mary University in London.
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
We discuss the recognition and treatment of necrotizing fasciitis. Hosts: Aurnee Rahman, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Critical Care , General Surgery Show Notes Table of Contents 0:00 – Introduction 0:41 – Overview 1:10 – Types of Necrotizing Fasciitis 2:21 – Pathophysiology & Risk Factors 3:16 – Clinical Presentation 4:06 – Diagnosis 5:37 – Treatment 7:09 – Prognosis and Recovery 7:37 – Take Home points Int
Originally published at The Pediatric EMS Podcast on March 5, 2035. Reposted with permission. Please visit their site HERE to see all the amazing podcasts or subscribe to their RSS HERE. This is the Pediatric EMS Podcast with the mission to provide case-based discussion with evidence-based recommendations by content experts in prehospital pediatric medicine in order to advance the care of children outside the hospital.
National Rural Health Association December 2024 Policy Paper Bridging the gap: A policy framework for sustainable community paramedicine in rural America Authors: Katie Gorndt, Kimberly Haverly, Tom Syverson The post NRHA | Community Paramedicine Framework appeared first on American Ambulance Association.
When I started as a paramedic in Hartford in January of 1995, I was given a 100-page protocol book to memorize. There were fewer than 50 protocols in the book, along with pages for 24 medications and 8 procedures. The book was approved by the two largest hospitals in Hartford. Looking through the book today, it is truly an antiquated. For instance, there was no protocol for stroke or STEMI.
Happy New Year, and w elcome back to another edition of ESO product updates. Thanks to our new and improved feedback process, our customers have been more involved than ever in our Product Roadmap. Your input is invaluable to our team and integral to the improvements and enhancements you’ll find below. So, without further ado, here are the latest updates from ESO in Q4 2024 and whats just ahead on the horizon , all of which h as been made possible by our incredible ESO community : Content
Okay everyone, think about your tongue. Maybe move it around a bit, check in with it, consider what it means to you. Now imagine that your tongue suddenly shriveled up and fell off and that in its place is a tongue-sized isopod aka rollie pollie aka pillbug. Just there, hanging out, forever. How are you feeling? Horrified? Disgusted? Hey, we get it.
A Simplified Protocol for Intralipid Administration in the ED Ultrasound-guided nerve blocks (UGNBs) are becoming more common in emergency medicine practice. These techniques allow the modern emergency physician to deliver targeted pain control in conjunction with using lower doses of other analgesics. Recently, numerous Emergency Department (ED) groups have demonstrated the efficacy of UGNBs for pain control with a low rate of complications. 1-3 This cohort study included data from the National
When you think about strokes, you probably picture a slurred speech, middle-aged hypertensive smoker with half their face drooping. You dont picture atoddler in a car seat or a baby in a crib. But the reality is that strokes happen to kids, too.As paramedics, we thrive on pattern recognition, but pediatric strokes are theultimate zebra in the room. They dont present like adult strokes; theyre incredibly rare,and the clock is still ticking as fast.
Welcome to the first episode of the Broomedocs podcast for 2025. Justin and I are back for more nerdy goodness to make you smarter in the Resus room, or at a pub trivia night more likley… wether it is about salt correction, dissection or infection we can help you out! Listen in and learn! Or if you don’t have enough Youtube content featuring aging bearded men – you can watch over on Justin’s channel here: Airway, breathing, cellphone: a new vital sign?
Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities CHICAGO [Jan. 10, 2025] As wildfires rage across California, the American Burn Association (ABA) is prepared to assist burn centers and healthcare providers in responding to burn injuries resulting from these devastating events.
Introduction Out-of-hospital cardiac arrest remains a global health problem. There is emerging evidence that the use of extra-corporeal membrane oxygenation during resuscitation [ECPR], may help to improve outcomes. Several prehospital services around the world are now able to provide on-scene ECPR. However, the early identification of patients is a key factor in enabling this level of response to OOHCA.
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.
Yesterday evening, March 14, the United States Senate by a vote of 54 to 46 passed the Full-Year Continuining Appropriations and Extensions Act, 2025 (H.R. 1968) to fund the federal […] The post Congress Extends Ambulance Add-On Payments Through September 30 appeared first on American Ambulance Association.
We all know the key to a thorough patient assessment is to approach it systematically so that we dont become distracted (by that bleeding scalp wound) or skip steps that may yield valuable information (like listening to breath sounds). Theres a reason we are all taught head-to-toe surveys: so that we work our way through essential assessment points, avoiding a haphazard exam where key signs are missed.
A typical hospital produces about 137 terabytes of data per day, more than twice the data housed in the Library of Congress. Yet, up to 97% of hospital data are unused. But what if all that data helped you improve patient outcomes, streamline operations, and support performance initiatives? What could you achieve if you had a patient’s prearrival care information in hand when they arrived at the emergency department (ED)?
Methodology 3/5 Usefulness 3/5 Connolly SJ, et al. N Engl J Med. 2024 May 16;390(19):1745-1755. Editorial: Reversing Oral Anticoagulation in Intracerebral Hemorrhage. Question and Methods: This unblinded, multicentre randomized controlled trial studied whether Andexanet improved hemostatic efficacy compared to usual care in patients with acute intracerebral hemorrhage using factor Xa inhibitors.
PCC Members, Further to the bulletin issued on March 6, 2025 Member Messages regarding the impact of tariffs and counter-tariffs on equipment, supplies and services used to provide paramedic services across Canada, we want to provide an update on our advocacy activities and share resources to members as our messaging is expanding across government and the public.
In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy.
The Congressional Fire Services Institute (CFSI) will hold its annual Fire and Emergency Services Symposium and Dinner on February 12-13 in Washington, DC. CFSI is a consensus organization for the nations fires service that advocates for policies that have been approved by its National Advisory Committee, which consists of over 30 national fire service organizations including the National Volunteer Fire Council (NVFC).
Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections BALANCE Investigators. NEJM 2024; DOI: 10.1056/NEJMoa2404991 Clinical Question In hospitalised patients with bloodstream infections (BSI), is antibiotic treatment for 7 days, compared to treatment for 14 days, non-inferior with respect to mortality at 90 days?
Alex (Sandy) MacQuarrie , PhD and Paramedic, reflects on his move from Canada to Australia, principles of simulation in medical education & his personal experience with cardiac arrest. Topics discussed: Constructivism in education Organic versus mechanistic approach to learning Difference between feedback and debriefing Socratic method versus Advocacy-Inquiry model Peer-to-peer feedback Psychological safety in the classroom Emotional Seriousness in simulation NHET-SIM Certification Prebriefi
St.Emlyn's - Emergency Medicine #FOAMed This blog post provides concise summaries of recent critical care trials, including HEMOTION, PREOXI, BLING III, CLASSIC, EVIDENCE, VICTOR, and PARAMEDIC-3. Each trial is examined for its key findings, strengths, limitations, and practical implications for clinical practice. The post aims to inform healthcare professionals about the latest evidence-based practices in critical care.
Medicare Ambulance Extender Bill Introduced in House Yesterday, March 18, Representatives Claudia Tenney (R-NY), Terry Sewell (D-AL), Cliff Bentz (R-OR), Paul Tonko (D-NY), Mike Carey (R-OH), Danny Davis (D-IL), Carol […] The post House Reintroduces Vital Medicare Extender and EMS Workforce Bills appeared first on American Ambulance Association.
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