EMS 12-Lead
MAY 15, 2024
TCP in the ROSC Patient: False Electrical Capture at 75mA Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the second installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.
Emergency Medicine Cases
APRIL 2, 2024
In this part 2 of our 2-part podcast on asthma with Dr. Sameer Mal and Dr. Leeor Sommer, we dig into the recognition and management of life-threatening asthma. We answer such questions as: what are the key elements in recognition of threatening asthma? What are the most time-sensitive interventions required to break the vicious cycle of asthma? What are the best options for dosing and administering magnesium sulphate, epinephrine, fentanyl and ketamine in the management of the crashing asthmatic
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
The Skeptics' Guide to EM
APRIL 13, 2024
Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. NEJM Feb 2024 Date: April 12, 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA. He is an assistant professor in Emergency […] The post SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke first appeared on The Skeptics Guid
ALiEM
MARCH 18, 2024
A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. She stated she was typing on a computer keyboard approximately 10 minutes prior to presentation and she noticed a sudden popping sensation at the base of her right ring finger. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger.
Critical Care Scenarios
APRIL 24, 2024
We discuss the role of point-of-care ultrasound in evaluating the patient with kidney injury and assessing volume status, with Abhilash Koratala (@nephroP), nephrologist, Director of Clinical Imaging for Nephrology at the Medical College of Wisconsin, and champion of nephrology-focused ultrasound. Find us on Patreon here! Buy your merch here! Takeaway lessons References Episode 4 with … Continue reading "Episode 73: POCUS for nephrology, with Abhilash Koratala" We discuss the role of point-of-ca
High Performance EMS
MARCH 8, 2024
There is plenty of data in the world, the key to improving performance is to discover the right information and make an appropriate decision, based on facts, in time to change outcomes for the better. Computers are quite useful in aggregating and processing data to distill information in support of the decision-making process, but artificial intelligence and machine-learning has increased our expectations of cyber assistance.
Pediatric EM Morsels
MARCH 29, 2024
Often our job requires us to consider the presence of needles of significant illness in the haystack of nonspecific symptoms. With the help of our favorite geneticist , Dr. Liz Baker, we will dive into the haystack headfirst and find those needles. Hopefully, without getting poked. Let’s consider Inborn Errors of Metabolism Presenting in the ED : Inborn Errors of Metabolism: Basics Common Presentations, Uncommon Kiddos For the child with lethargy, vomiting, acidosis, hypoglycemia , organom
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
Core EM
APRIL 25, 2024
The RSS feed URL you're currently using [link] will stop working shortly.
EMOttawa
MARCH 14, 2024
Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more than 3x more often than anterior circulation strokes.1 Similar to anterior circulation strokes, posterior strokes are most commonly […] The post Posterior Circulation Strokes appeared first on EMOttawa Blog.
First 10 EM
APRIL 22, 2024
As mentioned in my most recent review, publication bias has been a major concern when trying to decide whether to prescribe paxlovid. Pfizer rushed to publish their positive study (EPIC-HR), but refused to release the results of a second simultaneous study (EPIC-SR) that was stopped (due to futility) at the exact same time. With the […] The post EPIC-SR: The negative paxlovid data Pfizer has been sitting on appeared first on First10EM.
EMS 12-Lead
MARCH 30, 2024
TCP In Transit: A case reviewing transcutaneous pacing, false electrical capture, and re-arrest. Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the first installment of a blog series showing how transcutaneous pacing (TCP) can be difficult, and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.
Emergency Medicine Cases
APRIL 2, 2024
In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain. The post ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain appeared first on Emergency Medicine Cases.
The Skeptics' Guide to EM
MARCH 2, 2024
Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department at Nassau University […] The post SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections first appeared on Th
ALiEM
MARCH 5, 2024
Which medication can be derived from the bark of the pictured tree? Aspirin Atropine Colchicine Quinine Reveal the Answer 1. Aspirin Background The photo shows a weeping willow, a member of the Salix genus of trees. Willow tree bark contains salicin from which aspirin (acetylsalicylic acid) can be derived. For over 3500 years, willow bark has been used as a traditional medicine to treat fevers and pain [1].
FOAMfrat
APRIL 25, 2024
In this episode, we discuss a recent paper on false electrical capture and pre-hospital transcutaneous pacing by paramedics. The guests, Tom Boutilet, Josh Kimbrell, and Judah Kreinbrook, discuss their research findings and the implications for paramedics. They conducted a retrospective study and found that paramedics often mistakenly believe they have electrical capture when they do not.
St. Emlyn's
MAY 18, 2024
St.Emlyn's - Emergency Medicine #FOAMed The practice of coordinating, consulting and managing an entire acute clinical service in real-time is fairly unique to emergency medicine. Central to this is the EPiC (or emergency physician in charge) role #FOAMed @stemlyns with @codingbrown The post An EPiC mental model. St Emlyn’s appeared first on St.Emlyn's.
Pediatric EM Morsels
MARCH 15, 2024
We encounter seizures commonly in the Emergency Department. While they can be dramatic and devastating, we have learned to become comfortable with the wide variety that may present in children. From the simple febrile seizure to the complex seizure, we know how to stabilize and how to evaluate. While fortunately most seizure activity is short lived, we also know that status epilepticus can be difficult to manage, and persistent seizures should make us consider specific etiologies (ex.
American Ambulance Association
FEBRUARY 8, 2024
This content is for AAA members only. Please either Log In or Join! The post OHSA Notice of Proposed Rule Making (NPRM) Emergency Response Standard appeared first on American Ambulance Association.
NVFC
FEBRUARY 13, 2024
On December 21, the Occupational Safety and Health Administration (OSHA) announced that it will issue a Notice of Proposed Rulemaking (NPRM) to modernize the agency’s “Fire Brigades” standard. This standard was first published and last updated in 1980. This proposed updated standard would issue several new requirements that would be very burdensome, and in many cases impossible, for volunteer fire departments to comply with.
EMOttawa
JANUARY 25, 2024
Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience, this post acts as a quick […] The post Mechanical Ventilation Basics appeared first on EMOttawa Blog.
First 10 EM
APRIL 2, 2024
Give your patients a break. Nobody is a perfect diagnostician. Not even the best trained physician can determine, with 100% accuracy, which patients have serious pathology. Even with advanced testing, we aren’t close to perfect. However, if you listen to the subtext of breakroom complaints, it seems like we expect patients to be better diagnosticians […] The post Are you a perfect diagnostician?
EMS 12-Lead
APRIL 9, 2024
David Didlake @DidlakeDW EMS personnel responded to the residence of an 81 y/o Male with syncope. His spouse had called 911 after she heard a loud “thud” in the adjacent room. He was found altered, hypotensive, and with a large hematoma to the left periorbital region. No 12 Lead ECG was captured, but telemetry did reveal the following: The spouse offers a pertinent medical history to include HTN and HLD, and furthermore states that he hasn’t previously complained of any chest discomfort, or shor
Emergency Medicine Cases
APRIL 23, 2024
In this month's EM Quick Hits podcast: Justin Morgenstern on the first RCT of high dose nitroglycerin in SCAPE, Andrew Neill on Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) indications and evidence, Brit Long on indications for CT in suspected diverticulitis, Tahara Bhate on Central Retinal Artery Occlusion (CRAO) and diagnostic error, Matthew McArthur on penicillin allergy labels, myths and penicillin challenges, and Susan Lu on how ED physician personality influences patie
The Skeptics' Guide to EM
FEBRUARY 11, 2024
Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. EMJ Nov 2023. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Sy
FirstNet Authority
FEBRUARY 29, 2024
Update on February 22 Network Outage Blog joseph.rey@fir… Thu, 02/29/2024 - 13:49 By Joe Wassel, Executive Director and CEO, First Responder Network Authority Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters. Follow us on Twitter , Facebook , Instagram , and LinkedIn for the latest FirstNet Authority updates.
Dr. Smith's ECG Blog
FEBRUARY 22, 2024
Written by Pendell Meyers A woman in her 30s called EMS for acute symptoms including near-syncope, nausea, diaphoresis, and abdominal pain. EMS arrived and found her to appear altered, critically ill, and hypotensive. An ECG was performed: What do you think? Extremely wide complex monomorphic rhythm just over 100 bpm. The QRS is so wide and sinusoidal that the only real possibilities left are hyperkalemia or Na channel blockade.
EMCrit Project
MAY 16, 2024
Piperacillin-tazobactam is an antibiotic that a lot of people love to hate. Combine this with the conservatism that often (rightfully) surrounds drug safety, and it creates a lot of volatility. Before going further, we should review some recent history regarding piptazo. In the early 2010's, a series of retrospective correlational studies found that patients treated […] EMCrit Project by Josh Farkas.
Life in the Fastlane
JANUARY 15, 2024
Sheralyn Guilleminot and Mike Cadogan Real-World Applications of Artificial Intelligence in Medicine Interview with critical care clinician, and AI enthusiast, Dr Sameer Shaikh on the many ways to use AI to save time and increase efficiency in healthcare
St. Emlyn's
FEBRUARY 6, 2024
St.Emlyn's - Emergency Medicine #FOAMed This week I am in Zermatt, Switzerland for ‘The Big Sick’ conference. This is something I have been looking forward to years, but major heart surgery (valves not pipes) and […] The post Top resus papers for TBS. St Emlyn’s appeared first on St.Emlyn's.
NVFC
APRIL 9, 2024
On February 5, the Occupational Safety and Health Administration (OSHA) published a Notice of Proposed Rulemaking (NPRM) to modernize the agency’s “Fire Brigades” standard with a proposed new “Emergency Response Standard.” This NPRM’s publication triggered the beginning of a public comment period that was initially scheduled to conclude on May 6. Thanks to feedback from the emergency services community, OSHA has extended this public comment period to June 21, 2024.
EMOttawa
APRIL 11, 2024
Patients living with functional neurologic disorders (FND) have been deeply stigmatized by the medical system. In a patient survey by FND Hope (an international organization for the research and advocacy around FND) 82% of patient respondents felt they had been treated poorly due to stigma relating to their FND diagnosis, primarily by emergency physicians [1] […] The post Functional Neurologic Disorders appeared first on EMOttawa Blog.
First 10 EM
JANUARY 15, 2024
We are once again buried in a wave of viral respiratory illnesses, and much of the burden of illness is still COVID. I did a pretty thorough review of all COVID antiviral therapies in 2022, both on First10EM and on the EMCases Journal Jam, but that was 2 years ago. I think most of us […] The post Paxlovid evidence: still very little reason to prescribe appeared first on First10EM.
EM Literature of Note
MARCH 12, 2024
A few words regarding an article highlighted in one of my daily e-mails – a report regarding the Elders Risk Assessment tool (ERA) from the Mayo Clinic. The key to the highlight is the assertion this score can be easily calculated and presented in-context to clinicians during primary care visits, allowing patients with higher scores to be easily identified for preventive interventions.
Emergency Medicine Cases
MARCH 19, 2024
In this part 1 of our 2-part podcast series on Asthma Management we explore a systematic approach to managing patients presenting to the ED with asthma exacerbations. Our discussion will emphasize the critical role of a thorough history and physical examination in effectively stratifying patient risk and guiding treatment/disposition decisions. Additionally, we'll examine the importance of providing comprehensive discharge medications and instructions to mitigate both mortality and morbidity ass
The Skeptics' Guide to EM
JANUARY 6, 2024
Reference: Remick KE, et al. National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. JAMA Netw Open. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. Her research focuses on prehospital care of children with anaphylaxis. […] The post SGEM #425: Are You Ready for This?
Don't Forget the Bubbles
JANUARY 29, 2024
A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Of those patients admitted with RSE, a subset will go on to develop super-refractory status epilepticus (SRSE).
Dr. Smith's ECG Blog
APRIL 2, 2024
An elderly man collapsed. There was no bystander CPR. Medics found him in ventricular fibrillation. He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED.
Expert insights. Personalized for you.
331 
Let's personalize your content