Mind The Bleep

DECEMBER 16, 2023

It is the most commonly imported tropical disease in the UK, and is a medical emergency. However, patients do not always notice mosquito bites.

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Infectious Diseases Best Practices Seizures 52

Pediatric Emergency Playbook

NOVEMBER 1, 2015

Etomidate is perfectly acceptable, but ketamine is actually a superior drug to etomidate in the rapid sequence intubation of children in septic shock. in Anethesia and Analgesia in 2000. Ketamine is reasonable as well: there is no contraindication to ketamine except for known hydrocephalus. It is safe in head trauma.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

Taming the SRU

NOVEMBER 29, 2023

Lumbar puncture with xanthochromia or > 2000 RBCs in tube 4 should increase suspicion for SAH. Hemorrhagic shock is the most common etiology of instability in trauma and should always be highest on the differential. There is growing evidence that negative NCHCT + CTA outside of traditional 6-hour window is sufficient for diagnosis.

Stroke 53

Stroke EKG/ECG Shock Resuscitation 53

RebelEM

MARCH 27, 2023

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. 2000 May 4; PMID: 10793162 Harvey CE, et al. N Engl J Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric EM Morsels

JULY 21, 2023

Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma. Fun fact for animal lovers!- cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! 2008 Apr;39(4):1347-8. doi: 10.1161/STROKEAHA.107.498345.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 88

Psychiatric Seizures Emergency Department Pediatrics 88

Pediatric Emergency Playbook

JANUARY 1, 2017

Facial grimacing is a weak indicator of pain in neonates ( Liebelt 2000 ). Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. Include practicalities such as how well the pain may be controlled as an outpatient.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

OCTOBER 5, 2024

ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants. 2000; 6:460–3. IV fluid resuscitation as needed.

EMS 86

EMS Infectious Diseases Sepsis Hospitals 86

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." Committee on Shock. 1950s & 1960s Resuscitation Research. Trimble, Tom, RN CEN.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EB Medicine

AUGUST 6, 2019

Nachi: Well, I’m sure more of those studies are still coming. Nachi: Well that was a ton of information and background on the DOACs. Jeff: That is simply shocking! Nachi: But do note that the literature directly comparing the DOACs is far more limited and mostly of poor quality. Jeff: Agree. Let’s get started with some basics.

Emergency Department 40

Emergency Department Stroke Wellness Administration 40

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. 23 Pelvic binding remains a critical resuscitation step well within the purview of the ED physician, and can be reviewed here: [link].

Fractures 57

Fractures Resuscitation Operations EMS 57

Emergency Medicine Ireland

DECEMBER 5, 2022

Expect to see this more in the cold, shocked post bypass patient or in someone who’s already having a lot of arrhythmias. This type of maths does not translate well to audio format and indeed there are actually several of these calculations available just to make it even more confusing. 2000 Nov;28(11):3631-6.

Shock 40

Shock Wellness 40

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. 2000 Aug;30(1):17-24. They are used clinically to detect pathological inflammation or measure response to treatment [1-2].

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

EB Medicine

JANUARY 2, 2019

Interestingly, groups have examined outpatient care with 2 days of daily IM ceftriaxone vs inpatient IV antibiotic therapy and they found that there may be a higher than acceptable risk in the outpatient setting as several required eventual admission and one developed septic shock in their relatively small trial.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

MARCH 11, 2024

The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. 18 Patients with signs and symptoms of severe dehydration or shock, including stupor, coma, uncontrollable vomiting, extreme fatigue that prevents drinking, and unstable vital signs should receive IV fluid resuscitation.

Dehydration 102

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 102

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Premature, gradual reversal of inverted T waves to positive (upright) deflections by 48 to 72 hours after MI onset in the presence of well formed Q-waves. Rupture can be either free wall rupture (causing tamponade) or septal rupture, causing ventricular septal defect with left to right flow and resulting pulmonary edema and shock.

EKG/ECG 91

EKG/ECG Shock COPD Wellness 91