Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. The post Glasgow Coma Scale in Children appeared first on Pediatric EM Morsels. In emergency medicine, we often use illness scripts and protocols to help drive our decision-making. Less than 8, intubate! 2018): 192–200.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. 2004 Feb;35(2):520-6. Epub 2004 Jan 15.

Stroke 101

Stroke Outcomes EMS Seizures 101

RebelEM

JANUARY 9, 2024

You decide she is stable to be discharged home on levofloxacin (See REBEL EM for antibiotic coverage in CAP ) but consider giving her a first dose intravenously. Lancet 2004; 364: 1141-8. appeared first on REBEL EM - Emergency Medicine Blog. A CXR demonstrates a right middle lobe opacity. PMID: 1664833 Addo-Yobo E, et al.

Infectious Diseases 99

Infectious Diseases Pediatrics EMS Administration 99

The Skeptics' Guide to EM

AUGUST 10, 2024

Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table. He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Reversal of Warfarin: Freeman et al.

Stroke 90

Stroke Airway Management Documentation/Coding Outcomes 90

RebelEM

JULY 24, 2023

This approach has been shown to benefit patients when agents like propofol and midazolam are used. ( Russotto 2022 , Choi 2004 ). appeared first on REBEL EM - Emergency Medicine Blog. However, there is scant evidence on the more common induction agents ketamine and etomidate. Paper: Driver BE et al.

Resuscitation 98

Resuscitation Outcomes Emergency Department EMS 98

RebelEM

MAY 29, 2023

Crit Care 2004. appeared first on REBEL EM - Emergency Medicine Blog. PMID: 14707556 Richards-Belle et al. Lower Versus Higher Exposure to Vasopressor Therapy in Vasodilatory Hypotension: A Systematic Review with Meta-Analysis. Crit Care Med 2023.

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

ACEP Now

SEPTEMBER 5, 2024

Our state chapter members and leaders are uniquely positioned to follow EMRA’s lead in partnering with local EM residency programs to improve communication of ACEP’s value to EM-bound medical students and EM residents by hosting residency visits or local events relevant to our shared mission.

Leadership 98

Leadership PPE EMS Wellness 98

RebelEM

AUGUST 14, 2023

4 XBJ received approval from the China Food and Drug Administration in 2004, 2 although the FDA of the United States has not approved it. More on this Topic: First10EM: Finally, a cure for sepsis: Herbs REBEL EM: Sepsis 3.0 appeared first on REBEL EM - Emergency Medicine Blog.

Sepsis 98

Sepsis Outcomes Administration EMS 98

ACEP Now

AUGUST 1, 2023

Factoring such, an order to transfer the patient immediately by ground or air EMS is the only actual support per se these non-physicians receive. Quillen College of Medicine (2003) Response The workforce study shook the foundation of emergency medicine (EM). The workforce dilemma is a challenge we will face for years to come.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

RebelEM

JANUARY 29, 2024

appeared first on REBEL EM - Emergency Medicine Blog. PMID: 21422387 Wan S et al. Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials. PMID: 15262836 Sharifi M et al. PMID: 27422214 Wang C et al.

Stroke 136

Stroke Outcomes Hospitals Administration 136

Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. Upon EMS arrival, the patient was in cardiac arrest. EMS shows you the prescription bottle with a handful of capsules remaining. From 2004 to 2009, prescriptions in the US increased by 50%.

Seizures 52

Seizures Resuscitation Administration Poisoning 52

The Skeptics' Guide to EM

JULY 9, 2022

This committee’s findings supported the use of tPA in less than three hours ( Ingall et al 2004). They published their findings in Annals of EM 2009. NINDS commissioned an independent committee to investigate if any of these imbalances invalidated the entire trial. What are your thoughts on this commissioned report?

Stroke 52

Stroke Emergency Department EMS Outcomes 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

The paramedic notes called STEMI into question: “EMS disagree with monitor for STEMI callout. With both EMS and ED computer interpretations reading ‘STEMI’, the emergency physician activated the cath lab. Comparing J-point between leads noted no significant ST elevation or depression, with QRS prolongation from RBBB.”

EKG/ECG 73

EKG/ECG EMS Shock Ultrasounds 73

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. Written By Magnus Nossen — with edits by Ken Grauer and Smith. 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.

EKG/ECG 131

EKG/ECG Shock Hospitals Sepsis 131

PHEM Cast

APRIL 21, 2021

2004 Aug;99(2):607-13, Hasegawa K et al. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. J Trauma 2003; 54:444-453 Mort TC. Anesth Analg. DOI:10.1002/14651858.CD011136.pub2.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

PHEM Cast

JULY 6, 2017

[link] The West Midlands surgical skills course offers cadaveric training for PHEM and EM practitioners on rare life saving procedures. Click here to go straight to their page. Anatomy The Guidelines Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Frerk et al. Abrahams, P. Meiring, J.

Airway Management 52

Airway Management Academics Operations Resuscitation 52

PHEM Cast

DECEMBER 1, 2017

For example, here are the locations identified as ‘2nd ICS mid clavicular line’ amongst 25 EM physicians in a 2005 EMJ paper. Be particularly careful when using the 2nd intercostal space mid-clavicular line that you are sufficiently lateral. Note – again please do not use this location! Marasco, S., Injury , 39 (1), 9–20.

Academics 52

Academics Radiology Radiology Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Annals of EM 2020. Background: Chronic marijuana use was recognized by Allen el al in 2004 to cause cyclical vomiting in patients from South Australia. Additionally, they host selected guests for special episodes, and publish blogs dedicated to more advanced medical questions or topics. Reference: Ruberto et al.

Hospitals 40

Hospitals Emergency Department Ultrasounds EMS 40

Advanced Emergency Nursing from AENJ

DECEMBER 18, 2014

Classic Advice to New Interns (Commentary upon 10 Commandments of EM) Ten Commandments of Emergency Medicine Luke & Cusack Cork Emergency Medicine 2014 The Derriford twelve commandments of emergency medicine: a model for good practice in a changing world, or a survival guide for new medical staff Smith, J. 2004 Aug;27(2):193-4.

Mass Casualty Incidents 40

Mass Casualty Incidents Burns Urgent Care Pediatrics 40

RebelEM

JANUARY 23, 2023

Noninferiority trials, covered here on REBEL EM , are helpful when the experimental treatment offers a distinct advantage over the standard treatment. 2004 Feb;113(2):347-52. In this case, cetirizine may be advantageous as it may have a more favorable side effect profile than diphenhydramine. J Allergy Clin Immunol. PMID: 14767453.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Pediatric Emergency Playbook

OCTOBER 1, 2015

EMS is bringing you a child with a VP shunt, port-a-cath, trached on a vent, seizing, hypotensive, and now desaturating – ETA – 3 minutes. Pediatr Clin N Am 51 (2004) 305– 325 Kusminsky RE. Eur Respir J 2004; 23: 430–434 Shinkwin CA, Gibbin KP. Are you ready? Medicine is evolving. Pediatr Clin N Am 55 (2008) 1343–1358 Garton HJ.

Pediatrics 40

Pediatrics Fractures Resuscitation Burns 40

Northwestern EM Blog

JANUARY 24, 2022

And for most forms, EM physicians are not typically shocked by shock. 2004; 139(11):1199-1203. This state may arise due to impaired oxygen delivery to tissues, impaired oxygen utilization by the tissues themselves, increased oxygen consumption, or a combination of these mechanisms. The Internet Book of Critical Care. Arch Surgery.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Advanced Emergency Nursing from AENJ

APRIL 8, 2014

Implementation and care directives for "EMS" mouth-to-airway. LeFanu, James (1997) Hero who put himself through hell The Sunday Telegraph 16 February 1997 **Blog recounting Pask's intrepidity and personal experimentation. Sir Edward Sharpey-Schafer and his simple and efficient method of performing artificial respiration.

Resuscitation 40

Resuscitation Ambulance Services Research Military 40

ALiEM

MARCH 7, 2024

Ultrasound in EM , 2015 [15] Retrospective case series in a pediatric ED, time frame not specified N=5 3-21 years Hydronephrosis, ureteral jets, twinkling artifact, and the visualization of urinary tract stones were identified in patients with renal colic. Ann Emerg Med. 2005;45(5):510-513. doi:10.1016/j.annemergmed.2004.11.010 Pediatrics.

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. N Engl J Med [Internet] 2013;368(21):2004–13.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

EMDocs

FEBRUARY 29, 2024

2004 May-Jun;156(3):159-62. An interesting cause of wide complex tachycardia: Ashman’s phenomenon in atrial fibrillation. J Emerg Med. 2013 Dec;45(6):835-41. Kennedy LB, Leefe W, Leslie BR. The Ashman phenomenon. J La State Med Soc. PMID: 15233390. Gouaux JL, Ashman R. Am Heart J. 1947 Sep;34(3):366-73.

EKG/ECG 105

EKG/ECG EMS Hospitals 105

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 2004 Nov;30(11):2017-20. Epub 2004 Jul 24. 2004 Sep;70(9):805-10.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

EMDocs

OCTOBER 23, 2023

Author: Kristine Jeffers, MD ( EM Physician , San Antonio Uniformed Services Health Education Consortium) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 21 May 2004 Hoges K, Davids B, Swaim L. 2020 Sep;127(10):1269-1279. Spilsbury K, Hammond I, Bulsara M, Semmens JB. BJOG 2008; 115:1473.

OB/GYN 95

OB/GYN Operations EMS Ultrasounds 95

RebelEM

MAY 15, 2024

Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 122.0 – Neutropenic Fever appeared first on REBEL EM - Emergency Medicine Blog. Neutropenic Fever: Fever (one reading of 38.3C British Journal of Haematology.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

Automatic transport ventilator versus bag valve in the EMS setting: a prospective, randomized trial. Study finds EMS able to do more tasks, document better, perform physiological monitoring, with use of ATV. Efficacy and safety in patients on a resuscitator, Oxylator EM-100, in comparison with a bag-valve device. Grainge, C.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 40

Pediatric EM Morsels

APRIL 5, 2024

Jensenius 2004) Let’s take a moment to review Tickborne Illnesses and International Travel : Tickborne Illnesses and Major Rickettsial Diseases: Basics Most of these illnesses are acquired from exposure to a rural area during travels including camping, hiking, safaris, and livestock.

CDC 164

CDC Infectious Diseases Pediatrics Shock 164

Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). . -- Finally, a dedicated syncope unit may improve evaluation and outcome (17). Quinn et al.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. 2004 Jul;15(4):248-250. Predictors of impending acute chest syndrome in patients with sickle cell anaemia. 2020 Feb 12;10(1):2470. PMID: 32051480; PMCID: PMC7015921. Pathophysiology of Sickle Cell Disease. Annu Rev Pathol. 2019 Jan 24;14:263-292. Epub 2018 Oct 17. PMID: 30332562; PMCID: PMC7053558.

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

Dr. Smith's ECG Blog

JANUARY 21, 2023

Case submitted and written by Dr. Mazen El-Baba and Dr. Evelyn Dell, with edits from Jesse McLaren EMS brought a John Doe, in his 30s, who was found in an urban forest near a homeless encampment on a cool fall day. EMS reported an initial GCS of 8 with pupils equal and reactive. There were no signs of trauma on scene or on the patient.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Don't Forget the Bubbles

SEPTEMBER 18, 2023

2004 Sep 25;364(9440):1141–8. Available from: [link] The CAP-IT Trial: Amoxicillin Dose and Duration in Children with Community-Acquired Pneumonia – REBEL EM – Emergency Medicine Blog [Internet]. Addo-Yobo E, Chisaka N, Hassan M, Hibberd P, Lozano JM, Jeena P, et al. The Lancet. Cochrane Database Syst Rev [Internet].

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

The Skeptics' Guide to EM

NOVEMBER 30, 2024

An alumnus of Tacoma Community College's paramedic program Missy served as a paramedic for the Bremerton Fire Department for nearly 12 years and has been involved in paramedic education since 2004. Case: You’re doing a ride along with your local emergency medical service (EMS) crews and responding to an out-of-hospital cardiac arrest (OHCA).

Administration 100

Administration CPR Airway Management Resuscitation 100

EMDocs

JANUARY 20, 2025

2004 Jan-Feb;17(1):37-43. 2004 Apr 15;2:11 Fonseca BK, Holdgate A, Craig JC. ”, REBEL EM blog, January 9, 2024. 2021 May 26;13(5):e15253. Ishibe S, Peixot AJ. Methods of assessment of volume status and intercompartmental fluid shifts in hemodialysis patients: implications in clinical practice. Semin Dial. Swaminathan A.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75