Taming the SRU

DECEMBER 11, 2023

PATIENT PRESENTATION A young woman with a past medical history of major depressive disorder presented to the emergency room via EMS for a report of intentional ingestion of an unknown substance. EMS reported that she was vomiting profusely on their arrival to the scene but during transport became increasingly lethargic.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. 2008 Apr;39(4):1347-8. Epub 2008 Feb 28. 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. 107.498345.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

RebelEM

JULY 20, 2023

EMS radios in for a burn patient and to anticipate a difficult airway. Emergency Medicine (EM) is an amazing specialty because anything can come through the door at any moment. This same reality makes practicing EM incredibly challenging and at times downright terrifying. You can hear the tension in their voice. Acad Emerg Med.

EMS 75

EMS Burns Airway Management Wellness 75

The Skeptics' Guide to EM

JANUARY 27, 2024

He is also an assistant medical director for EMS at the Centre for Paramedic Education and Research in Hamilton, Ontario, Canada. Fanaroff et al looked at the ACC/AHA guidelines from 2008-2018 [4]. Case: You are an advanced care paramedic dispatched to the scene of a 53-year-old female with chest pain.

Administration 127

Administration Academics EKG/ECG EMS 127

RebelEM

JANUARY 18, 2024

appeared first on REBEL EM - Emergency Medicine Blog. to 0.97; p = 0.02 Length of ICU Stay 906 patients Prehospital Abx: 300 pts No Prehospital Abx: 606 pts Pooled Mean Difference 0.11; 95% CI -1.85 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

ECG Guru

JUNE 28, 2024

EMS found him pale, diaphoretic, and anxious. Dr. Robbert de Winter, et al, described this pattern in a letter to the editor of the New England Journal of Medicine in 2008. The Patient This ECG is from a 57-year-old man complaining of sub-sternal chest pain for 30 minutes. The ECG The rhythm is normal sinus rhythm at 98 bpm.

EKG/ECG 81

EKG/ECG Emergency Department EMS 81

RebelEM

MARCH 6, 2024

2008 Jul 1;31(7):table of contents. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 119.0 – Sleep Hygiene appeared first on REBEL EM - Emergency Medicine Blog. Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report.

Leadership 103

Leadership Hospitals EMS 103

EMDocs

DECEMBER 11, 2023

De Winter Sign [4,6] First described in 2008 this pattern be seen in proximal left anterior descending artery occlusion and should be evaluated by emergent angiography. 2008 Nov 6;359(19):2071—2073. Her vital signs are stable. Her ECG is shown below. Source: [link] This case is consistent with the De Winter Sign. Ann Emerg Med.

EKG/ECG 119

EKG/ECG Emergency Department Academics Operations 119

RebelEM

JUNE 26, 2024

Clin J Am Soc Nephrol 2008; 3:324–330. Crit Care Med 2008; 36: 3246-51. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 125.0 – Hyperkalemia appeared first on REBEL EM - Emergency Medicine Blog. Definition: A serum potassium level > 5.5 rhabdomyolysis -> hydration) Remove inciting factors (i.e.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

EMDocs

SEPTEMBER 7, 2023

Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”. Due to the limited availability of laboratory assays for DEG, clinicians should rely on a high index of suspicion, history, and routine lab work for diagnosing DEG toxicity. References: Abubukar et al. Schier, Capt.

Poisoning 94

Poisoning CDC Administration Emergency Department 94

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

Taming the SRU

APRIL 14, 2024

EM@3AM: Hernia.” Biomedical Imaging and Intervention Journal , vol. 4, 1 July 2009, p. e14, www.biij.org/2009/4/e14/. Accessed 9 Apr. Jenkins, John T, and Patrick J O’Dwyer. Inguinal Hernias.” 7638, 31 Jan. 269–272, [link]. Long, Brit. “EM@3AM: ScienceDirect , www.sciencedirect.com/science/article/pii/S0736467913011396. 121–128, [link].

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

RebelEM

SEPTEMBER 13, 2023

PMID 18768946 Post Created By: Anand Swaminathan MD, MPH (Twitter @EMSwami ) Post Peer Reviewed By: Salim Rezaie MD (Twitter @SRRezaie) The post REBEL Core Cast 108.0 – Angioedema appeared first on REBEL EM - Emergency Medicine Blog. of people who take NSAIDs ( Nzeako 2010 ).

Allergic Reactions 105

Allergic Reactions Airway Management Anaphylaxis Emergency Department 105

Taming the SRU

NOVEMBER 27, 2023

2008 Sep;122(3):105e-117e. New York: McGraw-Hill Education. [2] 2] Lemmon JA, Janis JE, Rohrich RJ. Soft-tissue injuries of the fingertip: methods of evaluation and treatment. An algorithmic approach. Plast Reconstr Surg. doi: 10.1097/PRS.0b013e3181823be0. 0b013e3181823be0. PMID: 18766028. [3] 3] Leggit JC. Acute and Chronic Paronychia.

Soft Tissue Injuries 95

Soft Tissue Injuries Emergency Department EMS Fractures 95

PHEM Cast

DECEMBER 12, 2016

Injury; 2008 (39): 967-969. Joint Position Statement of Nat Assoc EMS Physicians and ACS Committee on Trauma. Practice Management guidelines for ED Thoracotomy. J Am Coll Surg. 2001, 193 (3): 303-309. When should we stop resuscitative efforts after blunt traumatic arrest. J Am Coll Surg; 2003 (1): 106-111.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

RebelEM

NOVEMBER 2, 2022

EMRAP: C3 Live Paracentesis Video LITFL: Spontaneous Bacterial Peritonitis SinaiEM: SBP Pearls REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)? JAMA 2008; 299(10):1166-78. Louis, Mosby, Inc., 2010, (Ch) 90: p 1186-1205. References Runyon BA et al. Ascitic fluid analysis in malignancy‐related ascites.

EMS 52

EMS Administration Hospitals 52

The Skeptics' Guide to EM

MARCH 6, 2021

Managing editor of EM:RAP and Associate Editor at REBEL EM. Managing editor of EM:RAP and Associate Editor at REBEL EM. Background: Epistaxis is a common Emergency Department (ED) complaint with over 450,000 visits per year and a lifetime incidence of 60% ( Gifford 2008 , Pallin 2005 ). Reference: Reuben A et al. SGEM#210 ).

EMS 52

EMS Emergency Department Outcomes 52

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. 2008 Jul;26(7):1446-52. 2019 Aug;50(8):2023-2029.

Stroke 101

Stroke Outcomes EMS Seizures 101

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! link] Fitzgerald, M., Mackenzie, C.

Academics 52

Academics Radiology Radiology Resuscitation 52

RebelEM

MARCH 13, 2023

Does the inclusion of patients pronounced dead on scene and the presence of a physician-based EMS organization affect the pooled mortality rate and survival with favorable neurologic outcomes for prehospital TCA? Subcategory data on EMS system type is still extremely variable, given the range of included EMS systems and regions.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

EMDocs

OCTOBER 30, 2023

Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. 2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. Authors: Saran S. 11 Table 1. J Am Coll Radiol.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

ACEP Now

JUNE 7, 2023

Patient arrival by EMS increased and more of those patients were admitted. About 20 percent of ED arrivals in 2022 came by ambulance, and 36 percent of those EMS patients were subsequently admitted, compared to about 14 percent of ambulatory arrivals. Admission rates for EMS patients is about 36 percent.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

PHEM Cast

APRIL 16, 2018

Anneals of EM; 2015: 297-307. 2008; 64: 9-14/ Critical Care; 2012. Slessor et al. To Be Blunt: are we wasting our time? Emergency Deaprtment Thoracotomy following blunt trauma: a systematic review & meta-analysis. Leis CC et sl. TCA: should advanced life support be initiated? 2013; 74: 634-8. Jacobs et al. 2015; 108: 11-16.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

Dr. Smith's ECG Blog

MAY 2, 2019

Written by Pendell Meyers I received this prehospital ECG (we receive prehospital ECGs by telemetry from EMS in a large area around our hospital) and was told that there was a patient in her 50s with chest pain who was headed to an outside hospital (which happens to be a catheterization center).

Hospitals 52

Hospitals EKG/ECG Wellness EMS 52

ACEP Now

DECEMBER 11, 2023

EMS arrivals increased; many of those patients (35 percent) were admitted. A lower volume of walk-in patients resulted in a relative increase in patients arriving by EMS. Long term trends remain intact, as these intake processing times decreased in most years since 2008, when the intake time was about 41 minutes.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

ACEP Now

MAY 3, 2023

When she took the role in 2008, it was a newly created job tasked with expanding AARP’s approach to making health products and services available to its members from third party companies. Dr. Yeh believes emergency physicians have core skills that allow them to flex their EM muscles in careers outside the ED. “We

EMS 52

EMS Outcomes Emergency Department Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

Queen of Hearts now thinks that this one looks like posterior OMI, since the STD does appear worst in V3-4: None of this seems to have been understood by the EM doctor or the cardiologist who was consulted. He was diagnosed as NSTEMI. He had already been given aspirin and heparin.

EKG/ECG 83

EKG/ECG Shock Documentation/Coding Academics 83

ACEP Now

SEPTEMBER 13, 2023

Years before, he’d started his EM career as medical director of the ER at Memphis’ public hospital and Memphis Fire EMS. 1 “I remarked that EM was not even a specialty then, and suggested it might be an opportune time for an updated IOM report that examined the achievements and challenges of emergency care in the U.S.,”

EMS 45

EMS Research Academics Military 45

The Skeptics' Guide to EM

MAY 6, 2023

Fast forward to 2008 when an ACEP resolution called for a group to study “excited delirium,” and to disseminate the paper to Emergency Medical Services (EMS) and law enforcement. ACEP has made the equitable treatment of patients a priority, including recognition of the role that implicit bias exerts in EM [6].

EMS 40

EMS Hospitals 40

EMDocs

APRIL 22, 2024

EMS verbalized concern to EPs that an “intracranial bleed” may have precipitated the event. Rockville (MD): Office of the Surgeon General (US); 2008. 2008 Mar;28(3):370-2. Paramedics reported that coworkers activated them after the patient was discovered unconscious with labored breathing. Am J Prev Med. doi: 10.1016/j.amepre.2009.12.017.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

EMDocs

JULY 9, 2024

[link] Dubowitz H, Feigelman S, Lane W, Kim J. Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) Model. Pediatrics. 2009 Mar;123(3):858-64. doi: 10.1542/peds.2008-1376. PMID: 19255014.

Pediatrics 75

Pediatrics Emergency Department Research Burns 75

The Skeptics' Guide to EM

FEBRUARY 24, 2018

He writes an excellent blog called EM Nerd , which he describes as nihilistic ramblings. The second, the larger CORTICUS study, published in the NEJM in 2008 found no benefit of the use of corticosteroids compared to placebo. There was also the HYPRESS trial that we reviewed on SGEM#168 with Salim Rezaie from REBEL EM.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

EMDocs

JANUARY 4, 2024

2008 Apr;51(4):412-5, 415.e1. Sirianni AJ, Osterhoudt KC, Calello DP, Muller AA, Waterhouse MR, Goodkin MB, Weinberg GL, Henretig FM. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Ann Emerg Med. doi: 10.1016/j.annemergmed.2007.06.004. 2007.06.004.

Seizures 94

Seizures EKG/ECG Poisoning Shock 94

The Skeptics' Guide to EM

JANUARY 27, 2018

Excluded: Triage category 1, PIVC insertion by EMS, or transfers from another hospital * Intervention: Ten-week educational training, change champions, advertising, surveillance and feedback * Comparison: Pre-intervention data was collected for 12 days before, and 12.5 days after, the intervention. .

Emergency Department 40

Emergency Department Academics Outcomes Research 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. Higginson, I.,

Mass Casualty Incidents 40

Mass Casualty Incidents Burns Urgent Care Pediatrics 40

Taming the SRU

MARCH 14, 2023

Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. 2008) Shprecher, Schwalb, Kurlan. The seizure abated with rectal diazepam given by the squad. The patient arrives hemodynamically stable and post-ictal, unable to answer any questions. Neuroradiology.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 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 55 (2008) 1343–1358 Garton HJ. Pediatr Clin N Am 55 (2008) 1299–1314 Munck A et al. Are you ready? Medicine is evolving. Home Parenteral and Enteral Nutrition.

Pediatrics 40

Pediatrics Fractures Resuscitation Burns 40