The Skeptics' Guide to EM

FEBRUARY 10, 2018

In 2009, a study by Panickar et al found no positive effect in giving steroids to pre-school children with wheeze (2). It is really common during the winter months and often due to a viral infection (1). There has always been some uncertainty about the benefit of prednisolone for viral wheeze in pre-school children.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

Dr. Smith's ECG Blog

JULY 18, 2014

the presence of such well developed, wide, anterior Q-wave suggests completed transmural STEMI. Case Continued 2 days later the patient became increasingly tachycardic, hypotensive, ashen, clammy (in cardiogenic shock) and had a new murmur. Apr 28, 2009. Raitt et al.), Armstrong et al.), The initial troponin I was 23.7

EKG/ECG 52

EKG/ECG Shock Ultrasounds Wellness 52

PHEM Cast

JULY 14, 2016

Crane T, Cooke MW, Wellings R, Wayte S, Higgins J. Journal of Emergencies, Trauma, and Shock. 2009 May;10(2):74–8. Elsevier Ltd; 2015 Apr 1;46(4):528–35. Smyth M, Cooke MW. Value of a rigid collar: in need of more research and better devices. Emergency Medicine Journal. 2013 May 13;30(6):516–6. The University of Warwick.

Hospitals 52

Hospitals Fractures Shock Research 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. Journal of Emergencies, Trauma and Shock, 3(1), 39. 2009) Trauma in the Obstetrical Patient. Not in the textbook, but it worked. Usually, in the ED, the simple and great goal is to get the parturient upstairs to OB-GYN, if you have one, as soon as possible. 2014) Emergency Care Institute, New South Wales.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

PHEM Cast

APRIL 18, 2016

All things Pre Hospital Ketamine – Minh Le Cong Key point: patients remember if you manage their pain well. Blackham & Benger, 2009. Many of the lectures were recorded today and will be available to view soon on the Trauma Care website. Muscle spasm is superior to any artificial method.

Fractures 40

Fractures Administration Operations Shock 40

Pediatric Emergency Playbook

JANUARY 1, 2017

Further, children participate in and absorb their family’s culture and specific personality from a very young age ( Finley 2009 ). Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. Knowing the context of the episode may help.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

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

PulmCCM

OCTOBER 9, 2023

Called NICE-SUGAR trial ( NEJM 2009 ), conducted at 42 hospitals in Australia and New Zealand, it found that intensive glucose control actually harmed people, by frequently inducing severe hypoglycemia. But it’s hard, very hard, to feel like one is “doing nothing” while a patient in cardiogenic shock deteriorates.

Shock 52

Shock Outcomes Hospitals Wellness 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. This patient’s severe aortic stenosis (AS) and associated severe cardiogenic shock likely created the ECG pattern, resulting in a very difficult challenge for our inpatient team. Fundamentally, cardiogenic shock is an issue of decreased cardiac output.

EKG/ECG 52

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 52

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. This has been studied in children as well, and an elevated lactate in children – typically above 4 – was a predictor of prolonged ICU course and mortality in septic patients.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

RebelEM

JANUARY 25, 2024

CHF, in particular, lends itself well to diagnosis and treatment with PoCUS, as it readily reveals the presence of B lines. 2009 Oct;114(7):1053-64. Epub 2009 Aug 20. POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. vs. 18.3%). vs. 74%), consolidation (37.3% Radiol Med.

Ultrasounds 122

Ultrasounds Outcomes COPD Hospitals 122

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 54

Fractures Resuscitation Operations EMS 54

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 Emergency Playbook

AUGUST 1, 2017

2009; 197:211-215. 2009 Jun;123(6):1548-55 Chinn WM, Zavala DC, Ambre J. Evid Based Rev Surg. 2013;216(3):501-505. Petroianu A. Diagnosis of acute appendicitis. Int J Surg. 2012; 10:115-119. Mazeh H et al. Tip appendicitis: clinical implications and management. Amer J Surg. Puig S et al. Semin Roentgenol. 2008; 22-28. Pediatrics.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Pediatric Emergency Playbook

MAY 1, 2017

Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

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. Crit Care Explor. 2022 Feb 8; PMID: 35156050 Higgins TL et al.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

EMDocs

JANUARY 20, 2024

Symptoms of heart failure and cardiogenic shock may develop in more severe cases. The most common findings on ECG are ST elevation , most often in the anterior precordial leads, as well as sinus tachycardia and QT interval prolongation.

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

EMDocs

DECEMBER 18, 2023

Septic shock is high on the differential diagnosis for this patient’s presentation. Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. What are the most up-to-date guidelines for managing this patient?

Sepsis 65

Sepsis Fluid Resuscitation Shock Resuscitation 65

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 96

Infectious Diseases Administration Sepsis Anaphylaxis 96

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. However, IgE-mediated or not, anaphylactic shock is possible in either case. 8 The data in Mayer et al.

Stroke 87

Stroke Radiology Radiology Emergency Department 87