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Over the past few years, there has been an increase in emergencydepartment (ED) volumes and lengths of stay. The effect of emergencydepartment crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. J Crit Care. N Engl J Med. Crit Care Explor.
End-Tidal CO2 monitoring has a variety of uses in the EmergencyDepartment. Capnography in the emergencydepartment: a review of uses, waveforms, and limitations." The Journal of emergency medicine 53.6 2011): 544-549. 2011): 189-196. Annals of emergency medicine 63.2 2017): 829-842.
pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197
HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergencydepartment via emergency medical services. She arrives in the emergencydepartment agitated and unable to answer questions appropriately. This does not deviate from general resuscitation principles for acute hemorrhage. N Engl J Med.
Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. Overall all-cause adult survival was 6.1%.
Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. first appeared on The Skeptics Guide to Emergency Medicine. Case: During a busy emergencydepartment (ED) shift the paramedic phone rings.
The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. Evaluating the Pediatric Early Warning Score (PEWS) System for Admitted Patients in the Pediatric EmergencyDepartment. Acad Emerg Med. Emerg Med J. What is the problem?
As a member of the Air Force, deployed to Afghanistan in 2011, I have seen war where I should have seen it—in a designated war zone. As an emergency medicine resident, I have seen the toll that workplace violence is taking on our specialty, our patients, and our entire medical community.
It is worth noting, that with “Sepsis 3” many of these terms will become out-of-date – but validation work is required… The Rivers’ paper can be accessed here: [link] It was a single centre study which compared standard care with protocolised resuscitation packaged together as early goal-directed therapy (EGDT).
Joseph is a Consultant Emergency Physician with the inpatient Trauma Service and EmergencyDepartment at the Alfred in Melbourne, and is also head of International Programs (South Asia) with the National Trauma Research Institute. Injury 2011 Sep;42(9):913-6 The diagnosis of acute urethral trauma.
Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline. Tintinallis Emergency Medicine: A Comprehensive Study Guide, 8e. Pediatric Emergency Care, 27 (10), 978-985. Antiemetics as needed.
Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in EmergencyDepartments: An Analysis of a Multicenter Prospective Observational Study. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2
For a deep dive into intubation, see Intubation of the critically unwell Child in the emergencydepartment – Don’t Forget the Bubbles (dontforgetthebubbles.com) For all things neonatal (lines and tubes), see Neonatal lines and tubes – Don’t Forget the Bubbles (dontforgetthebubbles.com) Why does it matter?
Western Journal of Emergency Medicine, 12(4), 571. Western Journal of Emergency Medicine , Vol 15 Issue 6 has five articles related to pregnancy. Critical care medicine, 33(10), S259-S268. Preeclampsia/ Eclampsia - EmergencyDepartment Resources. {3 abstracts} Luckett-Gatopoulos, S. Postpartum Emergencies.
Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. A 45-year-old outdoor enthusiast presents to the emergencydepartment with fever, headache, myalgias, and malaise. 2011 Feb 15;52(4):e56-93. Clin Infect Dis. doi: 10.1093/cid/cir073.
In the emergencydepartment (ED), physicians face the challenge of making rapid decisions that can significantly impact patient outcomes. However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation.
Am J Emerg Med. In this study, the Broselow tape had the best overall accuracy, with 50.7% (vs 30.88% for APLS 2011) of estimates occurring within 10% of measured weight and 80.0% (vs 55% for APLS 2011) estimates within 20% of measured weight. 2024 Aug;82:26-32. doi: 10.1016/j.ajem.2024.04.053. 2024.04.053. Epub 2024 May 3.
James Broselow, a family medicine-turned-emergency medicine physician from Hickory, North Carolina , recognized that his team spent a lot of time trying to calculate doses of medications rather than spending their mental energy on the actual medical decisions for the resuscitation. Academic Emergency Medicine, 14: 500-501.
Pulmonary embolism in the pediatric emergencydepartment. for the American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; American Heart Association Council on Peripheral Vascular Disease; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology.
PECARN prediction rule for cervical spine imaging of children presenting to the emergencydepartment with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergencydepartment with blunt trauma: a multicentre prospective observational study.
It is not possible during acute resuscitation or at any time before a complete investigation, or even trial, to know who is innocent, guilty, or what occurred during the altercation. Ballistic injuries in the emergencydepartment. Emergency medicine practice, 13(12), 1-30. Gustafson, C. G., & Visintainer, C.
This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form. Pulmotor is 1907. Beecher, M.
The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.
haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1
Resuscitation 2020. Mil Med 2011. Evidence-Based Heatstroke Management in the EmergencyDepartment. West J Emerg Med 2021. April 26, 2023) Acute Hyperthermia in the EmergencyDepartment. First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis.
One of our largest responsibilities in the EmergencyDepartment is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. 2011; 364(3):255-264.
Introduction: Neurologic emergencies are common in the EmergencyDepartment (ED), and blood pressure management is critical to immediate management. 2011 Sep;15(2):211-40. A non-contrast head computed tomography (CT) demonstrates a diffuse hyperdensity consistent with subarachnoid hemorrhage (SAH). N Engl J Med.
It is currently the subject of future research and publication in the emergencydepartment setting. 2011; 106 : 732–737. [iv] Right Brachiocephalic Vein Origin Access for the Resuscitation of Shocked Adult Trauma Patients. i] Leibowitz A, Oren-Grinberg A, Matyal R. iv] Breschan C, Graf G, Jost R et al. Green et al.
Case Follow-up: The patient required a dose of lorazepam in the emergencydepartment. 2011; 109: 418-422. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. She was admitted on a cardiac monitor with serial EKGs every four hours.
4 In an emergencydepartment (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2011 Mar;123(16):1788-1830.
neutropenia) ( Babl 2011 , Dokko 2014 ). You do not want to be caught in the position of potentially precipitously providing cardiopulmonary resuscitation in a child undergoing palliative care, because of a lack of understanding of how increasingly large doses of pain medications can affect breathing and circulation ( AAP 2000 ).
A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergencydepartment with fever, chills, and dysuria. Management 9-12 Patients such receive standard resuscitation care including: Antipyretics such as Tylenol (650-1000 mg PO), Ibuprofen (600 mg PO), or Toradol (15mg IV).
Trauma surgeons have traditionally relied on ABGs to assess acid-base status for overall prognostication of trauma injury severity and to screen for occult injury or malperfusion, as this might alter management and aggressive resuscitation. Int J Emerg Med. Eur J Emerg Med. 2023 Mar 10;16(1):18. doi: 10.1186/s12245-023-00486-0.
Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community EmergencyDepartment With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergencydepartment: a non-inferiority multicentre randomised controlled trial. Emerg Med J. 2011 Dec 15;343:d7506. N Engl J Med.
34 “The mother, or other trusted adult, places her mouth over the child’s open mouth, forming a firm seal as if about to perform mouth-to-mouth resuscitation. Am J Emerg Med. Emergencydepartment management of foreign bodies of the external ear canal in children. Thieme; 2011. 2004;22(4):310-314. Am Fam Physician.
Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergencydepartments of cancer centers in three continents. 2011 Jun;153(6):773-9. Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Ann Emerg Med.
An 18-month-old boy presents to the emergencydepartment with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergencydepartment , as it can be performed with ongoing resuscitation efforts. Resuscitation. , 148 , 173–190. Epstein, J.,
Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. In lower-resource settings, the evidence is stronger against a liberal approach to volume resuscitation. Andrews et al.
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