EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 75

EMS Fluid Resuscitation Resuscitation Radiology 75

EMDocs

DECEMBER 2, 2023

BMC Neurol 11 , 8 (2011). He has no known medical history and has never been to the doctor. Kelliny, M., Binaghi, S. Cerebral aneurysm exclusion by CT angiography based on subarachnoid hemorrhage pattern: a retrospective study. link] Fang C, Leavitt JA, Hodge DO, Holmes JM, Mohney BG, Chen JJ. JAMA Ophthalmol. 2017 Jan 1;135(1):23-28.

EMS 67

EMS Operations Pediatrics Emergency Department 67

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Emergency Medicine News 33(12):p 8,9, December 2011. | Inoculation usually occurs by penetrating injury , which seeds the tendon sheath. Unrecognized or persistent infection can lead to necrosis of the tendon.

EMS 70

EMS Fractures Operations Ultrasounds 70

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 94

Sepsis Administration Documentation/Coding Fractures 94

PHEM Cast

DECEMBER 1, 2017

Journal of Special Operations Medicine : a Peer Reviewed Journal for SOF Medical Professionals , 13 (4), 53–58. Prehospital needle aspiration and tube thoracostomy in trauma victims: a six-year experience with aeromedical crews. The Journal of Emergency Medicine , 13 (2), 155–163. Beckett, A., Pannell, D., Acharya, S., Branco, B.

Academics 52

Academics Radiology Radiology Resuscitation 52

PHEM Cast

DECEMBER 12, 2016

Resuscitation; 2011: 1194-1197 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. Guidelines for withholding or termination of resuscitation in prehospital cardiopulmonary arrest.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. It can also able to be applied in multiple scenarios, not just the operating theatre, and it more accurately depicts real-world practice. 2011 May;106(5):617–31 Cook TM. Why is it important? Part 1: Anaesthesia.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98

EMDocs

SEPTEMBER 9, 2023

Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. New York, NY: McGraw-Hill Medical; 2011:207-211. Emergency Medicine News 33(12):p 8,9, December 2011. | Arch Orthop Trauma Surg. 2007;127:115-119. Chapter 11: Hand. In: Simon RR, Sherman SC, eds. Closing the Gap.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

Mind The Bleep

SEPTEMBER 17, 2024

Regular medications. Retrieved from [link] ] Rabies Post-Exposure Prophylaxis Management. UK Health Security Agency. Retrieved from [link] ] Nygaard, M., & Dahlin, L. Dog bite injuries to the hand. Journal of plastic surgery and hand surgery, 45(2), 96–101. link] Chu, D. Eftekari, S. Nicksic, P. J., & Poore, S.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Greater Sydney Area HEMS

APRIL 26, 2023

Although remember, as is observed intra-operatively from tourniquet application, muscle can tolerate hours of hypoxia. 2011, 22:77-86. This occurs via inadequate muscle perfusion. Thus, ST-induced rhabdo is secondary to stasis rather than direct physical trauma (as seen in crush injury). ST mechanisms can occur before then. Merchant D.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

PHEM Cast

JULY 6, 2017

Cricothyrotomy performed with the Melker set or the QuickTrach kit: procedure times, learning curves and operators’ preference. British Journal of Anaesthesia (2011) 106 (5): 617-631. Il Giornale Di Chirurgia , 35 (7-8), 165–170. Woodall, N., & Frerk, C. link] Dover, K., Howdieshell, T.

Airway Management 52

Airway Management Academics Operations Resuscitation 52

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. They passed away a few days after a second operation. Children will swallow almost anything. Why should Orbeez be an exception? Unfortunately, the anastomosis broke down. It’s beads, too!

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Taming the SRU

JANUARY 29, 2024

Variations in sensitivity are thought to be related to operator technique, patient habitus, and difficulty evaluating the subclavian vein beneath the clavicle. [12] 2011 Dec;77(12):1606-12. 13] Ultimately, catheter-based venography is the gold-standard for diagnosis of thrombosis of the upper extremity deep veins.

Emergency Department 92

Emergency Department Fractures Hospitals Operations 92

ALiEM

AUGUST 9, 2023

The lung POCUS is also operator-dependent, and it has a steep learning curve. 2011 Oct;140(4):859-866. Limitations Lung pathology may be missed without a complete lung POCUS scanning protocol, as you will only see pathology located directly under the probe. J Ultrasound Med. 2017 Nov;36(11):2325-2328. West J Emerg Med.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Northwestern EM Blog

DECEMBER 20, 2021

Management is orthopedic consultation for operative stabilization [12]. doi:10.1136/archdischild-2011-301245. Physical exam classically shows external rotation and abduction of the hip during hip flexion. References Smith E, Anderson M, Foster H. The child with a limp: a symptom and not a diagnosis. 2012;97(5):185-193.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Pediatric Emergency Playbook

MARCH 1, 2016

Often children even with high-grade splenic and liver lacerations can be managed non-operatively. Unfortunately, a negative FAST cannot help with detecting or grading the laceration for non-operative management. CT Abdomen and Pelvis, IV contrast: helpful in grading splenic and liver lacerations with goal to manage non-operatively.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

PHEM Cast

SEPTEMBER 6, 2017

2013;118(1):192-201. doi:10.1097/ALN.0b013e318278c8b6 0b013e318278c8b6 A Prolonged phase II, increased α angle, and steeper phase III suggest bronchospasm or airway obstruction.

CPR 52

CPR Resuscitation Operations Wellness 52

Ken Grauer, MD

SEPTEMBER 6, 2024

Depending on which of above considerations is operative — the differential diagnosis of the rhythm in ECG #1 will be between: i ) A reentry SVT rhythm with retrograde atrial conduction; ii ) ATach ( A trial T achycardia ) ; — or — iii ) Junctional Tachycardia. ECG Blog #40 — Another regular SVT that turned out to be AFlutter.

EKG/ECG 248

EKG/ECG Administration Wellness Operations 248

Pediatric Emergency Playbook

FEBRUARY 1, 2016

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. 2011 Dec;71(6):1869-72. J Pediatr Surg. 2013 Jun;48(6):1377-83. Stannard A, Eliason JL, Rasmussen TE.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

Pediatric Emergency Playbook

JANUARY 1, 2017

Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. CRIES ( Table 1 ) was validated for post-operative patients; to adapt its use for the ED, the most conservative approach is to substitute “preoperative baseline” with normal range for age.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Greater Sydney Area HEMS

FEBRUARY 20, 2024

This would therefore remove some of the limitations (perceived or real) around time delays associated with using ultrasound for central access as there would be no need for probe covers and positioning of the portable ultrasound (which often needs the help of a second operator, a significant limitation in a small prehospital medical team).

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

" [Coroners Society] King Richard I (the Lionheart) needed vast sums of money for the Third Crusade, operation of the kingdom, and for his ransom fro m Duke Leopold of Austria. Accessed 07/30/2016. Frontline® Post Mortem: Death Investigation in America. Accessed 07/30/2016.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Mind The Bleep

FEBRUARY 7, 2024

One of the few exceptions would be if the patient is paralysed, e.g. for an operation. 52-60, 2011. Initiation of breathing: Non synchronised, e.g. not physiological. this is very rarely used anymore as it is more likely to cause more barotrauma and result in asynchrony between the baby and the ventilator. 5-11, 2022.

Wellness 52

Wellness Seizures Documentation/Coding Operations 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

ET Hostile Fire Environments Murphy’s Law of Combat Operations [includes coarse military humor] Firearms in the Entertainment Industry International Movie Firearms Database Horman, GS. PMID: 24350154 [PubMed] PMCID: PMC3860682 Tactical Combat Casualty Care (ppt) Dan S. Mosely, Maj USA MC FS 20 Jun 05 Treatment Reviews Bruner, D.,

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Don't Forget the Bubbles

JUNE 17, 2024

Exposure to incivility hinders clinical performance in a simulated operative crisis. 2011 Apr 1;78(2):202-9. Journal of nursing care quality. 2020 Jan 1;35(1):70-6. Katz D, Blasius K, Isaak R, Lipps J, Kushelev M, Goldberg A, Fastman J, Marsh B, DeMaria S. BMJ Quality & Safety. 2019 May 31:bmjqs-2019. Keller R, Allie T, Levine R.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. 2011 Jan;3(1):118-27. 2011 Aug;18(8):781-96. 2011 Sep;18(9):1011. In: StatPearls [Internet].

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

Taming the SRU

MAY 27, 2024

This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak. If the volume of fluid is anticipated to re-accumulate quickly, a drain should be placed. a) left image: normal pleural cavity, image accessed from 2313 The Lung Pleurea - Pleural cavity - Wikipedia ; under CC 3.0

Emergency Department 85

Emergency Department Ultrasounds Radiology Radiology 85

EMDocs

JUNE 21, 2023

Common operator errors Failing to enter joint capsule before injecting STS. 2011 Nov;71(5):E110-3. When in the joint, you’ll obtain synovial fluid. Inject lidocaine first, then slowly start injecting STS looking at the wound for saline coming out. You can range the joint which may help you see fluid extruding. Clin Orthop Relat Res.

Soft Tissue Injuries 69

Soft Tissue Injuries Fractures Dislocations Radiology 69

RebelEM

MARCH 27, 2023

First ED-based study to evaluate how operational effects such as crowding can affect patient care in the form of LPV Included ARDS criteria relating to the usage of LPV in the ED allowing evaluation as to whether patients with ARDS were more likely to receive LPV settings. 2011 Feb 15; Epub 2010 Aug 27. PMID: 19325480 Gajic O, et al.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

EB Medicine

AUGUST 1, 2018

From 2010 to 2011, the number of ED visits by children aged 12 to 17 years old due to synthetic cannabinoid use also has doubled. Make sure that the patient knows not to operate vehicles or heavy machinery under the influence of drugs. Discharge home should be in the care of a sober family member or friend.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

RebelEM

SEPTEMBER 11, 2023

Similarly, surgeons might hesitate to operate on older patients with multiple comorbidities due to higher associated risks. 2011 Mar;18(3):227-35. For instance, patients showing signs of jaundice and elevated bilirubin, indicative of choledocholithiasis, would more likely undergo MRCP and ERCP. Acad Emerg Med. PMID: 21401784.

Ultrasounds 65

Ultrasounds Radiology Radiology Emergency Department 65

PEMBlog

JUNE 5, 2024

Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. 2011 Aug;58(2):145-55. That’s a spine or neurosurgery operation. MMWR Recomm Rep. 2012 Jan 13;61(RR-1):1-20. PMID: 22237112. Factors associated with cervical spine injury in children after blunt trauma.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

JUNE 1, 2017

Fontan Operation and the Single Ventricle. 2011; 2(1):70-72. 2011 Jan-Jun; 4(1): 81–83. 2011; 32:492-497. 2011; 552-555. 2011; 128(6):1-6 Munk K et al. References Congenital AboulHosn JA et al. Congenit Heart Dis. 2007; 2:2-11. Aliku TO et al. Acute Myocardial Infarction related to Blunt Thoracic Trauma.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

RebelEM

NOVEMBER 3, 2022

Albert 2011, Jabre 2009) However, the existing literature comparing etomidate and ketamine is conflicting. The environment, operator-related factors, and equipment are different in a pre-hospital vs. ED setting. Background: Rapid sequence intubation (RSI) induction agent selection remains a heavily debated matter.

Outcomes 52

Outcomes Emergency Department Sepsis Hospitals 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

It wrongly frightened some medical personnel as it was operated by a 50 psi wall source or from a step-down regulator from a tank (some thought the patient received wall 50 psi or 1500 psig from the tank directly to the lung. The Demand Valve was the answer to this, appearing in 1964.Upon Grainge, C. Weingart, S. Excellent article.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 40

Advanced Emergency Nursing from AENJ

MAY 27, 2014

St John History Volume 10 (2010-2011) **Australian review of Sparklet Resuscitators and CO2 therapy. The Therapeutic Use of Carbon Dioxid After Anesthesia and Operation. Select Bibliography: Fahey, D OStJ. The use of carbon dioxide in resuscitation. Link to photograph of Yandell Henderson, Ph. Biographical Memoirs, V. Haggard, H.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Don't Forget the Bubbles

AUGUST 10, 2023

Non-operative approaches There is ongoing controversy regarding the best treatment of fingertip amputations, More extensive wounds are treated surgically. Operative approaches (from orthoinfo & the plasticsfella) More extensive wounds (often zone 2 & 3) are treated surgically. They do not improve outcomes.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52