Don't Forget the Bubbles

JUNE 17, 2024

Loss of psychological safety and mental well-being persist long after the episode and can impact future episodes of care. Exposure to incivility hinders clinical performance in a simulated operative crisis. 2011 Apr 1;78(2):202-9. The lasting effects of incivility cannot be understated. Journal of nursing care quality.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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

Greater Sydney Area HEMS

APRIL 26, 2023

Both the stuff of legend and go by multiple names including harness hang syndrome and orthostatic intolerance, as well as bigfoot and the abominable snowman, respectively. Although remember, as is observed intra-operatively from tourniquet application, muscle can tolerate hours of hypoxia. 2011, 22:77-86. That’s it? Merchant D.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

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 Academics Documentation/Coding 52

ALiEM

AUGUST 9, 2023

F Heart Rate 138 bpm Blood Pressure 102/61 Respiratory Rate 32 Oxygen Saturation (room air) 100% He is well appearing but has increased work of breathing. The lung POCUS is also operator-dependent, and it has a steep learning curve. 2011 Oct;140(4):859-866. On arrival, his vital signs are: Vital Sign Finding Temperature 99.7

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 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. Acad Emerg Med.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

PHEM Cast

SEPTEMBER 6, 2017

H Spontaneously breathing carbon dioxide waveforms where phase III is not well delineated. 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. I Dual capnogram in one lung transplantation patient.

CPR 52

CPR Resuscitation Operations Shock 52

Pediatric Emergency Playbook

MARCH 1, 2016

Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. Often children even with high-grade splenic and liver lacerations can be managed non-operatively. 2011 May;18(5):477-82. In children, this is simply not the case. Acad Emerg Med. Ann Emerg Med.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Northwestern EM Blog

DECEMBER 20, 2021

Typically well appearing with normal labs, however, this is a diagnosis of exclusion and a septic joint should be ruled out. Management is orthopedic consultation for operative stabilization [12]. doi:10.1136/archdischild-2011-301245. Affects ages 3-8, males to females 2:1 [3]. References Smith E, Anderson M, Foster H.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. 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. J Pediatr Surg.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

Advanced Emergency Nursing from AENJ

MAY 27, 2014

Henderson , it would seem, was an enthusiast, well-convinced of his opinions, with missionary zeal, who would firmly argue his positions and tirelessly campaign them. 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.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

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. Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. That’s a spine or neurosurgery operation. PMID: 22237112.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer. 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. Do not compromise your care.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Mind The Bleep

FEBRUARY 7, 2024

Your histogram allows you to visualise how well your patient is oxygenating over a longer time period rather just a snapshot, and this gives you the opportunity to optimise oxygenation by altering ventilator settings if required. One of the few exceptions would be if the patient is paralysed, e.g. for an operation.

Wellness 52

Wellness Seizures Documentation/Coding Operations 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

However, none of the formulas have proven to be definitively better than another and none are well correlated with outcomes or events! the QT-RR relationship exhibits substantial intersubject variability as well as a high intrasubject stability. How well did the nomogram work in this derivation study? short QT syndrome , SQTS).

EKG/ECG 52

EKG/ECG Outcomes Wellness Hospitals 52

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. All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Pediatric Emergency Playbook

APRIL 1, 2017

Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. Look for a small tip diameter (to fit in the ear canal as well as the nose) and a strong “hold” (at least a 3-lb hold). Thieme; 2011. 2013.12.028.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

EB Medicine

AUGUST 1, 2018

Jeff: Because the current DEA controlled substances schedule designations are based on original chemical names, synthetics have gained popularity as manufacturers are able to produce newer compounds and circumvent DEA designation as well as routine urine drug screening tests. Jeff: And the etiology of CHS is not well understood.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Don't Forget the Bubbles

MAY 24, 2023

Crouzon syndrome, Pierre-Robin sequence, Down syndrome, Beckwith-Wiedemann syndrome) I njuries to the face, mandible, pharynx, or neck S leeping issues such as snoring due to adenotonsillar hypertrophy It’s essential to have a well-planned approach to managing the difficult airway. 2011 May;106(5):617–31 Cook TM. Why is it important?

Airway Management 98

Airway Management Pediatrics Teamwork Emergency Department 98

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. They do not understand rational or logical thinking.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Advanced Emergency Nursing from AENJ

MAY 27, 2015

If mere criminality was the only matter, there’s some cash, personal electronics, appliances, and business machines; if not merely criminal, and well-studied beforehand, there are to be had radioactive materials, drugs, toxins, chemicals, and many who would pay a ransom for the loved ones within. 2011) Emergency Preparedness.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

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. It was extremely well-liked by field personnel, but virtually unknown in hospitals. Grainge, C. Weingart, S.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

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 95

Sepsis Fractures Documentation/Coding Administration 95

EB Medicine

JANUARY 2, 2019

Jeff: Perhaps most importantly, no history or physical alone can rule in or out an ectopic pregnancy, for that you’ll need testing and imaging or operative findings. Per a 2010 and 2011 Cochrane review, there is not evidence to recommend one antibiotic over another, so let your local antibiograms guide your treatment.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

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 104

EMS Fractures Soft Tissue Injuries Ultrasounds 104

PulmCCM

MARCH 7, 2025

Any self-respecting surgeon or anesthesiologist will tell you that patients undergoing surgery before the weekend receive just as high a quality of care as those operated on earlier in the week. between 2008 and 2011, patients in the U.K. overall—but they also found that patients with operations on Sundays had increased risk.

Outcomes 116

Outcomes Hospitals Operations Radiology 116

Taming the SRU

MARCH 3, 2025

In addition to smoke inhalation injury from fires, many chemical substances can cause inhalation injury as well including but not limited to nitrogen dioxide, ammonia, chlorine, hydrogen sulfide, ammonia, and by-products from rubber and plastic.

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

They also proved that only expired air resuscitation guaranteed sufficient inflation volumes; that exhaled air was a suitable resuscitating gas; and that the operator would have continuous feedback from each breath. Lubricate well. June 6, 2011. Gerkin] Priceless. Use a soft tube: latex, silicone, or PVC softened in warm water.

Airway Management 40

Airway Management Resuscitation EMS CPR 40

Mind The Bleep

SEPTEMBER 17, 2024

Management The management is guided by the examination findings which are covered in the respective chapter, this section will delve into the importance of a number of those steps, as well as further long-term care. Regular medications. Always consider management as per ATLS protocol and SEPSIS 6 if relevant. UK Health Security Agency.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52