RebelEM

MARCH 22, 2023

Valsalva maneuvers Have patient bear down as if they are having a bowel movement Have patient blow as hard as they can into a straw Syringe technique Postural Modification Success rate: 43% vs. 17% (standard Valsalva) (Appleboam 2015) Details of technique found at the St. An alternate administration approach can be found on ALiEM.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

PulmCCM

DECEMBER 11, 2024

This is “burying the lede” The fact that we can’t define sepsis (and never could) is critical because it injects uncertainty (you can debate how much) into every published clinical study (as compared to, say, trials on ischemic stroke, myocardial infarction, or cancer).

Sepsis 45

Sepsis Shock Research Wellness 45

EB Medicine

AUGUST 6, 2019

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Jeff: Rivaroxaban, trade name Xarelto, the second FDA approved DOAC, is used for stroke prevention in those with nonvalvular afib and VTE treatment.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

EB Medicine

AUGUST 1, 2018

Jeff: A systematic review and meta-analysis from 2015 found low-quality evidence to support cannabis therapy for appetite suppression in HIV and aids patients; moderate-quality evidence for treatment of chronic pain and spasticity; and also moderate quality evidence for some chronic debilitating diseases. times higher risk of stroke or TIA.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Taming the SRU

MAY 3, 2023

However, inhalational administration of epoprostenol requires certain equipment, namely a drug delivery device such as an Aerogen nebulizer (5). Furthermore, these rapid changes in pulmonary vascular resistance can lead to significant reduction in RV stroke volume and subsequent RV dilation & tricuspid regurgitation (16).

Wellness 52

Wellness Hospitals Shock Outcomes 52

EB Medicine

SEPTEMBER 1, 2018

As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. Unfortunately, this myokymia may not respond to antivenom administration and myokymia of the chest well and torso can necessitate intubation in extreme cases. Jeff: What a team! Jeff: What a team!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Pediatric Emergency Playbook

JANUARY 1, 2017

CRIES is a 10-point scale, using a physiologic basis similar to APGAR: Crying; Requires increased oxygen administration (distress and breath-holding); Increased vital signs; Expression; and Sleeplessness ( Krechel 1995 ). Once the pain is controlled, less frequent administration of medications, with frequent reassessments, are indicated.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Administrative data from an integrated health system of 11 Southern California EDs were used to identify cardiac outcomes after ED presentation for syncope from January 1, 2002, to December 31, 2005. to 1.45) for fatal or nonfatal stroke. Annals of Emergency Medicine March 2015 ; Volume 65, Issue 3, Pages 268–276.e6 to 3.80).

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EB Medicine

FEBRUARY 1, 2019

Nachi: And patients with neurologic deficits or severe sudden-onset headaches, should be transported immediately to the nearest available stroke center. Nachi: In addition to monitoring ABCs, early care involves the administration of analgesics and anti-emetics. For a visual reference, see Table 3 in the print issue.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. Stroke Authors’ Recommendation: CTA head/neck should be acquired in patients with stroke symptoms presenting within 24 hours of symptom onset.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% 2015) reported a sensitivity of 98.9% 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.,

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

ACEP Now

DECEMBER 11, 2023

Food and Drug Administration regarding the efficacy of oral phenylephrine as a nasal decongestant, caused a ruckus. The GRASE Pathway Phenylephrine has been available for oral administration within the FDA scope of non-prescription drugs under the designation Generally Recognized as Safe and Effective (GRASE).

Administration 64

Administration Outcomes Research Stroke 64

Don't Forget the Bubbles

JULY 5, 2023

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. What is the role of transcranial dopplers in primary prevention of strokes? What strategies are useful for secondary stroke prevention?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126