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Our patients have varied past medical histories that require us to be well-versed in even the most uncommon disorders (or know where to look things up in a pinch)! 2017 Jun 27;10:197-207. You may not make the diagnosis, but detecting the clues is important for the family! Michelet M, Schluckebier D, Petit LM, Caubet JC.
Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Prehosp Emerg Care.
The patient was ultimately discharged from the EmergencyDepartment with primary care and neurology referrals along with seizure precautions and advised to abstain from Kratom use. Treating Kratom toxicity varies based upon the clinical presentation as well as severity of symptoms. 2017 Jul 1;176:63-70. Epub 2017 May 10.
You’re in the paediatric emergencydepartment, typing some notes for the child you’ve just discharged. Promoting hot debriefing in an emergencydepartment. 2017; 55(5); 449-453. Scand J Trauma Resusc Emerg Med. Emergency Medicine Residents Experience Acute Stress While Working in the EmergencyDepartment.
The most recent and well-known trial is the PROCAMIO trial (1). It was published in European Heart Journal in 2017. Well, the trial was a multicenter prospective open label trial. Well, lets look at some other trials. 2017 May 1;38(17):1329-1335. Great question. Ok, so what did the PROCAMIO trial find? Eur Heart J.
Well keep it short, while you keep that EM brain sharp. A 45-year-old outdoor enthusiast presents to the emergencydepartment with fever, headache, myalgias, and malaise. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e. Most common causes of leukopenia Infections: 36.4% Medications: 25.6%
Physicians, nurses, and staff in emergencydepartments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. J Emerg Nurs. J Am Coll Emerg Physicians Open. Accessed October 10, 2023.
In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.
Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the EmergencyDepartment with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergencydepartments. 2022;251:127-133.
Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergencydepartment (ED) with fever, cough, myalgias, headache and congestion. Wallach et al JAMA Intern Med 2017 , previously reported that subgroup claims are often not corroborated by subsequent studies and rarely confirmed.
The Wounds Common among patients who use xylazine, the necrotic and exudative wounds are still not fully understood [5-8], but are likely due in part to direct cytotoxic effects of the drug and its impurities, as well as possible nutritional deficiencies common in those with dependence. 2017 Jun;32:660-6. JAMA Network Open.
2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergencydepartment visits annually relative to alcohol use. He returned to the emergencydepartment, and you had the great privilege of saving his life.
The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. emDOCs.net – Emergency Medicine Education. The adhesive cover itself serves as a sterile barrier and a slick surface to improve probe maneuverability.
Interrater reliability of Glasgow Coma Scale scores in the emergencydepartment. Ann Emerg Med. J Surg Res. 2019 Sep;241:112-118. doi: 10.1016/j.jss.2019.03.038. 2019.03.038. Epub 2019 Apr 22. PMID: 31022676. Gill MR, Reiley DG, Green SM. 2004;43:215-223. Rowley G, Fielding K. 1991;337:535-538.
12 How do we address these disparities in the emergencydepartment? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.
1,2] Patients at risk for suicide often interact with emergency medical care. Suicide-related behavior (SRB) accounts for 1% of all EmergencyDepartment (ED) visits; additionally, greater than 8% of patients visiting emergencydepartments are likely experiencing suicidal ideation at the time of the encounter.[3-5]
A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergencydepartment after being found unresponsive at home. Vital signs were within normal limits on arrival to the EmergencyDepartment. 2017 Sep-Oct;50(5):561-569. Epub 2017 Apr 19. Blood glucose was not low at 162 mg/dL.
You should always follow your local practice guidelines and recommendations as well as adhere to approved medications in your facility. Document what you gave and why, as well as the impact. If a patient has a PRN on their med list do that! Route of administration If the patient is cooperative, offer oral medications first.
Patients often seek care in the emergencydepartment (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. We prefer an in-plane, superior to inferior approach, but an out-of-plane technique can be performed, as well. 2017 Dec 22;31:277-284. J Emerg Med.
7-year-old Tilly is brought to your emergencydepartment at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergencydepartments [1]. Tilly is normally fit and well, with no significant past medical history. by her father. She is obviously uncomfortable.
[display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. EmergeNcyDepartment use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. Reference: Caputo et al.
If you were working in a busy emergencydepartment, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Acad Emerg Med. 2017 ; 24 ( 1 ): 120 - 124 2. Am J Emerg Med. Am J Emerg Med. Am J Emerg Med.
[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Fever in the EmergencyDepartment Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Critical Care Medicine 2017. display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al.
These clinically challenging intubations prompted emergency clinicians to turn to a KOBI technique and forgoing the use of an NMBA, which are not without risk. Additionally, many if not most emergency physicians do not receive adequate training on topical awake intubations (TAI) (11). Int J Emerg Med. 2017 Dec;10(1):1.
Study included children, as well as adults. population at large Enrollment was terminated at an interim analysis due to predefined futility criteria that suggested that there was a 1% chance that carrying the trial to completion would demonstrate a most effect or least effective treatment. This increases applicability or ED care.
emergencydepartments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergencydepartment – A Swedish cohort study. Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Circulation. 2018;137(12).
DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. “Fomepizole” in Goldfrank’s Toxicologic Emergencies , 11e Eds. JAMA , vol. 15, 15 Apr.
[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. Pediatrics 2017 Guest Skeptic: Dr. Anthony Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. Anthony is also the creator of SketchyEBM.
Critical care nursing clinics of North America 29 2 (2017): 251-258. Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. As emergency physicians, we need to be familiar with the nuances of these devices so we can safely manage the airway just as we would any sick patient.
BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. In the US, adults accounted for 6.6
Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergencydepartment and specifically the use of ketamine. His twitter handle is @PainFreeED.
[display_podcast] Date: September 12th, 2017 Reference: Sinert et al. J Allergy Clin Immunol Pract 2017. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine. J Allergy Clin Immunol Pract 2017.
The Case: A 56-year-old male with no significant past medical history presents to the emergencydepartment with worsening swelling, pain, and erythema of the right elbow. Patient Course: In the emergencydepartment, the patient received lab work that was remarkable for WBC 11.8, J Emerg Med. and ESR 26. emDocs.net.
Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - EmergencyDepartment Management of North American Snake envenomations.
Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergencydepartment looked at the usefulness of blood tests in 101 children. You receive a referral for a 7-year-old Josh, who presented to the emergencydepartment (ED) with a 5-day history of fever, cough, and borderline oxygen saturation.
This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on EmergencyDepartment Management of Patients With Complications of Bariatric Surgery. Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.
[display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. Case: You are working the afternoon shift in the paediatric emergencydepartment. Your shift is almost over and the department finally seems to be under control.
A 19-year-old female with a past medical history of epilepsy presented to the emergencydepartment for evaluation of rash and fever. 2017 Jun 9;18(6):1243. Two days prior to presentation she began to experience fevers with a Tmax of 103°F. The patient endorsed associated pruritus and cervical lymphadenopathy with the rash.
Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The EmergencyDepartment is a challenging work environment for a variety of reasons.
A 77-year-old man presented to the emergencydepartment (ED) with hip pain following a fall. See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. Opioid-Prescribing Patterns of Emergency Physicians and Risk of Long-Term Use.
[display_podcast] Date: November 24th, 2017 Reference: Roldan et al. AEM November 2017 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. display_podcast] Date: November 24th, 2017 Reference: Roldan et al. AEM November 2017.
This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergencydepartment. The PSS-3 assesses for depression/hopelessness and suicidal ideations in the past 2 weeks as well as lifetime history of suicide attempt.
Hosts Jeff Nusbaum, MD, and Nachi Gupta, MD, cover all aspects of the acute management of this condition, from initial diagnosis and treatment in the emergencydepartment to novel biomarkers and new and controversial therapies.
Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergencydepartment complaining of cough for 3 days and fever for the last day. 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.
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