Don't Forget the Bubbles

JULY 26, 2023

For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. Typical features include: HR >220bpm Narrow complex regular tachycardia P waves difficult to identify In this case there is no shock present so we can proceed to the right branch of the ALSG guideline.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. This should be suspected in patients with intraoperative cardiac arrest or shock.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Taming the SRU

FEBRUARY 19, 2024

A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock. In general, radial artery readings in patients with shock likely underestimate central pressure which can lead to increasing vasopressor dosing. PMID: 35338337. Keville, M.

Shock 59

Shock Resuscitation Ultrasounds Research 59

RebelEM

JANUARY 25, 2024

A 2018 systematic review and meta-analysis of 25 studies focusing on the accuracy of emergency lung ultrasound showed sensitivity of 85-95% and specificity of 75-90% for pneumonia, sensitivity of 78% and specificity of 94% for COPD/asthma, and sensitivity of 75-90% and specificity of 80-90% for acute heart failure [4]. Lancet Respir Med.

Ultrasounds 125

Ultrasounds Outcomes COPD Hospitals 125

ACEP Now

MARCH 14, 2024

Electrical injuries—excluding lightning injuries—account for roughly 10,000 nonfatal shock incidents a year and 500 deaths a year. In the operating room, there was minimal urinary output and the bladder pressures were 35 mmHg under sedation and analgesia. 2018 Nov;20(11):1-20. Click to enlarge.) His ECG was unremarkable.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Taming the SRU

AUGUST 30, 2023

This finding was not significantly different among operators with different levels of experience, or between adults and children. A 2018 USA multi-center prospective RCT involving 1,656 adult patients published in NEJM used varying PCT cut-offs to guide antibiotic initiation in the emergency department. 2018 Aug 1;10(8):a028456.

Infectious Diseases 89

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

PEMBlog

JUNE 5, 2024

You should also consider the possibility of quote unquote spinal shock. than it is spinal shock. And hypotension, bradycardia, or temperature instability can result from hemorrhagic and or spinal shock. That’s a spine or neurosurgery operation. Cervical Spine Injury Risk Factors in Children With Blunt Trauma.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EB Medicine

JUNE 6, 2019

Nachi: Moving on to blood pressure: frank hypotension should make you immediately think of a ruptured AAA or septic shock 2/2 an intra abd infection. You can also use the shock index, which as a reminder is simply the HR/SBP. The greatest value of a lactate level is to detect occult shock and sepsis. In one study, a SI > 0.7

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. Published 2018 Aug 13.

Operations 95

Operations EMS Fluid Resuscitation Resuscitation 95

RebelEM

DECEMBER 19, 2022

This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. While many healthcare systems across the world operate in a similar fashion, the United States does not.

EMS 52

EMS CPR Shock Resuscitation 52

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. 12 Patients with pelvic fractures and concerning straddle mechanisms should be thoroughly evaluated for genitourinary injuries.

Fractures 60

Fractures Resuscitation Operations EMS 60

EB Medicine

AUGUST 1, 2018

I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the August 2018 issue of Emergency Medicine Practice. Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Jeff: So that wraps up the August 2018 episode of Emplify.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

NOVEMBER 13, 2023

26 With regards to penetrating neck injuries, particularly those in which the platysma is violated, CTA of the neck has allowed a shift away from mandatory operative exploration of Zone 2 neck wounds (those in the mid-neck). However, IgE-mediated or not, anaphylactic shock is possible in either case. Stroke 2018, 49 (10), 2323-2329.

Stroke 103

Stroke Radiology Radiology Emergency Department 103

Don't Forget the Bubbles

JULY 5, 2023

Afro-Caribbean patients should be screened for sickle cell before anaesthesia for possible pre-operative transfusion. Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. J Hematol 2018; 93: 363-370 Rubin LG, Schaffner W. Macharia AW et al.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126