EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Resuscitation. The management of accidental hypothermia.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

ALiEM

APRIL 12, 2023

Ever finally step away from a busy resuscitation and someone stops you for peripheral IV access? Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. emDOCs.net – Emergency Medicine Education. No problem. Trick of the Trade 1. Hemmings, Talmage D.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

The Skeptics' Guide to EM

MAY 25, 2019

Date: May 23rd, 2019 Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surgery March 2019. Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. Date: May 23rd, 2019 Reference: Joseph et al.

Military 52

Military Resuscitation PPE Emergency Department 52

ACEP Now

JANUARY 13, 2024

1 The questions raised by this tragedy are many: How did a gun make its way into the emergency department in the first place? Data from the National Institutes of Health suggests that up to three percent of ED visits result in a weapon being confiscated, and there has been an increase of 20 percent of firearm deaths since 2019.

Emergency Department 52

Emergency Department Resuscitation Patient Safety Hospitals 52

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. 2019, Bauer, Gerlach et al. 2019, Evans, Rhodes et al. N Engl J Med. 2023;388(6):499-510. 2021, Jarczak, Kluge et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Date: November 21st, 2019 Reference: Daley et al. Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Daley et al.

Ultrasounds 52

Ultrasounds Emergency Department Academics Outcomes 52

Northwestern EM Blog

APRIL 15, 2024

Tracheostomy emergencies." Emergency Medicine Clinics 37.1 2019): 109-119. While most of the immediate complications of tracheostomy will occur in the ICU, these patients still frequent our emergency department with and without tracheostomy related emergencies. Am J Emerg Med. References 1.Bontempo,

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

The Skeptics' Guide to EM

JUNE 6, 2020

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Respir Crit Care Med 2019. Guest Skeptic: Dr. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Respir Crit Care Med 2019.

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). Therefore, fluid resuscitation and maintenance are important. Goldfrank's Toxicologic Emergencies, 11e. McGraw Hill; 2019. Juurlink JN. Antipsychotics.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 52

EMDocs

SEPTEMBER 7, 2023

2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department. 2,10 Initial stabilization of DEG toxicity includes correcting acid-base abnormalities, electrolyte abnormalities, and volume resuscitation. McGraw Hill, 2019.

Poisoning 66

Poisoning CDC Administration Emergency Department 66

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. This does not deviate from general resuscitation principles for acute hemorrhage. Thromb Res.

Administration 78

Administration Fractures Anaphylaxis Head Injuries 78

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. a Sengstaken-Blakemore tube) may be used as a temporizing measure for unstable UGIB but should not delay emergent esophagogastroduodenoscopy (EGD). Stable Patients For both stable and resuscitated patients, high-dose IV proton pump inhibitor therapy (i.e., 2019:94(4):697-703.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

EMDocs

JANUARY 17, 2024

When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). 5) From 2012 to 2019, pediatric benzonatate prescribing soared by 62%. (9)

Poisoning 67

Poisoning Seizures Pediatrics EMS 67

EB Medicine

JULY 8, 2019

I’m Jeff Nusbaum and I’m back with Nachi Gupta for the 30 th episode of EMplify and the first Post-Ponte Vedra Episode of 2019. This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA?

Airway Management 52

Airway Management CPR Outcomes Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

JANUARY 25, 2020

NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults.

EMS 40

EMS Airway Management Administration Resuscitation 40

ACEP Now

OCTOBER 30, 2023

A notable achievement was ESEM’s co-organization of the International Federation of Emergency Medicine Trauma Update Symposium in 2015. These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. Stroke 2019; 50:e344. 2019 Aug;50(8):2023-2029. Epub 2019 Jun 20. appeared first on emDOCs.net - Emergency Medicine Education. PMID: 35579034.

Stroke 73

Stroke Outcomes EMS Seizures 73

PHEM Cast

APRIL 21, 2021

Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2

Airway Management 52

Airway Management Resuscitation Hospitals EMS 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. DISCLAIMER: THE […] The post SGEM#243: Enough is Enough (O2 Saturation of 94-96%) first appeared on The Skeptics Guide to Emergency Medicine. The Lancet 2018. The Lancet 2018.

Administration 52

Administration Poisoning Hospitals Outcomes 52

Taming the SRU

OCTOBER 1, 2023

This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. Ann Emerg Med. J Emerg Trauma Shock. Published 2019 Dec 3. Ann Emerg Med.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

EMDocs

JUNE 7, 2023

Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Parenteral organophosphorus poisoning in a rural emergency department: a case report. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9th Edition. BMC Res Notes. 2013; 6:524.

Poisoning 83

Poisoning Airway Management Seizures PPE 83

EMDocs

JUNE 27, 2024

2019 Jan 24;14:263-292. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4 C or 100.4 Am J Hematol.

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. Ann Emerg Med. Int J Emerg Med.

Emergency Department 90

Emergency Department Ultrasounds Administration Burns 90

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

This finding does not alter the need to pursue emergent reperfusion, although it might suggest a poorer prognosis.”[3] Am J Med 2019, 132(5):622-630. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Harhash AA, Huang JJ, Reddy S, et al.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. J Crit Care. N Engl J Med. Crit Care Explor.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2019 Oct-Dec;29(4):169-171.

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

The Skeptics' Guide to EM

APRIL 11, 2020

Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: It has been a hard shift. You wish you […] The post SGEM#289: I Want a Dog to Relieve My Stress in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 52

Emergency Department Resuscitation Wellness 52

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. J Spec Oper Med.

Resuscitation 89

Resuscitation Outcomes Operations Hospitals 89

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). Guo T, Fan Y, Chen M, et al.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." Then she began complaining of severe dizziness and quickly went into ventricular fibrillation and resuscitation was initiated by hospital staff. She was defibrillated and resuscitated.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

Don't Forget the Bubbles

AUGUST 12, 2024

What neuroprotective measures can we undertake in the emergency department? After a traumatic brain injury, all children and young people should have a C-ABCDE rapid assessment for life-threatening injuries (as per ATLS guidelines) focussed on trauma resuscitation and stabilisation, followed by a secondary assessment.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. and Emergency Medicine residents, in 12 hour shifts.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Don't Forget the Bubbles

JUNE 30, 2023

In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EMDocs

DECEMBER 16, 2023

An 18-month-old boy presents to the emergency department with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Resuscitation. , 148 , 173–190. Heatstroke.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68