EMDocs

OCTOBER 19, 2024

We’ll keep it short, while you keep that EM brain sharp. Leukocytosis, as well as mild leukopenia, are common. Published 2020. link] The post EM@3AM: Bacterial Tracheitis appeared first on emDOCs.net - Emergency Medicine Education. 2][3] Evaluation Labwork CBC: A white blood cell count is variable and nonspecific.

EMS 106

EMS Pediatrics Sepsis Airway Management 106

Ken Grauer, MD

APRIL 26, 2024

The ECG in Figure-1 — was obtained on the scene by EMS ( E mergency M edical S ervices ). ECG Blog #193 — Reviews the basics for predicting the " culprit " artery ( as well as reviewing why the term "STEMI" — should be replaced by "OMI" = O cclusion-based MI ).

EKG/ECG 392

EKG/ECG Resuscitation EMS Wellness 392

EMDocs

MAY 25, 2024

We’ll keep it short, while you keep that EM brain sharp. Cham: Springer International Publishing; 2020:387-395. The post EM@3AM: Sialadenitis appeared first on emDOCs.net - Emergency Medicine Education. She is breathing comfortably but seems to experience significant pain at the associated site of swelling. Neuroradiol J.

EMS 96

EMS Dehydration Operations Hospitals 96

Emergency Medicine Cases

DECEMBER 30, 2020

It goes without saying that 2020 presented many challenges for the worldwide EM community. As we enter 2021 I thought it important to reflect on what we did well in 2020, what made us proud to be EM docs, so that we keep this perspective and keep on growing as a community going forward.

EMS 52

EMS Wellness 52

EMDocs

JUNE 8, 2024

We’ll keep it short, while you keep that EM brain sharp. Post septal (retrobulbar) is higher risk to vision and requires CT imaging to diagnose as well as thorough exam to check for proptosis, afferent pupillary defect, increased intraocular pressure [7]. McGraw Hill, 2020. and John O. Weiner, Gabrielle. Savvy Steroid Use.”

EMS 96

EMS Allergic Reactions Poisoning Emergency Department 96

Pediatric EM Morsels

NOVEMBER 3, 2023

falciparum accounts for >70% of cases of imported malaria , primarily seen in those returning from travel in Sub-Saharan Africa (Mischlinger 2020) Other species include P. For non-complicated malaria use oral Co ART em. 2020 Mar 11;33(2):e00104-19. vivax , P. malariae , and the less common P. knowlesi and P. vivax and P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

EMDocs

APRIL 27, 2024

We’ll keep it short, while you keep that EM brain sharp. Otology & Neurotology 41(8):p 1004-1011, September 2020. | link] The post EM@3AM: Malignant/Necrotizing Otitis Externa appeared first on emDOCs.net - Emergency Medicine Education. He says the pain is worse at night and when he is chewing. and Staphylococcus spp.

EMS 102

EMS Infectious Diseases Radiology Radiology 102

EMDocs

NOVEMBER 19, 2024

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Published 2020. His roommate found an empty pill bottle on the floor next to him. Psychol Res Behav Manag.

Poisoning 108

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 108

Pediatric EM Morsels

JULY 26, 2024

These females should have imaging with either MRI or CT as well as abdominal or transvaginal ultrasound to assess for ovarian teratoma. 2020 Feb;75:55-62. The post Anti-NMDA Receptor Encephalitis in Children and Adolescents appeared first on Pediatric EM Morsels. The prevalence ranges from 12.5%-61% doi: 10.1016/j.seizure.2019.12.016.

Psychiatric 271

Psychiatric Seizures Outcomes Pediatrics 271

EMDocs

JULY 29, 2023

We’ll keep it short, while you keep that EM brain sharp. September 9, 2020. 2021.3.51501 The post EM@3AM: Suppurative Parotitis appeared first on emDOCs.net - Emergency Medicine Education. A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night.

EMS 90

EMS Dehydration Ultrasounds Emergency Department 90

Pediatric EM Morsels

AUGUST 11, 2023

This is the 601st Ped EM Morsel ! Having authored 575 ( well, now 576 ) of them, I am often quite convinced that there are no new topics to discuss. 2020 Oct 24;12(10):e11141. The post Perichondritis of the Ear in Children appeared first on Pediatric EM Morsels. Can Fam Physician. 2022 Sep;68(9):661-663. doi: 10.1097/01.pec.0000248687.96433.63.

Burns 130

Burns Pediatrics EMS Outcomes 130

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Orso 2020] One pediatric study in this systematic review, and the intubated patients had worse outcome than non-intubated Early airway protection = lower rates of complications (in TRAUMA), but this is not always true with medical patients.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" But he did well. Both were awake and alert with normal vital signs. What do you think?

EKG/ECG 127

EKG/ECG EMS Outcomes Wellness 127

Pediatric EM Morsels

APRIL 7, 2023

Observation, interaction with patient, as well as parent information is key to bring the whole picture together! American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. 2020 Apr 28;4(8):1554-1588. doi: 10.1182/bloodadvances.2019001142.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

The Skeptics' Guide to EM

JULY 29, 2023

Emergency Medical Services (EMS) is called and on arrival the patient is walking but has obvious facial trauma and is complaining of some neck pain. As an EMS crew member, you are tasked with deciding what method of spinal motion restriction to use. He has a brief loss of consciousness (LOC) and then awakens and is ambulatory on scene.

Head Injuries 95

Head Injuries EMS Research Emergency Department 95

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? 2020 Nov;163(5):915-922. Epub 2020 Jun 2. 2020, August 18). Article: Kim DJ et al. Acad Emerg Med.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

The Skeptics' Guide to EM

JULY 8, 2023

Managing editor of EM:RAP and Associate Editor at REBEL EM. Managing editor of EM:RAP and Associate Editor at REBEL EM. She looks well enough to go home but asks if she should be prescribed oseltamivir (Tamiflu) because some of her friends have been given it recently by their doctors.

CDC 107

CDC Hospitals EMS Emergency Department 107

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Date: January 27th, 2020 Guest Skeptics: Dr. Richelle Cooper is a Professor of Emergency Medicine at the UCLA Department of Emergency Medicine. Dr. Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. Reference: Dorsett et al.

Wellness 52

Wellness Emergency Department EMS 52

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

Ken Grauer, MD

JULY 22, 2023

The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. Some amount of time passed at home — during which his chest discomfort persisted The patient was hemodynamically stable at the time he was seen by EMS, when ECG #1 was recorded.

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

RebelEM

JUNE 7, 2023

Moderate Patients The vast majority of patients will present with a concerning history but clinically may look relatively well. 2020 Apr 30;382(18):1739-1748. In that population, it is essential to recognize that the absence of oropharyngeal lesions/burns cannot exclude the presence of gastrointestinal injury internally. N Engl J Med.

Poisoning 94

Poisoning Burns Resuscitation Pediatrics 94

The Skeptics' Guide to EM

OCTOBER 17, 2020

Date: October 14th, 2020 Guest Skeptic: Dr.Salim Rezaie is a community emergency physician at Greater San Antonio Emergency Physicians (GSEP), where he is the director of clinical education. Salim is probably better known as the creator and founder of the wonderful knowledge translation project called REBEL EM. Reference: Rowell et al.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . appeared first on REBEL EM - Emergency Medicine Blog. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 130

Sepsis Hospitals Administration Outcomes 130

Pediatric EM Morsels

APRIL 28, 2023

Has undergone many modifications as well to include up to 5 types. The Athlete is at risk of both Osgood Schlatter’s disease as well as Tibial Tubercle Avulsion Fracture. 2020): e0186–e0186. J Bone Joint Surg Am 62(2):205–215 The post Tibial Tubercle Avulsion Fracture appeared first on Pediatric EM Morsels.

Fractures 130

Fractures Pediatrics Operations Wellness 130

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 90

Ultrasounds Documentation/Coding Wellness EMS 90

RebelEM

FEBRUARY 24, 2025

Well, the established cutoff for the distensibility index is 18%. Nov 2020; PMID: 33140173 Hanson J, et al. Distensibility index (DI) Distensibility IVC = ( (IVC max – IVC min) / IVC Max ) * 100 The IVC distensibility index is used for IVC assessment in mechanically ventilated patients. Why does it matter? Ann Intensive Care.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Dr. Smith's ECG Blog

APRIL 30, 2024

I fully acknowledge some speculation — given that we lack precise timing of these serial tracings, as well as not knowing the corresponding serum K+ level at the time each tracing was recorded. This is relevant to interpretation of the initial (EMS) ECG in today's case — as I explain momentarily!

EKG/ECG 109

EKG/ECG CPR EMS Resuscitation 109

EMergucate

APRIL 28, 2020

He looks well from the end of the bed and his haemodynamics a… Following is an ECG of a 62 years of age Vietnamese man who has presented with an 8 hour history of intermittent left sided chest pain.

EKG/ECG 52

EKG/ECG Wellness EMS 52

EMergucate

APRIL 7, 2020

He’s in a mild discomfort but looks well from the end of the bed … Following is an ECG of a 25 years old man with a four day history of left sided chest pain and its 0400 hours in the morning.

EKG/ECG 52

EKG/ECG Wellness EMS 52

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm.

EKG/ECG 132

EKG/ECG Documentation/Coding Psychiatric EMS 132

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

Dr. Smith's ECG Blog

DECEMBER 19, 2023

EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49. It appears EMS obtained two EKGs, but unfortunately these were not saved in the medical record. The EMS crew was only BLS certified, so EKG interpretation is not within their scope of practice. Before and after of the LAD shown below.

EKG/ECG 128

EKG/ECG EMS Wellness Operations 128

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. The ECG below was recorded by EMS. Regarding my Systematic assessment of ECG #1: There is significant baseline artifact , as well as baseline wander. Written by Magnus Nossen — with edits by Grauer. What is your assessment?

Seizures 114

Seizures EKG/ECG EMS Stroke 114

The Skeptics' Guide to EM

OCTOBER 31, 2020

Date: October 29th, 2020 Guest Skeptic: Martha Roberts is a critical and emergency care, triple-certified nurse practitioner currently living and working in Sacramento, California. She is the host of EM Bootcamp in Las Vegas, as well as a usual speaker and faculty member for The Center for Continuing Medical Education (CCME).

Burns 52

Burns Emergency Department EMS Wellness 52

Taming the SRU

JUNE 24, 2024

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart. Bektas, Firat, and Secgin Soyuncu. The efficacy of transcutaneous cardiac pacing in ED.”

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 90

Dr. Smith's ECG Blog

AUGUST 6, 2024

All ECGs were recorded by EMS, and transferred to a PCI capable center for evaluation. There may be hyperacute T waves from V2-V5, as well as in leads I and II. We have addresssed this issue on a number of occasions ( See My Comment in the April 25, 2023 — July 21, 2019 — December 10, 2019 — and January 10, 2020 posts).

EKG/ECG 105

EKG/ECG Wellness Hospitals EMS 105

The Skeptics' Guide to EM

MAY 30, 2020

Date: May 29th, 2020 Reference: Erramouspe et al. AEM May 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: May 29th, 2020 Reference: Erramouspe et al. AEM May 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is hypotensive and tachycardic.

Head Injuries 52

Head Injuries Academics EMS Outcomes 52