Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Less than 8, intubate!

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. UpToDate;2022. Accessed December 31, 2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. In: Post TW, ed.

EMS 92

EMS Infectious Diseases Pediatrics Research 92

EMDocs

MARCH 30, 2024

We’ll keep it short, while you keep that EM brain sharp. Intervertebral disks lie between vertebrae and act as shock absorbers. A 27-year-old man was brought into the emergency department via EMS after being stabbed. Treasure Island (FL): StatPearls Publishing; August 8, 2022. The spinal canal houses the spinal cord.

EMS 105

EMS Fractures Emergency Department Dislocations 105

Pediatric EM Morsels

MARCH 29, 2024

Pediatr Rev (2022) 43 (7): 371–383. link] The post Rebaked: Inborn Errors of Metabolism presenting in the ED appeared first on Pediatric EM Morsels. Pediatrics. 2000; 105:e 10. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A. Schrier Vergano.

Dehydration 297

Dehydration Pediatrics Sepsis EMS 297

RebelEM

MAY 25, 2023

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

NOVEMBER 6, 2023

Background Information: Vasoplegic shock is defined as hypotension with normal or increased cardiac output and can commonly occur in post-cardiac surgery patients having received cardiopulmonary bypass. Hydroxocobalamin Versus Methylene Blue for the Treatment of Vasoplegic Shock Associated With Cardiopulmonary Bypass. 2023 Jul 19.

Shock 71

Shock Administration Academics Hospitals 71

Dr. Smith's ECG Blog

JULY 9, 2024

His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. Meyers and Smith in the October 15, 2022 post of Dr. Smith's ECG Blog ). 15, 2022 post). As per My Comment in the above-cited Oct.

EKG/ECG 116

EKG/ECG Resuscitation Shock CPR 116

Emergency Medicine Cases

JANUARY 2, 2023

Based on a blend of number of listens, feedback from listeners, website visits and my personal faves, here is EM Cases Top 10 of 2022. The post Top 10 of 2022 – EM Cases Podcasts & Blogs Highlights of the Year appeared first on Emergency Medicine Cases.

EMS 52

EMS Stroke Shock 52

Pediatric EM Morsels

MARCH 17, 2023

Ahmed 2008, Meyers 2022) Of course, treat any other systemic symptoms (like respiratory failure, hypotension) as you typically would. If you are managing a snake bite from a snake that does not typically reside in the U.S., please utilize other resources and local Toxicology experts for help with management protocols.

CDC 130

CDC Poisoning Pediatrics Shock 130

RebelEM

JANUARY 18, 2024

Health Sci Rep 2022. septic shock) earlier antibiotics most likely makes a difference in morbidity and mortality, however earlier antibiotics in all patients who meet SIRS criteria may not be a good thing and potentially cause more harms than good. Health Sci Rep 2022. appeared first on REBEL EM - Emergency Medicine Blog.

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Shocked x 2 without effect. Warning: if this is VT, a calcium channel blocker can result in shock and death. Read this post: Idiopathic Ventricular Tachycardias for the EM Physician 2. We are told that " the Patient was Shocked X2 Without Effect." The choice was to use electrical cardioversion with sedation. K returned 3.6

EKG/ECG 139

EKG/ECG Shock Academics Documentation/Coding 139

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. When EMS arrived the patient was in ventricular fibrillation. They shocked him twice before return of spontaneous circulation. He was intubated in the field and sedated upon arrival at the hospital.

EKG/ECG 118

EKG/ECG CPR EMS Hospitals 118

ACEP Now

JULY 7, 2023

However, between four and five percent of cases of VT or VF will be refractory to standard management, with nonperfusing arrhythmia persisting despite repeated shocks. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. amiodarone or lidocaine). References Tsao CW, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

EMDocs

AUGUST 15, 2023

Published April 15, 2022. Accessed May 7, 2022. StatPearls Publishing; 2022. Accessed May 17, 2022. Accessed May 7, 2022. Accessed May 7, 2022. Accessed May 7, 2022. Accessed May 7, 2022. Treatment of snakebite poisoning. Am J Hosp Pharm. 1991;48(10):2190-2196. Venomous Snakes | NIOSH | CDC.

Poisoning 98

Poisoning CDC Administration EMS 98

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). 2011 Dec;6:1-4.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. Published 2022 Jan 3.

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

When EMS found her, she was dyspneic and diaphoretic. Taking a step back , remember that sinus tachycardia is less commonly seen in OMI (except in cases of impending cardiogenic shock). As per Dr. Frick — sinus tachycardia is usually not seen with acute OMI unless the patient is in cardiogenic shock. Both were wrong.

EKG/ECG 128

EKG/ECG Ultrasounds Shock EMS 128

RebelEM

APRIL 29, 2024

2022 PMID: 35206981 2. Healthcare 2022 PMID: 35206981 Post Peer Reviewed By: Frank Lodeserto, MD & Salim R. Rezaie, MD (Twitter/X: @srrezaie ) The post Don’t Forget About the IO in the Critically Ill Patient appeared first on REBEL EM - Emergency Medicine Blog. References: 1 Astasio-Picado Á et al. Healthcare.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

JANUARY 4, 2024

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. Accessed 12/18/2022. Accessed 12/18/2022. 2022; 55:232.e3-232.e4 Cardiotoxicity: Overdose can cause prolonged QRS and QTc intervals.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

Taming the SRU

JUNE 24, 2024

Follow this algorithm in patients with unstable bradycardia with acute heart failure, change in mental status, or concern for shock, physicians should start with atropine, 1 mg and may be continued every 3 to 5 minutes if effective. The American Journal of Emergency Medicine , vol. 2090–2093, [link] Moayedi, Siamak, et al. Circulation , vol.

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 90

RebelEM

JUNE 8, 2023

2022 Sep 5. 2022 2022 Sep 5. Nontraumatic hypotension and shock in the emergency department and the prehospital setting, prevalence, etiology, and mortality: a systematic review. Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults. Am J Emerg Med. Am J Emerg Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

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. At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. N Engl J Med.

EMS 52

EMS CPR Shock Resuscitation 52

ALiEM

JULY 17, 2023

sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. Many of these findings were similar to a study of the 2022 EM Match results by Murano et al., What does this mean for the future of EM? Is student disinterest the problem?

EMS 52

EMS Burns Emergency Department Shock 52

EM Literature of Note

MARCH 2, 2023

There are only four effective interventions in Emergency Medicine An incorrect report on Emergency Department diagnostic errors Finally, not every article relevant to Emergency Medicine lands in an EM journal – hence the Annals of Emergency Medicine Journal Club.

Emergency Department 52

Emergency Department Resuscitation Shock EMS 52

RebelEM

AUGUST 14, 2023

in both groups Mean APACHE II score was 12 in both groups Almost half of the patients had septic shock at enrollment Mean time from sepsis identification to randomization was 1.4 More on this Topic: First10EM: Finally, a cure for sepsis: Herbs REBEL EM: Sepsis 3.0 2022 Nov 11;11(22):6696. 906 randomized to the Placebo cohort.

Sepsis 98

Sepsis Outcomes Administration EMS 98

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Date: November 10th, 2022 Reference: de-Madaria E et al. Date: November 10th, 2022 Reference: de-Madaria E et al. Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

The Skeptics' Guide to EM

JUNE 18, 2022

Date: June 18th, 2022 Reference: Crombie et al. Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. Date: June 18th, 2022 Reference: Crombie et al. What do you advise him?

Shock 40

Shock Resuscitation Administration Emergency Department 40

RebelEM

AUGUST 12, 2024

Epub 2022 Aug 28. Epub 2022 Aug 28. 2020 Mar 14; PMID: 32183395 Post Peer Reviewed By : Salim Rezaie, MD (Twitter/X: @Srrezaie ) The post The PROTECTION Trial – A Randomized Trial of Intravenous Amino Acids for Kidney Protection appeared first on REBEL EM - Emergency Medicine Blog. The PROTECTION trial.

Outcomes 81

Outcomes Hospitals Operations Shock 81

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. Written By Magnus Nossen — with edits by Ken Grauer and Smith.

EKG/ECG 131

EKG/ECG Shock Hospitals Sepsis 131

The Skeptics' Guide to EM

JULY 16, 2022

Date: July 16th, 2022 Reference: Lamontagne F et al. Date: July 16th, 2022 Reference: Lamontagne F et al. Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice.

Sepsis 40

Sepsis Shock Outcomes EMS 40

RebelEM

JANUARY 25, 2024

POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. 2022 Dec;106:9-38. Epub 2022 Aug 1. Published on February 28, 2022. appeared first on REBEL EM - Emergency Medicine Blog. Epub 2014 Jul 3. PMID: 24998674. Kok B, Wolthuis D, Bosch F, van der Hoeven H, Blans M.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

EMDocs

APRIL 22, 2024

EMS verbalized concern to EPs that an “intracranial bleed” may have precipitated the event. However, as shock resolved and hemodynamic stability improved, RV strain and underfilling of the LV remained apparent 30 minutes after ROSC (Vid 4). 2022 Sep;24(6):579-581. Epub 2022 Jun 30. Updated 2022 Aug 8]. 2021.100852.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

RebelEM

OCTOBER 5, 2023

About 25% of the excluded patients had septic shock, but the classification of hypotension as septic shock was at the discretion of the treating team. 2022) involving 586 ICU-admitted patients with severe community-acquired pneumonia (CAP), no benefit was observed from methylprednisolone administration.

Research 94

Research Outcomes Administration Shock 94

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

Queen of Hearts now thinks that this one looks like posterior OMI, since the STD does appear worst in V3-4: None of this seems to have been understood by the EM doctor or the cardiologist who was consulted. The notes now refer to the patient being in cardiogenic shock, on pressors. Published 2022 Feb 20. J Cardiol Cases.

EKG/ECG 83

EKG/ECG Shock Documentation/Coding Academics 83

Dr. Smith's ECG Blog

JANUARY 8, 2024

Think of this diagnosis when a patient with CP and SOB again calls EMS for CP the day after acute coronary occlusion is ruled out (ie, by cath done the day before ) — especially when O2 saturation is reduced. Think of this diagnosis when a patient with CP and SOB + elevated troponin — has normal coronary arteries on cardiac cath.

EKG/ECG 71

EKG/ECG Resuscitation Hospitals EMS 71

AED Leader

JULY 19, 2023

According to 2022 statistics from the American Heart Association, there are more than 356,000 out-of-hospital cardiac arrests in the United States every year and just over 10% of EMS-treated victims survive to hospital discharge. What Are the Benefits of a WiFi AED? cprINSIGHT Analysis. Emergency services support.

CPR 52

CPR Shock EKG/ECG Hospitals 52