Emergency Live

JANUARY 5, 2024

The Impact of Climate Change and Humanitarian Responses in 2023 Natural Disasters and Climate Impact In 2023, extreme weather events were witnessed, with wildfires in Canada and Portugal devastating thousands of hectares.

Burns 52

Burns 52

ALiEM

MARCH 18, 2024

Many report a burning sensation to the finger. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. Patients usually present with pain, swelling, tingling, numbness, and ecchymosis.

Burns 122

Burns Academics Emergency Department 122

PEMBlog

OCTOBER 17, 2023

Patients often describe a sensation of burning or stinging pain rather than itching. It presents with acute onset, rapidly progressive, symmetric swelling and erythema of the hands and feet, often with petechiae or purpura. It may also be associated with fevers and a lacy erythematous macular rash like classic Parvovirus B19.

Urgent Care 69

Urgent Care Burns Pediatrics Emergency Department 69

ACEP Now

AUGUST 29, 2023

Burns, professor of management at the Wharton School, University of Pennsylvania, will pull back the curtain on the evolving world of private equity in health care and how it is trending. The post September 2023 News from the College appeared first on ACEP Now. 9—Kickoff Party with a speakeasy theme at the Old Reading Terminal Oct.

Burns 52

Burns Emergency Department EMS 52

Dr. Smith's ECG Blog

AUGUST 18, 2024

We've periodically reviewed cases regarding Pacemaker Troubleshooting ( See the February 18, 2024 post — the January 13, 2024 post — the October 19, 2022 post — the August 3, 2022 post — the May 21, 2023 post — the June 19, 2024 post — and the November 9, 2018 post , to name a number of them ).

EKG/ECG 110

EKG/ECG Fractures Burns Wellness 110

Greater Sydney Area HEMS

SEPTEMBER 20, 2023

Nasendoscopy for prognosticating airway burns: – Topicalise nose and throat with co-phenylcaine spray – Use NPA for scope passage – Can leave NPA in (if tolerated) for subsequent scopes 9. Hard and soft signs of penetrating neck injury can be found here. Morbidly obese patient with challenging IV access?

Burns 53

Burns 53

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]. as well as an analysis of the 2023 Match by Pupazan and Cook in Emergency Medicine News [3,4]. A staggering 131 (47%) EM residency programs had unfilled PGY-1 positions among in 2023 [7].

EMS 52

EMS Burns Emergency Department Shock 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. In 2023 — it should be EASY to locate and transmit previous ECGs for comparison from established patients.

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

Pediatric EM Morsels

AUGUST 11, 2023

Auricular Perichondritis = infection or inflammation of the cartilaginous section of external ear Risk Factors: [ Kim, 2022; Rivera-Morales, 2020; Stewart, 2006 ] High Ear Piercing (ex, through Helix, Antihelix, or Scapha) Lacerations Blunt Trauma (and hematoma formation) Burns “Bug Bites” and Digital Trauma (ie, scratching) Iatrogenic (..)

Burns 130

Burns Pediatrics EMS Outcomes 130

Dr. Smith's ECG Blog

JANUARY 5, 2024

Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." Smith comment: No patient over 25 years of age with unexplained chest burning should be discharged without a troponin rule out, no matter how normal the ECG. The following ECG was obtained.

EKG/ECG 121

EKG/ECG Burns Urgent Care Documentation/Coding 121

RebelEM

APRIL 29, 2024

World J Emerg Surg 2023 PMID: 36918947 3. 2023 PMID: 37502742 11 Schwalbach KT et al. Clinical Management of Intraosseous Access in Adults in Critical Situations for Health Professionals. Healthcare. 2022 PMID: 35206981 2. Efficacy of intraosseous access for trauma resuscitation: a systematic review and meta-analysis. Resusc Plus.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

AUGUST 7, 2023

Anesth Analg 2023. Anesth Analg 2023. Peri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial.

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

Don't Forget the Bubbles

OCTOBER 18, 2024

2023 Nov 1;177(11):1132-1140. JAMA Pediatr. 2023;177(11):1132–1140. doi:10.1001/jamapediatrics.2023.3526 2023.3526 Kleidon TM, Gibson V, Cattanach P, Schults J, Royle RH, Ware RS, Marsh N, Pitt C, Dean A, Byrnes J, Rickard CM, Ullman AJ. JAMA Pediatr. doi: 10.1001/jamapediatrics.2023.3526. PMID: 37695594; PMCID: PMC10495929.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

EMDocs

OCTOBER 21, 2023

Reference article,   Radiopaedia.org (Accessed on 15 Apr 2023) [link] Mattle HP, Arnold M, Lindsberg PJ, Schonewille WJ, Schroth G: Basilar artery occlusion. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Accessed April 13, 2023. Accessed on April 5, 2023.)

EMS 97

EMS Stroke Outcomes Hospitals 97

EMDocs

JULY 9, 2024

2023 Jan-Feb;23(1):93-101. Gottlieb LM, Hessler D, Long D, Laves E, Burns AR, Amaya A, Sweeney P, Schudel C, Adler NE. Coverage of Health-Related Social Needs (HRSN) Services in Medicaid and the Children’s Health Insurance Program (CHIP) November 2023. Acad Pediatr. doi: 10.1016/j.acap.2022.08.011. 2022.08.011. Epub 2022 Sep 6.

Pediatrics 74

Pediatrics Emergency Department Research Burns 74

Taming the SRU

JANUARY 1, 2024

However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons including obesity, edema, IV drug use, surgical scars, dialysis, burns, and others (1,2). In this post, we will review multiple alternative sites and techniques available for establishing peripheral access. Emerg Med J.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

ACEP Now

JUNE 7, 2023

The main symptoms of phytophotodermatitis are burning, itchy erythema, and edema, which usually begin 24 hours after exposure. Post-burn, it can also cause long term hyperpigmentation. Accessed May 16, 2023. The curious cases of burn by fig tree leaves. Ficus carica L. leaf anatomy: Trichomes and solid inclusions.

Burns 52

Burns Research Poisoning 52

Taming the SRU

AUGUST 30, 2023

However, PCT can be elevated in severe trauma, such as burns or surgery [5,25]. Specific Evidence: Septic arthritis: According to the European Journal of Bone and Joint Infection’s 2023 guidelines for septic arthritis of native joints (SANJO), no blood tests have adequate sensitivity or specificity to either diagnose or exclude SANJO.

Infectious Diseases 89

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

EMDocs

DECEMBER 4, 2023

When US is available, but the tech would be required to come in at night, we don’t want to burn them out when we can use an approach with a temporizing measure so the patient can get their study safely n a less emergent timeframe. Accessed September 20, 2023. Thrombosis J 13, 18 (2015). link] Deep Venous Thrombosis (DVT).

Ultrasounds 96

Ultrasounds Documentation/Coding Wellness EMS 96

ACEP Now

APRIL 4, 2024

Accessed December 1, 2023. Burns E, Buttner R. Accessed December 1, 2023. Dextrocardia. life in the fast lane. July 19, 2021. Available at: [link]. Kong B, Wang N, Dou L, Cao D. Coronary Artery Disease. 2019;30(5):390-392. Right Ventricular Infarction. Right Ventricular Infarction. Life in the Fast Lane. February 8, 2021.

EKG/ECG 40

EKG/ECG Burns Documentation/Coding Emergency Department 40

Pediatric Education

OCTOBER 29, 2023

Common fine particulate matter < 2.5 µm ( PM 2.5 ) sources include the natural sources of biomass burning, coal burning, road and soil dust, sea spray aerosols, wildfire particles, and volcanic dust. Accessed August 1, 2023. Human sources of PM 2.5 Recent Insights into Particulate Matter (PM2.5)-Mediated AirNow.gov.

Burns 40

Burns Pediatrics Stroke 40

ACEP Now

AUGUST 9, 2024

This excruciating pain is described by many victims as a continuous burning, tingling, and numbness. More severe systemic reactions like delirium, seizures, limb paralysis, blood pressure changes, respiratory distress, dysrhythmia, myocardial ischemia, and syncope are rare. References Mouchbahani-Constance S, Choinière M, Sharif-Naeini R.

Poisoning 52

Poisoning Burns Seizures Fractures 52

Pediatric Education

MAY 14, 2023

Trauma Burns Chest Inhalation Neurogenic due to increased intracranial pressure. Accessed February 6, 2023. Reexpansion pulmonary edema is not very common but occurs after rapid reexpansion of the lung after a few days of collapse. Neurogenic pulmonary edema can be hard to differentiate from cardiogenic pulmonary edema. In: StatPearls.

Pediatrics 40

Pediatrics Infectious Diseases Burns Wellness 40

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) Female to male predominance with a ratio of 3:2. Oka, 2023) It has various other names but one is Cast Syndrome due to a slight increased risk with patients in hip spica casts. Ganss, 2018) There are additional associations with scoliosis, burn injuries, and spinal cord injuries. (Oka, Record, 2015).

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

ACEP Now

DECEMBER 17, 2024

In spring 2023, nearly 95 percent of house staff voted to unionize with the Committee of Interns and Residents (CIR), a branch of the Service Employees International Union (SEIU) and the largest and oldest house staff union in the country. Contract negotiations began in fall 2023, but progress was slow. link] Published May 24, 2023.

Burns 105

Burns Hospitals Documentation/Coding Emergency Department 105

Don't Forget the Bubbles

OCTOBER 7, 2024

Up to 5% of burns occur secondary to electrical injuries, and this rises to 27% in developing countries. Significant injuries can occur even in the absence of extensive burns or other signs of external injury. Children, especially toddlers, may insert objects into outlets, leading to shocks or burns.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

ACEP Now

MARCH 14, 2024

Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm. FIGURE 1: Electrical burns of the patient’s bilateral feet. FIGURE 2: Traumatic amputation and electrical burn of the patient’s left arm. He was intubated by EMS due to the extent of his injuries.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

RebelEM

MAY 29, 2023

Crit Care 2023. Crit Care 2023. Crit Care Med 2023. Limited, small studies on its use in septic shock do not make a clear argument for use. Paper: Ibarra-Estrada, M et al. Early Adjunctive Methylene Blue in Patients with Septic Shock: A Randomized Controlled Trial. NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

EMDocs

JULY 15, 2023

She has had pruritus and swelling to the site accompanied by a painful burning sensation and a couple “painful knots” on her right inguinal region. Retrieved March 2, 2023, from [link] Levine, B. 2023, February 14). Retrieved March 2, 2023, from [link] Smith, J. Retrieved March 2, 2023, from [link] Smith, J.

EMS 92

EMS Infectious Diseases Shock Ultrasounds 92

Don't Forget the Bubbles

JUNE 30, 2023

And hot off the press… the international PATCH ( P rehospital A ntifibrinolytics to T rauma C oagulopathy and H aemorrhage) study (just published on 14th June 2023) compared a prehospital TXA bolus, followed by an eight-hour infusion with placebo in more than 1300 adult patients from 21 hospitals across three countries. 2023 Jun 14.

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

Don't Forget the Bubbles

FEBRUARY 5, 2025

E.g. burns, neurosurgery, interventional radiology. Don’t Forget the Bubbles, 2023. (All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? link] Faculty of Forensic and Legal Medicine.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

EMDocs

NOVEMBER 27, 2023

Burn center transfer for management of severe exfoliative dermatitis Predictive factors for serious cases have yet to be identified, however allopurinol associated DRESS has a higher associated progression to serious DRESS and death rate. McGraw-Hill Education; 2023. and/or N-acetylcysteine (NAC). Adverse Cutaneous Drug Reactions.

EMS 96

EMS Sepsis Burns EKG/ECG 96

Greater Sydney Area HEMS

APRIL 5, 2023

In this study 30% had pathologic findings on fibreoptic laryngoscopy despite no symptoms. However, we are probably intubating too many of these patients, even if symptomatic (also worth checking out this study ).

Burns 40

Burns 40

Don't Forget the Bubbles

JULY 31, 2023

2023 May 31;12(5):290-297. Pediatric Emergency Care March 15, 2023. | The author reviewed this article after having a burning desire to question where the guidance came from! 2023 Jun 25. 2023 May;182(5):2205-2214. Epub 2023 Mar 3. J Pediatric Infect Dis Soc. doi: 10.1093/jpids/piad024 What’s it about?

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

PEMBlog

MAY 15, 2023

References Burns, Ed, et al. “QT Pre-Publication Peer Review This post underwent pre-publication peer review on Thursday May 11, 2023. This must be grounded in a discussion of the most common etiologies of syncope and what makes their particular presentation concerning vs reassuring (see above). QT Interval.” Buttner, Robert, et al.

Pediatrics 97

Pediatrics EKG/ECG Emergency Department Burns 97

Don't Forget the Bubbles

MARCH 31, 2025

2023 Nov;7(1):e002094. doi: 10.1136/bmjpo-2023-002094. Some special patients (burns and trauma) were not described in the study. Fernndez-Sarmiento J, Sierra-Zuiga MF, Salazar Gonzlez MP, Lucena N, Soares Lanziotti V, Agudelo S. BMJ Paediatr Open. PMID: 37989355; PMCID: PMC10668252. Whats it about? Why does it matter?

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

ACEP Now

AUGUST 15, 2023

The impact of burn-out on emergency physicians and emergency medicine residents: a systematic review. Accessed July 12, 2023. References Verougstraete D, Hachimi Idrissi S. Acta Clin Belg. 2020;75(1):57-79. Lloyd S, Streiner D, Shannon S. Burnout, depression, life and job satisfaction among Canadian emergency physicians.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90