EM SIM Cases

SEPTEMBER 19, 2024

Treatment includes tourniquet application to the limb and rapid blood product administration. Boating Trauma Download [link] ECG Source = [link] The trauma team will be activated and he will be brought to the ED. Intubation for clinical course and pain management need to be addressed with disposition to the operating room.

Shock 52

Shock Emergency Nursing Operations Administration 52

PulmCCM

NOVEMBER 17, 2023

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. Download his free textbook here. OP is operating point. See text for details. shows inspiratory holds with inverse, linear relationship between Pra and CO/VR; only Ppc is varied here. References 1.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

RebelEM

AUGUST 7, 2023

Traditional RSI entails preoxygenation followed by near-simultaneous administration of an induction agent followed by a neuromuscular blocker. REBEL Cast Ep122: Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients Click here for Direct Download of the Podcast Paper: Bandyopadhyay A et al.

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

American Medical Compliance

FEBRUARY 15, 2023

Congress established the Occupational Safety and Health Administration (OSHA), with the purpose of creating safe and health conscience work conditions. Passing the exam will qualify the individual for an assisted living administrator certificate. Furthermore, OSHA estimates that 5.6 The specific requirements of the exam vary.

Administration 52

Administration Infectious Diseases Operations Best Practices 52

American Medical Compliance

FEBRUARY 15, 2023

Congress established the Occupational Safety and Health Administration (OSHA), with the purpose of creating safe and health conscience work conditions. Passing the exam will qualify the individual for an assisted living administrator certificate. Furthermore, OSHA estimates that 5.6 The specific requirements of the exam vary.

EMS 52

EMS Administration Infectious Diseases Operations 52

EMDocs

JUNE 2, 2023

Podcast: Play in new window | Download (Duration: 19:53 — 27.3MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Pharmacologic Management In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children. If a patient has a PRN on their med list do that!

Psychiatric 91

Psychiatric Pediatrics Emergency Department Administration 91

The Skeptics' Guide to EM

DECEMBER 25, 2021

JAMA 2021 This was an SGEM Journal Club and all the slides from the presentation can be downloaded using this LINK. Clinical Question: Does administration of calcium during out-of-hospital cardiac arrest improve sustained return of spontaneous circulation? As a reminder, here are the five rules for SGEM JC. Reference: Vallentin et al.

CPR 52

CPR Administration Outcomes Hospitals 52

RebelEM

OCTOBER 5, 2022

mg/dL 10.5 – 12.0 mg/dL 10.5 – 12.0

Dehydration 52

Dehydration Psychiatric Administration EKG/ECG 52

EMDocs

JUNE 9, 2023

Podcast: Play in new window | Download (Duration: 15:51 — 21.8MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Safe prehospital transport of the agitated child In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

EMS 97

EMS Documentation/Coding Pediatrics Psychiatric 97

RebelEM

NOVEMBER 2, 2022

Pneumoniae, Enterococci 3rd Generation Cephalosporin covers vast majority of cases Ceftriaxone 25 mg/kg up to 1 gm daily Cefotaxime 25 mg/kg up to 1 gm Q8 Alternate antibiotic choices Ciprofloxacin 400mg IV BID Levofloxacin 750mg IV daily Piperacillin/Tazobactam 4.5g grams/kg within 6 hours 1.0

EMS 52

EMS Administration Hospitals 52

Downeast Emergency Medicine

JULY 17, 2021

Pain was assessed 20 minutes following administration and if pain persisted, a second dose of the original medication was given. Download article summaries EIDINEJAD ET AL. Treatment groups were 5 mg morphine, 15 mg ketorolac, or 5mg morphine and 15 mg ketorolac together. All 3 groups were given promethazine as needed for nausea.

Emergency Department 52

Emergency Department Wellness Administration EMS 52

RebelEM

MARCH 22, 2023

REBEL Core Cast 98.0 – AVNRT Click here for Direct Download of the Podcast Definition: A regular, narrow-complex rhythm with a ventricular rate that is typically > 160 bpm. An alternate administration approach can be found on ALiEM. Serum troponins should not routinely be obtained.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

RebelEM

MARCH 23, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal Click here for Direct Download of the Podcast Clinical question : Is a phenobarbital-based or lorazepam-based alcohol detoxification protocol associated with a lower hospital length of stay compared to Ativan for alcohol withdrawal?

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

PHEM Cast

APRIL 10, 2016

The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

PulmCCM

NOVEMBER 11, 2021

Accordingly, the baseline PPV was 20%, suggesting greater preload dependency prior to phenylephrine administration. Download his free textbook here. Goertz AW, Schmidt M, Seefelder C, Lindner KH, Georgieff M: The effect of phenylephrine bolus administration on left ventricular function during isoflurane-induced hypotension.

Stroke 40

Stroke Sepsis Administration Wellness 40

RebelEM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. In most cases, prehospital cardiac arrests often necessitate a second ambulance crew simply to assist with compressions, patient transfer or medication administration anyway.

EMS 52

EMS CPR Shock Resuscitation 52

PulmCCM

JANUARY 4, 2022

As well, the volume of administration might be much lower than 500 mL, with previous research indicating that 4 mL/kg of crystalloid was an optimal volume needed to increase mean systemic filling pressure. Download his free textbook here.

Wellness 40

Wellness Outcomes Sepsis Stroke 40

RebelEM

JANUARY 25, 2023

2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

PulmCCM

OCTOBER 16, 2023

Download the central line checklist from John Hopkins here. These measures have dramatically increased hospital administrators’ attention to CLABSI rates, and have likely had an effect of reducing actual rates of CRBSI. Many states have instituted mandatory reporting of CLABSI. continue to be evaluated.

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. Click here for Direct Download of the Podcast Paper: Bouzat P et al. Severe acute traumatic coagulopathy = PT >1.5

Administration 143

Administration Outcomes Resuscitation Radiology 143

Don't Forget the Bubbles

FEBRUARY 5, 2025

Excessive IV fluid administration should be avoided due to the risk of acidosis, coagulopathy and electrolyte disturbance – all of which evidence shows significantly increased mortality. What GCS would the administration be recommended for? Prehospital Blood Administration and the Hateful Eight. Stabbings in Adolescents.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. REBEL Core Cast 122.0 – Neutropenic Fever Click here for Direct Download of the Podcast. Early administration of antibiotics is the only factor known to reduce this mortality. Febrile neutropenia is a condition conveying high mortality.

Infectious Diseases 98

Infectious Diseases Administration Sepsis Anaphylaxis 98

RebelEM

JUNE 12, 2024

REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy Click here for Direct Download of the Podcast. Rapid administration may induce nausea and emesis. If the patient doesn’t respond to maximum pharmacologic therapy, venous-arterial ECMO should be considered.

Poisoning 101

Poisoning Stroke Shock Resuscitation 101

RebelEM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE? Clin Exp Emerg Med 2023.

Stroke 136

Stroke Outcomes Hospitals Administration 136

RebelEM

JUNE 26, 2024

Definition: A serum potassium level > 5.5 patients can jump from peaked T waves to sine wave) Management Basics: ABCs, IV, O 2 , Cardiac Monitor and, 12-lead EKG Identify + treat underlying cause of hyperkalemia (i.e. rhabdomyolysis -> hydration) Remove inciting factors (i.e. furosemide) Dialysis for anuric patients (i.e.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

RebelEM

NOVEMBER 16, 2022

benzocaine) Consider the diagnosis in any patient with cyanosis and hypoxia that doesn’t respond to oxygen administration Administer methylene blue to any patient with abnormal vital signs, metabolic acidosis, end organ dysfunction or, a serum level > 25% References: Price DP. Chapter 127. Read more

Seizures 52

Seizures Administration Airway Management COPD 52

RebelEM

MAY 18, 2023

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension Click here for Direct Download of the Podcast Paper: The National Heart, Lung and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

Sepsis 103

Sepsis Shock Resuscitation Outcomes 103

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. If so, could this be done safely? These questions are asked in the first paper that we reviewed.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Downeast Emergency Medicine

DECEMBER 1, 2021

Outcomes included the occurrence of precipitated withdrawal and any other serious adverse event attributable to buprenorphine administration including sedation, decreased respiratory rate, hypoxia, or rescue naloxone administration in the ED or within 24 hours following discharge. Download article summaries D’ONOFRIO ET AL.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

Taming the SRU

MAY 30, 2023

The AirRx app contains information regarding common medications and equipment available, top diagnoses, medicolegal information and more, and is available to download for free. mg/mL) single-dose 2*-mL ampule or equivalent, 2 Lidocaine injection, 20-mg/mL single-dose 5-mL ampule or equivalent, 2 Nitroglycerin, 0.4-mg

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

PulmCCM

SEPTEMBER 9, 2021

Arguably, this might be mitigated by slower volume administration. Download his free textbook here. It is suggested that rapid, fluid resuscitation generates an abrupt rise in atrial natriuretic peptide, shears the glycocalyx which then impairs vascular reactivity.

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

RebelEM

JULY 31, 2023

REBEL Cast Ep121: The Battle of the Blades – VL vs DL Click here for Direct Download of the Podcast Article: Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults [published online ahead of print, 2023 Jun 16]. 1420 patients were enrolled.

Operations 98

Operations Outcomes Emergency Department Airway Management 98

Ken Grauer, MD

MARCH 8, 2025

Be ready with prudent administration of IV fluids if blood pressure drops ( See ECG Blog #190 for more on RV MI, and its different hemodynamics ). A DDENDUM # 2 ( 3/8/2025 ) : I've included below an Audio Pearl a Video Pearl and links for download of PDFs reviewing the ECG diagnosis of AV Blocks.

EKG/ECG 259

EKG/ECG Wellness Administration 259

Sensible Medicine

APRIL 3, 2025

I download the album to my mp3 player, and relished it. If you think the rules we have in medicine are sensible— the policies and administration reasonable— you are wrong. I listened in the car, on the shuttle, and walking to OB-GYN rounds, as a 3rd year medical student.

OB/GYN 108

OB/GYN Administration Wellness Hospitals 108

Don't Forget the Bubbles

AUGUST 13, 2023

decreased cognitive function in future B. meningitis C. epilepsy D. encephalitis Answer 3 The correct answer is C.

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Sensible Medicine

SEPTEMBER 5, 2023

I make both my posts available here to articulate how the current administration’s vaccine regulation has failed. Vinay Prasad PART 1: The Biden administration seems set on pushing out a fall booster for all age groups. Yet, this administration does not want any. ” That is spot on. We explained that more in NEJM.

CDC 98

CDC Administration Hospitals Research 98

Sensible Medicine

JULY 27, 2023

Specifically MedRxiv and SSRN have been reluctant to post articles critical of the CDC, mask and vaccine mandates, and the Biden administration’s health care policies. Yet, these rejected articles have been eventually published and been downloaded massively. Preprint servers appear to be playing politics. Our paper is rock solid.

CDC 98

CDC Administration Research Hospitals 98