Administration and Download - Emergency Care Today

REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

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

Administration Outcomes Resuscitation Radiology

Crafting And Refining Your Massive Transfusion Protocol – Part 3

The Trauma Pro

AUGUST 18, 2023

The Broxton tool covers all the basics and includes some additional data points that cover activation criteria, TXA administration, and administration of uncrossmatched blood. You can download a copy by clicking here. Click here to check it out. In the next post, I’ll continue with activation criteria for the MTP.

Administration

Administration Operations Hospitals Wellness

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

RebelEM

SEPTEMBER 27, 2023

Treatment is guided by administration of sodium-bicarbonate. Treatment is guided by administration of sodium-bicarbonate. A newly “wide QRS”, especially with hemodynamic instability, should prompt consideration of sodium channel blockade and not ventricular tachycardia. Boehnert 1985 ). Read more

Poisoning

Poisoning Seizures Administration EKG/ECG

REBEL Core Cast 100.0 – Alcoholic Ketoacidosis

RebelEM

APRIL 26, 2023

REBEL Core Cast 100.0 – Alcoholic Ketoacidosis Click here for Direct Download of the Podcast Definition and Physiology Alcoholic ketoacidosis is a starvation state that occurs in the patient with severe ethanol use disorder. Remember to evaluate for concurrent medical illness: gastritis, pancreatitis, pyelonephritis, pneumonia, sepsis.

Sepsis

Sepsis Administration EMS

REBEL Core Cast 126.0 – Peds Hem Onc Emergencies

RebelEM

JULY 10, 2024

Take Home Points Early administration of antibiotics (within 60 min) in patients with fever and neutropenia is life saving. REBEL Core Cast 126.0 – Peds Hem Onc Emergencies Click here for Direct Download of the Podcast. Avoid sedation and lying supine and steroids in patients with mediastinal masses.

Seizures

Seizures Administration EMS Wellness

Major Trauma – Injuries by Assault

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

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault

Atrial Fibrillation

EM SIM Cases

JULY 28, 2024

His interests include medical education and leadership, sports medicine, and health care administration. Atrial Fibrillation Download ECG 1: [link] ECG 2: [link] This case comes from Dr Aneesha Thouli and Dr Brad Stebner. Dr Brad Stebner is a staff emergency physician at Kelowna General Hospital.

Leadership

Leadership Administration EKG/ECG Hospitals

REBEL Core Cast 118.0 – IM vs PO NSAIDs

RebelEM

FEBRUARY 21, 2024

REBEL Core Cast 118.0 – IM vs PO NSAIDs Click here for Direct Download of the Podcast Bottom Line Up Top: There is no difference in analgesic efficacy between oral and intramuscular NSAIDs. Ibuprofen superior secondary to cost, ease of administration + lack of pain w/ administration. 2019; 36: 401-6.

Administration

Administration Emergency Department EMS Research

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. Click here for Direct Download of the Podcast Paper: Knack SKS et al. REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

Outcomes

Outcomes Emergency Department Administration Resuscitation

Boating trauma

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

Shock Emergency Nursing Operations Administration

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

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

Stroke Outcomes Hospitals Administration

ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

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

Operations Ultrasounds Resuscitation Blood Transfusions

REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

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

Head Injuries Airway Management Outcomes Burns

Aseptic Training for Healthcare Providers

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

Administration Infectious Diseases Operations Best Practices

HIPAA Training For Emergency Medical Services (EMS)

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

EMS Administration Infectious Diseases Operations

REBEL Core Cast 90.0 – Methemoglobinemia

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

Seizures Administration Airway Management COPD

SGEM#353: At the COCA, COCA for OCHA

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

CPR Administration Outcomes Hospitals

REBEL Core Cast 87.0 – Hypercalcemia

RebelEM

OCTOBER 5, 2022

mg/dL 10.5 – 12.0 mg/dL 10.5 – 12.0

Dehydration

Dehydration Psychiatric Administration EKG/ECG

PEM Currents – Agitation in Children – Episode 3: Pharmacologic Management

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

Psychiatric Pediatrics Emergency Department Administration

REBEL Core Cast 125.0 – Hyperkalemia

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

EKG/ECG Administration Burns EMS

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

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

Sepsis Shock Resuscitation Outcomes

PEM Currents – Agitation in Children – Episode 4: Safe prehospital transport

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

EMS Documentation/Coding Pediatrics Psychiatric

Journal Club - Tranexamic Acid in Trauma

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

Head Injuries Administration Outcomes Seizures

Journal Club - Emergency Department Initiated Buprenorphine for Opioid Use Disorder

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

Emergency Department Documentation/Coding Leadership Administration

REBEL Core Cast 89.0 – Spontaneous Bacterial Peritonitis

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

EMS Administration Hospitals

Journal Club - Pain management of Renal Colic

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

Emergency Department Wellness Administration EMS

REBEL Core Cast 98.0 – AVNRT

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

EKG/ECG EMS Pediatrics Stroke

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal

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

Emergency Department Outcomes Burns Hospitals

Episode 7: Sepsis

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

Sepsis Fluid Resuscitation Resuscitation Emergency Department

ICU Physiology in 1000 Words: Phenylephrine Pushes & Stroke Volume

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

Stroke Sepsis Administration Wellness

What Minimal Volume of Intravenous Fluid Challenges the Heart?

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

Wellness Outcomes Sepsis Stroke

REBEL Core Cast 94.0 – SBO

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

Operations Sepsis Resuscitation Ultrasounds

How to prevent central line infections

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

CDC Hospitals Ultrasounds Documentation/Coding

Grand Rounds Recap 4.26.23

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

OB/GYN Ultrasounds Pediatrics Resuscitation

Back to the BaSICS: does the infusion rate of a fluid bolus affect mortality?

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

Resuscitation Fluid Resuscitation Sepsis Outcomes

REBEL Core Cast 122.0 – Neutropenic Fever

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

Infectious Diseases Administration Sepsis Anaphylaxis

REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy

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

Poisoning Stroke Shock Administration

REBEL Cast Ep121: The Battle of the Blades – Video Laryngoscopy vs. Direct Laryngoscopy

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

Operations Outcomes Emergency Department Airway Management

REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

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

EMS CPR Shock Resuscitation

ECG Blog #472 — At Least 4 Major Findings

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

EKG/ECG Wellness Administration

Febrile Seizures

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

Seizures Pediatrics Dehydration Radiology

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

Older children and adults usually present with ACS 2-3 days after hospitalisation due to pulmonary infarction (in situ sickling), hypoventilation due to rib infarction (which may be exacerbated by recent narcotic administration) or fat embolism. Haemoglobin is usually lower than baseline and white cells count is often raised.

Blood Transfusions

Blood Transfusions Stroke Dehydration Sepsis

The Annual COVID19 Booster

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

CDC Administration Hospitals Research

Preprint Servers have Repeatedly Censored our Work on COVID-19 Policy

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

CDC Administration Research Hospitals

REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

Crafting And Refining Your Massive Transfusion Protocol – Part 3

Trending Sources

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

REBEL Core Cast 100.0 – Alcoholic Ketoacidosis

REBEL Core Cast 126.0 – Peds Hem Onc Emergencies

Major Trauma – Injuries by Assault

Atrial Fibrillation

REBEL Core Cast 118.0 – IM vs PO NSAIDs

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

Boating trauma

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

Aseptic Training for Healthcare Providers

HIPAA Training For Emergency Medical Services (EMS)

REBEL Core Cast 90.0 – Methemoglobinemia

SGEM#353: At the COCA, COCA for OCHA

REBEL Core Cast 87.0 – Hypercalcemia

PEM Currents – Agitation in Children – Episode 3: Pharmacologic Management

REBEL Core Cast 125.0 – Hyperkalemia

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

PEM Currents – Agitation in Children – Episode 4: Safe prehospital transport

Journal Club - Tranexamic Acid in Trauma

Journal Club - Emergency Department Initiated Buprenorphine for Opioid Use Disorder

REBEL Core Cast 89.0 – Spontaneous Bacterial Peritonitis

Journal Club - Pain management of Renal Colic

REBEL Core Cast 98.0 – AVNRT

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal

Episode 7: Sepsis

ICU Physiology in 1000 Words: Phenylephrine Pushes & Stroke Volume

What Minimal Volume of Intravenous Fluid Challenges the Heart?

REBEL Core Cast 94.0 – SBO

How to prevent central line infections

Grand Rounds Recap 4.26.23

Back to the BaSICS: does the infusion rate of a fluid bolus affect mortality?

REBEL Core Cast 122.0 – Neutropenic Fever

REBEL Core Cast 124.0 – Hyperinsulinemia Euglycemia Therapy

REBEL Cast Ep121: The Battle of the Blades – Video Laryngoscopy vs. Direct Laryngoscopy

REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

ECG Blog #472 — At Least 4 Major Findings

Febrile Seizures

Sickle Cell Disease Module

The Annual COVID19 Booster

Preprint Servers have Repeatedly Censored our Work on COVID-19 Policy

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