RebelEM

FEBRUARY 19, 2024

Historically the administration of vasopressors was restricted to central venous catheters (CVC) due to concerns for local tissue injury resulting from vasoconstriction if extravasation occurred from a peripheral IV. Peripheral Administration of Norepinephrine: A Prospective Observational Study. Paper: Yerke JR et al. CHEST 2024.

Administration 134

Administration Sepsis EMS Shock 134

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. This is the only situation in which aspirin is recommended for administration in children, as the benefits outweigh the risks of Reye syndrome. link] The post EM@3AM: Kawasaki Disease appeared first on emDOCs.net - Emergency Medicine Education. Lakhani, N. UpToDate;2022.

EMS 87

EMS Infectious Diseases Pediatrics Research 87

EMDocs

NOVEMBER 4, 2023

We’ll keep it short, while you keep that EM brain sharp. A) Administration of a 30 mL/kg bolus of normal saline B) Admission for intravenous vancomycin C) CT scan of the pelvis D) Emergency surgical consultation and broad-spectrum antibiotics Answer: D Fournier gangrene is necrotizing fasciitis of the perineal, genital, or perianal anatomy.

EMS 90

EMS Ultrasounds Emergency Department Infectious Diseases 90

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. The post EM@3AM: Basilar Artery Occlusion appeared first on emDOCs.net - Emergency Medicine Education. Median time from ED arrival to diagnosis was 8 hours 24 min in one study, with only 19% being diagnosed within the 4.5-hour hour IV thrombolytic window.

EMS 95

EMS Stroke Outcomes Hospitals 95

ACEP Now

JANUARY 5, 2025

Fibrinogen levels should also be obtained, where available, if severe hemorrhage suggests the potential need for administration of fibrinogen concentrate. Special thanks to Dr. Kevin Wasko, guest expert on the EM Cases podcast on this topic, who inspired this column.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

Pediatric EM Morsels

JULY 19, 2024

Soak the gauze with epinephrine (1:10,000) or TXA (our THIRD route of administration) Apply pressure laterally to the tonsillar fossa with the gauze covered Magill forceps. The post Post-Tonsillectomy Hemorrhage: ReBaked Morsel appeared first on Pediatric EM Morsels. Don’t await for fancy meds to arrive from pharmacy.

Pediatrics 290

Pediatrics Airway Management Wellness Operations 290

RebelEM

MARCH 12, 2024

The post Clinical Conundrums: Should I Pretreat Patients with Contrast Allergy Prior to IV Contrast Administration? appeared first on REBEL EM - Emergency Medicine Blog. Administer the pretreatment medications as this should prevent any severe allergic reaction.

Allergic Reactions 58

Allergic Reactions Administration EMS 58

Emergency Live

JANUARY 12, 2024

A Detailed Guide for Aspiring EMS Helicopter Pilots First Steps and Training To become an Emergency Medical Services (EMS) helicopter pilot, it is essential to hold a commercial helicopter pilot’s license, which requires a Federal Aviation Administration (FAA) second-class medical certificate, although some employers may require a first-class (..)

Administration 98

Administration EMS 98

Pediatric EM Morsels

MAY 24, 2024

Evaluation of unintentional injury and trauma is one of the hallmarks of the EM and PEM physician. Low Risk Inta-Adbominal Trauma: Just Light ‘Em Up? The post Low Risk Intra-Abdominal Trauma: Rebaked Morsel appeared first on Pediatric EM Morsels. J Am Coll Surg. 2017;224:449-460. doi:10.1016/j.jamcollsurg.2016.12.041.

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

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. appeared first on REBEL EM - Emergency Medicine Blog. 4F-PCC contains factors II, VII, IX, X as well as Proteins S and C.

Administration 139

Administration Outcomes Resuscitation Radiology 139

Taming the SRU

FEBRUARY 7, 2024

AirCare - Derm Emergencies - R4 Capstone - Landmarks of EM - Global Health - Toxicology Aircare Grand ROunds WITH Drs.

Administration 98

Administration PPE Ultrasounds Poisoning 98

ACEP Now

OCTOBER 13, 2023

An official reason for the closure was not immediately available from the hospital administration, but residents there said they were told the surprise move was likely because of financial reasons. “We We feel that this decision was made without adequate assessment of the negative impacts this WILL have on our patients.

Patient Safety 132

Patient Safety Administration Emergency Department EMS 132

Dr. Smith's ECG Blog

FEBRUARY 20, 2024

A 20-something type, 1 diabetic presented by EMS with altered mental status. Notice the heart rate is approximately 130 This EMS ECG proves that the rhythm of the top ECG is VT. Blood pressure was 117/80, pulse 161, Resp 45, SpO2 100 on oxygen. Here is the 12-lead ECG: Wide complex tachycardia What do you think? 2 hours later

EKG/ECG 131

EKG/ECG EMS Administration 131

RebelEM

JANUARY 18, 2024

Time to antibiotic therapy (from triage, not from onset of infection) has become a quality metric to improve the time to administration of these medications. Prehospital Administration of Broad-Spectrum Antibiotics for Sepsis Patients: A Systematic Review and Meta-Analysis. appeared first on REBEL EM - Emergency Medicine Blog.

Sepsis 130

Sepsis Hospitals Administration Outcomes 130

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM. Clinical Question: Is naloxone administration in undifferentiated OHCA associated with survival to hospital discharge?

Hospitals 104

Hospitals CPR EMS Outcomes 104

RebelEM

NOVEMBER 20, 2023

Food & Drug Administration website. Pharmacokinetics, safety, and cardiovascular tolerability of phenylephrine HCl 10, 20, and 30 mg after a single oral administration in healthy volunteers. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog.

EMS 52

EMS Administration 52

Pediatric EM Morsels

NOVEMBER 3, 2023

For non-complicated malaria use oral Co ART em. Food and Drug Administration Approval of Artesunate for Severe Malaria: Enough to Achieve Best Practice? PMID: 30666615 The post Imported Malaria appeared first on Pediatric EM Morsels. Treating malaria is an ART! Add oral Primaquine if known to have P. vivax or P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

RebelEM

SEPTEMBER 29, 2022

to 6.8L) WATERFALL Trial Fluid Administration Critical Findings: The trial was stopped early due to an interim analysis demonstrating a high incidence of fluid overload with no significant difference in the primary outcome. The aggressive fluid administration arm is far less aggressive than what was historically recommended for pancreatitis.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

PEMBlog

JUNE 7, 2023

After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children.

Pediatrics 123

Pediatrics Psychiatric Emergency Department EMS 123

EB Medicine

JUNE 12, 2024

Practical use and research on co-ingestions Emergency Medical Services (EMS) and Pre-Hospital Care Importance of ABCs in acute opioid overdose cases. Anecdotal insights on changing naloxone administration dosages. Urine drug testing limitations and false positives/negatives. Naloxone usage trends and an empirical approach.

Emergency Department 84

Emergency Department Administration EMS Research 84

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

RebelEM

OCTOBER 30, 2023

The optimal approach to fibrinogen administration in massive hemorrhage protocols is unknown. Most major hemorrhage protocols give a balanced transfusion of PRBCs, FFP, and platelets in ratios approaching concentrations found in whole blood. Fibrinogen products may also be needed to stabilize clots and stem bleeding. Paper: Davenport R et al.

Administration 125

Administration Blood Transfusions Outcomes Hospitals 125

American Medical Compliance

FEBRUARY 27, 2023

OSHA Training for Emergency Medical Services (EMS) will educate emergency medical workers on how to protect themselves and others while adhering to State and Federal OSHA regulations. Elements of the hierarchy of controls include elimination, substitution, engineering controls, administrative controls, and PPE.

EMS 52

EMS PPE Administration Urgent Care 52

Pediatric EM Morsels

JULY 28, 2023

Risk Factors that seem to stay consistent: Administration of Bicarb for correction of acidosis has been shown to be associated with cerebral edema and DOES persist after correcting for severity of DKA! 13406 The post Cerebral Edema and Diabetic Ketoacidosis: Rebaked appeared first on Pediatric EM Morsels. Pediatr Diabetes.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. The EMS Fraud Waste and Abuse Training is designed to educate EMS workers on how to prevent, detect, and report fraud, waste, and abuse in the healthcare setting. No precise measure of healthcare fraud exists.

EMS 52

EMS Administration Documentation/Coding Operations 52

ACEP Now

NOVEMBER 8, 2024

Emergency medical services (EMS) scope of practice is governed by the state, but national scope of practice guidelines are available for the four different EMS provider levels. Conclusion EGAs offer multiple benefits in managing patient airways and have found generally wide acceptance in the protocols of numerous EMS provider levels.

Airway Management 40

Airway Management EMS Hospitals Administration 40

Ziqitza HealthCare Ltd

FEBRUARY 7, 2024

In the ever-changing landscape of emergency medical services (EMS), innovation is the key to saving lives and improving patient outcomes. The post Ziqitza – Emergency Medical Services (EMS) Innovations appeared first on Ziqitza HealthCare Ltd | Emergency Medical/Ambulance Service Provider.

Telemedicine 52

Telemedicine EMS Ambulance Services Hospitals 52

The Skeptics' Guide to EM

OCTOBER 19, 2024

Annals of EM 2024. Ketamine’s administration is flexible, with several routes available including IV, intranasal (IN), and more recently, nebulized forms. Annals of EM 2024.

Emergency Department 99

Emergency Department EMS Research Administration 99

RebelEM

NOVEMBER 30, 2023

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Studies without a clear timeframe for fluid administration. 2.89, p = 0.01.

Sepsis 118

Sepsis Fluid Resuscitation Resuscitation Administration 118

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

RebelEM

SEPTEMBER 27, 2023

Treatment is guided by administration of sodium-bicarbonate. Post Created By: Sanjay Mohan MD Post Peer Reviewed By: Salim Rezaie MD (Twitter @SRRezaie ) The post REBEL Core Cast 109.0 – Na Channel Blocker Poisoning appeared first on REBEL EM - Emergency Medicine Blog.

Poisoning 100

Poisoning Seizures Administration EKG/ECG 100

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery. Ways to get involved?

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

EMDocs

JUNE 9, 2023

After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children. That includes the patient, EMS personnel, and general public.

EMS 96

EMS Documentation/Coding Pediatrics Psychiatric 96

ACEP Now

NOVEMBER 7, 2023

Expand Your Knowledge of the Business of EM Practice Essentials, an online, asynchronous curriculum developed by ACEP and EMRA, dives into reimbursement, contracts, operations and risk management, and other topics that may not have been covered in depth during medical school or residency. Learn more at openbook.acep.org.

Leadership 98

Leadership Administration Research Risk Management 98

Emergency Medicine Cases

MAY 5, 2020

The post EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis Pediatrics EMS Fractures 52

ALiEM

OCTOBER 26, 2023

The Problem: Emergency Medicine (EM) in Pakistan has moved from developing to developed stage in the last decade [1]. It is an innovation that is based on a community of practice merged with the need-based assessment of a young EM residency program in a developing country. Internet connection: A stable internet connection is a must.

EMS 64

EMS Academics Evidence-Based Practice Emergency Department 64

RebelEM

APRIL 26, 2023

Thiamine 100mg IV 4 Fix electrolyte abnormalities (Hypokalemia, Hypomagnesemia) Administration of bicarbonate is generally unnecessary. Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 100.0 – Alcoholic Ketoacidosis appeared first on REBEL EM - Emergency Medicine Blog. If not, dextrose containing fluids will suffice.

Sepsis 127

Sepsis Administration EMS 127