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We’ll keep it short, while you keep that EM brain sharp. Food and Drug Administration. The post EM@3AM: Murine Typhus appeared first on emDOCs.net - Emergency Medicine Education. Emerg Infect Dis. 2017;23(8):1268-1273. doi:10.3201/eid2308.161861 Cross R, Ling C, Day NP, McGready R, Paris DH. Expert Opin Drug Saf. January 2022.
Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. Therefore, administration of IV morphine (A) would not be recommended. link] The post EM@3AM: Stercoral Colitis appeared first on emDOCs.net - Emergency Medicine Education.
Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration.
We’ll keep it short, while you keep that EM brain sharp. A) Administration of mannitol B) Admission for observation C) Discharge home D) Discharge home with oral steroids Answer: B The patient has a skull fracture with an overlying laceration. Administration of mannitol (A) is indicated for patients with elevated intracranial pressure.
We’ll keep it short, while you keep that EM brain sharp. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank. Available from: [link] Guldner GT, Smith T, Magee EM. Vital signs include BP 90/48, HR 122, T 98.3 F, RR 16, SpO2 97% on room air. J Emerg Med. 2012 Aug;43(2):e157-61.
To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Crystalloid may help, but neurogenic shock may not respond to fluid administration. Never fear. In: StatPearls [Internet].
Second-generation antipsychotic medications: Pharmacology, administration, and side effects. His roommate found an empty pill bottle on the floor next to him. The bottle contained 100 mg quetiapine tablets, and 50 tablets were unaccounted for. Innov Clin Neurosci. 2018;15(7-8):20-22. Published 2023. Accessed October 23, 2023. Micromedex.
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.
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.
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.
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.
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.
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.
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.
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 (..)
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.
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.
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.
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
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints. IV fluids administrated, IV vancomycin and piperacillin-tazobactam. Complete primary and secondary survey. Start cooling as quickly as you can, and stop at 102. Resuscitate and administer antibiotics. ROS unremarkable.
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