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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This could be due to paralysis of the muscles which protect the upper airway. His name is Ben.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. Ann Emerg Med. PMID: 4136544.

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Impact of Emergency Department Crowding on Lung Protective Ventilation

RebelEM

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. This is a critical error that leads to poorer outcomes for patients in need of critical care.

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emDOCs Revamp: Alcohol Withdrawal

EMDocs

A 36-year-old male presents to the emergency department after being found down at home by his spouse. Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. Emerg Med Pract. Acad Emerg Med. 2015; 17(6): 1-19. Borgundvaag B, Bellolio F, Miles I, et al.

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SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?

The Skeptics' Guide to EM

She is also the local director of the difficult airway EMS course at Washington State. When emergency department (ED) staff roll her to remove her clothing her humeral intraosseous (IO) is dislodged. Yes Was the outcome accurately measured to minimize bias? The classic location for IO placement is the tibial plateau.

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SGEM#450: Try Again – Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage

The Skeptics' Guide to EM

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Stroke 69
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The Latest in Critical Care, 7/3/23 (Issue #7)

PulmCCM

emergency departments and ICUs were randomized to undergo either DL or VL for intubation. More than 90% of the intubations were performed by emergency medicine residents (~70%) or critical care fellows (~23%). At six months of followup, there was no difference in the rate of good neurologic outcome (43.5%