The Skeptics' Guide to EM

APRIL 27, 2024

She is also the local director of the difficult airway EMS course at Washington State. Case: EMS arrives with a 58-year-old woman who suffered an out-of-hospital cardiac arrest (OOHCA). Despite that weak evidence, placement of IO in OOHCA has become a routine procedure for many EMS providers. tibial & 2.3%

Resuscitation 93

Resuscitation Airway Management EMS Outcomes 93

EMDocs

MARCH 9, 2024

1: Epinephrine or Airway First in OHCA? Spoon Feed In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine.

Head Injuries 98

Head Injuries Airway Management Outcomes EMS 98

The Skeptics' Guide to EM

AUGUST 10, 2024

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. INTERACT-3 reported the odds of a poor functional outcome were lower in the goal-directed intensive care bundle group compared to usual care (SGEM#413).

Stroke 90

Stroke Airway Management Documentation/Coding Outcomes 90

Pediatric EM Morsels

JUNE 9, 2023

Multimodal management can help avoid variceal bleeding. Luoto, 2020 ] Acute Esophageal Variceal Bleeding: Management Guidelines on the management of acute variceal bleeding in children are limited and debated due to limited pediatric-specific evidence. Prepare airway management tools (hoping to avoid needing them).

Pediatrics 154

Pediatrics Head Injuries Airway Management Resuscitation 154

JournalFeed

JUNE 1, 2024

Monday Spoon Feed : A retrospective study of 60 patients who received a fixed-dose ketamine of 250 mg by EMS observed that 6 were intubated in the ED. For access to more, please visit JournalFeed.org for details about becoming a member. There was no association between weight-based dose of ketamine and risk for intubation.

Airway Management 52

Airway Management EMS Outcomes Hospitals 52

RebelEM

AUGUST 7, 2023

Re-oxygenation with BMV can increase airway-related adverse events (i.e. Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation. What They Did: Prospective randomized clinical trial Patients randomized to: Delayed Sequence Intubation (DSI): IV ketamine 1.5mg/kg in 0.5

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

The Skeptics' Guide to EM

JANUARY 25, 2020

His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Case: A 60-year-old male is […] The post SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial first appeared on The Skeptics Guide to Emergency Medicine. Date: January 9th, 2020 Reference: Casey et al.

EMS 40

EMS Airway Management Administration Resuscitation 40

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

The Skeptics' Guide to EM

MARCH 2, 2019

Effect of a Strategy of a Supraglottic Airway Device
vs. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. The AIRWAYS-2 Randomized Clinical Trial. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. The AIRWAYS-2 Randomized Clinical Trial.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

Critical Care Now

AUGUST 31, 2024

PMID: 36088303 Background: Emergency intubations often involve managing contaminated airways, where the standard 14 Fr Yankauer catheter may be insufficient. The 28 Fr DuCanto catheter, developed by Dr. James DuCanto, is designed to handle thicker fluids, potentially improving airway management.

Airway Management 52

Airway Management EMS Research Outcomes 52

PulmCCM

APRIL 18, 2024

This outcome measure was less robust than intubation attempts, because the “failure” definition included simply switching devices, which the intubator was permitted to do at any time for any reason. Patients randomized to direct laryngoscopy were four times more likely to require multiple intubation attempts (7.6%

Airway Management 98

Airway Management Operations EMS Research 98

Taming the SRU

OCTOBER 16, 2024

ALiEM provides a great overview of how to manage these injuries here: [link]. Amputations Distal to DIP may require revision amputation, which is in the purview of EM physicians. Major contributing factors for poor outcomes in this patient population (Dalton et. Consider antibiotics for high risk patients (e.g.,

Airway Management 74

Airway Management Fractures CDC Pediatrics 74

Emergency Medicine Cases

AUGUST 24, 2021

In this Part 1 of our 2-part EM Cases podcast series on Geriatric Trauma, Dr. Barbara Haas, Dr. Camilla Wong and Dr. Bourke Tillman answer questions such as: why are older patients under-triaged to trauma centers and how does that affect outcomes? How should we adjust airway management for the older trauma patient?

Resuscitation 52

Resuscitation Head Injuries Airway Management Shock 52

The Skeptics' Guide to EM

MARCH 11, 2023

He is a former New York City paramedic and this summer will be starting fellowship training in EMS medicine at UNM. The fire-based crew has basic life support (BLS) airway supplies including the King Laryngeal Tube, the paramedic crew carries iGel supraglottic airways (SGAs) in addition to their intubation equipment.

Airway Management 52

Airway Management Basic Life Support CPR Resuscitation 52

Critical Care Now

APRIL 5, 2022

Reading Time: 5 minutes Simon Taxel NRP, BA Simon is a paramedic, crew chief, and public safety diver with the Pittsburgh Bureau of EMS. While anyone can experience a TBI, the available data suggests that the social determinants of health have a substantive impact on the outcomes associated with them.

Airway Management 52

Airway Management EMS CDC Pediatrics 52

ACEP Now

MARCH 6, 2024

Gotta catch ‘em all!” The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome.

Research 52

Research Airway Management Stroke Outcomes 52

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). It is particularly useful in cases of physically difficult airway management, such as in patients with obesity, limited neck mobility, or cervical spine immobilization.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

PHEM Cast

APRIL 21, 2021

Positioning From: [link] Recommended Rich Levitan resources Podcast 70 – Airway Management with Rich Levitan Airway axes From: McGuire B, Hodge K. Click here to hear what our friends over at the Resus Room think about Airways 2 References (kindly shared by Rich) Davis DP et al. Tracheal intubation. 20(12);681-686.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Don't Forget the Bubbles

MAY 3, 2023

Results of this study showed that the use of low-dose insulin infusion led to similar clinical outcomes and fewer adverse events compared to the standard-dose insulin infusion. Also, the study was conducted in a centre where clinicians commonly use a bougie for airway management. Why does it matter? Why does it matter?

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

ACEP Now

JULY 7, 2023

This is a discussion of a potentially disastrous airway outcome. She was reported to have had a mechanical fall, landing face forward without loss of consciousness, and has had a continuous nosebleed since then, per EMS and the home care provider. Due to her sole language being Russian, the initial history was limited.

Airway Management 45

Airway Management EMS Burns Operations 45

Taming the SRU

DECEMBER 6, 2023

ems grand rounds: southwest ohio protocol updates WITH dr. weekley Ideally, medications will be administered IV or IO, therefore endotracheal tube drug administration will be de-emphasized. If there is no improvement in 20 minutes, EMS will call medical control regarding further decisions. Remember who you are and who you represent.

Leadership 57

Leadership Stroke Airway Management EMS 57

EM Updates

MARCH 24, 2021

The primary tool for emergency airway management then became the traditional laryngoscope , a device little improved since the 1940s, until the advent of video laryngoscopy in the early 2000s which changed everything.

Operations 52

Operations Airway Management EMS Wellness 52

RebelEM

MARCH 27, 2023

However, that practice is long-outdated and patients managed on lower tidal volumes (6 ml/kg) were found to have decreased mortality. Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. REFERENCES: Acute Respiratory Distress Syndrome Network et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

ACEP Now

NOVEMBER 14, 2023

So next time you are faced with a patient with massive hemoptysis heading for respiratory failure in your ED, take an organized approach such as this seven-step one to maximize your patient’s chance of survival with good neurologic outcome. A special thanks to Drs. J Emerg Med. 2017;52(4):433-437. Weingart S. EMCrit blog website.

Radiology 52

Radiology Radiology Emergency Department Airway Management 52

EB Medicine

MARCH 1, 2019

Moreover, when airway management is needed, advanced airway techniques by ALS crews were associated with decreased odds of survival. Jeff: And don’t forget to get the crash details from the EMS crew before they depart! Early defibrillation is linked to better outcomes. of those patients. Ann Emerg Med.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

RebelEM

JULY 31, 2023

In this blog post, we explore the study’s key findings, strengths, and limitations, providing valuable insights while navigating the complexities of airway management in critically ill adults. Outcomes: Primary Outcome: Successful intubation on the first attempt. 1420 patients were enrolled. 1420 patients were enrolled.

Operations 98

Operations Outcomes Emergency Department Airway Management 98

EMDocs

JUNE 7, 2023

Airway management should not be delayed. 7 Airway management: consider early airway management. Indira M, Andrews MA, Rakesh TP: Incidence, predictors, and outcome of intermediate syndrome in cholinergic insecticide poisoning: a prospective observational cohort study. In: Mattu A and Swadron S, ed.

Poisoning 98

Poisoning Airway Management Seizures PPE 98

The Skeptics' Guide to EM

NOVEMBER 30, 2024

Missy has been teaching airway management for over a decade and is the creator of the Prehospital Emergency Airway Course which is taught throughout Washington State. Case: You’re doing a ride along with your local emergency medical service (EMS) crews and responding to an out-of-hospital cardiac arrest (OHCA).

Administration 100

Administration CPR Airway Management Resuscitation 100

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Buffington] NTI largely supplanted by RSI: Current resuscitation practice focuses on the oral route for airway management and intubation. We’ve heard, or been through, tales of early EM when BNTI was the fall-back for awkward intubations before EM could claim credentialing for RSI. Be alert to changes in waveform.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40