Taming the SRU

OCTOBER 16, 2024

Pregnant patients are inherently higher risk for VTE, and because of this are excluded from normal clinical decision tools like Wells Criteria that would normally be able to help guidance our clinical decisions. of all cases of maternal mortality. However, this doesn’t mean you’re not alone.

Airway Management 74

Airway Management Fractures CDC Pediatrics 74

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 90

CPR Burns Airway Management Wellness 90

Emergency Medicine Cases

SEPTEMBER 12, 2017

As ED docs we’re particularly well suited to take a lead in disaster medicine. We own this. The post Episode 100 Disaster Medicine appeared first on Emergency Medicine Cases.

Airway Management 52

Airway Management EMS Wellness 52

Northwestern EM Blog

MARCH 1, 2025

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

EMDocs

NOVEMBER 1, 2023

ECG – May show tachycardia or rate related ST depressions Laboratory evaluation: CBC w/ differential – may reveal leukocytosis with left shift CMP, Lipase – can reveal alternative intra-abdominal diagnoses as well as show findings of end-organ hypoperfusion (elevated serum creatinine, transaminitis, etc.)

Operations 94

Operations Radiology Radiology Fluid Resuscitation 94

RebelEM

AUGUST 7, 2023

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. that would not be possible in an agitated/combative patient.

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

EM Curious

AUGUST 5, 2015

Onto the FOAMed RICH LEVITAN AIRWAY MANAGEMENT [VIDEO LECTURE]: A fantastic airway lecture discussing novel ideas about management of the difficult airway. Rebel EM brings us some pearls to managing both the patient, as well as parents expectations. You must watch this video here !

Airway Management 52

Airway Management EMS Ultrasounds Pediatrics 52

Resus Review

APRIL 23, 2015

P ediatric airway management is one of the most stressful and fearful activities within the emergency department. The rigid shape works extremely well for seating the mask in the hypopharynx, and is reuseable. The figure below is the pediatric airway cart in our pediatric resuscitation bay.

Pediatrics 52

Pediatrics Airway Management Resuscitation Emergency Department 52

PHEM Cast

MARCH 17, 2016

Preoxygenation and Prevention of Desaturation During Emergency Airway Management. video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. Annals of Emergency Medicine. 2015; 65(4): 371-376. Weingart SD, Levitan RM. Annals of Emergency Medicine.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

ACEP Now

JULY 7, 2023

Per discussion with family over the phone it was determined she had mild dementia, but had been feeling well prior to her mechanical fall. 8,9 The SALAD maneuver was developed to overcome the challenges faced during intubation of a massively contaminated airway. Review of systems was unable to be obtained due to confusion. Resusc Plus.

Airway Management 45

Airway Management EMS Burns Operations 45

Advanced Emergency Nursing from AENJ

OCTOBER 18, 2014

An example would be the recent ACLS graduate who tells the airway manager, who is ventilating the patient well without a leak, that he/she is holding the mask “upside-down”. This deliberate choice is known to the expert, but not well-published in basic literature. —David Dunning ” (as cited in Wikipedia article, below).

Airway Management 40

Airway Management Emergency Nursing Pediatrics Wellness 40

ACEP Now

OCTOBER 11, 2024

Preparation If possible, AMPLE (allergies and airway history, medications, past medical history, last oral intake, and events leading up to the intubation) history should be obtained, as well as a physical exam. Pediatric airway management. 6 Before any pediatric RSI is initiated, the proper equipment should be prepared.

Pediatrics 52

Pediatrics Airway Management Emergency Department Wellness 52

RCEM Learning

APRIL 9, 2024

Maintain a Positive Mindset and Well-being: Exam preparation can be demanding, so it’s important to take care of your mental and physical well-being. A positive mindset and well-being contribute to better focus and performance during the exam.

Infectious Diseases 52

Infectious Diseases Airway Management Resuscitation Poisoning 52

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11).

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

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

JULY 20, 2023

This can be plotted as a Forgetting Curve (Figure 2), the slope of which depends on many things – the quality of the teacher, if stress is included in the training, if you’re well fed, have good sleep, etc. This is the idea of learning something so well you bring yourself well above the line of competence.

EMS 75

EMS Burns Airway Management Wellness 75

Advanced Emergency Nursing from AENJ

JULY 9, 2015

How versatile are your airway skills? Most airway management is done with the patient supine and on a table. Importantly, you should practice airway support and BVM facing the patient "from the south" (facing cephalad). Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric.

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Airway Management Pediatrics Resuscitation Emergency Nursing 40

Ziqitza HealthCare Ltd

JANUARY 25, 2024

Advanced cardiac monitors, cutting-edge defibrillators, and high-tech airway management tools have been integrated into the ambulances. The incorporation of advanced critical care equipment ensures that ALS ambulances are well-equipped to handle a wide range of medical emergencies.

Ambulance Services 52

Ambulance Services Basic Life Support Airway Management Hospitals 52

RCEM Learning

APRIL 9, 2024

Take care of your physical and mental well-being, and ensure you get adequate rest and relaxation. Remember, the MRCEM Intermediate SBA exam requires a combination of knowledge, critical thinking, and time management skills. Stay Calm and Confident: Prior to the exam, maintain a calm and positive mindset.

Infectious Diseases 52

Infectious Diseases Airway Management Dislocations Poisoning 52

Greater Sydney Area HEMS

APRIL 15, 2023

Consider skin-to-skin on Mum’s chest to keep an otherwise well baby warm. Be meticulous with your airway management and ensure you are achieving good inflation. The nutshell: Most babies don’t need intervention at birth, and those who do respond to stimulus and warming, with no further help required.

Hospitals 85

Hospitals Resuscitation Hyperthermia / Hypothermia Teamwork 85

Pediatric Education

MARCH 31, 2024

Patient Presentation A 2-year-old female came to clinic for her well child care. Torus Palatinus and Airway Management. Her parents had no concerns except they had noted a “bump” in the middle of the roof of her mouth. It hadn’t changed over time and didn’t seem to bother her. Surg Radiol Anat SRA.

Airway Management 40

Airway Management Pediatrics Wellness 40

University of Maryland CC Project

JANUARY 9, 2023

He is the Associate Medical Director and Director of Research of the Medical ECMO Program at the Center for Acute Respiratory Failure, as well as Medical Director of Intermediate Care and Pre-Critical Care Services. He presents a lecture during Critical Care Grand Rounds entitled "ECMO for Respiratory Pandemics".

Research 40

Research Wellness Airway Management 40

RebelEM

MARCH 27, 2023

There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. Unfortunately, its not clear whether the documentation came from RTs or ED providers.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

RebelEM

FEBRUARY 15, 2024

These patients can be at risk of vomiting and aspiration and often prompts clinicians to pursue definitive airway management to avoid pneumonia and other complications. Additionally, intubation can risk hemodynamic instability as well as hypoxemia from the procedure itself. Paper: Freund Y et al. References: Freund Y et al.

Poisoning 141

Poisoning Airway Management Seizures Shock 141

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 106

Seizures Hyperthermia / Hypothermia Emergency Department EMS 106

Pediatric EM Morsels

JULY 21, 2023

Consider other indicators of need for airway management, such as gag reflex. GCS scores are validated in trauma populations , but it has its limitations in the medical populations. It’s complicated. Less than 8 doesn’t always mean intubate ! References : Teasdale G, Jennett B. Assessment of coma and impaired consciousness.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

OCTOBER 19, 2024

Leukocytosis, as well as mild leukopenia, are common. Definitive airway management should be pursued early. Signs and symptoms include stridor (inspiratory or expiratory), fever, productive and painful cough, thick secretions, and tenderness of the trachea. [2-4] ampicillin-sulbactam).

EMS 111

EMS Pediatrics Sepsis Airway Management 111

ACEP Now

MARCH 6, 2024

Many clinicians staffing emergency departments intubate infrequently, as well, and these results are likely applicable to a wide scope of practice. Now, a randomized, controlled trial clearly demonstrates some patients with low GCS are far more likely to be harmed by an aggressive approach to airway management. N Engl J Med.

Research 52

Research Airway Management Stroke Outcomes 52

PulmCCM

APRIL 18, 2024

Anesthesiology residents literally stop counting, generally performing well over a thousand intubations in a four-year residency (compared to pulmonary-critical care fellows’ mere nine months total in the ICU on a traditional research/clinical split), including extensive experience on difficult airways and advanced airway management.

Airway Management 98

Airway Management Operations EMS Research 98

EMDocs

SEPTEMBER 25, 2023

They increase the risks of hypoxia and acidosis during the apneic period as well as hypotension and hypoperfusion caused by the abrupt transition from negative-pressure to positive-pressure ventilation (10). Incidence and factors associated with cardiac arrest complicating emergency airway management.

Emergency Department 93

Emergency Department Soft Tissue Injuries Operations Airway Management 93

PulmCCM

JULY 3, 2023

Every airway manager should ideally be an expert with both DL and VL, but mathematics and muscle memory suggest that if your training included video, and you keep doing some intubations with video, it will be more difficult to achieve or maintain the same expertise at DL as airway experts who trained exclusively on DL. (If

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

Don't Forget the Bubbles

MAY 3, 2023

There was no difference between the low-dose and high-dose insulin infusion groups regarding the time to resolution of hyperglycaemia, time to resolution of acidosis as well as the rate of blood glucose change. Also, the study was conducted in a centre where clinicians commonly use a bougie for airway management. Low-dose ( 0.05

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

Critical Care Now

APRIL 5, 2022

Among children with severe TBI, the implementation of the new guidelines leads to a substantial improvement in adjusted survival to hospital admission as well as survival to discharge. Hypoxia must be prevented. If indicated aggressive BLS airway management with positive pressure ventilation (PPV) is appropriate.

Airway Management 52

Airway Management EMS CDC Pediatrics 52

RebelEM

NOVEMBER 16, 2022

Methemoglobinemia Pathoophysiology Mechanism of Action Pathophysiology Oxidized iron sites on MetHb unable to bind oxygen Remaining binding sites with increased affinity for binding oxygen Causes a leftward shift in the oxyhemoglobin dissociation curve Results in decreased tissue oxygen delivery Normal situation Red cells constantly exposed to oxidant (..)

Seizures 52

Seizures Administration Airway Management COPD 52

EM SIM Cases

MARCH 14, 2023

Feedback from the junior learners has included comments about how they can feel very lost and confused when they first join the simulation training sessions because of the chaos they feel in the room; they feel that it’s difficult to learn how to incorporate the basics of CPR and advanced airway management into a more complex scenario.

CPR 52

CPR Resuscitation Pediatrics Academics 52

Pediatric Emergency Playbook

NOVEMBER 1, 2015

Pediatric airway management is a skill that integrates the three types of knowledge as described by the ancient Greeks: episteme , or theoretical knowledge, techne , or technical knowledge, and phronesis , or practical wisdom, also called prudence. It is safe in head trauma. It is a good choice for the hypotensive trauma patient.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

EB Medicine

NOVEMBER 1, 2018

Nachi: There is a school of thought out there that victims of electrical injury can have delayed onset arrhythmias and require prolonged cardiac monitoring – however several well-designed observational studies, including 1000s of patients, have demonstrated no such evidence. Jeff: Let’s move on to evaluation in the emergency department.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40