PEMBlog

APRIL 24, 2024

There is a validated Pediatric Stroke Scale from the NIH that can be used in conjunction with a stroke protocol that involves Neurology, Radiology, and a local/regional Stroke Team. Pediatric strokes are rare and challenging to diagnose. Retrospective use has been shown to be valid and reliable in one cross-sectional study ( Beslow 2012 ).This

Stroke 59

Stroke Pediatrics Blood Transfusions Radiology 59

RCEM Learning

NOVEMBER 28, 2022

It is important to closely monitor the patient’s haemodynamic status and repeat the pelvic x-ray post binder removal because a well-applied pelvic binder can mask fracture. Case courtesy of Dr Paul Clarke Learning bite Avoid unnecessary movement of the patient. See example below of pelvic x-ray with and without binder.

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

EMDocs

JULY 3, 2023

All patients with concern for SAH need a rapid primary survey to assess the airway, breathing, and circulation as well as a comprehensive neurologic exam to create a baseline for the patient. 27 Prudent transfer of patients to a center with neurosurgical capabilities should be considered in any SAH, though this is not well studied.

Seizures 85

Seizures Stroke Outcomes EMS 85

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma. NEJM 1994. [2] Cureus 2022.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

EMDocs

JUNE 3, 2023

23 Pelvic binding remains a critical resuscitation step well within the purview of the ED physician, and can be reviewed here: [link]. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 63

Documentation/Coding Seizures Wellness Psychiatric 63

Taming the SRU

MAY 30, 2023

Frederick 1st trimester pregnancy accounts for 10% of all ED visits from women of reproductive age 28% present on weekends 37% present after hours Despite the fact that a lot of these patients present after hours, radiology is rarely available 24/7 TVUS diagnoses nearly 50% of early pregnancies after an inconclusive transabdominal US ED-performed TVUS (..)

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52