Board Bombs

SEPTEMBER 10, 2023

Hospital administrators take note. Sepsis: burn the stopwatches. Hospital administrators take note. Sepsis: burn the stopwatches. We promise this isn't clickbait. We're covering what's important in sepsis care. Take a guess what we won't be covering. It begins with an L and ends in -actate. September 11th, 2023.

Burns 52

Burns Sepsis Administration Hospitals 52

University of Maryland Department of Emergency Med

JULY 6, 2023

Burns are common pediatric injuries and usually represent preventable unintentional trauma. Approximately 10% of children hospitalized with burns. Click to view the rest

Burns 61

Burns Pediatrics Hospitals 61

Emergency Medicine Cases

MAY 21, 2019

It turns out that for all burn patients—from minor to severe—there is a lot of room for improvement in ED management, counselling and disposition. The post Ep 124 Burn and Inhalation Injuries: ED Wound Care, Resuscitation and Airway Management appeared first on Emergency Medicine Cases.

Airway Management 52

Airway Management Burns Resuscitation Fluid Resuscitation 52

The Trauma Pro

OCTOBER 3, 2023

I have seen several patients in follow-up who basically stopped wearing their brace as soon as they were out of the hospital. Int J Burns Trauma 12(4):168-174, 2022. But it appears to be so small that the question of whether a brace is really necessary needs to be asked. Most braces are expensive and uncomfortable.

Fractures 202

Fractures Dislocations Operations Burns 202

Don't Forget the Bubbles

OCTOBER 7, 2024

Up to 5% of burns occur secondary to electrical injuries, and this rises to 27% in developing countries. Significant injuries can occur even in the absence of extensive burns or other signs of external injury. Children, especially toddlers, may insert objects into outlets, leading to shocks or burns.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Northwestern EM Blog

JULY 15, 2024

Indeed, there are many inciting sources that can be divided into direct—pneumonia, aspiration, intrathoracic procedures—and indirect—non-pulmonary sepsis, pancreatitis, trauma/burns, blood product transfusion (“TRALI”)—lung injury. 2024, Jul 15). Initial Resuscitation in ARDS [NUEM Blog. Expert Commentary by Esposito, AJ.

Resuscitation 98

Resuscitation Burns Emergency Department Sepsis 98

Ken Grauer, MD

JULY 22, 2023

The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. The C ASE C ontinues : En route to the hospital — another tracing was done 2 minutes after ECG #1.

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

ACEP Now

MARCH 14, 2024

Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm. FIGURE 1: Electrical burns of the patient’s bilateral feet. FIGURE 2: Traumatic amputation and electrical burn of the patient’s left arm. He was intubated by EMS due to the extent of his injuries.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

RebelEM

MAY 29, 2023

It also reduced length of stay in ICU and hospital without adverse effects. What They Did: Single-center, parallel, double blind, randomized controlled trial performed in a medical-surgical ICU (Mexico) Both groups received: Adjunctive vasopressin initiated at a dose of 0.03 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. Intravenous vs.intraosseous vascular access during out-of-hospital cardiac arrest – protocol for a randomized clinical trial. PMID: 33350794 10 Meilandt C. Resusc Plus. 2023 PMID: 37502742 11 Schwalbach KT et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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? ETT onto a fiberoptic scope. ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

Sensible Medicine

SEPTEMBER 19, 2024

As a result, one-third of doctors are burned out and doctors have the highest suicide rate of any profession. Trust in hospitals and doctors decreased from 70% to 40%, according to a JAMA study published last month. We have not given doctors the time or resources to study the root causes of disease.

Research 145

Research Military Poisoning Burns 145

Taming the SRU

AUGUST 11, 2024

This was felt to be a necessary change in response to decreasing ITE scores and first-time board pass rates The written exam will still be required and is not changing The new certifying exam will be offered in-person in Raleigh, North Carolina with 9 sessions per year There will be two case types: clinical care cases and objective structured clinical (..)

Sepsis 89

Sepsis Burns Shock Operations 89

Dr. Smith's ECG Blog

JUNE 13, 2024

Click here to sign up for Queen of Hearts Access Case A 58-year-old woman presented to the ED with burning chest pain that started 2-3 hours earlier while sitting on a porch swing. The family filed a lawsuit against the physician and the hospital. The hospital and doctor reached confidential settlements. They were dismissed.

EKG/ECG 93

EKG/ECG Documentation/Coding EMS Burns 93

Don't Forget the Bubbles

SEPTEMBER 11, 2024

I have been a doctor for half of my life, and my journey to burnout has been a 25-year slow burn that began the day I graduated. And so the slow burn continues… As you become increasingly exhausted, you lose self-control, making it harder to protect yourself from the demands of your job. There is still time to repair. Nothing changes.

Burns 88

Burns Hospitals Emergency Department Wellness 88

University of Maryland CC Project

MAY 25, 2023

Chadi Abouassaly, Assistant Program Director of General Surgery at Medstar Washington Hospital Center and Associate Medical Director of the Trauma and Burn ICU presents a lecture on Pancreatitis as part of the DC5 lecture series.

Burns 40

Burns Hospitals 40

PHEM Cast

JANUARY 4, 2017

Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Boet S, Bould MD, Layat Burn C, Reeves S. Top 10 (+1) tips to get started with in situ simulation in emergency and critical care departments. Bredmose PP, Habig K, Davies G, Grier G, Lockey D. BMJ Quality & Safety. 2013; 22: 468-477.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

Don't Forget the Bubbles

OCTOBER 18, 2024

Clinical practice guidelines Midline Catheters, Dr Liz Prentice, Anaesthetic Department, The Royal Children’s Hospital, Melbourne, September 2011 The post Midline Catheters in Paediatrics – The Long and Short of it. JAMA Pediatr. 2023 Nov 1;177(11):1132-1140. doi: 10.1001/jamapediatrics.2023.3526. PMID: 37695594; PMCID: PMC10495929.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

Ziqitza HealthCare Ltd

JUNE 13, 2024

Burns For burns, place the injured area under running cool water for at least 10 minutes. This should be done in case of minor burns for instant relief. In case of major burns, call emergency medical services immediately. Do not apply ice, butter, or any ointment. Cover the injured area with a sterile dressing.

Burns 52

Burns Stroke Ambulance Services Seizures 52

PHEM Cast

SEPTEMBER 25, 2019

Parenteral penicillin for children with meningococcal disease before hospital admission: case-control study. Sörensen HT, Nielsen GL, Schönheyder HC, Steffensen FH, Hansen I, Sabroe S, Dahlerup JF, Hamburger H, Olsen J: Outcome of pre-hospital antibiotic treatment of meningococcal disease. 2006 Jun 3;332(7553):1295–8.

Ambulance Services 52

Ambulance Services Sepsis Burns Hospitals 52

Sensible Medicine

MAY 31, 2023

Her outpatient follow-up appointments were scheduled; we had reviewed her safety plan; she felt well and ready to leave the hospital. Barely thirty years old, and she had just burned her last bridge and had nowhere to go. Her hospital course was uneventful, and she made good therapeutic use of her time on the unit.

Psychiatric 95

Psychiatric Hospitals Wellness Military 95

Emergency Medicine Journal

OCTOBER 26, 2023

Background In-hospital alcohol testing provides an opportunity to implement prevention strategies for patients with high risk of experiencing repeated alcohol-related injuries. However, barriers to alcohol testing in emergency settings can prevent patients from being tested. to 0.61) and low falls (aOR=0.17, 95% CI 0.12 to 3.48).

Burns 52

Burns Hospitals 52

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 86

Sepsis Shock Resuscitation Fluid Resuscitation 86

RebelEM

AUGUST 7, 2023

What They Did: Prospective randomized clinical trial Patients randomized to: Delayed Sequence Intubation (DSI): IV ketamine 1.5mg/kg in 0.5

Head Injuries 96

Head Injuries Airway Management Outcomes Burns 96

Don't Forget the Bubbles

JUNE 30, 2023

And hot off the press… the international PATCH ( P rehospital A ntifibrinolytics to T rauma C oagulopathy and H aemorrhage) study (just published on 14th June 2023) compared a prehospital TXA bolus, followed by an eight-hour infusion with placebo in more than 1300 adult patients from 21 hospitals across three countries. in the placebo group).

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

American Medical Compliance

OCTOBER 27, 2023

Over 80% of all intensive care patients treated with an indwelling urinary tract catheter throughout their hospital stay had catheter-associated urinary tract infections (CA-UTIs). Within the first 30 days of hospitalization, the incidence of CA-UTIs exceeds 100%. The rate of occurrence is 3%–10% per day of catheterization.

Burns 52

Burns Hospitals 52

Rural Doctors Net

AUGUST 24, 2013

Q2 : What equipment is available in YOUR hospital (or prehospital pack) to help manage his bleeding? Again circumstances will differ – some rural hospitals will have theatre capability and access to blood – some not. P 120 BP 80. Cap refill 3 secs. Tender in LUQ. Q1 : What are your priorities in managing this patient?

Burns 52

Burns Hospitals 52

ACEP Now

OCTOBER 10, 2024

On physical exam, you notice what appears to be a blister from a burn on her right palm (see photo on cover). When you are done, you tell the mother what you found and ask her if there is any way the child could have been burned. Case Resolution Given the location of the burn, pediatric burn surgery was consulted.

Forensics 40

Forensics Domestic Violence Burns Pediatrics 40

ACEP Now

APRIL 2, 2024

degress Fahrenheit), caustics (low pH), and voltage—causing a Ca++ and Na+ action potential influx that confers the sensation of pain and burning to the brain. Oral exposure creates a spicy burning sensation (or pungency) in the mouth that can extend to the throat and stomach (and eventually the rectum—“ fire tuchus ”).

Burns 40

Burns Poisoning Seizures Stroke 40

RebelEM

JULY 20, 2023

INTRODUCTION You’re moonlighting in a remote access hospital. EMS radios in for a burn patient and to anticipate a difficult airway. The patient is horribly burned. She was smoking with her home O2 on and has severe mixed partial and full thickness burns to the chest, neck, face, and airway. They’re rolling up now.

EMS 74

EMS Burns Airway Management Wellness 74

ACEP Now

AUGUST 15, 2023

Dr. Koo is an emergency physician and attending at MedStar Washington Hospital Center in Washington, and St. Mary’s Hospital in Leonardtown, Maryland. The impact of burn-out on emergency physicians and emergency medicine residents: a systematic review. References Verougstraete D, Hachimi Idrissi S. Acta Clin Belg. J Emerg Med.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

EB Medicine

NOVEMBER 1, 2018

It was peer reviewed by Dr. O’Keefe and Dr. Silverberg from Florida State University College of Medicine and Kings County Hospital, respectively. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. Most electrical injuries present with burns to the skin. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Rural Doctors Net

AUGUST 30, 2013

James and Casey are used to this kind of stuff (although Casey’s mostly in-hospital and has even got a CT scanner…James is used to working out of a tent wearing just rabbit skins). The visual confrontation of a man in pain with an obvious amputation and airway burns will induce a catecholamine surge in all but the psychopathic.

Burns 52

Burns Hospitals Ambulance Services Wellness 52

EMDocs

NOVEMBER 27, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

EMS 91

EMS Sepsis Burns EKG/ECG 91

Pediatric Emergency Playbook

DECEMBER 1, 2015

Case 1: Toddler with an oral commissure burn An electrical burn to the angle of the mouth cauterizes superficial bleeding vessels, and hours later the wound becomes covered with a white layer of fibrin, surrounded by erythema. Most patients do well, and the burn heals by secondary intention. Take Home Points 1. J Pediatr Surg.

Burns 40

Burns EKG/ECG Emergency Department Shock 40

ALiEM

FEBRUARY 9, 2024

These in the high-risk category are usually admitted to the hospital to assess for AMI as well as other causes of troponin elevation. The discomfort has a burning character, though he has never been diagnosed with reflux before. What if you have a patient with intermediate findings? It started 2 hours ago.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

Taming the SRU

MAY 11, 2024

Guidelines also support not administering HTS in the pre-hospital setting, yet the available data is weak. The available data does not support any benefit of administration of hyperosmolar therapy in the setting of a TBI. What do we do at UC?

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92