Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 90

CPR Burns Airway Management Wellness 90

Taming the SRU

FEBRUARY 7, 2024

Vaughan SJS/TEN and DRESS are life-threatening drug reactions that require immediate discontinuation of the drug and specialist involvement In SJS/TEN, if >10% skin involvement or worsening symptoms, transfer the patient to a Burn Center DRESS has characteristic multi organ involvement, so a high level of suspicion for complications should be maintained (..)

PPE 98

PPE Administration Ultrasounds Poisoning 98

Northwestern EM Blog

MAY 2, 2022

More modest lactic acid elevations are less likely to be related to cyanide poisoning and should not prompt intervention, especially in an asymptomatic patient, unless the level is persistently elevated despite adequate resuscitation. There is lower quality evidence for reduced myocardial infarction and mortality risk as well.

Burns 52

Burns Poisoning EKG/ECG Operations 52

Taming the SRU

MAY 11, 2024

Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review.

Resuscitation 92

Resuscitation Administration Fluid Resuscitation Research 92

Taming the SRU

NOVEMBER 4, 2023

D Thompson and Goel C-spine Imaging: NEXUS is a large, well-done study validating criteria for low-risk of cervical injury that are easy to remember and use at the bedside, and is used in our clinical decision guidelines on AgileMD. Differences with Canadian criteria from NEXUS include elderly, ROM and mechanism.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation Burns Emergency Department 84

Taming the SRU

JUNE 24, 2024

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart. Skin burns and irritation can also result from the pacing pads and cause pain. Sedation can be adequately achieved with benzodiazepines. EMCrit Blog.

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 90

Don't Forget the Bubbles

JULY 31, 2023

Our team have scoured what’s new (well, mostly new!) 2004) Positive end expiratory pressure during resuscitation of premature lambs rapidly improves blood gases without adversely affecting arterial pressure. The author reviewed this article after having a burning desire to question where the guidance came from! Harding, R.,

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

ACEP Now

AUGUST 15, 2023

While there has been ample discussion of “the practice of mindfulness” in health care workers that improves mental well-being, when do we have this time? However, expressing genuine gratitude for yourself and others is powerful for your mental and physical well-being. However, they should not define our wellness. Acta Clin Belg.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Contraindications for USGIV are the same as for any PIV: overlying skin infection, AV fistula in the extremity, previous surgery impacting vasculature, proximal trauma, or burns.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

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

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

PHEM Cast

MARCH 17, 2016

References Wilmalasena Y, Burns B, Reid C, Ware S., Effects of face mask ventilation in apneic patients with a resuscitation ventilator in comparision with a bag-valve-mask. video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. 2016: 28(1); 67-72.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. 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.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. Critical Care Medicine.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Rural Doctors Net

AUGUST 30, 2013

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. Sure he’s got a traumatic amputation – your tourniquet has arrested the bleeding, but there may well be more blood loss. Before we even get to this patient, it’s worth stepping back.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

PulmCCM

FEBRUARY 19, 2024

Well … no. Panelists called this “low certainty evidence from five before-after studies that this intervention may be associated with lower mortality and fewer unsuccessful resuscitation events.” More health care professionals are burned out or disengaged. Let’s take a closer look.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

Northwestern EM Blog

SEPTEMBER 12, 2022

This post will discuss a brief overview of hospital planning and operational setup with key elements of a disaster response from events that cause high numbers of blunt trauma, penetrating trauma, burns or crush injuries that may be seen following explosive events, mass shootings, or large scale motor vehicle collisions, to name a few.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Pediatric Emergency Playbook

NOVEMBER 1, 2015

We have a few minutes to optimize, to resuscitate before we intubate. Ketamine is reasonable as well: there is no contraindication to ketamine except for known hydrocephalus. The goal is a good general perfusion and a balanced resuscitation, ensuring enough cerebral perfusion without disrupting nascent clots.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

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. Burns B, Habig K, Eason H, Ware S. A translator was called; however, she was not answering questions appropriately per the translator’s dictation. Ann Am Thoracic Soc. 2017;14(3):368-375.

Airway Management 45

Airway Management EMS Burns Emergency Department 45

PEMBlog

JUNE 5, 2024

Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. Resuscitate with volume and blood. In my experience, doing a neurologic exam is really difficult in the resuscitation area, especially when a patient is supine and has an immobilized c spine.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

APRIL 1, 2017

11 Beware the “double-ring” sign: this is a button battery13 This is an emergency: the electrolyte-rich mucosa conducts a focal current from the narrow negative terminal of the battery, rapidly causing burn, necrosis, and possibly perforation. Coin en face – in the esophagus – lodged at the thoracic inlet.12 Emergent removal is required.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. For children greater than one year who are preverbal, a well performing scale is the FLACC score: Face, Legs, Activity, Cry, Consolability ( Table 3 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

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 64

Documentation/Coding Seizures Psychiatric Wellness 64

Dr. Smith's ECG Blog

JANUARY 11, 2025

Here is his triage ECG: Here is the digitized version with higher image quality: He was rushed to the resuscitation area for "unstable VTach." 3rd seeing definite ST elevation in lead I , as well as in the other high-lateral lead ( = lead aVL ). It is a wide complex regular tachycardia at a rate of 120. Is it ventricular tachycardia?

EKG/ECG 137

EKG/ECG Shock Resuscitation Burns 137

Taming the SRU

MARCH 3, 2025

million fires in 2020, with some studies quoting over 500,000 emergency room visits annually for burn and inhalation injuries (4). Because of this high number of visits, it is important for ED physicians to have a broad knowledge base for treating chemical inhalation injuries as well as fire and smoke related injuries.

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

JANUARY 6, 2025

She receives IV calcium gluconate and bicarbonate as well as oral potassium binders for hyperkalemia. 89 The high malnutrition rate is caused by factors such as a heavy disease burden, particularly malaria, as well as poor food consumption and inadequate infant and child feeding practices. Hypoglycemia is managed with IV dextrose.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75