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Don't Forget the Bubbles
MAY 10, 2023
You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. They’re getting CPR. Promoting hot debriefing in an emergency department. Scand J Trauma Resusc Emerg Med. Emergency Medicine Residents Experience Acute Stress While Working in the Emergency Department.
JournalFeed
MARCH 25, 2023
Nonstop CPR Spoon Feed Routinely pausing chest compressions during cardiac arrest to intubate in the emergency department is not necessary; this is especially true if you have video laryngoscopy and a bougie.
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Don't Forget the Bubbles
NOVEMBER 29, 2023
You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This is referred to as CPR I nduced C onsciousness ( CPRIC ). Ann Emerg Med. His name is Ben.
EB Medicine
NOVEMBER 17, 2020
Write us at emplify@ebmedicine.net.
Don't Forget the Bubbles
JUNE 19, 2024
PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. CASP checklist for Clinical Prediction Rule (CPR) studies Is CPR clearly defined? Lancet Child Adolesc Health. 2024 Jun 3:S2352-4642(24)00104-4.
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Taming the SRU
MARCH 27, 2024
It has a small sample size and may not be generalizable as it was carried out in Denmark where physicians were present on all transport vehicles and there is a very high portion of the population trained in providing bystander CPR. Hill, J.
EMDocs
OCTOBER 9, 2023
Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado.
The Skeptics' Guide to EM
APRIL 27, 2024
When emergency department (ED) staff roll her to remove her clothing her humeral intraosseous (IO) is dislodged. This is because of the ease of finding anatomic landmarks and their location away from other procedures like defibrillation, CPR, and airway management. The classic location for IO placement is the tibial plateau.
ACEP Now
DECEMBER 6, 2024
After resuming CPR and administering an additional 400 mcg IV NTG, the patient achieved return of spontaneous circulation with sinus tachycardia. This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm.
Dr. Smith's ECG Blog
MAY 19, 2020
She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). ECMO Flow was achieved after approximately 1 hour of high quality CPR. An elderly woman had sudden ventricular fibrillation.
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EMDocs
JANUARY 16, 2024
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Am J Emerg Med. 1996;40(3):483-485. Accidental hypothermia.
Taming the SRU
JULY 2, 2023
End-Tidal CO2 monitoring has a variety of uses in the Emergency Department. Cardiac Arrest As mentioned before, tidal CO2 is a function of metabolic rate and cardiac output, so capnography can be utilized during CPR to monitor the effectiveness of chest compressions. The Journal of emergency medicine 53.6 2017): 829-842.
Critical Care Now
JULY 14, 2024
Several meta-analyses examining the efficacy of eCPR have been published, including either patient data from RCTs or data from both RCTs and observational trials, with the results indicating either a statistically significant benefit in neurologically favorable survival, or no difference with eCPR compared to conventional CPR.
EB Medicine
NOVEMBER 1, 2018
But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Let’s move on to evaluation in the emergency department. Jeff: You’re right. Jeff: You’re right.
PEMBlog
AUGUST 20, 2024
This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. So, eCPR, extracorporeal cardiopulmonary resuscitation, is an advanced medical procedure used in cases of cardiac arrest where traditional CPR has failed.
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Dr. Smith's ECG Blog
SEPTEMBER 3, 2023
This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.
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EM SIM Cases
MAY 9, 2023
EHS arrived, provided oxygen supplementation, and brought them to your tertiary emergency department, with access to PICU. The team should begin CPR and follow the PALS pediatric bradycardia algorithm. The team should begin CPR and follow the PALS pediatric bradycardia algorithm. Pediatric Drowning Download Hon, K. ,
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EB Medicine
MARCH 1, 2019
This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. The Western Trauma Association broadens the ED thoracotomy window a bit to include anyone with no signs of life but less than 10 minutes of CPR. Ann Emerg Med.
The Skeptics' Guide to EM
MARCH 2, 2019
JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. It required multiple attempts which caused several prolonged interruptions in CPR.
The Skeptics' Guide to EM
DECEMBER 25, 2021
Bystander CPR is being performed. The paramedics performed high-quality CPR and follow their ACLS protocol. CPR is continued while a supraglottic airway is placed successfully. The patient is transported to the emergency department with vital signs absent (VSA). The monitor is hooked up.
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The Skeptics' Guide to EM
FEBRUARY 25, 2023
Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. Your team begins high quality cardiopulmonary resuscitation (CPR). Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base.
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ACEP Now
AUGUST 15, 2023
Staff interrupt you while you’re in Room 3 with a patient you’ve placed on BiPAP, “We have an incoming patient with CPR in progress in five minutes,” the nurse says before adding, “Room 4’s family really wants to talk with you again.” Dr. Koo is an emergency physician and attending at MedStar Washington Hospital Center in Washington, and St.
The Skeptics' Guide to EM
MAY 20, 2023
She is part of the Don’t Forget the Bubbles team and faculty at Queen Mary University in London where she teaches part of the Paediatric Emergency Medicine MSc. They started cardiopulmonary resuscitation (CPR) until EMS arrived. He had been having some upper respiratory symptoms in the previous days.
The Skeptics' Guide to EM
JANUARY 9, 2021
JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services at Tacoma Community College. Case: During a busy emergency department (ED) shift the paramedic phone rings.
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The Skeptics' Guide to EM
AUGUST 14, 2021
Missy is also now the director for Difficult Airway EMS course in Washington State Case: An EMS crew arrives to your emergency department (ED) with a 58-year-old female who suffered a witnessed ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA). Background: We have covered OHCA multiple times on the SGEM.
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Don't Forget the Bubbles
JUNE 17, 2024
Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). A third RCT demonstrated that even brief low-level incivility could increase the risk of major error during CPR by up to 66%.
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The Skeptics' Guide to EM
SEPTEMBER 11, 2021
The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.
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ACEP Now
OCTOBER 11, 2024
Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 3 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Am J Emerg Med.
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The Skeptics' Guide to EM
DECEMBER 2, 2017
He is currently deployed, practicing emergency medicine in an undisclosed location. Case: You are working a regular shift in the emergency department when you hear a code blue called. SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine?
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Mind The Bleep
DECEMBER 27, 2024
Im currently in my third year of working in a rural district general hospital Accident and Emergency Department, and one of the things that has struck me most is the use of pre-hospital medicine. Ive always had a keen interest in pre-hospital medicine.
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ACEP Now
JANUARY 4, 2025
The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established. ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in C booththe main trauma roomwith an ED tech administering CPR. Click to enlarge.)
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ACEP Now
MAY 9, 2024
But since the mid 80s, we have realized that EMS is the clinical practice of emergency medicine outside of the emergency department. Emergency physicians who are not EMS specialized can turn to a number of resources for assistance. But there weren’t the physician resources to support that need,” he said.
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RebelEM
NOVEMBER 20, 2023
Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. The enrolled population was severely injured, with a median ISS of 41, and 23% received CPR.
EMDocs
JANUARY 17, 2024
When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). Upon ED arrival, she had a heart rate (HR) of 160 and blood pressure (BP) of 80s/40s.
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The Skeptics' Guide to EM
NOVEMBER 13, 2021
Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care at Nassau University Medical Center. Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergency department (ED).
Ziqitza HealthCare Ltd
JULY 23, 2023
Ventilators are used in operating rooms, emergency departments, critical care transport units, and air medical transports. They also trained with basic first-aid treatments and training like CPR to save lives. It is a very efficient and well-invented service in the emergency field. Such services can save lives.
Taming the SRU
OCTOBER 1, 2023
This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department. Ann Emerg Med. doi:10.1097/TA.0000000000002192
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Advanced Emergency Nursing from AENJ
NOVEMBER 7, 2015
We had only first aid, oxygen, and CPR to offer. In my opinion, hypnosis is a little-understood but potentially valuable technique for the emergency department. Why isn't hypnosis used more in emergency departments? Hypnosis in the treatment of acute pain in the emergency department setting.
The Skeptics' Guide to EM
NOVEMBER 16, 2019
Laura Melville ( @lmelville535 ) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest.
Dr. Smith's ECG Blog
OCTOBER 20, 2013
Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes. A middle-age woman with h/o hypertension was found down by her husband. With ventilations and epinephrine, she regained a pulse.
Don't Forget the Bubbles
JULY 26, 2023
Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.
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Dr. Smith's ECG Blog
AUGUST 9, 2019
At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1.
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Pediatric Emergency Playbook
APRIL 1, 2017
Be ready to perform CPR. Children 1 year and up, unconscious – CPR: start CPR with chest compressions (do not perform a pulse check). Am J Emerg Med. Emergency department management of foreign bodies of the external ear canal in children. After 30 chest compressions, open the airway. 2004;22(4):310-314.
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