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.

CPR 52

CPR Administration Outcomes Hospitals 52

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 ). High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. How do you manage this situation?

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

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.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

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.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

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.

Resuscitation 52

Resuscitation CPR Outcomes Sepsis 52

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.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

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).

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

RebelEM

DECEMBER 19, 2022

In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. On the topic of EMS and similar to the pilot study, there was an incredibly high amount of bystander CPR performed. Thus limiting the external validity of this paper’s findings.

EMS 52

EMS CPR Shock Resuscitation 52

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.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Research Documentation/Coding 40

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. 1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC).

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

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.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

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 ). His name is Ben. Burgart, A.M.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Don't Forget the Bubbles

MAY 3, 2023

Results of this study showed that the use of low-dose insulin infusion led to similar clinical outcomes and fewer adverse events compared to the standard-dose insulin infusion. Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children? Why does it matter? Resuscitation.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

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. As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11].

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Fractures COPD Hospitals Emergency Department 97

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). Ann Emerg Med. link] Published April 13, 2023.

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. Key to survival is high-quality CPR and early defibrillation.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

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.

EKG/ECG 135

EKG/ECG Resuscitation CPR Emergency Department 135

ACEP Now

OCTOBER 11, 2024

1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance. Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. Acad Pediatr.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

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.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

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]. Outcome: Primary Outcome: All-cause mortality at 90 days. Paper: Jansen JO, Hudson J, Cochran C, et al.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

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. The data was analyzed in relation to initial rhythm, outcomes and changes or delay in treatment. Results: Over 8.5

Resuscitation 52

Resuscitation EKG/ECG Hospitals Emergency Department 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Clin Chem [Internet] 2020;Available from: [link] Smith mini-review: Troponin in Emergency Department COVID patients Cardiac Troponin (cTn) is a nonspecific marker of myocardial injury.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

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.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

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? The survival rate for adults to hospital discharge is 24.8%.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

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. The American journal of cardiology 2011;107:495-500.

EKG/ECG 52

EKG/ECG Shock Emergency Department Wellness 52

Don't Forget the Bubbles

DECEMBER 5, 2023

Roughly 30% of patients with ulcerative colitis are diagnosed as children or young adults, and this early diagnosis is associated with poorer long-term outcomes. The primary outcome measure was the time patients collected their repeat prescriptions, i.e. their adherence. PMID: 37666511; PMCID: PMC10498382. What’s it about?

Resuscitation 111

Resuscitation Outcomes CPR Emergency Department 111

Taming the SRU

SEPTEMBER 1, 2023

Lane & Mcdonough Definition of an immediate whole body CT (iWBCT) scan Shortly after patient arrival. 2015) reported a sensitivity of 98.9%

Sepsis 96

Sepsis Fractures Documentation/Coding Administration 96

Don't Forget the Bubbles

JANUARY 6, 2025

Reviewed by: Mikaeel Jaffer Article 2: Does the duration of pre-hospital CPR affect neurological outcomes? Yasuda M, Amagasa S, Kashiura M, et alDuration of prehospital and in-hospital cardiopulmonary resuscitation and neurological outcome in paediatric out-of-hospital cardiac arrestEmergency Medicine Journal 2024;41:742-748.

Dislocations 59

Dislocations CPR Ultrasounds Resuscitation 59

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65