The Skeptics' Guide to EM

FEBRUARY 11, 2024

Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. first appeared on The Skeptics Guide to Emergency Medicine. She is received in the resuscitation room.

Emergency Department 120

Emergency Department Resuscitation Hospitals Research 120

Taming the SRU

DECEMBER 17, 2024

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none. Emerg Med Australas 2013;25(6):52734.

Dehydration 82

Dehydration Fluid Resuscitation Administration Resuscitation 82

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. Enter Nith Inshore Rescue!

Hospitals 52

Hospitals Ambulance Services Operations Teamwork 52

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergency department – A Swedish cohort study. Resuscitation. Resuscitation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

ACEP Now

DECEMBER 6, 2024

Before nitroglycerin (NTG) could be administered, the patient became unresponsive and was transferred to the resuscitation bay, where the monitor revealed a ventricular fibrillation arrest. We present a case of refractory ventricular fibrillation resuscitation due to coronary vasospasm from recent amphetamine use with IV NTG.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

The Trauma Pro

AUGUST 15, 2023

One of the most creative solutions I’ve seen is the use of a hospital security officer. They know the hospital layout cold, including that obscure corner where the blood bank is located. In the emergency department, the surgeon or emergency physician can do this. Think about it.

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Administration 130

Taming the SRU

MARCH 27, 2024

Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial. In this study, the authors aim to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients. Hill, J.

Resuscitation 97

Resuscitation Outcomes CPR Hospitals 97

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

The Skeptics' Guide to EM

JUNE 15, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Pre-hospital personnel placed the patient in a cervical spine collar, obtained peripheral intravenous (IV) access, administered 250cc of 0.9%

Resuscitation 89

Resuscitation Patient Safety Operations Emergency Department 89

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. first appeared on The Skeptics Guide to Emergency Medicine. Prehospital Emergency Care. Prehospital Emergency Care.

Resuscitation 74

Resuscitation Airway Management EMS Outcomes 74

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Reference: Cashen K, Reeder RW, Ahmed T, et al.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Taming the SRU

MARCH 30, 2024

Visiting lecturer: structural leadership - taming the sru - r4 sim and oral boards “Innovation Meets the Bedside: The Evolution of New Models of Emergency Care Delivery” WITH dr. ben bassin “What problem are you trying to solve?”

Hyperthermia / Hypothermia 93

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 93

The Trauma Pro

NOVEMBER 12, 2024

This is a quality initiative that was developed by the Emergency Medical Services for Children program (EMS-C), which partnered with the American College of Emergency Physicians, the Emergency Nurses Association, and the American Academy of Pediatrics. This is of significance to both trauma and non-trauma hospitals.

Pediatrics 113

Pediatrics Emergency Nursing Hospitals Resuscitation 113

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

Critical Care Now

JULY 14, 2024

This week’s article, by Heuts et al, titled “Extracorporeal cardiopulmonary resuscitation versus standard treatment for refractory out-of-hospital cardiac arrest: a Bayesian meta-analysis” is a fresh take on the issue. Now, before we dive into the weeds, we need to establish what exactly a Bayesian meta-analysis is.

Resuscitation 98

Resuscitation CPR Outcomes Sepsis 98

Don't Forget the Bubbles

JUNE 30, 2023

In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Taming the SRU

MARCH 11, 2024

Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). Knee dislocations make up less than 0.5% No open wound. ABI’s were 1.1 bilaterally.

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. appeared first on REBEL EM - Emergency Medicine Blog.

Outcomes 95

Outcomes Administration Emergency Department Resuscitation 95

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). The patient is extubated and decannulated four days later.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

EM Ottawa

NOVEMBER 2, 2023

Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1)

Emergency Department 117

Emergency Department Wellness Hospitals Resuscitation 117

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. 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].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Broome Docs

MARCH 28, 2024

A non-inferiority randomized controlled trial comparing nebulized ketamine to intravenous morphine for older adults in the emergency department with acute musculoskeletal pain. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation. Age Ageing.

PPE 107

PPE Ultrasounds Resuscitation Administration 107

EMDocs

JUNE 12, 2024

Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic. Giancarelli et al found that 97% of patients who underwent massive transfusion protocols during trauma resuscitation were hypocalcemic (iCa < 1.1 The diamond of death: Hypocalcemia in trauma and resuscitation. Am J Emerg Med.

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. 3 A three-pronged management approach provides a framework for addressing post-tonsillectomy bleeds: resuscitation, early ENT consultation with transport arrangements, and temporizing measures applied to control bleeding.

Airway Management 90

Airway Management Operations Resuscitation Pediatrics 90

Broome Docs

NOVEMBER 17, 2024

Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. Resuscitation. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Resuscitation.

Administration 62

Administration Resuscitation Radiology Radiology 62

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. It is currently the subject of future research and publication in the emergency department setting. i] Leibowitz A, Oren-Grinberg A, Matyal R. Anesthesiology 2018; 128 : 38–43. [v]

Ultrasounds 98

Ultrasounds Shock Research Operations 98

EMDocs

SEPTEMBER 14, 2024

Source Use of Glucagon-Like Peptide-1-Agonists and Increased Risk of Procedural Sedation and Endotracheal Intubation in the Emergency Department. Ann Emerg Med. Source The impact of time to defibrillation on return of spontaneous circulation in out-of-hospital cardiac arrest patients with recurrent shockable rhythms.

Emergency Department 71

Emergency Department Resuscitation Pediatrics Research 71

The Skeptics' Guide to EM

DECEMBER 2, 2017

Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival. JAMA 2017 Guest Skeptic: Dr. Bob Edmonds is an Emergency Physician in the US Air Force. He is currently deployed, practicing emergency medicine in an undisclosed location. The survival rate for adults to hospital discharge is 24.8%.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests first appeared on The Skeptics Guide to Emergency Medicine.

Advances Cardiac Life Support (ACLS) 40

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

ACEP Now

AUGUST 15, 2023

You may be ruminating on the unsuccessful resuscitation of a cardiac arrest in a young mother, all the notes to be done, or the dread of possibly missing something on the patients you signed out or discharged. The senior nurse who was the key lead in a resuscitation when you were occupied with a crash femoral central line.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

PulmCCM

JULY 3, 2023

emergency departments and ICUs were randomized to undergo either DL or VL for intubation. More than 90% of the intubations were performed by emergency medicine residents (~70%) or critical care fellows (~23%). Registries like the National Emergency Airway Registry only partially address that important gap in data.

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. Overall all-cause adult survival was 6.1%.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

The Skeptics' Guide to EM

JANUARY 9, 2021

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. first appeared on The Skeptics Guide to Emergency Medicine. Case: During a busy emergency department (ED) shift the paramedic phone rings.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

EB Medicine

OCTOBER 2, 2022

In this episode, Sam Ashoo, MD interviews Rawad Rayes, MD and Eva Tovar Hirashima, MD, MPH – two of the authors of the August 2022 PEMP article on Pediatric Firearm Injuries to the Extremity: Management in the Emergency Department. Episode Outline: How common are pediatric firearm injuries?

Pediatrics 52

Pediatrics Emergency Department Resuscitation Hospitals 52