This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
On a busy day shift in the emergencydepartment, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? This is the essence of emergency medicine. Dr. Koo is faculty and an emergency physician at MedStar Washington Hospital Center in Washington, D.C.,
Fluid management in the EmergencyDepartment (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.
This time we have our first group of colleagues from Birmingham Children’s HospitalEmergencyDepartment. Intranasal fentanyl and discharge from the emergencydepartment among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective.
Im currently in my third year of working in a rural district general hospital Accident and EmergencyDepartment, 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!
Edmonson and Adler for this infographic that concisely emphasizes key concepts for the recognition and initial management of acute respiratory distress syndrome (ARDS) in the EmergencyDepartment. Initial Resuscitation in ARDS [NUEM Blog. 2024, Jul 15). Expert Commentary by Esposito, AJ.
You’re in the paediatric emergencydepartment, typing some notes for the child you’ve just discharged. Resuscitation is a team sport. As you arrive in resus, so too do half the children’s hospital. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. Ready your team.
The biggest question is, why does your hospital want you to use it? Typically, hospital administrators pressure trauma programs to adopt an eTFS at some point after implementing the hospital-wide use of an electronic health record (EHR). When I started this series nearly 15 years ago, many hospitals still used paper charting.
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 emergencydepartment with blunt trauma: a multicentre prospective observational study. Resuscitation.
A young woman, 13 days post-tonsillectomy, comes into your rural emergencydepartment (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.
EmergencyDepartmentResuscitative 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%
Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line.
You are the Paediatric doctor on call and receive a call for an incoming patient to the emergencydepartment. Tragically, several attempts at resuscitation upon arrival at the emergencydepartment were unsuccessful. Pediatric Endotracheal Intubations for Airway Management in the EmergencyDepartment.
The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergencydepartment: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. Sepsis is a significant cause of mortality in children, and fluid resuscitation is a key treatment strategy.
Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline. Iron Ingestion: an Evidence-Based Consensus Guideline for Out-of-Hospital Management. Basic assessment: airway, breathing, circulation.
Diagnosis of Acute Aortic Syndrome in the EmergencyDepartment (DAShED) study: an observational cohort study of people attending the emergencydepartment with symptoms consistent with acute aortic syndrome. first appeared on The Skeptics Guide to Emergency Medicine. She is received in the resuscitation room.
Resuscitate prior to intubation. Bronchoscopy (Pulmonology/critical care): Used in intubated patients, those too unstable for CT despite resuscitation, or if the source of bleeding is not clear despite other imaging (CT). Am J Emerg Med. The emergencydepartment evaluation and management of massive hemoptysis.
Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergencydepartments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergencydepartment – A Swedish cohort study. Resuscitation. Resuscitation.
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.
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.
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 emergencydepartment, the surgeon or emergency physician can do this. Think about it.
If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Stercoral colitis in the emergencydepartment: a review of the literature. International journal of emergency medicine, 17(1), 3. Annals of emergency medicine, 82(1), 3746.
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 emergencydepartment (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergencydepartment (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.
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.
Because the patient had asystole, was resuscitated without difficulty, and had no neurologic function, suspected a cerebral hemorrhage was suspected as the etiology of the arrest, specifically subarachnoid hemorrhage. in Vienna found that 27 of 765 (4%) of out of hospital cardiac arrests (OHCA) were due to SAH. Kurkciyan et al.
Source Use of Glucagon-Like Peptide-1-Agonists and Increased Risk of Procedural Sedation and Endotracheal Intubation in the EmergencyDepartment. 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.
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.
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.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergencydepartment. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.
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.).
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.
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?”
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.
Background: Standard rapid sequence intubation (RSI) in the emergencydepartment involves administration of an induction agent and a neuroblocking agent in quick succession. appeared first on REBEL EM - Emergency Medicine Blog.
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 EmergencyDepartment that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.
While a randomized control trial should be done to evaluate the effect of early proning in a controlled environment, these studies suggest that we should consider using this in our EmergencyDepartment for patients who present with hypoxia and concern for mild to moderate ARDS without urgent need for intubation. Crit Care Med.
. #3: Handy EMS OHCA Handoff Checklist Spoon Feed In this video review, information contained in out-of-hospital cardiac arrest (OHCA) patient handoffs was highly variable, which is an area for quality improvement and standardization. Resuscitation. Try this checklist! 2023 Aug;189:109834. doi: 10.1016/j.resuscitation.2023.109834.
Introduction Frostbite is a frequent presenting complaint to emergencydepartments (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)
Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. EmergencyDepartmentResuscitative 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].
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 emergencydepartment (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado. J Am Heart Assoc.
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%.
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.
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.
emergencydepartments 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.
We organize all of the trending information in your field so you don't have to. Join 5,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content