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Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. 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.
Hypothermia for Neuroprotection in Convulsive Status Epilepticus. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. He then has another seizure in the department.
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 emergencydepartment (ED) shift the paramedic phone rings.
Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. They performed high-quality CPR and shocked the patient twice before giving amiodarone via intraosseous (IO).
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergencydepartment: a non-inferiority multicentre randomised controlled trial. Emerg Med J. 2018 Sep 11;362:k3843. doi: 10.1136/bmj.k3843.
The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?
Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.
The fragility index of these findings found to be 1 for VC and 9 for DED Obtaining a second defibrillator in the emergencydepartment or intensive care unit can be very easy to do. With everything just mentioned considered, DED, in addition to other resuscitative therapies, should still be used for patients in RVF. N Engl J Med.
An 18-month-old boy presents to the emergencydepartment with loss of consciousness. As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. What is your diagnosis, and what are your next steps in evaluation and management? 1 Fever is usually < 40C. 1 Fever is usually < 40C. Temps greater than 41.5C
A gravid woman presents to your emergencydepartment (ED). Neonatal resuscitation is common; 10 percent of the four million newborns in the U.S. 2 These rare scenarios are difficult to prepare for; resuscitation guidelines are not strictly followed in more than 90 percent of cases. How do you stabilize this patient?
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). Classification of hypothermia.
First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Resuscitation 2020. Evidence-Based Heatstroke Management in the EmergencyDepartment. West J Emerg Med 2021. April 26, 2023) Acute Hyperthermia in the EmergencyDepartment.
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?” Predictions scores such as the HOPE score can be used to guide treatment.
3 Once the patient arrives in your emergencydepartment, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Fluid resuscitation will likely be warranted, and with crystalloid solution is most appropriate. 4 Another study cited only 2.3
Previous triad of death = hypothermia, acidosis, and coagulopathy. Liver dysfunction, secondary cirrhosis, critical illness, trauma, and hypothermia reduce citrate metabolism. Hypothermia also leads to hypoCa. Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic.
There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergencydepartment). Any life-threatening hyperthermia should be treated immediately with an ice bath.[2] Therefore, fluid resuscitation and maintenance are important.
Yates Foot Infection NSTIs are rare but deadly pathology that need to be considered with any soft tissue infection NSTI is a clinical diagnosis, but there are many imaging and laboratory assessments to help increase clinical suspicion Expedited disposition to the OR for NSTIs under 12 hours from ED presentation significantly decreases mortality Emesis (..)
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.).
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. Airway management in place when ROSC was achieved, or resuscitation was discontinued.
What neuroprotective measures can we undertake in the emergencydepartment? After a traumatic brain injury, all children and young people should have a C-ABCDE rapid assessment for life-threatening injuries (as per ATLS guidelines) focussed on trauma resuscitation and stabilisation, followed by a secondary assessment.
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.
Labs and Lytes 040 Author: Dr Nasreen Bahemia Peer reviewers: Dr Craig Johnston, A/Prof Chris Nickson A 56-year-old female presented to the EmergencyDepartment (ED) with 2 days of severe nausea, vomiting and diarrhoea. It refers to hypernatraemia, hyperventilation, haemodialysis, and induced hypothermia.
The other important moment to always think of the heart (sorry, cardiologists, I don’t think about the heart 24/7) is when a collapsed neonate presents to your emergencydepartment, especially if blood pressure is present. Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia.
Intranasal fentanyl and discharge from the emergencydepartment among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0
Children often spend many hours in the emergencydepartment (ED) before being sent home or admitted. In this issue of Pediatrics , Leyenaar and colleagues reported on a trial to compare the effectiveness of direct admission to bypass their emergencydepartments. Pecenka C, et al. 2024 Sep 21;404(10458):1157-1170.
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, million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.
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. However, there is limited evidence to guide decisions on when to stop resuscitation efforts in this population.
Signs of malnutrition – which places patients at higher risk for infection – can include cachexia, muscular wasting, sunken eyes, redundant skin folds, edema, brittle skin and hair, bradycardia, hypotension, and hypothermia. HIV Prevention and Treatment: The Evolving Role of the EmergencyDepartment. Ann Emerg Med.
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