Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. Ann Emerg Med. Int J Emerg Med.

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Emergency Department Ultrasounds Administration Burns 92

EM Ottawa

NOVEMBER 27, 2023

Question and Methods: Multi-center pragmatic Bayesian RCT comparing 90d all-cause mortality and 10 secondary outcomes in trauma patients with hemorrhage receiving REBOA + standard of care vs. standard of care alone Findings: At 90d, 54% of patients in the […] The post Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta (..)

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Emergency Department Resuscitation Outcomes 58

St. Emlyn

JUNE 4, 2024

St.Emlyn's - Emergency Medicine #FOAMed This study in the Journal of Trauma Acute Care Surgery shows that emergency department (ED) intubation for patients needing urgent haemorrhage control surgery is linked to higher mortality and complications.

Emergency Department 48

Emergency Department Resuscitation Research Outcomes 48

RebelEM

APRIL 29, 2024

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.

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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.

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Dehydration Fluid Resuscitation Administration Resuscitation 84

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. Pediatric Endotracheal Intubations for Airway Management in the Emergency Department.

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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. You initiate standard, simultaneous assessment and resuscitation following the Advanced Trauma Life Support (ATLS) principles. Reference: Jansen et al.

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Resuscitation Patient Safety Operations Emergency Department 112

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.

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Emergency Department Resuscitation Hospitals EKG/ECG 130

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. These unprocessed emotions can lead to vicarious trauma , especially in resuscitation providers. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. Resuscitation.

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RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. J Crit Care. N Engl J Med. Crit Care Explor.

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Emergency Department Operations Academics Documentation/Coding 52

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.

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Resuscitation EKG/ECG Documentation/Coding COPD 98

Taming the SRU

JULY 24, 2024

Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world.

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Sepsis Resuscitation Emergency Department Wellness 89

EM Literature of Note

JANUARY 27, 2024

A brief post collating a few bits of my various work published across the interwebs … The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Apple Podcasts Google Podcasts Soundcloud Naturally, there are continuing Journal Club features, covering the (..)

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Resuscitation Emergency Department Shock Wellness 96

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Post-resuscitation ECGs demonstrating ST segment elevation are significant in delineating which patients might benefit most from advanced reperfusion techniques. Resuscitation. Resuscitation.

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Resuscitation Shock Stroke Hospitals 98

The Skeptics' Guide to EM

APRIL 11, 2020

Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: It has been a hard shift. You wish you […] The post SGEM#289: I Want a Dog to Relieve My Stress in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine.

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Emergency Department Resuscitation Wellness 52

ACEP Now

OCTOBER 9, 2023

In life-threatening emergencies, it is often not possible to obtain such consent. 1 The time pressure of trauma resuscitations and the variable severity of injury make obtaining informed consent before a trauma exam difficult. Patient experiences of trauma resuscitation. Advanced Trauma Life Support: Student Course Manual.

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Resuscitation Research Stroke Emergency Department 126

ALiEM

JULY 22, 2023

You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. Note that conventional pressure bags may not be readily available in emergency departments and could blow the line you worked hard to secure. However, the crystalloid fluids are not flowing freely.

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Fluid Resuscitation Dehydration Emergency Department Administration 96

EB Medicine

NOVEMBER 17, 2020

Write us at emplify@ebmedicine.net.

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Emergency Department Shock Resuscitation CPR 40

EMDocs

JUNE 29, 2024

Resuscitation. 2: Nebulized vs IV Sub-dissociative Ketamine for Pain Spoon Feed Ketamine has been shown to be efficacious in managing acute pain conditions in the emergency department (ED), and this study showed equal efficacy between nebulized and intravenous administration of sub-dissociative ketamine (IV-SDK). . #2:

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Dr. Smith's ECG Blog

OCTOBER 20, 2013

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. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes.

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Resuscitation EKG/ECG Hospitals Emergency Department 52

The Trauma Pro

AUGUST 15, 2023

In the emergency department, the surgeon or emergency physician can do this. The emergency physician was left behind in the ED and the surgeon is up to her elbows in trouble. One best practice to consider: a highly trained trauma resuscitation nurse or advanced practice provider (APP) can run the MTP from the sidelines.

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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. February 2024.

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Resuscitation Airway Management EMS Outcomes 90

University of Maryland Department of Emergency Med

JUNE 8, 2023

Recognizing that the studies discussing emergency department thoracotomy (ERT) in traumatic injuries are performed at large institutions. Click to view the rest

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Resuscitation Emergency Department 60

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.

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Emergency Department Administration Dehydration EMS 52

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.

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Resuscitation CPR Outcomes Hospitals 99

EM Ottawa

OCTOBER 24, 2024

Historically, it has been used more frequently in the ICU than in Emergency Departments, likely due to provider comfort. […] The post Is there a Precedence for Precedex in the ED? It offers a unique profile of sedation without respiratory depression, making it an attractive option in various clinical scenarios.

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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). Resuscitation. The management of accidental hypothermia.

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Hyperthermia / Hypothermia Resuscitation CPR EMS 104

EMDocs

OCTOBER 28, 2023

Spoon Feed Don’t hang your hat on lactate clearance to assess therapeutic response to resuscitation in sepsis; there are too many confounders, and initial clearance does not necessarily project clinical course. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: 1: How Useful Is Lactate Clearance Anyway?

Emergency Department 85

Emergency Department Pediatrics Sepsis Resuscitation 85

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.

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Leadership Resuscitation Teamwork Patient Safety 105

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 95

Hyperthermia / Hypothermia Emergency Department Leadership Seizures 95

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.

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Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 104

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.).

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Resuscitation Operations Sepsis Pediatrics 139

EMDocs

AUGUST 22, 2023

Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Capnography for the nonintubated patient in the emergency setting. Ann Emerg Med. Predictive value of capnography for suspected diabetic ketoacidosis in the emergency department. West J Emerg Med.

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Emergency Department Blood Transfusions Resuscitation Sepsis 87

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)

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Emergency Department Wellness Hospitals Resuscitation 123

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. Resuscitation. The post Journal Feed Weekly Wrap-Up appeared first on emDOCs.net - Emergency Medicine Education. 2024 Aug;84(2):226-227. 2024.03.007.

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Emergency Department Resuscitation Pediatrics EKG/ECG 90

The Skeptics' Guide to EM

AUGUST 27, 2022

He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. […] The post SGEM#374: Bad Habits – Medications for Opioid Use Disorder in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine. Date: August 23rd, 2022 Reference: Schoenfeld et al.

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Emergency Department Research Administration Resuscitation 40

RebelEM

SEPTEMBER 9, 2024

A newborn boy presents to the emergency department shortly after a home delivery. Neonatal resuscitation in the delivery room. Cardiopulmonary resuscitation. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. The mother had routine prenatal care and reports that he was due in 2 days. Post TW, ed.

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