RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. 13 That is to say nothing of the effect that the type and response to shock has on the individual patients involved in these studies. Youre told they were in respiratory distress, febrile, and borderline hypotensive. Castro R, et al.

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Ultrasounds Shock Fluid Resuscitation Resuscitation 74

EMDocs

MARCH 23, 2024

Management of high-risk pulmonary embolism in the emergency department: A narrative review. Am J Emerg Med. Source Effectiveness of Fludrocortisone Plus Hydrocortisone Versus Hydrocortisone Alone in Septic Shock: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. doi:10.1016/j.ajem.2024.01.039

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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. N Engl J Med. 2000 May 4; PMID: 10793162 Harvey CE, et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

University of Maryland Department of Emergency Med

JANUARY 23, 2023

An Uncommon Cause of Shock Sepsis is the most common cause of distributive shock encountered in the emergency department and intens. Click to view the rest

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Shock Sepsis Emergency Department 40

ACEP Now

JANUARY 4, 2025

The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established. Clarke was then hired as assistant director in the emergency department (ED) at Pomona Valley Hospital, Pomona, Calif. Click to enlarge.) Click to enlarge.)

Forensics 52

Forensics Urgent Care Emergency Department Hospitals 52

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

Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

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Shock Sepsis Pediatrics Ultrasounds 40

EMDocs

NOVEMBER 19, 2024

Low-dose lipid emulsion for pediatric vasoplegic shock due to quetiapine and fluvoxamine overdose: a case report. J Emerg Crit Care Med Vol 6 (October 30, 2022) J Emerg Crit Care Med. His roommate found an empty pill bottle on the floor next to him. Intravenous lipid emulsion as an adjuvant therapy of acute clozapine poisoning.

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Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 6 What Can I Do Outside of Repeated Shocks and Standard ACLS? Circulation.

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Resuscitation Shock Stroke Hospitals 98

Greater Sydney Area HEMS

FEBRUARY 20, 2024

Obtaining access in shocked trauma patients can be notoriously difficult due to circulatory collapse. Those who are shocked, shut down with limited or no other options for peripheral access require central access. It is currently the subject of future research and publication in the emergency department setting.

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Ultrasounds Shock Research Operations 98

ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention. 2017 Jun;32:660-6. 2021.02.026.

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Emergency Department Operations Psychiatric EMS 64

EMDocs

DECEMBER 23, 2024

Do we still shock? Its narrow indication for stable VT means many emergency departments may not routinely stock the medication. After a little bit of etomidate and a quick shock, the patient was back in normal sinus rhythm and cardiology was consulted for evaluation. If the patient has a BP of 60/palp, its easy, right?

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EKG/ECG Shock Wellness EMS 75

EMDocs

AUGUST 24, 2023

Study design Multicenter prospective observational cohort study across seven urban emergency departments. 18.6%) Takeaways: Drawing blood cultures 30-120 min and 30-240 min after antibiotics has significant decrements in the rate of culture positivity in patients with septic shock. Difference of 12% (95% CI 5.4

Administration 95

Administration Sepsis Shock Emergency Department 95

Taming the SRU

JULY 24, 2024

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

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

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Life in the Fast Lane

JANUARY 10, 2024

John Mackenzie and Amanda Beech Procedure: Speculum examination Emergency Procedure: Speculum examination, how (and when) to find the cervix in the emergency department.

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Emergency Department Shock 105

Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. None of the physicians in the study believe that the rate of violence has decreased at all. Therefore this should remain high on the differential if a patient with history of SCAD presents with similar symptoms.

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EKG/ECG Shock Fractures Dislocations 93

EMDocs

OCTOBER 9, 2023

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 emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado. Circulation.

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Basic Life Support CPR Fractures Emergency Department 108

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. International Consensus Criteria for Pediatric Sepsis and Septic Shock.

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Hospitals Sepsis Fractures Emergency Department 78

ACEP Now

JUNE 6, 2023

When considering an optimized environment for compassionate patient communication, the chaotic emergency department (ED) probably gives some clinicians pause. Example: “ I can imagine this comes as a shock” or “ I can hear how upset you are.” Example: “Would it be okay for me to share some of my concerns?”

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Emergency Department Hospitals Best Practices Shock 98

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

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Administration Emergency Department Outcomes Documentation/Coding 98

EMDocs

MARCH 9, 2025

Clinical Presentation of Acute Osteomyelitis in the Pediatric Emergency Department. Pediatr Emerg Care. Which of the following, if present, would put this patient at a higher risk of osteomyelitis? 2020;8(6):e19.00202-e19.00202. doi:10.2106/JBJS.RVW.19.00202 19.00202 Stephan AM, Faino A, Caglar D, Klein EJ. 2022;38(1):e209-e213.

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Pediatrics EMS Infectious Diseases Fractures 52

EB Medicine

AUGUST 6, 2022

In this episode, Sam Ashoo, MD interviews Adam Sigal, MD and Stephanie Costa, MD - the authors of the August 2022 EMP article on Managing Acute Cardiac Valvular Emergencies in the Emergency Department. Listen to the discussion to hear more about the emergency medicine approach to valvular emergencies.

COPD 52

COPD Emergency Department Shock EKG/ECG 52

Dr. Smith's ECG Blog

JANUARY 1, 2024

AslangerE A 65-year-old gentleman presented to the emergency department after experiencing two recent ICD shocks in the preceding hours. The subsequent ECG, taken 5-10 minutes post-shock, depicted a soothing of ST deviation. This was contributed by Co-editor Emre Aslanger, an interventional cardiologist in Turkey.

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EKG/ECG Shock Emergency Department Administration 112

RebelEM

APRIL 29, 2024

World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Case: You are working night shift in the emergency department.

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Sepsis Emergency Department Seizures Pediatrics 52

PEMBlog

OCTOBER 18, 2023

Initially in the emergency department he was generally well-appearing with normal vital signs. Neonatal Toxic Shock Syndrome C. Neonatal Toxic Shock Syndrome-Like Exanthematous Disease E. This condition is Induced by the superantigen toxic shock syndrome toxin-1 (TSST-1), produced by Staphylococcus aureus.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Taming the SRU

SEPTEMBER 21, 2023

Results were similar in sensitivity analysis excluding patients with pre-intubation hypotension and including only patients intubated for shock. The study population used in this study is generally similar to the population encountered daily in the average emergency department in the United States.

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Outcomes Emergency Department Shock 93

The Skeptics' Guide to EM

JUNE 6, 2020

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Guest Skeptic: Dr. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Case: It’s another day in your emergency department (ED).

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Sepsis Shock Resuscitation Administration 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause.

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Emergency Department Sepsis Operations Dehydration 40

EMDocs

MARCH 30, 2024

Answer : Thoracic and Lumbar Spine Trauma Epidemiology: Approximately half of the vertebral injuries that are seen in the emergency department are thoracic and lumbar injuries. Intervertebral disks lie between vertebrae and act as shock absorbers. J Emerg Med. The spinal canal houses the spinal cord. September 30, 2017.

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EMS Fractures Emergency Department Dislocations 105

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Sepsis Hospitals 52

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

EB Medicine

DECEMBER 1, 2021

Imaging CXR Echo CT MRI Aortogram Treatment BP management Heart Rate Shock Surgery – Who goes and when? It is in Beta and your feedback is welcome. ED Care History HTN, Pulse defecits, Chest Pain, Syncope?Table Table 3 ADD-RS score Exam Diagnostics Labs EKG – STEMI?

EKG/ECG 52

EKG/ECG Emergency Department EMS Shock 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. 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.

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Shock CPR Hyperthermia / Hypothermia EMS 52

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. Then ACS (STEMI) might be primary; this might be cardiogenic shock. He had this ECG recorded. Are the lungs clear? Is the patient cool and pale?

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

Don't Forget the Bubbles

OCTOBER 10, 2024

The others, such as respiratory rate, heart rate, and decompensated shock, were excluded due to the presumed difficulty for non-healthcare professionals to assess them accurately. There is a significant misalignment between parent and professional scoring systems. Wilson K, Umana E, McCleary D, Waterfield T, Woolfall K. Arch Dis Child.

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Emergency Department Outcomes Research Operations 75