The Skeptics' Guide to EM

NOVEMBER 16, 2019

Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Research Documentation/Coding 40

Taming the SRU

MARCH 30, 2024

Predictions scores such as the HOPE score can be used to guide treatment.

Hyperthermia / Hypothermia 95

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 95

The Skeptics' Guide to EM

DECEMBER 16, 2017

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. Case: Johnny is a […] The post SGEM#199: Therapeutic Hypothermia – What is it Good For? He is known to have poorly controlled epilepsy.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 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. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

EM SIM Cases

NOVEMBER 3, 2023

Jared Baylis and Dr. Kelly Huang Dr. Baylis is the Simulation Medical Director at University of British Columbia – Southern Medical Program and Interior Health, as well as an editor of EM Sim Cases. CLINICAL VIGNETTE 58 y/o M presents with hyperthermia and confusion, and was found by bystanders to be acting strange.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG EMS Hospitals 52

RebelEM

JUNE 19, 2023

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. Primary Results Patients enrolled from 15 emergency medical services at 21 hospitals across 3 countries over 7 years. Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. Article: How-Berlemont C, Lamhaut L, Diehl J, et al. JAMA Cardiol. 1.15; P= 0.32

Hospitals 59

Hospitals Outcomes EKG/ECG Resuscitation 59

The Skeptics' Guide to EM

OCTOBER 22, 2022

Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying […] The post SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR? Background: We have covered Out of Hospital Cardiac Arrests (OHCAs) many, many times on the SGEM.

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

ACEP Now

OCTOBER 3, 2023

There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day. 2,3 TBI outcomes are profoundly linked to the timing and quality of care provided before patients reach the hospital. The guidelines also address issues related to EMS provider skill level, transportation modality, and destination for the patient.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. BLS for out-of-hospital cardiac arrest (OHCA).

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

The Skeptics' Guide to EM

MAY 8, 2021

He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. CPR is initiated and a hospital rapid response team is called.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 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. Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Date: August 12th, 2021 Reference: Daya et al.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

OCTOBER 24, 2020

Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience. Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience.

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Hegeman EM, et al. Schwindt EM, et al. Disparities in Clinical Ethics Consultation Among Hospitalized Children: A Case-Control Study.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. They had a difficult time getting a definitive airway pre-hospital.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

Broome Docs

OCTOBER 31, 2022

PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. Circulation. 2022 Sep 28:101161CIRCULATIONAHA122060106.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

Emergency Medicine Cases

FEBRUARY 9, 2021

How do we mitigate the risk of hypothermia? What can hospitals do to mitigate blood wastage? What should be the lab resuscitation targets? Why is serum calcium important to draw in the ED for the patient who is exsanguinating?

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Resuscitation Hospitals EMS 52

EMDocs

FEBRUARY 9, 2024

Authors: Adam Roussas, MD, MBA, MSE // Reviewed by: Jamie Santistevan, MD ( @jamie_rae_EMdoc, EM Physician, Presbyterian Hospital, Albuquerque, NM); Manpreet Singh, MD ( @MPrizzleER ); and Brit Long, MD ( @long_brit ) Case A 40-year-old female presents to the emergency department for palpitations and lightheadedness. Am J Emerg Med.

EKG/ECG 91

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 91

Don't Forget the Bubbles

JUNE 30, 2023

However, patients in the 1:1 group had the lowest 24-hour mortality ( 14% vs 18% vs 22% vs 24% ; p = 0.01), and in-hospital mortality ( 32% vs 36% vs 40% vs 44% ; p = 0.01). NEPTUNE 2023 was inaugural UK PEM trauma conference, hosted by Nottingham University Hospitals Trust, one of the largest major trauma centres in the UK.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

MAY 1, 2023

EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75 Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures. and NPV(50%).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert.

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 52

The Skeptics' Guide to EM

JUNE 24, 2017

Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline).

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia CPR Resuscitation EMS 40

RebelEM

DECEMBER 19, 2022

At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here.

EMS 52

EMS CPR Shock Resuscitation 52

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Nachi: Among metabolic abnormalities, patients can present with hyperthermia, hypoglycemia, hypokalemia, hyponatremia, and metabolic acidosis.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

JUNE 27, 2024

768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4

Pediatrics 94

Pediatrics Dehydration EMS Hospitals 94

Don't Forget the Bubbles

AUGUST 4, 2024

The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Morris and colleagues investigated the efficacy of refrigerated gel packs for therapeutic hypothermia in neonatal retrieval. Brewster RCL, et al.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics Burns Sepsis 52

Don't Forget the Bubbles

OCTOBER 2, 2024

The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Soll RF, Edwards EM. Original clinical studies Prevention of NICU Admission Hypothermia in Moderate- and Late-Preterm Infants. Pediatrics.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52

Don't Forget the Bubbles

DECEMBER 6, 2023

The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Abrams EM, et al. Risk Factors for Admission Hyperthermia and Associated Outcomes in Preterm Infants. Can’t get enough of Bubble Wrap?

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Research Hospitals 52

Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

EMDocs

JANUARY 6, 2025

Based on available hospital resources, the patient is treated for septic shock secondary to pneumonia and an infected wound using broad-spectrum antibiotics and IV crystalloid fluids. Undernourished children presenting to an urban emergency department of a tertiary hospital in Tanzania: a prospective descriptive study. 2017;3:17067.

Infectious Diseases 72

Infectious Diseases CDC PPE Rapid Diagnostic Testing 72