Emergency Medicine Cases

FEBRUARY 13, 2024

In order fix EM, each of us needs to understand systems issues and systems thinking, and advocate for a better system based on sound systems principles and specific solutions. In this main episode EM Cases podcast Anton is joined by Dr. Alecs Chochinov and Dr. Davie Petrie, two systems thinkers and leaders in EM. and many more.

EMS 89

EMS Operations Outcomes Wellness 89

EMDocs

AUGUST 12, 2023

We’ll keep it short, while you keep that EM brain sharp. Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. cc The post EM@3AM: Flexor Tendon Laceration appeared first on emDOCs.net - Emergency Medicine Education. Roberts, James R. DOI: 10.1097/01.EEM.0000410106.40227.cc

EMS 89

EMS Fractures Operations Ultrasounds 89

Pediatric EM Morsels

JUNE 30, 2023

link] PMID: 36553274 The post Congenital Pulmonary Airway Malformation (CPAM) appeared first on Pediatric EM Morsels. I know we already know this, but it especially true when you are talking about trying to obtain images on a wiggling fetus somewhere around the size of a banana. Dec: 9 (12): 1830.

Ultrasounds 284

Ultrasounds Pediatrics Operations EMS 284

EMDocs

DECEMBER 2, 2023

We’ll keep it short, while you keep that EM brain sharp. Available from: [link] yousef, CC BY-SA 4.0 <[link] via Wikimedia Commons The post EM@3AM: Oculomotor Nerve Palsy appeared first on emDOCs.net - Emergency Medicine Education. He has no known medical history and has never been to the doctor. Updated 2022 Jul 4].

EMS 86

EMS Operations Pediatrics Emergency Department 86

EMDocs

NOVEMBER 18, 2023

We’ll keep it short, while you keep that EM brain sharp. Liver Transplantation: Operative Techniques and Medical Management. x The post EM@3AM: Liver Transplant Complications appeared first on emDOCs.net - Emergency Medicine Education. Am J Transplant. 2022;22 Suppl 2:204-309. doi:10.1111/ajt.16978 McGraw Hill; 2021.

EMS 89

EMS Ultrasounds Emergency Department Outcomes 89

Pediatric EM Morsels

JULY 19, 2024

4-17% will rebleed No difference in rebleed rate between those that are treated operatively and those that are observed On average, the second bleed occurs 3-4 days after the first bleed Some bleeds are considered “ delayed post-tonsillectomy hemorrhage ” and can occur over 14 days after tonsillectomy. Well… sometimes it starts again.

Airway Management 290

Airway Management Pediatrics Wellness Operations 290

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) A systematic review linked SMA syndrome to the immediate post-operative period after surgery for scoliosis in pediatric patients, and found the mean days to onset of symptoms was 9. PMID: 31451453 The post Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children appeared first on Pediatric EM Morsels. BMJ Case Rep.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

RebelEM

NOVEMBER 6, 2024

PMID: 31082090 Post Peer Reviewed By: Anand Swaminathan MD, MPH (Insta @EMSwami) The post Elbow Dislocations appeared first on REBEL EM - Emergency Medicine Blog. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.

Dislocations 107

Dislocations Fractures Soft Tissue Injuries Outcomes 107

Emergency Medicine Journal

NOVEMBER 28, 2023

Background The regional emergency medical service (EMS) in Lombardy (Italy) developed clinical algorithms based on operator-based interviews to detect patients with COVID-19 and refer them to the most appropriate hospitals. Results The training set includes 264 976 patients, median age 74 (IQR 55–84).

Operations 52

Operations EMS Hospitals Outcomes 52

Pediatric EM Morsels

NOVEMBER 3, 2023

Both have a range of detection limits, which can be greatly dependent on operator. For non-complicated malaria use oral Co ART em. PMID: 30666615 The post Imported Malaria appeared first on Pediatric EM Morsels. Treating malaria is an ART! Add oral Primaquine if known to have P. vivax or P. 2019; 47(2): 183–193.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Emergency Medicine Journal

SEPTEMBER 25, 2024

Background Emergency Medical Services (EMS) studies have shown that prehospital risk stratification and triage decisions in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) can be improved using clinical risk scores with point-of-care (POC) troponin. The primary end point was the hospital diagnosis of NSTE-ACS.

EMS 97

EMS EKG/ECG Operations Hospitals 97

Pediatric EM Morsels

MARCH 1, 2024

Chest CT Demonstrates parenchymal disease better Allows for operative planning (if needed) Lung Abscess in Children: Management Rarity of the condition affects what is known (no randomized control trials on therapeutic options). The post Lung Abscess in Children appeared first on Pediatric EM Morsels. Pediatr Emerg Care.

Ultrasounds 173

Ultrasounds Pediatrics Operations Hospitals 173

The Skeptics' Guide to EM

JANUARY 25, 2025

Jestin Carlson is the Program Director for the AHN-Saint Vincent EM Residency in Erie Pennsylvania. Dr. Richard Bukata We have had the pleasure of both working for the Legend of EM, Dr. Richard Bukata.He is an amazing educator and a great human being.

Research 48

Research EMS Documentation/Coding Operations 48

Mind The Bleep

DECEMBER 27, 2024

A few years later, I took an active role in the EM Soc committee and helped to organise their annual conference – that year themed with a pre-hospital focus. Air Ambulance Charities operate many air ambulances in the UK and have associated rapid response cars for when the weather doesnt allow for flying.

Hospitals 52

Hospitals Ambulance Services Operations Teamwork 52

Ziqitza HealthCare Ltd

JANUARY 23, 2024

In the rapidly changing landscape of healthcare, Emergency Medical Services (EMS) play a critical role in saving lives and providing timely medical assistance. As we step into 2024, one company stands out as a pioneer in transforming EMS – Ziqitza Healthcare ltd.

EMS 52

EMS Telemedicine Ambulance Services Operations 52

Pediatric EM Morsels

APRIL 28, 2023

In general, non-operative treatment is reserved for Type I fractures and type II. Non-operative management is appropriate if extensor mechanism is intact and the avulsed fragment is displaced less than 2 mm or able to be reduced (hyperextension at the knee) to an acceptable degree of displacement.

Fractures 130

Fractures Pediatrics Operations Wellness 130

Pediatric EM Morsels

NOVEMBER 17, 2023

The post Cuffed Endotracheal Tubes for Children: ReBaked Morsel appeared first on Pediatric EM Morsels. 0.41), p < 0.001. 2016 Feb;30(1):3-11. doi: 10.1007/s00540-015-2062-4. Epub 2015 Aug 22. PMID: 26296534.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

EMDocs

OCTOBER 3, 2023

Here is an example of an order of operations for mid-shift overwhelm… Priority 1: Stabilize and manage critical (or potentially critical) patients. They say that dispo is king and you may want to put this elsewhere in your order of operations. This must always be the first priority. How do you re-enter your sequence?

Documentation/Coding 117

Documentation/Coding EMS Operations Emergency Department 117

Taming the SRU

SEPTEMBER 25, 2023

This places a significant responsibility on the EM physician to diagnose and treat fractures. Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture.

Fractures 101

Fractures Operations Emergency Department EMS 101

ACEP Now

MAY 4, 2023

EMS recognized a chest wall deformity with movement of the chest wall, and a splint was devised and taped around his chest for what was suspected to be a flail chest. On hospital day 2, he was taken to the operating room for surgical rib fixation. The post Case Report: EMS Says Flail Chest, But Is It? J Surg Res.

EMS 52

EMS Fractures Operations Ultrasounds 52

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

The Skeptics' Guide to EM

MARCH 2, 2024

He will need to be transferred to the tertiary care center which is 35 minutes away by ground EMS if it is a dissection. Type A AoDs generally require an emergent trip to the operating room as soon as they are identified to reduce the likelihood of a terrible outcome. You suspect an acute aortic dissection (AoD).

Emergency Department 131

Emergency Department Stroke Operations Hospitals 131

Dr. Smith's ECG Blog

JUNE 13, 2024

EMS arrived to a pulseless patient in V fib. They sued the the county-operated EMS service for allegedly not dispatching the call fast enough. You can read the defense EM expert report on Dr. Funk's site: [link] Case Outcome The EMTs were found to have personal immunity as part of their employment with the local government.

EKG/ECG 93

EKG/ECG Documentation/Coding EMS Burns 93

EMDocs

DECEMBER 6, 2024

5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. 9 Typical dose: Polyethylene glycol (Go-Lytely ) 25 mL/kg/hr in small children and 1.5-2 2 L/hr in adults. 9 There is no role for activated charcoal as it does not adsorb iron.11

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

American Medical Compliance

FEBRUARY 15, 2023

Such facilities may be fined for having problems but they remain to operate without paying penalties. Assisted Living Administrator Training Program Assisted living administrators’ main role in the facility is to oversee the daily operations of the facility.

EMS 52

EMS Administration Infectious Diseases Operations 52

American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. EMS Fraud Waste and Abuse Training Compliance Knowing various examples of FWA is part of FWA compliance training.

EMS 52

EMS Administration Documentation/Coding Operations 52

RebelEM

OCTOBER 2, 2023

The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics.

Operations 97

Operations Academics Fluid Resuscitation Outcomes 97

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery.

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

Don't Forget the Bubbles

JUNE 30, 2023

These procedures require an experienced operator. A joint statement released by the American College of Surgeons/American College of Emergency Physicians recommends that zone 1 REBOA should only be performed if the anticipated time to start the operation is less than 15 minutes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

ACEP Now

NOVEMBER 7, 2023

Expand Your Knowledge of the Business of EM Practice Essentials, an online, asynchronous curriculum developed by ACEP and EMRA, dives into reimbursement, contracts, operations and risk management, and other topics that may not have been covered in depth during medical school or residency. Learn more at openbook.acep.org.

Leadership 98

Leadership Administration Research Risk Management 98

RebelEM

APRIL 17, 2023

While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. appeared first on REBEL EM - Emergency Medicine Blog. Additionally, potential increases in resource utilization, healthcare expense, and ED length of stay are also essential considerations.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

Pediatric EM Morsels

JUNE 16, 2023

Arch Orthop Trauma Surg 2013;133(5):635-640.23443527 The post Morel-Lavallée Lesion in Children appeared first on Pediatric EM Morsels. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Soft Tissue Injuries 154

Soft Tissue Injuries Dehydration Fractures Operations 154

RebelEM

JUNE 19, 2023

We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures). Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators. PMID: 20554319 Post Peer Reviewed By: Salim R.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

NOVEMBER 20, 2023

Comparator: The control group received standard care provided at a major trauma center, including intubation, blood product transfusion, interventions like tourniquet application, and early operative or endovascular hemorrhage control. J Spec Oper Med. PMID: 30566723 Bulger EM, Perina DG, Qasim Z, et al. 2018;18(4):37-55.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

ACEP Now

SEPTEMBER 5, 2024

Our state chapter members and leaders are uniquely positioned to follow EMRA’s lead in partnering with local EM residency programs to improve communication of ACEP’s value to EM-bound medical students and EM residents by hosting residency visits or local events relevant to our shared mission.

Leadership 98

Leadership PPE EMS Wellness 98

Ziqitza HealthCare Ltd

MARCH 18, 2024

One critical area often overlooked is emergency medical services (EMS). As climate change intensifies, so do the challenges faced by EMS providers. As the demand for emergency assistance surges during such crises, EMS teams must be well-prepared to manage the influx of patients and navigate complex conditions to reach those in need.

Ambulance Services 52

Ambulance Services Telemedicine EMS Operations 52

Don't Forget the Bubbles

JUNE 19, 2024

Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. A proportion of the patients who were initially missed using the CDR were found to actually have risk factors documented in EMS reports or the medical record.

CPR 124

CPR Research Documentation/Coding Outcomes 124