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 94

Operations Radiology Radiology Fluid Resuscitation 94

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics.

Operations 102

Operations Academics Fluid Resuscitation Outcomes 102

American Medical Compliance

FEBRUARY 15, 2023

When you look for such courses, look for topics such as first aid, personal care, and resuscitation techniques. Such facilities may be fined for having problems but they remain to operate without paying penalties. This training is for nurses and those who have an administrative background whose goal is to become administrators.

EMS 52

EMS Administration Infectious Diseases Operations 52

PHEM Cast

DECEMBER 12, 2016

pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

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. This was in addition to a phenomenally fast EMS response time.

EMS 52

EMS CPR Shock Resuscitation 52

RebelEM

AUGUST 7, 2023

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. that would not be possible in an agitated/combative patient.

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

ACEP Now

NOVEMBER 16, 2023

emergency medicine (EM) residency training length has been a decades-long dilemma: four versus three years. First, is three years enough time to become an EM physician? But critical questions remain unanswered when it comes to specialization, career trajectory, and actual competence as an EM physician. percent versus 90.8

Academics 52

Academics EMS Telemedicine Research 52

RebelEM

JANUARY 25, 2023

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

EM SIM Cases

SEPTEMBER 19, 2024

EMS applied combat application tourniquet to leg on scene 45 minutes ago. Intubation for clinical course and pain management need to be addressed with disposition to the operating room. No LOC but altered with some reported alcohol consumption. Was wearing a life jacket with minimal submersion.

Shock 52

Shock Emergency Nursing Operations Administration 52

PHEM Cast

DECEMBER 1, 2017

For example, here are the locations identified as ‘2nd ICS mid clavicular line’ amongst 25 EM physicians in a 2005 EMJ paper. Pleural decompression and drainage during trauma reception and resuscitation. Journal of Special Operations Medicine : a Peer Reviewed Journal for SOF Medical Professionals , 13 (4), 53–58.

Academics 52

Academics Radiology Radiology Resuscitation 52

RebelEM

MARCH 27, 2023

What They Did: Retrospective, observational cohort study in a single high-volume academic hospital The ED had a 5 bed area used for ongoing management and resuscitation of patients who clinically deteriorate while boarding or while actively undergo a workup in other sections of the ED. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Taming the SRU

JULY 31, 2024

However, believers in this superstition will perceive crazier shifts if the word is uttered so you probably shouldn’t say it, or use cautiously Full moons have no impact on ED, EMS, or HEMS volumes or acuity. Nice people are not more likely to get cancer.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

RebelEM

JUNE 8, 2023

Rezaie, MD (Twitter: @srrezaie ) The post The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults appeared first on REBEL EM - Emergency Medicine Blog. Am J Emerg Med. 2016; PMID: 27720568 Guest Post By: Courney Knieriem, MD PGY-1, Emergency Medicine Resident RWJBH Community Medical Center, Toms River, NJ Courtneyknieriem.md@rutgers.edu

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Emergency Medicine Cases

JANUARY 4, 2022

What are the best strategies to efficiently get the patient in cardiogenic shock to definitive care, whether that be the cath lab or the operating room? How can we best pick up occult cardiogenic shock before it floured shock kicks in? Which patients with acute heart are safe to send home in general?

Shock 52

Shock Operations Ultrasounds Resuscitation 52

ACEP Now

JULY 7, 2023

She was reported to have had a mechanical fall, landing face forward without loss of consciousness, and has had a continuous nosebleed since then, per EMS and the home care provider. On EMS arrival, it was noted that the patient had what seemed to be a controllable nosebleed with difficulty locating the source due to constant oozing.

Airway Management 45

Airway Management EMS Burns Operations 45

Advanced Emergency Nursing from AENJ

JULY 9, 2015

They may be entrapped; have limited access; may be midway in an operating position that can’t be changed; may need to be sitting due to pulmonary edema, morbid obesity, aspiration prevention or for awake intubation. Resuscitation, 56(1), 83-89. YouTube.com [Time=33’11” Presentation] EMS World. Try these situations.

Airway Management 40

Airway Management Pediatrics Resuscitation Emergency Nursing 40

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is not possible during acute resuscitation or at any time before a complete investigation, or even trial, to know who is innocent, guilty, or what occurred during the altercation. Police officers have poor hit probability, ricochets may occur, suppressive fire may be used (“keep ‘em pinned down”), or even ‘spray and pray.”

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. She was defibrillated and resuscitated.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

DECEMBER 6, 2024

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. When analyzing the receiver operating characteristic (ROC) curve of the pooled data, optimal diagnostic accuracy of MDW for sepsis prediction was seen (pooled sensitivity of 0.838 and specificity of 0.704 for Sepsis-3 criteria). She had a fever of 38.7 °C

Sepsis 92

Sepsis Fluid Resuscitation Resuscitation Shock 92

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

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.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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. Assessed and provided feedback of pediatric resuscitations based on video review.

Resuscitation 93

Resuscitation Administration Fluid Resuscitation Research 93

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Czech Military resuscitation kit, 1969, mfr.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients.

Operations 98

Operations EMS Fluid Resuscitation Resuscitation 98

EMDocs

SEPTEMBER 25, 2023

Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway. Operators can manipulate the blade with less force to optimize the view, making it easier to identify and navigate the endotracheal tube into the trachea.

Emergency Department 92

Emergency Department Soft Tissue Injuries Operations Airway Management 92

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. It is most often blunt trauma.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

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). This should continue to make TXA part of standard trauma resuscitation while additional studies are performed.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

Don't Forget the Bubbles

MAY 3, 2023

Because of the retrospective nature of the study, the decision to use the bougie was operator-dependent. The effect of hand position on chest compression quality during CPR in young children: Findings from the Videography in Pediatric Resuscitation (VIPER) collaborative. Resuscitation. 2023;185:109741. O’Connell et al.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

PHEM Cast

JULY 6, 2017

[link] The West Midlands surgical skills course offers cadaveric training for PHEM and EM practitioners on rare life saving procedures. Cricothyrotomy performed with the Melker set or the QuickTrach kit: procedure times, learning curves and operators’ preference. Click here to go straight to their page. Frerk et al. Sottile, D.,

Airway Management 52

Airway Management Academics Operations Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 3, 2017

Guest Skeptic: Dr. Rory Spiegel is a clinical instructor at University of Maryland and a recent graduate of Stony Brook’s Resuscitation Fellowship. Guest Skeptic: Dr. Rory Spiegel is a clinical instructor at University of Maryland and a recent graduate of Stony Brook’s Resuscitation Fellowship.

Emergency Department 52

Emergency Department Resuscitation Operations EMS 52

Critical Care Now

JULY 7, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Methodological challenges, such as extended prehospital transport times, limited operator experience, and small sample size, introduce uncertainty to these findings.

Resuscitation 52

Resuscitation Military Outcomes Hospitals 52

Critical Care Now

JULY 7, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Methodological challenges, such as extended prehospital transport times, limited operator experience, and small sample size, introduce uncertainty to these findings.

Resuscitation 52

Resuscitation Military Outcomes Hospitals 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

The latter 1950s and 1960s, quested for nerve gas defense studying expired air resuscitation and modern resuscitology; developing intensive care units. To me, it harkens a new scientific renaissance of resuscitation science, emergency care, and creating systems for care. 1950s & 1960s Resuscitation Research.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Northwestern EM Blog

SEPTEMBER 12, 2022

This post will discuss a brief overview of hospital planning and operational setup with key elements of a disaster response from events that cause high numbers of blunt trauma, penetrating trauma, burns or crush injuries that may be seen following explosive events, mass shootings, or large scale motor vehicle collisions, to name a few.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52