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Well keep it short, while you keep that EM brain sharp. Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. BioMed Research International, 2020, 1-10. Journal of Research in Pharmacy Practice, 6(1), 31. link] Fan, L., Li, C., & Zhao, H.
Kendra Jackson and Rebecca Raffler While we’ve gotten to snack on a Morsel on this subject before , new guidelines and research surrounding DKA and cerebral edema have come to light since the first go ‘round! The Pediatric Emergency Medicine Collaborative Research Commitee. Authors: Drs. Lesson = treat early! 2002 Dec;141(6):793-7.
emergency medicine (EM) residency training length has been a decades-long dilemma: four vs. 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. 11 What should we take away?
This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). What They Did: Researchers performed a systematic review and meta-analysis. Am J Emerg Med. 2023;73:34-39.
Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM. On arrival, you find a 35-year-old male, pulseless and apneic with cardio-pulmonary resuscitation (CPR) in progress by a bystander.
Population: Patients successfully resuscitated from OHCA without a clear diagnosis on presentation who were stable for CT. Costs include actual cost of the scans as well as delaying other patients’ scans but also includes time taken away from resuscitation to move the patient to and from CT. IQR 2.2 – 69.5) Resus 2023.
Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. Most of the research on the use of MB has been in patients with vasoplegia following cardiopulmonary bypass. septic shock). 95% CI 15.4 vs 0.5% (Range 0.4
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.
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.
At our institution patients do not go for diagnostic heart catheterization and then get put on ECMO, they are initiated on ECMO during the time of their initial resuscitation and then go for heart catheterization once they are stabilized. Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 Control 3.8%
Emergency Critical Care Center (EC3) at the University of Michigan: Dedicated critical care unit within the emergency department that was created to improve access to timely, high-quality critical care after identifying a gap in emergency care delivery for patients Reduced risk-adjusted 30 day mortality among all ED patients, lower ICU admission rates (..)
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].
These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. The GCS must be obtained through interaction with the patient (i.e.,
The PATCH-trauma researchers sought to address this critique. 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). appeared first on REBEL EM - Emergency Medicine Blog.
Every year, the volume of published research continues to outpace capacity to consume. Gotta catch ‘em all!” Effect of lower vs higher oxygen saturation targets on survival to hospital discharge among patients resuscitated after out-of-hospital cardiac arrest: the exact randomized clinical trial. 2023;330(23):2267.
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. From my own experience, a vast array of medical care can be provided at events, from being able to suture at the scene, to commencing a full-blown resuscitation.
Additionally, there is ongoing research into targeting improvements in the interventions we know work. Examples include mechanical CPR, which hasn’t been shown to be superior to manual CPR but does make running a resuscitation easier, and dual sequence defibrillation, which appears to be useful in certain circumstances.
Robert’s academic interests include research and evidence-based medicine. Alongside his EM residency, he is doing a PhD in epidemiology. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Reference: Roberts et al.
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Background: It’s interesting to see how fluid resuscitation has been debated over the years. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL).
In this systematic review and meta-analysis, researchers aim to establish an accurate prehospital TCA mortality rate and explore associations between survivability and the many factors contributing to prehospital TCA management. However, we might expect on-scene advanced trauma resuscitation to prolong prehospital time sizably.
And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. These tables are used when assessing the usefulness of a test (or it’s sensitivity and specificity), and, when researching how useful tests are we need the majority of patients to fall into the green boxes.
Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. While REBOA may not be a universal solution, further research is needed to determine specifically which patients or injury patterns would benefit from its deployment.
Kids are Challenging Spoon Feed In this cross-sectional simulation study of seven EMS agencies in Oregon, researchers found that resuscitation quality was significantly lower in pediatric out of hospital cardiac arrests (OHCA) compared to adult OHCA as measured by defect free resuscitations.
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
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 ResuscitationResearch.
From the early 1950s to the early 1960s, validation by researchers such as James O. Pask) into drowning and funded early Cold War research into protection from Nerve Gas, that sprouted the saving of thousands of lives. Let's look at the early expired air resuscitation adjuncts!
PNU was withdrawn from the US market in 1979, however, there is still active small-scale manufacturing in the People’s Republic of China, and it is available online for purchase as a research chemical.¹ In these cases, PNU ingestion would most likely originate from exposure to an old household rodenticide or exposure to a “research chemical”.
Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.
AHA gives focused recommendations . The International Liaison Committee on Resuscitation (ILCOR) has for some years been meeting and agreeing upon resuscitation practices every five years; in addition to which there is the necessary slack time before and after each meeting to produce and disseminate the newly appropriate course materials.
Some other different features this year include: Integrated Research Forum: Get ready for an electrifying experience at ACEP’s Research Forum, emergency medicine’s premier research event! EM Showdown Quiz: Watch emergency physicians enter the BattleDocs Arena to answer tough medical questions for a chance to be crowned champion.
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. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Intensive Care Med. 2022 Jan;48(1):78-91. Epub 2021 Dec 14.
Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. And for most forms, EM physicians are not typically shocked by shock. Critical Care Research and Practice. However, what happens when the trusted treatment paradigm fails?
Dr. Dark: Our profession is composed of over 44,000 ABEM certified emergency physicians, about 96 percent of whom are EM residency trained. I would probably have to do some research to see if there are any particular subject areas that are problematic. Our conversation has been edited for space and clarity.
Adrenaline in cardiac arrest Jim Manning reviewed progress in resuscitation and compared ‘artificial perfusion’ with the effective interventions of ‘artificial ventilation’ and defibrillation. He argued that artificial perfusion is where we are least successful and reviewed the evidence for adrenaline.
In this main episode podcast 4-step Approach to Bradycardia and Bradydysrhythmias with electrophysiologist, educator and researcher Dr. Paul Dorian and Chair of Education for the ED at Cook County Hospital Dr. Tarlan Hedayati, we dig deep into bradycardia. What is BRASH syndrome and how can we recognize it?
Optimal management of septic patients has been a source of intense research, stemming from the landmark study by Rivers in 2001. Also, for research purposes we have to have a common definition, so Sepsis 3 came up with something called the SOFA score. Jeremy, can you give us a little historical context there? So quite a few changes!
St.Emlyn's - Emergency Medicine #FOAMed Here at St Emlyn’s we have often talked about decisions and decision complexity. Our belief is that one of the key attributes of the clinician who works in emergency care … JC: Prehospital transfusion decision making.
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.”
Any patient requiring high acuity care not thought to be infected with coronavirus was cared for in a different area that had previously been a low acuity zone, but which was subsequently equipped for resuscitation. Other agents, also part of research protocols, were not similarly limited to intubated patients. doi:10.1016/j.accpm.2020.06.011
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.
EMS Grand Rounds with Dr. Connelly - R4 Case Follow up with Dr. Broadstock - R1 Clinical Knowledge: Vitamin Deficiencies WITH Dr. de Castro - Lecture R3 Small Groups Tox,Tasks,Rashes WITH Dr. Fabiano, Dr. Kein, and Dr. Martella4 - Palliative Medicine Consultation WITH Dr. Kiser EMS Grand Rounds WITH Dr. ConnelLy What I learned in my time with Sydney (..)
Everything ECMO 048: History of ECPR evidence and considerations for future research Author: Dr George Walker Peer reviewer: A/Prof Aidan Burrell Introduction The first recorded attempts to resuscitate patients were as early as 1530 where Swiss physician Paracelsus used fireplace bellows to reinflate the lungs of those who had stopped breathing.
We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. Resuscitation. , 148 , 173–190. Point of care glucose in the field was 102 mg/dL.
Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Non-traumatic critically ill patients: There are many formulas (i.e.,
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