Dr. Smith's ECG Blog

JULY 25, 2024

EMS arrived and found him in Ventricular Fibrillation (VF). For clarity in Figure-1 — I've reproduced today's ECG — obtained following successful resuscitation of out-of-hospital cardiac arrest. This patient was witnessed by bystanders to collapse. They started CPR. He was defibrillated into VT.

Resuscitation 116

Resuscitation EKG/ECG CPR Shock 116

ACEP Now

JUNE 21, 2023

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?

EMS 114

EMS Academics Telemedicine Operations 114

Emergency Medicine Cases

NOVEMBER 28, 2023

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine (..)

EMS 114

EMS Pediatrics Resuscitation 114

RebelEM

DECEMBER 23, 2024

saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). PMID: 39250114 Clinical Question: In adult patients admitted for a vaso-occlusive episode, does early fluid resuscitation with Lactated Ringer solution compared to 0.9%

Fluid Resuscitation 82

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 82

EMDocs

SEPTEMBER 7, 2024

We’ll keep it short, while you keep that EM brain sharp. Laborator evaluation: CBC, CMP, lipase, type and screen, coagulation panel Treatment: 1-3 Resuscitation with blood products as necessary for hemodynamic stability. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank.

EMS 75

EMS Fluid Resuscitation Resuscitation Radiology 75

EMDocs

OCTOBER 19, 2024

We’ll keep it short, while you keep that EM brain sharp. 2][3] Management/Disposition ABCs and resuscitation if indicated Assessment for need of definitive airway is imperative as rate of intubation is high (38-100%) in various studies. [2][3][9] 2] Suggested antibiotics include: ceftriaxone or cefotaxime + vancomycin or clindamycin.

EMS 88

EMS Pediatrics Sepsis Airway Management 88

Emergency Medicine Cases

DECEMBER 3, 2024

On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C.

Documentation/Coding 95

Documentation/Coding EMS Resuscitation 95

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Available from: [link] The post Neurogenic Shock in Children appeared first on Pediatric EM Morsels. Never fear.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

Ken Grauer, MD

APRIL 26, 2024

The ECG in Figure-1 — was obtained on the scene by EMS ( E mergency M edical S ervices ). Unfortunately the patient arrested before catheterization could be completed — and could not be resuscitated. The patient was a man in his 90s, who ~1 hour earlier, noted the onset of severe CP ( C hest P ain ).

EKG/ECG 395

EKG/ECG Resuscitation EMS Wellness 395

Emergency Medicine Cases

NOVEMBER 12, 2024

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. Dr. George Kovacs and Dr. Andrew Petroniak answer this and other questions such as: how should we re-sequence the trauma resuscitation depending on immediate life-threats? and many more.

Airway Management 109

Airway Management Resuscitation EMS Head Injuries 109

Emergency Medicine Cases

JANUARY 15, 2019

EM Quick Hits is a brand new EM Cases podcast that contains 5 minute segments chosen from 10 specific topics by 10 different experts and educators. They include toxicology, trauma, ophthalmology, orthopaedics, resuscitation, human factors, addiction and pediatric emergencies.

Resuscitation 52

Resuscitation Pediatrics EMS Wellness 52

Emergency Medicine Cases

MAY 10, 2022

On this month's EM Quick Hits: Christina Shenvi on ACS in older people, Nour Khatib on rural NRP, Jess McLaren on how not to get fooled by ECG computer interpretation, Brit Long on hemophilia recognition and workup, Maria Ivankovic on persistent and intractable hiccups from EM Cases Summit 2021.

Resuscitation 52

Resuscitation EMS EKG/ECG Pediatrics 52

Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. 13406 The post Cerebral Edema and Diabetic Ketoacidosis: Rebaked appeared first on Pediatric EM Morsels. or serum bicarbonate between 11-17 mmol/L Moderate : venous pH < 7.2

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

Intensive Blog

MARCH 13, 2024

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.

CPR 130

CPR Resuscitation Outcomes Hospitals 130

Emergency Medicine Cases

SEPTEMBER 26, 2023

I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma.

Anaphylaxis 115

Anaphylaxis Resuscitation EMS 115

Emergency Medicine Cases

OCTOBER 22, 2024

Do you learn a lot from EM Cases?

Fractures 95

Fractures EMS Resuscitation 95

Emergency Medicine Cases

JULY 30, 2024

The post EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma appeared first on Emergency Medicine Cases.

Poisoning 96

Poisoning EMS Resuscitation 96

EMDocs

JULY 13, 2024

We’ll keep it short, while you keep that EM brain sharp. The post EM@3AM: Endometritis appeared first on emDOCs.net - Emergency Medicine Education. A 37-year-old G2P2 female with no other past medical history presents to the ED with a 2-day history of intermittent fever and foul-smelling vaginal discharge. Cochrane Database Syst Rev.

OB/GYN 64

OB/GYN EMS Sepsis Fluid Resuscitation 64

RebelEM

JUNE 14, 2023

Scott Weingart, MD put together a manual titled the Resuscitation Crisis Manual , which in short, is composed of two-page protocols for various situations that involve crashing patients. If not treated rapidly can become fatal. On the 1st page are the immediate actions that must be taken to stabilize a crashing patient.

Shock 145

Shock Allergic Reactions Resuscitation EMS 145

Emergency Medicine Cases

JUNE 15, 2020

In this EM Cases Best Case Ever podcast, Dr. Kari Sampsel, Emergency Physician at Ottawa Hospital and Assistant Professor at University of Ottawa, Medical Director of Sexual Assault and Partner Abuse Care Program guides us through an example of a perimortem C-section - a resuscitative hysterotomy at Janus General.

Sexual Assault 52

Sexual Assault Resuscitation EMS Hospitals 52

The Skeptics' Guide to EM

JANUARY 13, 2024

Resuscitation 2023. Date: January 11, 2024 Guest Skeptic: Dr. Chris Root is an EMS fellow in the Department of Emergency Medicine at the University of New Mexico Health […] The post SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

Hospitals 87

Hospitals CPR Resuscitation Airway Management 87

Emergency Medicine Cases

MAY 21, 2019

Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation volumes, inadequate analgesia and inappropriate wound dressings are just some of the issues where a small change to ED practice patterns could have a huge impact on patient care.

Airway Management 52

Airway Management Burns Resuscitation Fluid Resuscitation 52

RebelEM

APRIL 29, 2024

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

JULY 24, 2024

Do you know what the latest evidence in critical care/resuscitation? If this question makes you uncomfortable or you just don’t have time to keep up with the literature, you should sign up for the REBEL Lit Distillery at the ResusX Conference in Philly. Let us help you keep up to date.

Resuscitation 84

Resuscitation EMS 84

RebelEM

MAY 24, 2023

Take Home Points The Parkland formula can be used to be a guide for initial fluid resuscitation. Utilize response to treatment as a guide to continue fluid resuscitation. Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 102.0 – Burn Management appeared first on REBEL EM - Emergency Medicine Blog.

Burns 98

Burns Fluid Resuscitation Resuscitation EMS 98

Dr. Smith's ECG Blog

JULY 9, 2024

His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. He underwent resuscitation including vasopressors, inotropic support, and intubation. What do you think?

EKG/ECG 107

EKG/ECG Resuscitation Shock CPR 107

RebelEM

FEBRUARY 8, 2024

were they in the resuscitative phase? This study does not address the utility of arterial lines vs NIBP in the acute resuscitative phase Author Conclusion: “There was broad agreement between IABP and NIBP in critically ill patients over a range of BPs and severity of illness. appeared first on REBEL EM - Emergency Medicine Blog.

Resuscitation 126

Resuscitation Outcomes EMS Sepsis 126

RebelEM

NOVEMBER 30, 2023

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). Am J Emerg Med. 2023;73:34-39. What They Did: Researchers performed a systematic review and meta-analysis. Am J Emerg Med.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

Emergency Medicine Cases

OCTOBER 13, 2020

The post Neonatal Resuscitation NRP Rapid Reviews Video appeared first on Emergency Medicine Cases. Nick Clarridge runs through the NRP algorithm and delivers the nuggets of wisdom on how best to prepare for the sick neonate, best monitoring practices and ventilation strategies of the neonate.

Resuscitation 52

Resuscitation Pediatrics EMS 52

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.

Dislocations 89

Dislocations Shock EMS Sepsis 89

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch.

Hyperthermia / Hypothermia 85

Hyperthermia / Hypothermia Resuscitation CPR EMS 85

The Skeptics' Guide to EM

NOVEMBER 30, 2024

Case: You’re doing a ride along with your local emergency medical service (EMS) crews and responding to an out-of-hospital cardiac arrest (OHCA). After starting cardiopulmonary resuscitation (CPR), you note pulseless electrical activity (PEA) on the monitor. Most EMS providers are choosing the proximal tibial as their go-to IO access.

Administration 85

Administration CPR Airway Management Outcomes 85

RebelEM

JUNE 1, 2023

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. Resus 2023.

Outcomes 145

Outcomes Resuscitation Hospitals CPR 145

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

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

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.

Hospitals 95

Hospitals CPR EMS Outcomes 95

Emergency Medicine Cases

JUNE 18, 2024

To support EM Cases, please consider a donation here: [link] The post EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments appeared first on Emergency Medicine Cases.

Airway Management 69

Airway Management Poisoning EMS EKG/ECG 69

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

This was written by Magnus Nossen, from Norway, with comments and additions by Smith A 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. Resuscitation efforts were undertaken. How do you interpret the ECG?

EKG/ECG 133

EKG/ECG Resuscitation Academics EMS 133