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We’ll keep it short, while you keep that EM brain sharp. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. The post EM@3AM: Murine Typhus appeared first on emDOCs.net - Emergency Medicine Education. Curr Opin Infect Dis. 2016 Oct;29(5):433-9. Perera P, Mailhot T, Riley D, Mandavia D. 2009.09.010.
Regarding caval indexes, the advent of artificial intelligence and advanced learning has become integrated into many ultrasound machines. Ultrasound Med Biol. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial.
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?
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.
Some useful videos: Hopefully you found the podcast interesting, but since this is quite a visual topic we have put together some videos to demonstrate some of the pathologies discussed and what they look like on ultrasound: How does ultrasound work? Want to know how to use ultrasound? Their section on POCUS is here.
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.
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.
AirCare - Derm Emergencies - R4 Capstone - Landmarks of EM - Global Health - Toxicology Aircare Grand ROunds WITH Drs. Ultrasound: Make “windows of access”. Keep your upper chest and sternum clear. Lung and heart views are most critical in HEMS as they determine interventions that change patient care.
Clinical Take Home Point: In adult patients with trauma at risk of massive transfusion, receiving standard trauma resuscitation management, the addition of 4F-PCC did not result in a decrease in blood product consumption over 24 hours compared to placebo. appeared first on REBEL EM - Emergency Medicine Blog. to 3.33; P = 0.72
Patients were actively screened for DVT (all received lower extremity ultrasound on or around day 7). 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). Demographics were well balanced in the two groups.
Authors: Alex Rogers, MD (EM Resident Physician, Christus Spohn/Texas A&M University School of Medicine, Corpus Christi, TX); J.D. 2] Labs that may be useful after the initial resuscitation and for the admitting physician may include a basic metabolic panel and an arterial or venous blood gas analysis. [2]
Remember that while mistakes in resuscitation are often dissected and analyzed, it is equally crucial to acknowledge and celebrate the moments of impeccable execution, where lives are saved and hope is restored. He is on a vasopressin infusion now after the four unit bolus from the initial resuscitation. This guy is an ultrasound guru.
It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.
Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director. His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. When EMS arrived, they found the patient to be responsive only to painful stimuli and was moaning.
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. His primary interests are resuscitation, prehospital critical […] The post SGEM#231: You’re So Vein – IO vs. IV Access for OHCA first appeared on The Skeptics Guide to Emergency Medicine.
The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Part 1 here.
His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Case: A 60-year-old male is […] The post SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial first appeared on The Skeptics Guide to Emergency Medicine. Date: January 9th, 2020 Reference: Casey et al.
Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. EMS verbalized concern to EPs that an “intracranial bleed” may have precipitated the event. Introduction to Bedside Ultrasound, iBook Ch 2, Basic Cardiac, Pg 27.
Resuscitation , Volume 181,2022,Pages 140-146,ISSN 0300-9572, [link] Scott Weingart, MD FCCM. Available from: [link] Siamak Moayedi, Priya Patel, Nicholas Brady, Michael Witting, Timm-Michael L. Anteroposterior pacer pad position is better than anterolateral for transcutaneous cardiac pacing.” EMCrit 310 – Transvenous Pacemakers. EMCrit Blog.
We piloted a novel approach to HALO procedure training for senior EM trainees using low fidelity, user-resettable, peer-supported simulation. EM trainees in South-East Scotland completed a one-day training course, rating aspects of the day, and self-assessed pre-and post-training procedural confidence, on 7-point Likert scales.
The post EM Quick Hits 33 Polytrauma Tips & Tricks, Toxic Megacolon, ECG in PE, Patch Calls, CT Before LP, Nebulized Ketamine appeared first on Emergency Medicine Cases.
In this part 2 of our 2-part podcast series on Cardiac Arrest - The When, Why & How, we discuss some of the finer art of cardiac arrest care and answer questions such as: how should we best communicate to EMS, the ED team and the family of the patient to keep the team focused, garner the most important info and keep the flow of the code going?
The post EM Quick Hits 20 Imaging Renal Colic, Human Trafficking, Atrial Fibrillation During COVID, Transvenous Pacemaker Placement, COVID Lung POCUS, COVID Derm, Virtual Simulation appeared first on Emergency Medicine Cases.
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.
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. Ultrasound determination of chest wall thickness: implications for needle thoracostomy. link] Fitzgerald, M.,
The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonary embolism). Cardiac Ultrasound may be a surprisingly easy way to help make the diagnosis Answer: pulmonary embolism. Now another, with ultrasound.
Clinical pathologic case presentation - r1 diagnostics/therapeutics: Lumbar punctures - AIRWAY GROUND ROUNDS- r4 capstone - r3 taming the sru - ultrasound grand rounds Clinical pathologic case presentation WITH Drs. If assessing for SAH, xanthochromia may not appear until 12 hours after onset, though may appear after 2-4 hours.
hours earlier and went to OR 3.5 hours earlier and went to OR 3.5 billion passengers annually 1 medical emergency per 604 flights Most common complaints: Syncope/presyncope: 37.4% Respiratory symptoms: 12.1% Nausea and vomiting: 9.5% Diversion occurs 7.3% of in-flight emergencies Deaths occurred 0.3% Respiratory symptoms: 12.1%
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
Every 30 minutes, a range of topics draws new participants to discuss everything from mastering ultrasound techniques to finding career mentorship. EM Showdown Quiz: Watch emergency physicians enter the BattleDocs Arena to answer tough medical questions for a chance to be crowned champion. Emergency Ultrasound Management Course: (Sept.
Firstly do a bit of resuscitation. The key is to do an assessment, this likely includes having a sneaky peak at the heart and the lungs with ultrasound. Reading: Oh Chapter 61 Tasty Morsels of EM 130 The IBCC Deranged Physiology Welcome back to the tasty morsels of critical care podcast. Firstly do a bit of resuscitation.
Allan Shefrin tells his Best Case Ever of a child who presents in shock and discusses the causes of tension hydrothorax, indications for tube thoracostomy for hydrothorax and integration of POCUS into pediatric resuscitation. The post BCE 81 Tension Hydrothorax appeared first on Emergency Medicine Cases.
This is the first ever video podcast on EM Cases with Jordan Chenkin from EMU Conference 2017 discussing how to optimize three aspects of cardiac arrest care: persistent ventricular fibrillation, optimizing pulse checks and PEA arrest, with code team videos contrasting the ACLS approach to an optimized approach.
A bedside ultrasound was done by the emergency physician, using Speckle Tracking. EMS recorded the following ECG: What do you see? The first time I looked at this, from afar, I did not see it, but after drawing the lines, one can clearly see abnormal ST elevation very suggestive of high lateral STEMI.
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.
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Smith comment: This patient did not have a bedside ultrasound. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension.
CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: Diagnosis of appendicitis, in a pregnant patient, ultrasound vs. mri. Jeff: Next we have everybody’s favorite, the ultrasound. Jeff: Indeed. Sounds familiar.
And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Jeff : I’m an EMS fellow, what can I say… Anyway, on to my favorite section -- prehospital care. So quite a few changes!
Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Jeff: With your initial stabilization underway, you can begin to gather a more thorough history either from bystanders or EMS if they are still present.
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. Jeff: Next up is ultrasound.
A bedside cardiac ultrasound was performed with a parasternal long axis view demonstrated below: There is a large pericardial effusion with collapse of the right ventricle during systole. The beat-to-beat variation in QRS amplitude and morphology is electrical alternans. 780 cc of bloody fluid was removed from the pericardial cavity.
Nachi: And if the prehospital team is lucky enough, or maybe unlucky enough, i don’t know, to have a credentialed provider who can perform ultrasound for those suspected of having a blunt cardiac injury, the general prehospital data on ultrasound is sparse. Jeff: Great, let’s move onto ED care, beginning with the H&P.
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