Pediatric EM Morsels

SEPTEMBER 22, 2023

), 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. ” Children compensate for blood and volume loss very well… until they don’t. Available from: [link] The post Neurogenic Shock in Children appeared first on Pediatric EM Morsels.

Shock 304

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 304

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 81

OB/GYN EMS Sepsis Fluid Resuscitation 81

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. These topics are ones that either are not taught very well in training and/or that physicians tend to be not completely comfortable with.

Resuscitation 52

Resuscitation Pediatrics EMS Wellness 52

EMDocs

DECEMBER 6, 2024

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. 5 Severe metabolic acidosis persists Multi-system organ failure The endpoints of deferoxamine are less well defined but it can be weaned off as the patient is clinically improving, the anion gap resolves, and down-trending serum iron concentration.

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

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 103

Hospitals CPR EMS Outcomes 103

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 144

Outcomes Resuscitation Hospitals CPR 144

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

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 134

EKG/ECG Resuscitation Academics EMS 134

RebelEM

FEBRUARY 24, 2025

Well, the established cutoff for the distensibility index is 18%. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial. Why does it matter? Arterial Pulse Pressure Variation with Mechanical Ventilation. Am J Respir Crit Care Med.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

ACEP Now

JULY 7, 2023

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. Resuscitation. Resuscitation. Resuscitation. Resuscitation. Circulation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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

RebelEM

JUNE 26, 2023

4F-PCC contains factors II, VII, IX, X as well as Proteins S and C. 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.

Administration 139

Administration Outcomes Resuscitation Radiology 139

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

RebelEM

JUNE 7, 2023

Moderate Patients The vast majority of patients will present with a concerning history but clinically may look relatively well. General resuscitation with broad spectrum antibiotics and volume resuscitation if the patient appears to be septic. References Hoffman RS, Burns MM, Gosselin S. Ingestion of Caustic Substances.

Poisoning 94

Poisoning Burns Resuscitation Pediatrics 94

Taming the SRU

FEBRUARY 7, 2024

AirCare - Derm Emergencies - R4 Capstone - Landmarks of EM - Global Health - Toxicology Aircare Grand ROunds WITH Drs.

PPE 98

PPE Administration Ultrasounds Poisoning 98

ACEP Now

OCTOBER 3, 2023

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. The guidelines also address issues related to EMS provider skill level, transportation modality, and destination for the patient.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

RebelEM

SEPTEMBER 14, 2023

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%

Shock 133

Shock Outcomes Resuscitation Stroke 133

RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. This could have influenced care the patients received as well as reporting of adverse events (i.e. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4 Liberal: 14.9% Liberal: 14.9%

Sepsis 99

Sepsis Shock Resuscitation Outcomes 99

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.

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

RebelEM

JUNE 19, 2023

Demographics were well balanced in the two groups. 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.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. The malleability of arterial carbon dioxide makes it a potential therapeutic target. N Engl J Med. Epub 2023 Jun 15.

Hospitals 92

Hospitals Resuscitation Outcomes CPR 92

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

Don't Forget the Bubbles

JUNE 30, 2023

You will be running the show today, and you want to use your preparation time well. In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The trauma call goes out.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Dr. Smith's ECG Blog

APRIL 30, 2024

He was resuscitated into a perfusing rhythm. I fully acknowledge some speculation — given that we lack precise timing of these serial tracings, as well as not knowing the corresponding serum K+ level at the time each tracing was recorded. A patient was found down approximately 30 minutes after taking methamphetamine. Bystander CPR.

EKG/ECG 109

EKG/ECG CPR EMS Resuscitation 109

EM SIM Cases

NOVEMBER 12, 2022

Stephen Jensen, Brandon Bowdoin, and Kristen Whitworth as well as Spring Lutzen. EM physicians are required to task switch numerous times, often assessing a new patient immediately after critical interventions have been implemented on their current patient. This case as written by Drs.

Resuscitation 40

Resuscitation Stroke EKG/ECG Fractures 40

EM Ottawa

DECEMBER 28, 2023

There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog. Pediatric trauma is a high acuity but low frequency event (2).

Pediatrics 83

Pediatrics Documentation/Coding EMS Wellness 83

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm.

EKG/ECG 132

EKG/ECG Documentation/Coding Psychiatric EMS 132

RebelEM

SEPTEMBER 19, 2022

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. It is imperative that we continue to look at ways to improve cardiac arrest resuscitation. Article: Moore JC et al.

CPR 52

CPR Outcomes Resuscitation EMS 52

American Medical Compliance

FEBRUARY 15, 2023

No fines or fees are implemented as well. When you look for such courses, look for topics such as first aid, personal care, and resuscitation techniques. Hence, it is necessary to plan the core training well and the testing schedule accordingly. The state testing schedule is limited.

EMS 52

EMS Administration Infectious Diseases Operations 52

RebelEM

JULY 17, 2023

Got FDA exemption as well as went to the community and made sure their community was ok with the trial). appeared first on REBEL EM - Emergency Medicine Blog. Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession.

Outcomes 93

Outcomes Emergency Department Administration Resuscitation 93

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. Resuscitative thoracotomy is for penetrating trauma with signs of life wthin 10-15 minutes of arrival. Pediatrics.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

RebelEM

SEPTEMBER 23, 2024

You decide to intubate the patient after resuscitation. However, it is well-established that even a single dose of etomidate can cause adrenal suppression ( Albert 2011 ). Read More REBEL EM: From Debate to Data: Emerging Insights into Induction with Ketamine vs Etomidate. appeared first on REBEL EM - Emergency Medicine Blog.

EMS 68

EMS Resuscitation Outcomes Wellness 68

RebelEM

SEPTEMBER 26, 2022

Patients from both groups are well balanced regarding results from a wide range of coagulation studies. Rezaie, MD (Twitter: @srrezaie ) The post TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding appeared first on REBEL EM - Emergency Medicine Blog.

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

Taming the SRU

JUNE 24, 2024

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart. Resuscitation , Volume 181,2022,Pages 140-146,ISSN 0300-9572, [link] Scott Weingart, MD FCCM. EMCrit 310 – Transvenous Pacemakers. EMCrit Blog.

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 90

The Skeptics' Guide to EM

NOVEMBER 12, 2022

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).

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

PEMBlog

AUGUST 20, 2024

This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. Extracorporeal Cardiopulmonary Resuscitation. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

Dr. Smith's ECG Blog

JANUARY 8, 2024

Since that moment, she had had shortness of breath as well as pressure-like chest pain. Patient was given aspirin, sublingual nitro as well as heparin. She had been sitting doing work when she experienced "waves of chest tightness". Any kind of exertion made the shortness of breath considerably worse.

EKG/ECG 72

EKG/ECG Resuscitation Hospitals EMS 72