EMDocs

MAY 31, 2023

Author: Walid Malki, MD ( @Wandering_ER ) // Reviewed by: Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK) Welcome the Visual Wednesdays, a series that provides focused EM updates with infographics. The post Visual Wednesdays: Septic Shock Management appeared first on emDOCs.net - Emergency Medicine Education.

Shock 97

Shock EMS Sepsis 97

St. Emlyn

JUNE 23, 2024

St.Emlyn's - Emergency Medicine #FOAMed Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite emergency medical services (EMS) interventions.

Shock 109

Shock Outcomes Hospitals EMS 109

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 91

Dislocations Shock EMS Sepsis 91

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. 2, 8-10, 14 The clinical symptoms range from vague abdominal pain to florid septic shock and peritonitis secondary to bowel perforation. EMRA Antibiotic Guide.

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

EMDocs

SEPTEMBER 7, 2024

We’ll keep it short, while you keep that EM brain sharp. A 25-year-old man presents to the ED via EMS after he sustained a gunshot wound to the left flank. Clinical features include abdominal or flank pain; ecchymosis to the flank, periumbilical region, proximal thighs, or scrotum; and hemorrhagic shock early in the disease course.

EMS 93

EMS Fluid Resuscitation Resuscitation Radiology 93

EMDocs

OCTOBER 19, 2024

We’ll keep it short, while you keep that EM brain sharp. link] The post EM@3AM: Bacterial Tracheitis appeared first on emDOCs.net - Emergency Medicine Education. A 3-year-old male with no previous past medical history, born full term, and unvaccinated presents after 6 days of cough, fever, myalgias, and rhinorrhea. 1983;137(8):764.

EMS 106

EMS Pediatrics Sepsis Airway Management 106

Emergency Medicine Cases

JANUARY 2, 2024

Based on a blend of number of listens, feedback from listeners, website visits and personal faves, EM Cases Best of 2023 Top 10. The post EM Cases Best of 2023 Top 10 appeared first on Emergency Medicine Cases.

EMS 114

EMS Poisoning Shock 114

St. Emlyn

JUNE 23, 2024

St.Emlyn's - Emergency Medicine #FOAMed Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite emergency medical services (EMS) interventions.

Shock 86

Shock Outcomes Hospitals EMS 86

Pediatric EM Morsels

JUNE 2, 2023

link] The post Food Protein Induced Enterocolitis Syndrome (FPIES) appeared first on Pediatric EM Morsels. Food protein-induced enterocolitis syndrome in a tertiary pediatric center: safety of guideline-conforming food challenges. Allergy Asthma Clin Immunol 18, 54 (2022).

Dehydration 193

Dehydration Shock Pediatrics Emergency Department 193

Emergency Medicine Cases

APRIL 23, 2024

The post EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality appeared first on Emergency Medicine Cases.

EMS 117

EMS Resuscitation Outcomes Allergic Reactions 117

EMDocs

MARCH 30, 2024

We’ll keep it short, while you keep that EM brain sharp. Intervertebral disks lie between vertebrae and act as shock absorbers. A 27-year-old man was brought into the emergency department via EMS after being stabbed. She was walking her dog who pulled her backwards, landing on her buttocks on the pavement. Jpn J Radiol.

EMS 104

EMS Fractures Emergency Department Dislocations 104

RebelEM

NOVEMBER 6, 2023

Background Information: Vasoplegic shock is defined as hypotension with normal or increased cardiac output and can commonly occur in post-cardiac surgery patients having received cardiopulmonary bypass. Hydroxocobalamin Versus Methylene Blue for the Treatment of Vasoplegic Shock Associated With Cardiopulmonary Bypass. 2023 Jul 19.

Shock 71

Shock Administration Academics Hospitals 71

Dr. Smith's ECG Blog

FEBRUARY 22, 2024

Written by Pendell Meyers A woman in her 30s called EMS for acute symptoms including near-syncope, nausea, diaphoresis, and abdominal pain. EMS arrived and found her to appear altered, critically ill, and hypotensive. EMS reportedly gave 4 grams of calcium (unknown whether CaCl or gluconate) and 50 mEq of sodium bicarbonate.

EKG/ECG 142

EKG/ECG EMS Shock Wellness 142

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. link] The post EM@3AM: Kawasaki Disease appeared first on emDOCs.net - Emergency Medicine Education. A 3-year-old male with no past medical history presents to the ED with one week of daily fevers >102°F associated with four days of rash on the trunk. UpToDate;2022.

EMS 84

EMS Infectious Diseases Pediatrics Research 84

EMDocs

NOVEMBER 4, 2023

We’ll keep it short, while you keep that EM brain sharp. J Emerg Trauma Shock. doi:10.1258/0956462053888853 The post EM@3AM: Testicular/Scrotal Abscesses appeared first on emDOCs.net - Emergency Medicine Education. A 54-year-old male with a history of diabetes presents with “pain in my groin” for the past two weeks.

EMS 87

EMS Ultrasounds Emergency Department Infectious Diseases 87

Emergency Medicine Cases

NOVEMBER 5, 2019

The post EM Quick Hits 10 – TXA CRASH-3, CJEM Cellulitis, Double Defib, Serratus Anterior Block, PARC score, Toxic Shock Syndrome appeared first on Emergency Medicine Cases.

Shock 52

Shock EMS Head Injuries Pediatrics 52

EMDocs

MARCH 9, 2025

Well keep it short, while you keep that EM brain sharp. doi:10.1007/s00247-010-1557-2 The post EM@3AM: Pediatric Osteomyelitis appeared first on emDocs. A 2-year-old female with a past medical history of failure to thrive presents to the ED with her mother for evaluation of right arm pain. Ther Clin Risk Manag. 2023;19:1039-1049.

Pediatrics 52

Pediatrics EMS Infectious Diseases Fractures 52

Emergency Medicine Cases

JANUARY 14, 2020

In this CritCases blog, Shock and Hypoxia in Blunt Chest Trauma, a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Mike Misch guides us through a hairy thoracic trauma case, reviewing principles of trauma resuscitation, airway considerations, tension pneumothorax management and a rare and challenging trauma diagnosis.

Shock 52

Shock Ambulance Services Resuscitation EMS 52

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma. The post Glasgow Coma Scale in Children appeared first on Pediatric EM Morsels. Less than 8, intubate!

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Emergency Medicine Cases

MARCH 26, 2019

Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? Which fluid and how much fluid is best for resuscitation of the septic shock patients? What are the goals of resuscitation in the patient with sepsis or septic shock?

Sepsis 40

Sepsis Shock EMS Resuscitation 40

RebelEM

FEBRUARY 19, 2024

Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. REBEL EM: Peripheral Vasopressors – Safe or Dangerous? Crit Care Med 2021.

Administration 134

Administration Sepsis EMS Shock 134

RebelEM

MAY 25, 2023

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Pediatric EM Morsels

MARCH 29, 2024

link] The post Rebaked: Inborn Errors of Metabolism presenting in the ED appeared first on Pediatric EM Morsels. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A. Schrier Vergano. Pediatr Rev (2022) 43 (7): 371–383.

Dehydration 297

Dehydration Pediatrics Sepsis EMS 297

Emergency Medicine Cases

JANUARY 4, 2022

What is the preferred order of vasopressors and ionotropes in the management of cardiogenic shock? How can we best pick up occult cardiogenic shock before it floured shock kicks in? What is the evidence for intra-aortic balloon pumps, percutaneous ventricular assist devices and ECMO in the patient with cardiogenic shock?

Shock 52

Shock Operations Ultrasounds Resuscitation 52

EMDocs

SEPTEMBER 6, 2023

Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints. Shock types: distributive, cardiogenic, obstructive, metabolic, hypovolemic, adrenal. Learning points: Anatomic urinary obstruction with septic shock is deadly. Complete primary and secondary survey. ROS unremarkable.

Anaphylaxis 90

Anaphylaxis Shock Sepsis Stroke 90

RebelEM

OCTOBER 11, 2023

REBEL Core Cast 110.0 – On Shift Learning Pearls Click here for Direct Download of the Podcast Links EM: RAP: Atrial Fibrillation Update REBEL EM: The Pragmatic Combination of YEARS Score and Age-Adjusted D-Dimer Core EM: Age-Adjusted D-dimer (Using DDU) REBEL EM: Anaphylactic Shock REBEL EM: Core Cast 21.0 – ECG in Syncope Post Created (..)

Anaphylaxis 95

Anaphylaxis EMS EKG/ECG Shock 95

The Trauma Pro

AUGUST 22, 2023

The EMS report indicates that your incoming patient is in shock. A simple one is the use of any of your blood refrigerator products or emergency release blood , or a calculated score such as the ABC score or shock index (SI). Shock index (SI) is defined as the heart rate divided by the SBP. Sometimes, it’s obvious.

Shock 100

Shock Wellness EMS 100

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

Written by Pendell Meyers A man in his 40s called EMS for acute chest pain that awoke him from sleep, along with nausea and shortness of breath. Smith : LAD OMI with RBBB/LAFB is not only subtle on the ECG, but most of these patients are extremely ill: most I have seen are post-ROSC, in cardiogenic shock, or arrested shortly after.

EKG/ECG 124

EKG/ECG EMS Documentation/Coding Shock 124

Pediatric EM Morsels

NOVEMBER 3, 2023

For non-complicated malaria use oral Co ART em. PMID: 30666615 The post Imported Malaria appeared first on Pediatric EM Morsels. falciparum parasitemia , and no other defined cause of AMS (WHO 2023). Treating malaria is an ART! If concerned for severe malaria or inability to tolerate PO always start with IV ART esunate. vivax or P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

RebelEM

FEBRUARY 15, 2024

PMID: 38019968 Post Peer Reviewed By: Anand Swaminathan, MD (Twitter/X: @EMSwami ) The post The NICO Trial: NIV in Comatose Patients with Acute Poisoning appeared first on REBEL EM - Emergency Medicine Blog.

Poisoning 139

Poisoning Airway Management Seizures Shock 139

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. Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration.

EKG/ECG 119

EKG/ECG Resuscitation Shock CPR 119

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. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1%

Sepsis 99

Sepsis Shock Resuscitation Outcomes 99

RebelEM

SEPTEMBER 18, 2024

Skip the zones of the neck and focus on hard signs of vascular ( Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, Signs of stroke) or aerodigestive (Airway compromise, Bubbling wound, Extensive SubQ air, Stridor, Significant hemoptysis/hematemesis). Post Peer Reviewed By: Salim R.

Stroke 80

Stroke Shock EMS 80

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Shocked x 2 without effect. Warning: if this is VT, a calcium channel blocker can result in shock and death. Read this post: Idiopathic Ventricular Tachycardias for the EM Physician 2. We are told that " the Patient was Shocked X2 Without Effect." The choice was to use electrical cardioversion with sedation. K returned 3.6

EKG/ECG 141

EKG/ECG Shock Academics Documentation/Coding 141

RebelEM

SEPTEMBER 28, 2023

The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a pharmaco-invasive strategy resulted in similar rates of death, shock, heart failure, or reinfarction compared to primary PCI. Primary PCI: 95.7% Primary PCI: 95.7%

EKG/ECG 137

EKG/ECG Allergic Reactions Shock Stroke 137

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% Today we look at the CENSER trial. vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 86

Sepsis Shock Resuscitation Fluid Resuscitation 86

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40