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 105

Shock Outcomes Hospitals EMS 105

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 91

EMS Sepsis Shock Fluid Resuscitation 91

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 90

EMS Fluid Resuscitation Resuscitation Radiology 90

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 102

EMS Pediatrics Sepsis Airway Management 102

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 111

EMS Poisoning Shock 111

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 114

EMS Resuscitation Outcomes Allergic Reactions 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 80

Shock Outcomes Hospitals EMS 80

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 80

EMS Infectious Diseases Pediatrics Research 80

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 83

EMS Ultrasounds Emergency Department Infectious Diseases 83

Emergency Medicine Cases

MAY 4, 2021

The post EM Quick Hits 28 Cardiogenic Shock, Radiation Dose in Pregnancy, PoCUS in Airway Management, VIPIT, Angiotensin II, Short-Term Steroid Safety appeared first on Emergency Medicine Cases.

Airway Management 52

Airway Management Shock EMS Ultrasounds 52

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

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

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

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

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

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 86

Anaphylaxis Shock Sepsis Stroke 86

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

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

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

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

EMDocs

DECEMBER 31, 2023

Without further ado, here is our list of top posts from 2023 based on viewership from you, the readers: Neurogenic Shock: Definition, Identification, and Management in the ED We start off the list with a clinical post from Kira Brayan and Jenny Beck-Esmay on diagnosing and managing neurogenic shock! Stay tuned for 2024!

Poisoning 90

Poisoning Shock EMS Hospitals 90

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

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

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

EMergucate

MAY 30, 2016

Definition Cardiac index < 1.8L/min/m2 min/m2 Classification Killip ranking of heart failure originally done for 30-day mortality post-MI Asymptomatic 5% mortality … Continue reading →

Shock 40

Shock EMS 40

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 81

Sepsis Shock Resuscitation Fluid Resuscitation 81

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

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? CPR is currently in progress with a single shock having been delivered.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

ACEP Now

JULY 7, 2023

However, between four and five percent of cases of VT or VF will be refractory to standard management, with nonperfusing arrhythmia persisting despite repeated shocks. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. amiodarone or lidocaine). Resuscitation. Sakai T, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Taming the SRU

MARCH 10, 2024

critical AS, ASD, HCM) Arrhythmogenic right ventricular cardiomyopathy Pulmonary embolism Thoracic aortic dissection Transient occult shock Sepsis Hemorrhagic shock (ex. Can’t miss ED diagnosis for syncope Brady/tachy dysrhythmia, arrhythmias such as ARVC, channelopathy (Brugada) Acute MI Structural heart disease (ex.

EKG/ECG 97

EKG/ECG Shock Wellness EMS 97