Emergency Medicine Cases

NOVEMBER 22, 2022

In this EM Quick Hits podcast: Justin Morgenstern on fluids in pancreatitis, Leeor Sommer on nasal fractures, Christina Shenvi on delirium, Sheldon Cheskes and Rohit Mohindra on Dose VF, and Noor Khatib and Kari Sampsel on intimate partner violence.

Fractures 52

Fractures EMS Fluid Resuscitation Resuscitation 52

RebelEM

FEBRUARY 24, 2025

just be careful with pelvic fractures or any femoral arterial punctures/ devices. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial. 14,15 You might use a passive leg raise, which carries a roughly 250cc fluid challenge.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Emergency Medicine Cases

JULY 13, 2021

The post EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines appeared first on Emergency Medicine Cases.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fractures EMS Pediatrics 52

The Trauma Pro

APRIL 30, 2024

The resuscitation equipment is not on par with the OR, and one never knows exactly how long the procedure will last. Reference: Preperitoneal packing versus angioembolization for the initial management of hemodynamically unstable pelvic fracture: A systematic review and meta-analysis. Pay attention to hemodynamic stability.

Radiology 113

Radiology Radiology Research Fractures 113

EMDocs

OCTOBER 9, 2023

1 Though hydrocortisone is often included in ‘crash carts,’ the most recent consensus on cardiopulmonary resuscitation (CPR) has a weak recommendation against the use of corticosteroids during CPR. Consider the other complications of systemic steroids: weight gain, cataracts, fractures, and neuropsychiatric events.

Basic Life Support 109

Basic Life Support CPR Fractures Emergency Department 109

EM SIM Cases

NOVEMBER 12, 2022

The trauma will be an open book pelvic fracture with hypotension and a positive FAST. The resident will need to immediately evaluate the patient with hyperkalemia and give appropriate medications or they will decline. As they are pushing the medications, a Trauma Level One will be called.

Resuscitation 40

Resuscitation Stroke EKG/ECG Fractures 40

Northwestern EM Blog

MARCH 1, 2025

Absolute contraindications of prone positioning are severely increased intracranial pressure as positioning of the head in prone position can partially obstruct cerebral venous drainage, as well as unstable spinal fractures because the manipulation while repositioning a patient may lead to further injury (Guerin et. 2020; Koulouras et.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

ETM Course

JUNE 28, 2015

Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. Intra-Aortic Balloon Occlusion to Salvage Patients with Life-Threatening Hemorrhagic Shocks from Pelvic Fractures J Trauma 2010; 68(4): 942–8 (full article free text) 3. Stannard A, Eliason JL, Rasmussen TE. Martinelli et al.

Hospitals 52

Hospitals Resuscitation Shock Military 52

EM SIM Cases

DECEMBER 15, 2023

Sameer Sharif (Hamilton Health Sciences, Hamilton, Ontario) and Dr. Sophie Ramsden (Emergency Medicine Resident, McMaster University, Hamilton, Ontario) Why it Matters Major trauma patients sometimes decompensate after initial resuscitation. ICU has admitted the patient while she awaits OR later today to stabilize the spine.

Fractures 40

Fractures Resuscitation Academics Shock 40

PHEM Cast

JULY 27, 2021

Kenji Inaba.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

EM Curious

JULY 8, 2015

US GUIDED ULNAR NERVE BLOCK [BLOG]: Boxer's fracture need a reduction? Consider an ultrasound guided ulnar nerve block. Check out the case here and be sure to watch the video tutorial from 5minsono.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

Taming the SRU

FEBRUARY 12, 2024

CT HEAD Bilateral hemorrhagic contusions, left subdural hematoma with mass effect, scattered subarachnoid hemorrhage, occipital bone fracture and venous thrombosis adjacent to fracture site. This does not deviate from general resuscitation principles for acute hemorrhage.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

ETM Course

JUNE 17, 2015

In this episode we talk to Joseph Mathew, one of the authors of a great new article on a novel technique for tamponade of bleeding related to pelvic fractures. Delaying urinary catheter insertion in the reception and resuscitation of blunt multitrauma and using a full bladder to tamponade pelvic bleeding.

Fractures 40

Fractures Emergency Department Resuscitation Research 40

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

The Trauma Pro

MAY 2, 2023

Splint to reduce fracture bleeding. We are not always as fastidious as we should be because of the universal availability of blood products. Use direct pressure or direct suture ligation for external bleeding. Aggressively use damage control surgery. Don’t go for a definitive laparotomy which may take hours.

Blood Transfusions 100

Blood Transfusions Fractures Wellness Resuscitation 100

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

RCEM Learning

APRIL 9, 2024

Ensure that you have a solid understanding of the core subjects, including emergency medicine, clinical skills, critical care, resuscitation, and trauma management. Review the Exam Syllabus: Carefully go through the exam syllabus to identify the key topics and areas that will be tested.

Infectious Diseases 52

Infectious Diseases Airway Management Dislocations Poisoning 52

Taming the SRU

JULY 31, 2024

However, believers in this superstition will perceive crazier shifts if the word is uttered so you probably shouldn’t say it, or use cautiously Full moons have no impact on ED, EMS, or HEMS volumes or acuity.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

Don't Forget the Bubbles

MAY 8, 2024

Use of Initial Endotracheal versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room: Review of a National Database. Hemotympanum with a Basilar Skull Fracture. Luque V, et al. J Pediatr Gastroenterol Nutr. 2024 Apr;78(4):973-995. Halling C et al. 2024 Apr 15:114058. Verbakel J et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Pediatric Emergency Playbook

OCTOBER 1, 2015

The two most common complications of VP shunts are malfunction (due to obstruction, fracture, or kinking) or infection. The Huber needle is not a resuscitative line. Vascular Devices: assume the line is not functional, and use another to resuscitate, especially in port-a-caths. He is in compensated shock.

Pediatrics 40

Pediatrics Fractures Resuscitation Burns 40

Don't Forget the Bubbles

OCTOBER 2, 2024

He is diagnosed with a traumatic brain injury and a fracture to his right tibia and fibula. As the resuscitation continues, his heart rate falls, his respiratory effort becomes increasingly irregular and his systolic blood pressure rises. A full primary survey is carried out. Imaging is performed, including a CT Head.

Administration 49

Administration Pediatrics Outcomes Research 49

Dr. Smith's ECG Blog

JULY 3, 2020

She had multiple rib fractures as well as serious hemorrhage and underwent massive transfusion. She sustained chest wall trauma, including rib fractures with serious bleeding. Consider that the patient in this case was promptly resuscitated in the ED. Her initial troponin I, part of a critical care order set, returned at 0.55

Blood Transfusions 52

Blood Transfusions EKG/ECG Shock Fractures 52

Don't Forget the Bubbles

SEPTEMBER 5, 2024

In the emergency department resuscitation room, weight is usually estimated using an age-based formula until the child is stabilised and can be safely weighed. A recent systematic review found that children with obesity at school entry are more likely to experience back pain, slipped capital femoral epiphysis or fractures during childhood.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Don't Forget the Bubbles

NOVEMBER 11, 2024

His CT scan showed extensive cranial fractures, traumatic subarachnoid haemorrhage, and intraparenchymal haemorrhage. A 12-year-old boy presents with a significant head injury following a road traffic accident. At the scene, his lowest GCS was 5 (E1V2M2). He went to theatres for an ICP (intra-cerebral pressure) bolt.

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

EMDocs

JUNE 25, 2024

Most common traumatic injuries are fractures, TBIs, and thoracic or abdominal injuries. Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Always consider trauma and toxic exposure in the burn patient.

Burns 97

Burns Fluid Resuscitation Resuscitation Poisoning 97

Taming the SRU

OCTOBER 1, 2024

Look for the light bulb sign and always evaluate with scapular 'Y' view Lateral ankle fractures are classified by the Weber Classification, which is based on fracture location relative to the tibiotalar joint line A Jones fracture is a fracture at the 4th/5th metatarsal articulation. C above historical average.

Dislocations 74

Dislocations Fractures Poisoning Academics 74

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Depending on the height of the child and the height of the car, the initial impact will cause a femur fracture, a pelvic fracture, or direct abdominal trauma. Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. Resuscitative thoracotomy for blunt trauma has a dismal prognosis in children.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

Taming the SRU

OCTOBER 1, 2023

Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. PPV, rib fractures, and decreased GCS were predictive of conservative management failure [23]. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. Resuscitation. Rojas R, Wasserberger J, Balasubramaniam S.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Taming the SRU

MAY 11, 2024

Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review.

Resuscitation 92

Resuscitation Administration Fluid Resuscitation Research 92

Pediatric Emergency Playbook

MARCH 1, 2016

He sustained a femur fracture, splenic laceration, and blunt head trauma – the so-called Waddell’s triad. Resuscitative Pearls Our goal here is damage control. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery. Rib fractures on CXR predict pulmonary contusions.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Don't Forget the Bubbles

NOVEMBER 29, 2023

Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. His name is Ben.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Don't Forget the Bubbles

JULY 31, 2023

Radiographs from children with fractures, or disease processes affecting bone growth, were excluded. 2004) Positive end expiratory pressure during resuscitation of premature lambs rapidly improves blood gases without adversely affecting arterial pressure. Probyn, M.E., Hooper, S.B., Dargaville, P.A., McCallion, N., Crossley, K.,

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

Taming the SRU

MARCH 11, 2024

A careful skin examination is needed to assess for wounds suggestive of an open fracture or traumatic arthrotomy, skin necrosis, or any dimpling or puckering of the skin, as these can indicate an irreducible dislocation that must be reduced in the operating room.

Dislocations 108

Dislocations Emergency Department Fractures Operations 108

PEMBlog

JUNE 5, 2024

The most common injuries seen in these younger patients are growth plate fractures and ligamentous injuries. You more often will see vertebral body and arch fractures as opposed to the growth plate fractures and ligamentous injuries in the younger children. Resuscitate with volume and blood. than it is spinal shock.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

American Medical Compliance

FEBRUARY 28, 2024

CPR (cardio-pulmonary resuscitation) is a technique used to keep victims of sudden cardiac arrest and other emergencies, alive and to prevent brain damage until more advanced medical professionals arrive. The following CPR Refresher Course educates healthcare providers (HCP) on the basic principles of CPR.

CPR 52

CPR Fractures Resuscitation Wellness 52

Mind The Bleep

OCTOBER 17, 2024

Through this role, as an observer, I was able to experience various pre-hospital emergencies; the most common scenarios I attended were cardiac arrests, but I also attended trauma patients at the scene of road traffic accidents, fractures in a wilderness medicine setting, anaphylaxis, and many others.

Ambulance Services 52

Ambulance Services Anaphylaxis Hospitals Airway Management 52