The Trauma Pro

APRIL 23, 2024

These indicate a high risk for deeper injury and consist of the following: Vascular signs Refractory shock Pulsatile or difficult-to-control hemorrhage Large or expanding hematoma Audible bruit or palpable thrill (I hardly ever see anyone actually check the neck for these, so brush up your skills!) Hard signs.

Operations 113

Operations Stroke Shock 113

The Trauma Pro

JANUARY 3, 2024

They postulated that, since hemorrhagic shock can cause hyperfibrinolysis (HF) and early administration of agents like TXA seem to work better when given early, wouldn’t it be nice to have a more objective way of identifying it as early as possible? The study was prospective and observational and involved two Level I trauma centers.

Shock 113

Shock Operations Administration Hospitals 113

The Trauma Pro

APRIL 26, 2024

A multi-center trial published in 2015 showed an astounding 32% mortality rate for patients with shock from pelvic fracture. Unfortunately, it’s generally not feasible to operatively fix the pelvis acutely, and external fixation has limited impact on ongoing hemorrhage.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

The Skeptics' Guide to EM

DECEMBER 14, 2024

Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. Clinical Question: How accurately can a new clinical decision rule (The Phoenix Sepsis Score) diagnose pediatric sepsis and septic shock in hospitalized children within the first 24 hours? Reference: Sanchez-Pinto, L.N., Guest Skeptic: Prof.

Sepsis 101

Sepsis Shock Pediatrics Hospitals 101

EMDocs

DECEMBER 6, 2024

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. 2 L/hr in adults.

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

Sensible Medicine

JUNE 17, 2024

PFA destroys myocardium with electricity (shocks). Every “application” is actually a shock. PFA is especially concerning because the shocks in the left atrium create intense microbubbles. What’s more, the lack of esophageal damage has encouraged PFA operators to deliver more (not less) ablation.

Shock 126

Shock Stroke Operations Ultrasounds 126

PulmCCM

NOVEMBER 17, 2023

Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. OP is operating point. Shows what happens when Ppc, Pmsf, Rcardiac and Rvr all vary [grey operating points].

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

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

Greater Sydney Area HEMS

FEBRUARY 20, 2024

Obtaining access in shocked trauma patients can be notoriously difficult due to circulatory collapse. Those who are shocked, shut down with limited or no other options for peripheral access require central access. Right Brachiocephalic Vein Origin Access for the Resuscitation of Shocked Adult Trauma Patients. Green et al.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Pediatric EM Morsels

NOVEMBER 3, 2023

Both have a range of detection limits, which can be greatly dependent on operator. You should consider ordering this in all febrile children with fever <30 days from travel to a malaria-endemic country (Forgie 2022) Thick smears are 10 x more sensitive for malaria then thin smears, but thin smears are used to identify species.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Taming the SRU

AUGUST 11, 2024

ABEM updates - R4 Capstone - Sepsis Operations update - R3 taming the sru - traveler’s diarrhea abem updates WITH dr. melissa platt, abem board of directors Beginning 2026, ABEM will be requiring a new certifying exam to replace the previous oral boards.

Sepsis 89

Sepsis Burns Shock Operations 89

Don't Forget the Bubbles

JUNE 26, 2023

But, they may present postnatally with cyanosis/hypoxaemia due to insufficient pulmonary blood flow, cardiogenic shock due to insufficient systemic blood flow, or both. Whilst waiting for an operation, they need to be managed medically. Soon after the operation, the baby is noted to have junctional ectopic tachycardia (JET).

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

EMDocs

SEPTEMBER 7, 2024

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. 5 Clinical Presentation: 1-3 Variable presentation but may present with dropping hemoglobin/hematocrit without other findings in spontaneous cases.

EMS 93

EMS Fluid Resuscitation Resuscitation Radiology 93

PulmCCM

JUNE 5, 2023

Corticosteroids for community-acquired pneumonia have been studied with inconclusive results, and expert guidelines currently advise against their use except in patients with refractory septic shock. Patients with septic shock or influenza were excluded. standards of care. Some states’ screening rates are 1%.

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

AED Leader

APRIL 22, 2024

The Role of AEDs in Sudden Cardiac Arrest AEDs are portable electronic devices designed to deliver an electric shock to the heart and restore its rhythm during SCA. They are user-friendly and can be operated by individuals with minimal medical training. AEDs analyze the heart’s rhythm and determine whether a shock is needed.

CPR 52

CPR Shock Resuscitation Operations 52

EM SIM Cases

SEPTEMBER 19, 2024

WHY IT MATTERS Patients in hemorrhagic shock require blood products expeditiously as well as identification and definitive management of the source of bleeding. This case provides an opportunity to practice identification and treatment of multiple sources of blood loss in hemorrhagic shock.

Shock 52

Shock Emergency Nursing Operations Administration 52

AED Leader

JUNE 11, 2024

When faced with a life-threatening situation, every second counts, and having a defibrillator that is easy to operate can make a significant difference. Quick Shock Delivery and Fast Charging In a life-threatening situation, quick response time is vital. How quickly do Philips defibrillators deliver a shock?

CPR 52

CPR Shock Resuscitation Operations 52

EMDocs

NOVEMBER 1, 2023

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. upper endoscopy, transesophageal echo, etc.). 4 Fluid resuscitation and vasopressor use as appropriate.

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

PHEM Cast

APRIL 27, 2023

Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1.

Resuscitation 52

Resuscitation Shock Operations Hospitals 52

AED Leader

AUGUST 22, 2024

By delivering an electric shock to restore normal heart rhythm in cases of ventricular fibrillation or other arrhythmias, AEDs play a vital role in increasing survival rates following sudden cardiac arrests. AEDs are designed for easy use, so even people without medical training can operate them effectively in critical situations.

CPR 52

CPR Shock Operations Outcomes 52

RebelEM

NOVEMBER 20, 2023

Military practice guidelines recommend REBOA for profound shock (SBP <90mmHg) 1 and ACEP along with the American College of surgeons recommend REBOA for traumatic life-threatening hemorrhage below the diaphragm in patients with hemorrhagic shock who are unresponsive or transiently responsive to resuscitation. J Spec Oper Med.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Don't Forget the Bubbles

JUNE 30, 2023

Ranulf went white with the shock. These procedures require an experienced operator. A joint statement released by the American College of Surgeons/American College of Emergency Physicians recommends that zone 1 REBOA should only be performed if the anticipated time to start the operation is less than 15 minutes. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

AED Leader

MAY 3, 2024

AEDs are designed to deliver an electric shock to the heart, restoring its normal rhythm. AEDs are designed to be user-friendly and can be operated by anyone, even without medical training. Look for AED models with clear instructions, visual prompts, and audio guidance to assist users in CPR and delivering the electric shock.

CPR 52

CPR Operations Shock Pediatrics 52

Taming the SRU

JULY 24, 2024

National campaigns to improve sepsis care, namely the Centers for Medicare and Medicaid Services’ introduction of “Severe Sepsis and Septic Shock Early Management Bundle”, have faced many challenges in physician and provider adherence. Sepsis as a disease process has been difficult to both clearly define and quickly recognize.

Sepsis 89

Sepsis Resuscitation Emergency Department Wellness 89

Total Medical ComplianceHIPAA

OCTOBER 9, 2024

Mold buildup, sanitary sewer systems operating correctly, surfaces being free of microorganisms, equipment being cleaned/disinfected/sterilized properly, and supplies being free of damage are just a few other issues to look out for. For dental facilities only: Dental Unit Waterlines should be shocked then tested before use.

Hazardous Materials 59

Hazardous Materials Infectious Diseases PPE Shock 59

AED Leader

MAY 8, 2024

It features an advanced biphasic waveform, which delivers a highly effective shock to the patient’s heart. Its user-friendly design, the DBP 2003, ensures that responders can operate the device confidently and efficiently, even under stressful circumstances. How long does the battery of the Defibtech DBP 2003 last?

Shock 52

Shock CPR Operations Resuscitation 52

AED Leader

SEPTEMBER 27, 2024

The defibrillator sends an electric shock to stop this chaos, letting the heart’s natural pacemaker take back control. Giving a shock in time might just save a life. ” This portable lifesaver guided us with voice prompts as we attached it and administered a shock.

Shock 52

Shock Operations CPR Outcomes 52

AED Leader

MAY 9, 2024

Intuitive User Interface The Lifepak 100 features an intuitive user interface that makes it easy for anyone to operate without medical training. Its sophisticated algorithms can detect shockable rhythms, such as ventricular fibrillation or ventricular tachycardia, and deliver a shock if necessary.

Shock 52

Shock CPR Operations 52

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 81

Outcomes Hospitals Operations Shock 81

AED Leader

SEPTEMBER 28, 2024

Key takeaways AEDs, like the Philips HeartStart OnSite and ZOLL AED Plus, help save lives during sudden cardiac arrest by checking the heart’s rhythm and delivering a shock if needed. When buying an AED, consider where it will be used, how easy it is to operate, and maintenance costs. They are easy for anyone to use.

CPR 52

CPR Shock Pediatrics Operations 52

AED Leader

JULY 2, 2024

They are designed to rapidly deliver a high energy level, allowing the AED to administer a life-saving shock to the heart. An AED with a weak or expired battery may not deliver the required shock to restore the heart’s normal rhythm effectively. When a cardiac emergency occurs, every second counts.

Shock 52

Shock Operations Outcomes Wellness 52

AED Leader

MAY 28, 2024

These life-saving devices are designed to deliver an electric shock to the heart, restoring its normal rhythm and potentially saving a person’s life. An AED defibrillator portable machine is a compact and user-friendly device that delivers an electric shock to a person’s heart during sudden cardiac arrest.

Shock 52

Shock Operations Wellness 52

AED Leader

APRIL 26, 2024

A defibrillator is a device that delivers an electric shock to the heart in cases of sudden cardiac arrest, restoring its normal rhythm. These devices are designed to deliver an electric shock to the heart, which helps restore its normal rhythm. These devices deliver a lower energy shock and are suitable for pediatric patients.

Shock 52

Shock Pediatrics CPR Operations 52

AED Leader

DECEMBER 3, 2024

Automated External Defibrillators (AEDs) are vital devices that deliver shocks to restore normal heart rhythms, making them essential in emergency response situations. These compact and easy-to-use external defibrillators deliver lifesaving shocks to restore a regular heart rhythm. Durability : Built to perform in various environments.

Resuscitation 52

Resuscitation Shock CPR Operations 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

AED Leader

JUNE 25, 2024

Train Staff in AED Operation and Maintenance Proper training is essential for effectively using and maintaining your Philips AED. Expired pads or batteries may not deliver the shocks or power required in a life-saving situation. Q: How can I ensure my staff is adequately trained in AED operation and maintenance?

Operations 52

Operations Best Practices Documentation/Coding Shock 52

AED Leader

JULY 10, 2024

AEDs are portable devices that can be used to deliver an electric shock to the heart in the event of sudden cardiac arrest (SCA), potentially saving a person’s life. Its user-friendly interface and intuitive design make operating easy, even for individuals with little medical training.

CPR 52

CPR Shock Operations Resuscitation 52