EMDocs

NOVEMBER 1, 2023

2 , 4 , 5 Recommended by the American College of Radiology (ACR) Appropriateness Criteria but otherwise limited for cervical perforations or alternative etiologies of chest pain. 4 Fluid resuscitation and vasopressor use as appropriate. Beta lactam allergy: Clindamycin (900 mg IV) plus Ciprofloxacin (400 mg IV).

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. Overall all-cause adult survival was 6.1%.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

PHEM Cast

FEBRUARY 23, 2017

Priorities for the bleeding trauma patient must include: Minimum time to control of bleeding (tourniquets / haemostatics / knife / interventional radiology) Normothermia Appropriate choice of destination (knife / IR) ? Prehospital Blood Product Resuscitation for Trauma. We believed in permissive hypotension – we were probably wrong.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

Pediatric Emergency Playbook

MARCH 1, 2016

On arrival, he was in compensated shock, with tachycardia. 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. He decompensates and needs blood. Apply pressure whenever possible.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

PEMBlog

OCTOBER 26, 2023

Other complications include obstruction due to intussusception or volvulus, leading to bowel ischemia and shock. Radiology of Meckel’s Diverticulum. The most common presentation in children under 5 years of age is rectal bleeding, which may be intermittent or massive. The bleeding is usually painless. Clin Radiol.

Radiology 64

Radiology Radiology Administration Resuscitation 64

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED?

CPR 90

CPR Burns Airway Management Wellness 90

Taming the SRU

OCTOBER 1, 2023

Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. J Emerg Trauma Shock. doi:10.1148/radiology.144.4.7111716 Resuscitation. Rojas R, Wasserberger J, Balasubramaniam S. Ann Emerg Med. 1983;12(6):411-412. doi:10.1016/s0196-0644(83)80502-2 Sharma A, Jindal P. 2008;1(1):34-41. doi:10.2214/ajr.165.5.7572489

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

The latter 1950s and 1960s, quested for nerve gas defense studying expired air resuscitation and modern resuscitology; developing intensive care units. To me, it harkens a new scientific renaissance of resuscitation science, emergency care, and creating systems for care. 1950s & 1960s Resuscitation Research.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

RebelEM

JANUARY 25, 2023

Radiology US 90% 96% 14.1 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 0.27 – 0.83 Abdominal Distension 62 – 67% 89 – 96% 5.64 – 16.8 0.34 – 0.43 Abdominal X-ray 75% 66% 1.6

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

PEMBlog

JUNE 5, 2024

You should also consider the possibility of quote unquote spinal shock. than it is spinal shock. Resuscitate with volume and blood. And hypotension, bradycardia, or temperature instability can result from hemorrhagic and or spinal shock. This is due to the loss of sympathetic output and vasodilatation.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: Moving on to blood pressure: frank hypotension should make you immediately think of a ruptured AAA or septic shock 2/2 an intra abd infection. In one study, a SI > 0.7

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Pediatric Emergency Playbook

JUNE 1, 2017

Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. Meningococcemia Presenting as a Myocardial Infarction.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

JULY 8, 2019

Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. Jeff: Resuscitation should be aimed at early fluid replacement with IV crystalloids for hypovolemic patients and packed RBC transfusions for patients presumed to be unstable from hemorrhage. J Gastrointest Surg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

MARCH 6, 2024

shock index > 1, evidence of poor systemic perfusion). In other patients who are stable and the bleeding has resolved, CTA is of low yield If they are critically ill and have severe bleeding, resuscitate first and consult IR, radiology, and surgery. CTA is not necessarily in all patients with LGIB.

Blood Transfusions 103

Blood Transfusions Outcomes Resuscitation Radiology 103

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. 13 Massive transfusion protocols (MTP) are hallmarks of trauma resuscitation, and they are critical to the unstable pelvic fracture patient.

Fractures 60

Fractures Resuscitation Operations EMS 60

EB Medicine

JANUARY 2, 2019

Jeff: All patients with a positive pregnancy test and vaginal bleeding should receive an ultrasound performed by either an emergency physician or by radiology. Nachi: All unstable patients or those with suspected or proven ectopic or heterotopic pregnancies should be immediately resuscitated and taken for surgical intervention.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

Don't Forget the Bubbles

AUGUST 13, 2023

You are called to the resuscitation bay in your ED following arrival of the expected pediatric alert. However, if radiological evidence of raised intracranial pressure is seen, do not perform lumbar puncture. Raised intracranial pressure to be determined clinically rather than by CT scan.

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Don't Forget the Bubbles

OCTOBER 9, 2023

Both studies found external specialities , particularly cardiology and radiology, were more hostile than their own teams. It shocked me how big an effect this expert had on the teams, especially given the studied teams usually worked together and had an average of seven years of neonatal experience. My confidence took a knock.

Seizures 116

Seizures Incident Reporting Research Emergency Department 116