EMDocs

JANUARY 13, 2024

Source Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial. Source Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial. Crit Care Med. 2023 Nov 1;51(11):1449-1460.

Stroke 84

Stroke Shock Pediatrics Resuscitation 84

EM SIM Cases

NOVEMBER 12, 2022

The exact moment these orders are completed, a stroke activation will be called for a patient eligible for tPA. Stroke protocol needs to be followed and tPA will need to be given. At this time, the resident will need to follow up on the stroke and hyperkalemia patients before evaluating the patient presenting with depression.

Resuscitation 40

Resuscitation Stroke EKG/ECG Fractures 40

Taming the SRU

JULY 24, 2024

Population Patients were adult (18 or older) patients at a single academic emergency department who were triaged to a resuscitation bay and were not classified as a trauma, STEMI, stroke, cardiac arrest, or active labor. Importantly, only patients triaged to resuscitation bays were enrolled.

Sepsis 90

Sepsis Resuscitation Emergency Department Wellness 90

Kings County Downstate EM

MARCH 13, 2024

Key Initial Steps ABCs and Supportive Care Like any other resuscitation, attention should be primarily towards assessing the ABCs.

Stroke 40

Stroke Resuscitation EMS 40

RebelEM

FEBRUARY 8, 2024

were they in the resuscitative phase? were they in the resuscitative phase? This study does not address the utility of arterial lines vs NIBP in the acute resuscitative phase Author Conclusion: “There was broad agreement between IABP and NIBP in critically ill patients over a range of BPs and severity of illness. to 2.47; p – 0.04

Resuscitation 123

Resuscitation Outcomes EMS Sepsis 123

Emergency Medicine Cases

SEPTEMBER 21, 2021

The post EM Quick Hits 32 Checkpoint Inhibitors, Adult Epiglotitits, HSP, Heat Stroke, Bell’s Palsy and Leukemia appeared first on Emergency Medicine Cases.

Stroke 52

Stroke EMS Pediatrics Resuscitation 52

RebelEM

FEBRUARY 24, 2025

Of course, there are other methods of assessing fluid tolerance : Capillary refill evaluation, passive leg raise, central venous pressure measurement, pulmonary artery wedge pressures, stroke volume variation, pulse pressure variation, etc. Arterial Pulse Pressure Variation with Mechanical Ventilation. Am J Respir Crit Care Med.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

PulmCCM

NOVEMBER 17, 2023

Operating point guided resuscitation How do we make sense of this? The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR]. For any given hemodynamic state, measure or estimate the P ra and CO [or stroke volume, SV] simultaneously and repeatedly after each intervention. What does this mean?

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

EMDocs

JANUARY 11, 2025

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation.

EMS 97

EMS Sepsis Shock Fluid Resuscitation 97

University of Maryland CC Project

MARCH 7, 2022

Edward Hebert School of Medicine at the Uniformed Services University of the Health Sciences presents on Environmental Injuries including burns, electrical, altitude and heat stroke. Dr. Kevin Chung, Professor and Chair of the Department of Medicine, and professor of Surgery, at the F.

Burns 40

Burns Stroke Airway Management Resuscitation 40

EMDocs

NOVEMBER 20, 2023

Initial patient assessment and hemodynamic resuscitation should be performed simultaneously. DOAC reversal Recommendation: For patients on DOACs, we suggest reversal for the small subset of patients who present with a life-threatening LGIB that does not respond to initial resuscitation and cessation of the anticoagulant alone.

Resuscitation 103

Resuscitation Fluid Resuscitation Hospitals Research 103

Taming the SRU

OCTOBER 5, 2023

morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS (..)

Stroke 92

Stroke EKG/ECG Seizures CPR 92

Broome Docs

DECEMBER 9, 2023

Does BP management in haemorrhagic stroke matter? Does BP management in haemorrhagic stroke matter? Welcome to another episode of the Emergency Medicine Journal Club with Dr Justin Morgenstern. This month we cover a bunch of papers that look at a lot of topics and try to answer questions such as: Can I push Keppra safely?

Infectious Diseases 114

Infectious Diseases Emergency Department Stroke Pediatrics 114

EMDocs

SEPTEMBER 19, 2023

Airway plan discussed with resuscitation team. Also think about NCSE in patients with prior cerebral pathology (ie, ischemic stroke); a patient who was seizing, was treated, and is not coming out of their post ictal state; and in patients with unexplained altered mental status with no other cause.

Seizures 97

Seizures Documentation/Coding EKG/ECG Emergency Department 97

ACEP Now

NOVEMBER 7, 2023

Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines. Resuscitation. Resuscitation. Resuscitation. Resuscitation. Resuscitation. Circulation.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

Taming the SRU

NOVEMBER 29, 2023

Complex trauma resuscitations Blunt cardiac injury represents a range of conditions from clinically silent to fatal injuries. Posterior circulation stroke Patients with posterior strokes will likely have a low NIH. Lumbar puncture with xanthochromia or > 2000 RBCs in tube 4 should increase suspicion for SAH.

Stroke 53

Stroke EKG/ECG Resuscitation Shock 53

Emergency Medicine Cases

AUGUST 1, 2017

In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, we take you through a not uncommon stroke presentation which then develops into a challenge with regard to management of elevated ICP, hypertension and the airway.

Ambulance Services 52

Ambulance Services Stroke EMS Resuscitation 52

Taming the SRU

FEBRUARY 12, 2024

Discussion of Evidence for Management Initial management of DOAC overdose centers around establishing large-bore intravenous access and providing adequate resuscitation for hemodynamically unstable patients. This does not deviate from general resuscitation principles for acute hemorrhage.

Administration 81

Administration Fractures Anaphylaxis Head Injuries 81

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

EM Literature of Note

JANUARY 9, 2022

[link] Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients With Acute Ischemic Stroke Stopped early due poor outcomes in patients receiving alteplase prior to endovascular therapy.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

Taming the SRU

JULY 31, 2024

Barometric pressure, humidity, and temperature changes may influence stroke and fall incidence (especially in elderly patients with cardiovascular risk factors). Nice people are not more likely to get cancer. Black clouds don’t exist (but I still sort of think they do).

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

EM Literature of Note

OCTOBER 20, 2022

Don’t forget the Annals of Emergency Medicine Podcast , a lighthearted feel-good romantic comedy with Rory Spiegel, available for free on your choice of streaming platforms: Apple Podcasts Google Podcasts Soundcloud Bimonthly #FOAMed in ACEPNow : Updates from the 2022 International Stroke Conference A skeptical look at new tools for diagnosing (..)

Stroke 40

Stroke Sepsis Pediatrics Resuscitation 40

PulmCCM

JANUARY 22, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

The Skeptics' Guide to EM

DECEMBER 16, 2017

You quickly assess him in the resuscitation room, the team attempts intravenous (IV) access and collects labs while you give 10mg of midazolam intramuscularly and the seizures seem to stop. However, there is not good evidence that therapeutic hypothermia is neuroprotective in ischemic or hemorrhagic stroke, IHCA or traumatic brain injury.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

EB Medicine

AUGUST 6, 2019

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Jeff: Rivaroxaban, trade name Xarelto, the second FDA approved DOAC, is used for stroke prevention in those with nonvalvular afib and VTE treatment.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

RebelEM

JUNE 8, 2023

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. However, peripherally dosed push dose pressors, (PDPs), are beginning to be administered more frequently for management of acute hypotension.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

PulmCCM

JANUARY 24, 2024

This was in large part due to the recommendations from a task force of the International Liaison Committee on Resuscitation (ILCOR) , and their enshrinement in the American Heart Association’s 2005, 2010 and 2015 post-cardiac arrest management guidelines.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

PulmCCM

JANUARY 4, 2022

For example, should a fluid challenge fail to raise stroke volume [SV], a state of physiological preload intolerance exists and additional volume is arguably harmful ; further attempts to increase tissue perfusion might then be best achieved with vasoactives. For what are intravenous fluids diagnostic? mL/kg and 4.2 mL/kg, respectively.

Wellness 40

Wellness Outcomes Sepsis Stroke 40

EM Ottawa

JULY 6, 2023

Global temperatures are increasing and are projected to continue warming. The rates of warming across out planet are not uniform. In Canada, the loss of snow and sea ice reduces the reflectivity of the surface leading to increased absorption of solar radiation and a faster rate of warming compared to more southern regions.

Hyperthermia / Hypothermia 97

Hyperthermia / Hypothermia Stroke Hospitals Resuscitation 97

Taming the SRU

APRIL 13, 2023

Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C EtOH, amphetamines, or cocaine) Prescription drugs (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Emergency Playbook

APRIL 1, 2016

Less common causes of troponemia are: Kawasaki disease, pediatric stroke, or neuromuscular disease. Early Lactate Elevations Following Resuscitation From Pediatric Cardiac Arrest Are Associated With Increased Mortality. Don't go looking, if you won't do anything with the test. Pediatr Emer Care. 2013; 29:715-719. Pediatr Crit Care Med.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

JUNE 1, 2016

Conversely, is the heart rate too slow – even if the stroke volume is sufficient, if there is severe bradycardia, then cardiac output -- which is in liters/min – is decreased. Could this be a supraventricular tachycardia that does not allow for enough diastolic filling, leading to poor cardiac output? Chemically pace with atropine, 0.01

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

EM SIM Cases

NOVEMBER 3, 2023

This case comes from Dr. Jared Baylis and Dr. Kelly Huang Dr. Baylis is the Simulation Medical Director at University of British Columbia – Southern Medical Program and Interior Health, as well as an editor of EM Sim Cases.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG EMS Hospitals 52

Emergency Medicine Cases

JANUARY 18, 2022

In this months EM Quick Hits podcast: Ken Milne expertly walks us through the 10 biggest EM papers of 2021, Brit Long on a careful structured approach to Febrile Neutropenia to improve outcomes, Catherine Varner on how not to miss Peripartum Cardiomyopathy, Joe Nemeth on Anaphylaxis update and Anand Swaminathan gives us his approach to the Crashing (..)

Anaphylaxis 52

Anaphylaxis EMS Outcomes Hyperthermia / Hypothermia 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Administer O2 if necessary.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

EM Literature of Note

OCTOBER 14, 2024

“Lactated Ringer vs Normal Saline Solution During Sickle Cell Vaso-Occlusive Episodes” A “target trial emulation” providing observational evidence supporting the superiority of lactated ringers solution over normal saline for the resuscitation of patients being admitted with sickle cell crises.

Stroke 89

Stroke Emergency Department Resuscitation Best Practices 89

ACEP Now

OCTOBER 9, 2023

The concept of rapid assessment for heart attacks and strokes is not foreign to the general public, but these emergencies do not include rapid destruction of clothing, private examinations performed in front of audiences, or a quick succession of invasive procedures. Patient experiences of trauma resuscitation. 2017;152(9):843.

Resuscitation 126

Resuscitation Research Stroke Emergency Department 126