Taming the SRU

MARCH 14, 2023

Treatment If a patient is herniating in front of your eyes – hypertensive, bradycardic, altered, and not protecting their airway – secure the ABCs, provide hypertonic fluids (3% normal saline, mannitol), hyperventilate the patient, elevate the head of the bed and call neurosurgery. The secure the drain and close the three-way stopcock.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

ACEP Now

JULY 7, 2023

She was reported to have had a mechanical fall, landing face forward without loss of consciousness, and has had a continuous nosebleed since then, per EMS and the home care provider. Once the endotracheal tube has been secured, consistent suctioning must be ensured until the fluid collections have been controlled. Crit Care Med.

Airway Management 59

Airway Management EMS Burns Operations 59

Resus Review

MAY 6, 2015

This is the responsibility of everyone caring for an ECMO patient including nurses, perfusionists, respiratory therapists, physicians, and surgeons. Observe that it is positioned properly, securing sutures are in place, dressing is in place, and that there are no signs of infection, drainage, or bleeding. Listen for any unusual sounds.

Documentation/Coding 52

Documentation/Coding Wellness 52

ACEP Now

AUGUST 1, 2023

Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. On functionally useless in real time to patient care on-call rosters, these same physician assistants and/or nurse practitioners may be “backed up” by physicians.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Resus Review

APRIL 15, 2015

Given the risks, careful planning and preparations are critical. Pre-Proning Preparation Verify ETT is well secured. Perform any necessary wound care and change dressings. Assess lines and tubes for dislodgement/kinks/air entry Position arms in modified swimmers crawl. Place patient on FiO2 100% during turn.

EKG/ECG 52

EKG/ECG Wellness 52

ACEP Now

OCTOBER 15, 2023

Even with optimal care, patients may become dependent on a tracheostomy and/or gastrostomy in the long term. The neck should be palpated for subcutaneous air. Any intralaryngeal mucosal injury is likely to produce some degree of granulation tissue, which may lead to scarring or obstruction. Is the patient stridorous or hoarse?

Fractures 52

Fractures Dislocations Airway Management Operations 52

Greater Sydney Area HEMS

APRIL 15, 2023

While babies rapidly become bradycardic in response to hypoxia, they are also at risk of retinopathy when exposed to high fractions of oxygen, so it is usual to begin resuscitation in air but increase inspired oxygen fraction as further resuscitation is required. Resuscitate in air in the first instance, and reassess at 30 seconds.

Hospitals 85

Hospitals Resuscitation Hyperthermia / Hypothermia Teamwork 85

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Ruben’s insistence upon including a portable foot-operated aspirator did much to establish portable suction, not requiring power or oxygen supply, in field care. " Part I: Oral Airways, early resuscitation, and recognition of airway care. Anaesthesia and intensive care, 38, 10-15. Ambulances and emergency medical care.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

Don't Forget the Bubbles

JUNE 30, 2023

You ask your anaesthetist to get ready to sedate or intubate depending on their status – Significant risk to the department – you make sure security is aware And your patient arrives. There is decreased air entry, dull percussion at the left base, and minimal chest wall movement. Temperature 36.8C. Actively oozing.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

RebelEM

JANUARY 19, 2023

(Brims 2013) The RAMPP trial is the first large-scale randomized controlled trial to delineate whether ambulatory management of primary spontaneous pneumothorax can help reduce hospitalization compared to standard care. The device was removed if there was sufficient reexpansion (<1cm of apical air on chest X-ray) and no air leak.

Outcomes 52

Outcomes Hospitals Research EMS 52

Taming the SRU

JUNE 6, 2023

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

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59

EMDocs

JUNE 3, 2023

C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. Figure 2 provides an example of a sheet secured with zip-ties, and hemostats can also be used to secure the sheet. J Trauma Acute Care Surg. Anaesth Crit Care Pain Med. J Trauma Acute Care Surg. J Trauma Acute Care Surg.

Fractures 54

Fractures Resuscitation Operations EMS 54

RebelEM

MAY 22, 2023

The quality of emergency department pain care for older adult patients. saline Comparator: Hydromorphone 0.5mg administered IV in a 100 mL bag of 0.9% on 0–10 pain scale Patients receiving IV Hydromorphone improved by 4.6 (SD on 0–10 pain scale 95% CI for the difference of 1.0 Published online 2022:339-355. PMID: 35965031 Acetaminophen.

Administration 68

Administration Emergency Department Outcomes Hospitals 68

EMDocs

JANUARY 4, 2024

F, heart rate of 142 bpm, blood pressure of 114/66 mmHg, respiratory rate of 24 breaths/min, and oxygen saturation of 100% on room air. Patient must have bowel sounds and a secure airway (protecting their own airway or intubated). Critical Care Toxicology. Vitals on arrival included a temperature of 98.7°F, Clin Toxicol (Phila).

Seizures 65

Seizures EKG/ECG Poisoning Shock 65

Pediatric Emergency Playbook

APRIL 1, 2017

Consider sedation in children with special health care needs who may not be able to cooperate and technically delicate extractions. 11 Look for unilateral hyperinflation on expiratory films: air trapping. Be careful to visualize the area you are gripping, to avoid pulling on (and subsequently avulsing) soft tissue in the ear canal.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Her rejoinder was “I didn’t think to blow through the nose, but, boy, did I blow between the teeth! ” The nose in Early Modern Expired Air Resuscitation: Early teaching in expired-air resuscitation was three-fold. Few people now remember that a strong early proposal in the move for expired air resuscitation was Mouth to Nose.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40