The Bottom Line

JULY 7, 2024

In adult patients scheduled for cardiac surgery with cardiopulmonary bypass does infusion of a balanced solution of amino acids, commencing at the time of surgery, compared with balanced crystalloid alone (Ringer's Lactate) reduce the incidence of acute kidney injury (AKI)?

Operations 73

Operations 73

Dr. Smith's ECG Blog

JULY 7, 2024

Written by Jesse McLaren A previously healthy 60 year old developed exertional chest pain with diaphoresis, and called EMS. Here’s the EMS ECG, digitized with PM cardio. What do you think? There’s sinus arrhythmia with normal conduction, normal axis and normal voltages. There’s loss of R waves in V2-3 with hyperacute waves V1-5. There’s no significant ST elevation but there are two forms of ST depression: deWinter T wave V3-5 and precordial swirl with ST depression V6 reciprocal to subtle STE in

EKG/ECG 66

EKG/ECG Documentation/Coding EMS Wellness 66

ACEP Now

JULY 7, 2024

A 40-year-old woman with a history of untreated hypertension presented by ambulance after she was thrown from an ATV at unknown speeds and then crushed by the vehicle. The vehicle had no seatbelt or airbags, she was not helmeted, and she did not hit her head or lose consciousness. She reported 10/10 pain localized to her right arm and right flank, with no other complaints.

Operations 59

Operations Hospitals Administration Outcomes 59

AED Leader

JULY 7, 2024

When it comes to emergencies, being prepared can often be the difference between life and death. This is especially true when it comes to sudden cardiac arrest (SCA), a condition that can strike anyone, anywhere, at any time. As a traveler, it is essential to be equipped with the knowledge and skills to respond effectively in such an emergency. One critical tool that can make a significant impact in saving lives is an automated external defibrillator (AED).

Shock 52

Shock CPR Operations Resuscitation 52

ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. According to family at the scene, he has a history of seizures but has not been taking his medication recently. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. On arrival, he is obtunded, foaming at the mouth, and exhibiting generalized tonic-clonic seizure activity.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

PulmCCM

JULY 7, 2024

In April 2024, the Society of Critical Care Medicine (SCCM) issued new guidelines for glycemic control in critically ill patients. The statement relaxes only slightly SCCM’s 2012 guidelines that advised tighter glucose control based on the incorrect findings of early intensive glucose control trials.

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ACEP Now

JULY 7, 2024

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

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Emergency Department Pediatrics 52

ACEP Now

JULY 7, 2024

One night I found myself on the other side of the stretcher, as a patient waiting for a psychiatric assessment in an emergency department (ED). After drinking a couple of beers and texting a friend about my depression and marital issues, my friend was respectfully concerned about me. I had said that sometimes I would rather be dead than feeling this sad, so my friend convinced the police to place me under a mental hygiene arrest.

Psychiatric 52

Psychiatric Wellness Emergency Department EMS 52

Critical Care Now

JULY 7, 2024

Reading Time: 3 minutes Jansen JO, Hudson J, Cochran C, et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023;e2320850. PMID: 37824132 Hemorrhage is a major cause of preventable death in trauma patients, and early, expeditious, definitive hemorrhage control is a critical focus in trauma resuscitation.

Resuscitation 52

Resuscitation Military Outcomes Hospitals 52

ACEP Now

JULY 7, 2024

Question: A 68-year-old man presents with a one-month history of left elbow pain. What is the diagnosis? Olecranon bursitis Septic arthritis Olecranon fracture Triceps tendon rupture See the answer here. The post Visual Dx Question: What Is Causing This Elbow Pain? appeared first on ACEP Now.

Fractures 52

Fractures 52

ACEP Now

JULY 7, 2024

Answer: The correct answer is a) Olecranon bursitis. The most pathognomonic symptom is swelling in the posterior olecranon (elbow). It can be painless and may or may not have associated erythema or warmth. Pain, erythema, and warmth are much more common in septic compared with aseptic bursitis but can be present in either condition. Fever is associated with septic bursitis.

Fractures 52

Fractures 52

ACEP Now

JULY 7, 2024

I have learned more from my failures than my successes. My current practice is a hybrid of academic and community sites, and I have worked in myriad community hospitals from busy ones to single coverage critical access hospitals. Each has its own challenges and lessons. Emergency medicine residencies focus heavily on foundational knowledge, procedural competency, and professionalism.

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Resuscitation Risk Management Hospitals Critical Access 98