Emergency Medicine Education

OCTOBER 19, 2022

They concluded that “early norepinephrine infusion was not associated with 24-hour or in-hospital mortality among patients with blunt trauma and hemorrhagic shock.” ” Link to article

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Shock Hospitals 40

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.

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Shock Operations Administration Hospitals 147

University of Maryland Department of Emergency Med

JULY 1, 2023

Shock index (heart rate/systolic blood pressure) has been used to predict trauma outcomes. This study from American Journal of Emergency Medici. Click to view the rest

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Hospitals Shock Outcomes 71

Greater Sydney Area HEMS

NOVEMBER 26, 2023

Join us as Sydney HEMS Senior Staff Specialist Dr Brian Burns discusses the recognition, aetiology and treatment of different types of shock in our pre-hospital trauma patients.

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Burns Shock Hospitals 69

Sensible Medicine

APRIL 15, 2024

A common cause of cardiogenic shock occurs when a blocked coronary artery (myocardial infarction or MI) causes the heart to fail. Cardiogenic shock from MI has a death rate of about 50%. This is why the DanGer-Shock trial had to be done in Denmark, a place where doctors are perhaps a little less sure of themselves. It did not.

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Shock Sepsis Hospitals 72

The Skeptics' Guide to EM

FEBRUARY 25, 2023

2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

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Pediatrics Hospitals CPR Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 3, 2023

Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital. Circulation. Circulation.

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Hyperthermia / Hypothermia Hospitals Outcomes Documentation/Coding 52

University of Maryland Department of Emergency Med

DECEMBER 8, 2022

This paper outlines a training course by Hartford Hospital for general surgery and emergency medicine residents. Their goal was to assess pre-a. Click to view the rest

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Resuscitation Shock Hospitals 40

PulmCCM

APRIL 29, 2024

The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1). The stakes are going up. That was the pregame.

Infectious Diseases 52

Infectious Diseases Sepsis Administration Shock 52

AED Leader

APRIL 22, 2024

It is estimated that over 350,000 cases of out-of-hospital cardiac arrests occur annually in the United States alone. 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.

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CPR Shock Resuscitation Operations 52

The Trauma Pro

APRIL 26, 2024

In the last post in the series, I’ll discuss a paper in press that compares the efficacy and hospital charges of the two techniques. A multi-center trial published in 2015 showed an astounding 32% mortality rate for patients with shock from pelvic fracture.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Assessment was severe sudden cardiogenic shock. He remained hypotensive and in shock. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China.

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Shock EKG/ECG Outcomes Hospitals 52

Stop and Think

APRIL 16, 2024

I wrote this week, on Sensible Medicine, a summary of the DanGer-Shock trial of a mechanical assist device in patients with cardiogenic shock due to acute myocardial infarction (heart attack). Because doctors and hospital are compensated well for its use—which may be a reason why it became a popular device.

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Shock Wellness Hospitals 48

Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

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Shock Sepsis Pediatrics Ultrasounds 40

Mount Sinai EM

APRIL 7, 2023

TB is caused by the acid-fast bacillus Mycobacterium Tuberculosis and spreads via aerosolized respiratory secretions.

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Shock Hospitals 130

University of Maryland CC Project

JUNE 16, 2023

The first annual Mid-Atlantic Neurocritical Care Symposium will bring together experts from The University of Maryland/Shock Trauma Hospital, Johns Hopkins University, INOVA, Christiana Care, and beyond to discuss the basics of caring for critically ill neurological patients, as well as highlight recent innovations in the field.

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Shock Hospitals Wellness Stroke 70

ETM Course

JUNE 28, 2015

Just over a year ago London HEMS performed the first pre-hospital regtrograde endovascular balloon occlusion of the aorta (REBOA). Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. Shock 2014; 41(2): 130–7 12. 2011 Dec;71(6):1869-72 (full article free text) 2. Avaro et al.

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Hospitals Shock Resuscitation Military 52

Dr. Smith's ECG Blog

FEBRUARY 16, 2020

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Referring to Figure-1 — this 53-year old woman who presented in extremis with cardiogenic shock and an initial pH = 6.9, This was sent by a reader. and K was normal. Here was the ECG: There is sinus tachycardia.

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Shock Hyperthermia / Hypothermia EKG/ECG Hospitals 52

AED Leader

JUNE 18, 2023

In Oceanside, California (June, 2023) 67-year-old David Mills’ life was saved after he received 70 minutes of in-hospital and out-of-hospital CPR and electrical shocks from an AED. The post Man suffering cardiac arrest recovers after 70 minutes of CPR appeared first on AEDs for Sale | Buy Defibrillators and Accessories.

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CPR Shock Hospitals 52

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. veterans’ hospitals did not show a mortality reduction from low-dose methylprednisolone. standards of care.

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

AED Leader

OCTOBER 5, 2023

Ambulance worker Shaun McBride suddenly collapsed after strapping 72-year-old patient Tommy Stewart into a vehicle for transfer from Glen O’Dee Hospital in Banchory to Aberdeen Royal Infirmary in Scotland. Mr. Stewart couldn’t reach the horn but yelled for help until a hospital caterer came out and nurse Freya Smith-Nicol was alerted.

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CPR Shock Hospitals 52

RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1% Liberal: 14.9% Liberal: 14.9%

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Sepsis Shock Resuscitation Outcomes 83

PulmCCM

JANUARY 29, 2024

automated external cooling system) for all arrest patients (with any presenting rhythm, occurring in- or out-of-hospital) maintained for at least 24 hours; longer periods of fever prevention (which AHA now calls “temperature control”) for persistently comatose patients are also considered reasonable.

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Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

RebelEM

SEPTEMBER 28, 2023

In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. Thrombolysis in Myocardial Infarction Flow Grade 3 at Last Angiography was ≈87% in both groups Composite of Death, Shock, Heart Failure, or Reinfarction: Pharmaco-Invasive Treatment: 12.8% Primary PCI: 95.7% Primary PCI: 95.7% Primary PCI: 78.4%

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EKG/ECG Allergic Reactions Shock Stroke 127

PEMBlog

OCTOBER 18, 2023

Neonatal Toxic Shock Syndrome C. Neonatal Toxic Shock Syndrome-Like Exanthematous Disease E. Neonatal Toxic Shock Syndrome-Like Exanthematous Disease The patient was diagnosed with Neonatal Toxic Shock Syndrome-Like Exanthematous Disease (NTED). This patient was hospitalized for 4 days where he remained well-appearing.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

RebelEM

FEBRUARY 7, 2024

Triple antibiotic coverage is recommended. Suggested regimens include: Ampicillin AND Gentamicin AND Clindamycin OR Metronidazole Update tetanus vaccination Usually requires dilation and curettage to remove any retained products of conception or foreign bodies.

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Sepsis Shock Hospitals Ultrasounds 75

PHEM Cast

APRIL 27, 2023

– Wiles – 2013 – Anaesthesia Permissive hypotension versus conventional resuscitation strategies in adult trauma patients with hemorrhagic shock: A systematic review and meta-analysis of randomized controlled trials Risks and benefits of hypotensive resuscitation in patients with traumatic hemorrhagic shock: a meta-analysis | Scandinavian (..)

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Resuscitation Shock Operations Hospitals 52

EMDocs

DECEMBER 31, 2023

Without further ado, here is our list of top posts from 2023 based on viewership from you, the readers: Neurogenic Shock: Definition, Identification, and Management in the ED We start off the list with a clinical post from Kira Brayan and Jenny Beck-Esmay on diagnosing and managing neurogenic shock!

Poisoning 72

Poisoning Shock EMS Hospitals 72

Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. Infectious Disease Acquisition in Pediatric International Travelers: A 10-Year Review at a Canadian Tertiary Care Hospital. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Dr. Smith's ECG Blog

MAY 3, 2024

She was found by medics agitated, hypotensive, diaphoretic, and in shock. In fact, most do not make it to the hospital alive, which explains why only a tiny percent of OMI are due to full LM occlusion. A 60-something woman complained of sudden severe abd pain. There were 2 prehospital ECGs: What do you think?

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Shock EKG/ECG Hospitals EMS 102

PulmCCM

FEBRUARY 12, 2024

SCCM Guideline Update: Steroids for Community-Acquired Pneumonia, ARDS, Septic Shock Steroids are good medicine in the ICU, U.S. The 2017 SCCM/ESICM suggestion had been to use steroids for severe septic shock (requiring high-dose or multiple vasopressors). critical care professional societies agree.

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Shock Administration Sepsis Fractures 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Date: August 12th, 2021 Reference: Daya et al.

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Shock CPR Hyperthermia / Hypothermia EMS 52

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. Intravenous vs.intraosseous vascular access during out-of-hospital cardiac arrest – protocol for a randomized clinical trial. PMID: 33350794 10 Meilandt C. Resusc Plus. 2023 PMID: 37502742 11 Schwalbach KT et al.

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Resuscitation Administration Emergency Department Hospitals 102

University of Maryland CC Project

JUNE 16, 2023

The first annual Mid-Atlantic Neurocritical Care Symposium will bring together experts from The University of Maryland/Shock Trauma Hospital, Johns Hopkins University, INOVA, Christiana Care, and beyond to discuss the basics of caring for critically ill neurological patients, as well as highlight recent innovations in the field.

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Shock Hospitals Wellness 52

ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. This should be suspected in patients with intraoperative cardiac arrest or shock. References Garcia SE. Butt Lifts Are Booming.

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Emergency Department Operations Ultrasounds Hospitals 52

Taming the SRU

MARCH 10, 2024

There are also many costs to hypoglycemia, both in terms of financial burdens on hospitals/caretakers/patients, and in terms of morbidity and mortality. critical AS, ASD, HCM) Arrhythmogenic right ventricular cardiomyopathy Pulmonary embolism Thoracic aortic dissection Transient occult shock Sepsis Hemorrhagic shock (ex.

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EKG/ECG Shock Wellness EMS 86

ALiEM

MAY 29, 2023

If left untreated, it can lead to significant blood loss, shock, airway obstruction, and even death. Symptoms of massive epistaxis include sudden and heavy bleeding from the nose, difficulty breathing, dizziness, and a rapid heartbeat. Posterior Epistaxis Nasal Packing.

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Blood Transfusions Emergency Department Shock Hospitals 98