October 2018
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Oct 19 2018
EMS Suicide Risk – Let’s Take Care of Each Other
EMS providers had 39% greater odds of death by suicide than the general population in this Arizona-based sample. This problem is real. Reach out if you need help. See below.
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Oct 18 2018
How Many Intubations Does It Take For Proficiency?
It is estimated that to place an endotracheal tube (ETT) successfully in 30-60 seconds, using direct laryngoscopy, would take 3-5 years of experience and 137-243 endotracheal intubations (ETI). Increased experience did not reduce the time chest compressions were paused. The key take home is that ETI during CPR is really hard. Be prepared.
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Oct 17 2018
AIRWAYS-2 – SGA vs ETT for Out-of-Hospital Cardiac Arrest
There was no difference in good neurological recovery after non-traumatic out-of-hospital cardiac arrest at 30 days with use of a supraglottic airway compared to endotracheal tube.
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Oct 16 2018
EMS ETT or LT for OHCA? Answers in PART
For adults with out-of-hospital cardiac arrest, initial laryngeal tube insertion by emergency medical service providers was associated with improved 72-hour survival, return of spontaneous circulation, hospital survival, favorable neurologic outcome, and airway success compared to initial endotracheal tube insertion.
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Oct 15 2018
Triaging Children in Mass Casualty – Which Tool Is Best?
Four mass casualty incident (MCI) triage sorting systems performed similarly in children, each 57-59% accurate. Those considered were SALT, JumpSTART, Triage Sieve, and CareFlight.
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Oct 13 2018
Transgender Care
There was a helpful JAMA Internal Medicine article on caring for transgender patients this past month. This will help us apply it in the ED.
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Oct 12 2018
Distracting Injury and C-Spine Clearance
Clinical clearance of the c-spine missed an equal number of c-spine injuries on CT (10-13%) whether distracting injury (DI) was present or not.
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Oct 11 2018
Malpractice – Top Diagnoses | How to Not Get Sued
Malpractice suits against emergency physicians have some common themes. This post will help you understand them in brief.
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Oct 10 2018
Ketamine Dart for Agitation
Ketamine was effective for treatment of agitation, but 30% of patients given higher doses IM by EMS were intubated once in the ED.
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Oct 09 2018
Outpatient PE – sPESI or Hestia?
Simplified PESI (sPESI) and Hestia scores identified similar numbers of patients with pulmonary embolism as low risk. Both groups had similar 30-day all-cause mortality. However, interobserver reliability was better with sPESI.