Dynamic left ventricular outflow tract obstruction (LVOTO) is not a condition I learned about during residency, and it is not a condition I have diagnosed regularly, although I have probably missed it many many times. On First10EM, I usually prefer to start with a presenting symptom than a diagnosis, because […]
First10EM resuscitation plans
72 posts
Most resuscitation is pretty straightforward. No matter how sick the patient is, we select from a fairly limited list of interventions. Hypoxia: does the patient need facemask oxygen, highflow, BiPAP, or intubation? Hypotension: fluids, blood, vasopressors? This basic, well used menu serves us incredibly well for the vast majority of […]
This isn’t a full blog post, but just an opportunity to share a resource that I think many people will find valuable. In most pediatric resuscitations, I feel very comfortable standing with the Broselow tape in my hand for dosing. If it isn’t on the Broselow, I probably have time […]
Pulmonary embolism is probably discussed far more than is truly necessary. It receives more attention than almost any other pathology. We endlessly debate the best algorithms for diagnosis. We add new decision tools almost yearly. However, if there is one aspect of pulmonary embolism that might be under-discussed it is […]
Case Your patient is bleeding. A lot. Their vital signs are abnormal. They look very sick. (I am being intentionally vague, because the post is going to look at massive hemorrhage in general, rather than getting into the specifics of any one condition.) This post is a condensed clinical summary […]
This is a guest post by Dr. Katie Lin. Dr. Katie Lin is an Assistant Professor of Emergency Medicine at the University of Calgary, a Stroke Attending with the Calgary Stroke Program, and a critical care Flight Transport Physician with STARS Air Ambulance in Alberta. She completed her residency training and stroke fellowship in Calgary […]
I have written about the resuscitation of anaphylaxis and asthma before. However, I was forwarded the AMAX4 algorithm for the patient with asthma or anaphylaxis who is either unconscious or requiring assisted ventilation, and I think it is an important addition for our sickest patients. The heartbreaking backstory to this […]
The lateral canthotomy is a core emergency medicine procedure. It was one of the earliest topics covered on First10EM. Early intervention improves outcomes, but despite that, ED physicians frequently delay performing the procedure until the arrival of a specialist. (Beams 2016) A “one-snip” approach has been described that, based on […]
A 62 year old woman is brought into the emergency department by EMS after being found lethargic and confused. On arrival, she has a temperature of 34 degrees Celsius, a heart rate of 62, a blood pressure of 88/52, and an oxygen saturation of 92% on room air. The patient […]