Tactical Medicine News Blog

In this month's POCUS Cases Dr. Rob Simard explains the role of POCUS in distal radius fracture diagnosis and reduction, how to troubleshoot finding the echogenic line that represents the shaft of the radius, and the limitations of using POCUS for distal radius fractures... The post POCUS Cases 4 – Distal Radius Fracture Diagnosis and Reduction appeared first on Emergency Medicine Cases.

In this EM Cases main Episode 112 Tachydysrhythmias with Amal Mattu and Paul Dorion we discuss a potpurri of clinical goodies for the recognition and management of both wide and narrow complex tachydysrhythmias and answer questions such as: Which patients with stable Ventricular Tachycardia (VT) require immediate electrical cardioversion, chemical cardioversion or no cardioversion at all? Are there any algorithms that can reliably distinguish VT from SVT with aberrancy? What is the "verapamil death test"?  While procainamide may be the first line medication for stable VT based on the PROCAMIO study, what are the indications for IV amiodarone for VT? How should we best manage patients with VT who have an ICD? How can the Bix Rule help distinguish Atrial Flutter from SVT? What is the preferred medication for conversion of SVT to sinus rhythm, Adenosine or Calcium Channel Blockers (CCBs)? Why is amiodarone contraindicated in patients with WPW associated with atrial fibrillation? What are the important differences in the approach and treatment of atrial fibrillation vs. atrial flutter? How can we safely curb the high bounce-back rate of patients with atrial fibrillation who present to the ED? and many more... The post Ep 112 Tachydysrhythmias with Amal Mattu and Paul Dorian appeared first on Emergency Medicine Cases.

In this EM Cases main Episode 112 Tachydysrhythmias with Amal Mattu and Paul Dorion we discuss a potpurri of clinical goodies for the recognition and management of both wide and narrow complex tachydysrhythmias and answer questions such as: Which patients with stable Ventricular Tachycardia (VT) require immediate electrical cardioversion, chemical cardioversion or no cardioversion at all? Are there any algorithms that can reliably distinguish VT from SVT with aberrancy? What is the "verapamil death test"?  While procainamide may be the first line medication for stable VT based on the PROCAMIO study, what are the indications for IV amiodarone for VT? How should we best manage patients with VT who have an ICD? How can the Bix Rule help distinguish Atrial Flutter from SVT? What is the preferred medication for conversion of SVT to sinus rhythm, Adenosine or Calcium Channel Blockers (CCBs)? Why is amiodarone contraindicated in patients with WPW associated with atrial fibrillation? What are the important differences in the approach and treatment of atrial fibrillation vs. atrial flutter? How can we safely curb the high bounce-back rate of patients with atrial fibrillation who present to the ED? and many more... The post Ep 112 Tachydysrhythmias with Amal Mattu and Paul Dorion appeared first on Emergency Medicine Cases.

The 1stannual Rebellion in EM Clinical Conference took place in San Antonio, TX on May 11th– 13th, 2018.  If you missed out in 2018, the Rebellion is coming back June 28th – 30th, 2019.  Stay up to date as we plan the conference for this upcoming year at www.rebellioninem.com. The Missions of Rebellion in EM: Decrease Knowledge Translation: With 100s of journals and thousands of publications every year, it takes time for research to disseminate to clinical practice. Discussion of current literature and its application to practice is the key to facilitating safe best practices. Create a Community of Practice: It requires many to take care of the few www.bestintime.me. Patient care is a team sport that starts pre-hospital, continues through the ED, and finally into the hospital. Improve Patient Care: Decrease suffering and improve patient oriented outcomes “Learning is always rebellion…every bit of new truth discovered is revolutionary to what was believed before.” -Margaret lee Runbeck-

Background: Focused use of ultrasound in resuscitation of patients with shock and cardiac arrest has become increasingly embraced in both the emergency department (ED) as well as in the prehospital setting. Application of ultrasound, particularly of echocardiography, has the potential to identify treatable causes of shock and arrest, identify shockable rhythms and identify the presence of mechanical activity. All of these can affect management decisions and, potentially effect outcomes. Recent studies have led to concerns that integration of point of care ultrasound (POCUS) in cardiac arrest increases pauses in compressions. Thus, it is important to establish what POCUS adds to shock and arrest management.