Tag Archives: prehospital

Prehospital Emergency Medicine. We are different.

12 Mag

phem_sfondiChiari

YES prehospital professionals are different from any other medical provider.
YES Prehospital Emergency Medicine is different because is not just clinical competence and technical skills. It’s much more.
WE are different because performing skills or procedures depends not just from the right patient and the right indication, but is heavily influenced by the environment where we work and the team we lead.
BUT despite this we perform complex procedures even in the hardest situations.
WE are different because we always deal with the “contro” of a possible failure in the middle of nowhere, and the “pro” of a probable success in a safe and warm environment (as the nearest emergency room).
BUT despite this we act, succeed and learn from our failures.
WE are lucky because often our patients don’t have life treating conditions, they just need to talk and we probably are their last chance. 
WE love our job.
WE love Prehospital Emergency Medicine.

 

Join us in Rome to share the same passion

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Paziente con iperglicemia? Vuoi sapere se ha una chetoacidosi diabetica? Usa il capnografo!

16 Giu

capnograph_header

Troviamo un paziente diabetico e confuso. Facciamo subito uno stick glicemico. Ha 300 di glicemia! Perchè è confuso, ha una chetoacidosi diabetica o dobbiamo guardare altrove?

In un recente studio pubblicato sul West Journal of Emergency Medicine dal titolo “Predictive value of capnography for diagnosis in patient with suspected diabetic ketoacidosis in the emergency depatment” gli autori hanno esaminato 181 pazienti con glicemia superiore a 250 mg/dl e sospetta chatoacidosi diabetica.

In 62 di essi la diagnosi di chetoacidosi diabetica veniva confermata dalla presenza di corpi chetonici nelle urine ed acidosi metabolica (pH<7.3  bicarbonati <15 meq/dL).

Hanno dimostrato che un valore della capnografia superiore a 24,5 aveva un valore predittivo negativo dela patologia con una sensibilità ed una specificità del 90%.

Nonostante sia difficile individuare un valore di cut-off specifico (in questo studio 24,5 ha dimstrato una buona sensiblità e specificità, ma altri studi individuano valori differenti), si può affermare con sicurezza che una capnografia normale nei pazienti diabetici con iperglicemia esclude la chetoacidosi diabetica.

Quindi la prossima volta che vi trovate di fronte ad un diabetico confuso ed iperglicemico e dovete indirizzare la diagnosi, occhio al capnografo.

References:

Soleimanpour H et al. Predictive value of capnography for diagnosis in patient with suspected diabetic ketoacidosis in the emergency department. West J Emerg Med 2013

Capnography useful in identifyng patients with DKA

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Linee guida 2013 sulla gestione del paziente con trauma spinale. Novità per la Medicina d’urgenza preospedaliera

17 Mag

Scarica la trascrizione in italiano del podcast

Download English transcript of the podcast

Scarica le Linee Guida complete/Download Full Guidelines from Neurosurgery

CNS Spinal trauma management 2013 Selected Guidelines

Aggiornamento 2013 delle Linee Guida GOLD sulla diagnosi e la cura della BPCO

30 Apr

Scarica la trascrizione del podcast

Download english transcript

Scarica le Linee Guida GOLD

Download GOLD Guidelines

rt-PA e Stroke: IST-3 l’analisi dei risultati

10 Apr

Stroke 3

L’analisi detagliata dei dati dello studio più potente e promettente sull’uso del trombolitico nello stroke ischemico chiude definitivamente la discussione su uno studio nato per essere conclusivo, ma che ottiene il risultato, non solo di suscitare molti (e decisivi) dubbi, ma anche di scalfire alcune ragionevoli certezze.

Scarica la trascrizione del podcast

Scarica la Cronostoria dei trials sulla trombolisi nello stroke ischemico

Guarda la cronistoria dei trials sulla trombolisi nell’ictus ischemico

Leggi il post sul “pubblication bias”

Referencs:
  1. IST 3 Study The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen
  2. IST 3 analysys 2013
  3. Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: a systematic review.
    JAMA. 2003;289:454-469.
  4. Lexchin J, Bero LA, Djulbegovic B, et al. Pharmaceutical industry sponsorship and research outcome and quality: systematic review.
    BMJ. 2003;326:1167-1170

Managing the predicted difficult airway: a clinical case

6 Apr

How our daily practice changes when we manage a predicted difficult airway? This video podcast give us an interesting point of view from the prehospital field.

Triggerlab

Nurse and ventilator waveforms

thinking critical care

a blog for thinking docs: blending good evidence, physiology, common sense, and applying it at the bedside!

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More definitive diagnosis, better patient care

My CPD

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Critical Care Northampton

Reviewing Critical Care, Journals and FOAMed

OHCA research

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SonoStuff

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phemcast

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First10EM

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EMSPOCUS

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LITFL • Life in the Fast Lane Medical Blog

Emergency medicine and critical care medical education blog

emDOCs.net - Emergency Medicine Education

Our goal is to inform the global EM community with timely and high yield content about what providers like YOU are seeing and doing everyday in your local ED.

The Collective

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Dave on Airways

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FOAMcast

A Free Open Access Medical Education Emergency Medicine Core Content Mash Up

Broome Docs

Rural Generalist Doctors Education

St.Emlyn's

Emergency Medicine #FOAMed

BoringEM

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"CardioOnline"Basic and Advanced Cardiovascular medicine" Cariology" concepts and Review -Dr.Nabil Paktin,MD.FACC.دکتـور نبــــیل "پاکطــــین

این سایت را به آن دکتوران و محصلین طب که شب و روز برای رفاه نوع انسان فداکاری می کنند ، جوانی و لذایذ زندگی را بدون چشمداشت به امتیاز و نفرین و آفرین قربان خدمت به بشر می کنند و بار سنگین خدمت و اصلاح را بدوش می کشند ، اهداء می کنم This site is dedicated to all Doctors and students that aver the great responsibility of People’s well-being upon their shoulders and carry on their onerous task with utmost dedication and Devotionاولین سایت و ژورنال انتــرنتی علـــمی ،تخـصصی ، پــژوهشــی و آمــوزشــی طبـــی در افغــانســـتان

EmergencyPedia

Free Open Access Medical Education

Little Medic

Learning everything I can from everywhere I can. This is my little blog to keep track of new things medical, paramedical and pre-hospital from a student's perspective.

Prehospital Emergency Medicine Blog

All you want to know about prehospital emergency medicine

Italy Customized Travel Blog

Local Travel Agent, sommelier, food & wine expert in Florence, Italy

GoogleFOAM

The FOAM Search Engine

EM Lyceum

where everything is up for debate . . .

Pediatric EM Morsels

Pediatric Emergency Medicine Education

EM Pills

curiosità-novità-aggiornamenti in medicina d'urgenza

AmboFOAM

Free Open Access Medical Education for Paramedics

FOAM4GP

Free Open Access Meducation 4 General Practice

Rural Doctors Net

useful resources for rural clinicians

Auckland HEMS

Unofficial site for prehospital care providers of the Auckland HEMS service

ECHOARTE

L'ECOGRAFIA: ENTROPIA DELL'IMMAGINE

MEDEST

Prehospital Emergency Medicine

ruralflyingdoc

Just another WordPress.com site

EM Basic

Your Boot Camp Guide to Emergency Medicine

KI Doc

WE HAVE MOVED - VISIT WWW.KIDOCS.ORG FOR NEW CONTENT

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Prehospital Emergency Medicine

AMP EM

Academic Medicine Pearls in Emergency Medicine from THE Ohio State University Residency Program

ERCAST Emergency Medicine Podcasts

Emergency medicine, podcasts, reviews, opinion and curbside consults

Prehospital Emergency Medicine

 Academic Life in Emergency Medicine

Prehospital Emergency Medicine

Comments on: Homepage

Prehospital Emergency Medicine

Greater Sydney Area HEMS

The Pre-hospital & Retrieval Medicine Team of NSW Ambulance

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