armyemdoc

Read the story 👇 It's so often that those of us who work in EM and critical care see devastating injuries and wonder whether we're really making a difference... SPC Jordan Kirkpatrick is a @usarmy Soldier who was riding his motorcycle on his day off when he had a high-speed…

An RCT published this month found that polyethylene arterial catheters have a lower incidence of insufficiency (23% difference) compared to polyurethane. Insufficiency was defined as all the things that annoy us on a daily basis: over-dampening, under-dampening, clogging,…

In our review of emergency front of neck access (eFONA) AKA "surgical airway" or "cricothyrotomy" published this month, we found that since VL was released to the market: -Prehospital eFONA incidence has remained largely unchanged -Mortality rates associated with this procedure…

What are the A+ criteria for potential BCVI in children? This study publiahed this month enrolled 2283 children with a significant blunt mechanism and found the following factors were predictive of BCVI: -Temporal fracture -Sphenoid fracture -Orbital roof fracture -C1-C4…

Should women of child-bearing potential receive LTOWB in the setting of massive hemorrhage? We say yes. Check out my interview in US Medicine that follows our paper in Transfusion. usmedicine.com/clinical-topic… onlinelibrary.wiley.com/doi/10.1111/tr… #emergency #emergencymedicine #criticalcare…

Intern tip: You are called to the floor for a patient you are cross-covering in cardiac arrest. Here's 4 things for you to do your first time running a code. 1. Pull your ACLS cards. No one is going to make fun of you for pulling out your cards and following the algorithms.…

A DoD-funded study published this month found that sublingual sufentanil (aka Dsuvia) has similar efficacy and safety as more commonly used forms of analgesia for trauma. Too bad that all forms of sublingual sufentanil were pulled from the market as of last month. The military…

PFC Podcast 238: Bad Day in Ukraine ... Out now Lots of lessons learned in this one... All levels Link tree linktr.ee/Prolongedfield… @SpecOpsMedics @TacmedAus @NARescue @DeltaDev_Team @CeloxMedical @ATMA_Tactical @CommitteeonTCCC @armyemdoc @GreenBeretMD

Since I am giving you my two cents central lines, I will cover what to do in the event of inadvertent arterial cannulation. Management of complications of all types is important to learn. 1. Take a deep breath and remember that procedural complications happen to everyone that…

Got hemorrhage? Reach for a dialysis catheter and here's why... 1. The gauge (size) of the lumens are substantial. A standard triple-lumen central line has lumens thar are 16g (distal port) to 18g (proximal/medial ports). Smaller gauge = bigger diameter. A 14F dialysis line…

We are happy to share our last systematic review on a very important topic: Effect of pretreatment opioids on hemodynamics during emergency intubations: a systematic review journals.lww.com/euro-emergency…

Is burying the needle to the hub the right answer? PFC Podcast 237: Finger Thoracostomy Link tree linktr.ee/Prolongedfield… Listen ad free with premium membership on Spotify Apple Podcast or Patreon. @SpecOpsMedics @NARescue @armyemdoc @DeltaDev_Team @CeloxMedical

In this systematic review with meta-analysis published last week, they analyzed 34 studies, 655,000 ICU patients. -they found an overall incidence of 5% -in high-income countries it was 3% (that seemed high to me, anecdotally, am curious if others think the same) -in LMICs it was…

So how common are fireworks injuries? Well, the true denominator is pretty hard to determine since most of them are discharged home from the ED. Most of them do not meet criteria for capture into TQIP. But here's a summary of TQIP data: -From 2017-2023, there were about 8M…

Pressure on the bleed will always be the point, but it is nice to have some extra help. PFC Podcast 236: Hemostatic Agents Link tree linktr.ee/Prolongedfield… Listen ad free with premium membership on Spotify, Apple Podcast, or Patreon @SpecOpsMedics @CeloxMedical @armyemdoc

On prehospital cricothyrotomy in the US... this study published in June 2025 found: -Incidence of 1.9 per 100,000 EMS calls -Nearly half were performed in the setting of cardiac arrest -Most were performed on males <60 years -Successful placement was 83% Of note, they excluded…

Hypotension occurs in 45% of IV acetaminophen administrations. A SR-MA was published last week -5 studies -339 patients -Mean MAP drop of 6.8mmHg -More frequently occurs in febrile patients doi.org/10.1016/j.accp… #emergency #emergencymedicine #criticalcare #icu #airway #army…

Congrats to all of our newly minted attending physicians! The learning doesn't stop now. It just transitions to a different type of learning. There isn't a single shift that goes by that I'm not looking something up or bouncing a question off a colleague. #emergency…

Erythropoietin drugs have a long history of use in chronic anemia, particularly in the setting of CKD. But did you know they potentially have a lot of other uses, including for trauma? In this narrative review, we lay out the current state of the science for potential use of…