Osborone Waves 🥶

What is Hyperechoic?

Coming next week to FOAMfrat Studio – We are launching a new series, Psychological Injury, with Alex Jabr from Emergency Resilience! This series is all about recognizing, understanding, and managing different types of physiological injury! Check out the first episode next week! Not a FOAMfrat Studio member? Learn more by clicking the link below. https://bit.ly/4cBDs1r

In this episode of Good Reads, we explore a winter-time emergency involving a hypothermic patient found by police. The initial 12-lead ECG reveals bradycardia and prominent Osborne waves (J waves)—a hallmark of hypothermia. We discuss: How Osborne waves evolve as body temperature drops. How these waves can mimic STEMI, leading to potential misdiagnosis. Other conditions with similar ECG findings, include hypercalcemia, pericarditis, and Brugada syndrome. Timestamps: 00:00 Introduction and Case Presentation 00:30 Understanding Osborne Waves in Hypothermia 01:51 Progression and Mimics of Osborne Waves 02:27 Other Conditions Mimicking Osborne Waves 02:47 Conclusion and Key Takeaways

Atrial Flutter

In this episode, we discuss the mental framing and big-picture thought process behind the first 5 minutes of a mass casualty incident (MCI). Rommie Duckworth, a fire captain and shift commander, is a wealth of knowledge on this topic and speaks globally to prepare emergency responders for these events. Initial Assessment and Action Upon arrival at an MCI, the scene can often feel overwhelming. The key is maintaining focus on immediate, actionable goals. Rommie simplifies this into three crucial objectives: stop the killing, stop the dying, and move patients forward. This approach involves eliminating any ongoing threats that could exacerbate the situation, providing essential medical care, and ensuring that patients are moved swiftly to safety or more advanced care facilities. Stopping the Patient Generator A vital step in managing an MCI is to halt the "patient generator." For instance, in a scenario like a school shooting, this could mean ensuring the threat is neutralized before medical aid is administered. Traffic accidents might involve managing hazards like ongoing traffic or securing dangerous scenes to prevent further injuries. Whatever it is, you will consistently remain in an MCI milieu as long as the patient generator is allowed to continue. Pragmatic Triage Triage systems are foundational in MCI management, yet no system has proven superior. The focus should be on simplicity and patient forward movement. The UK’s 10-second triage system is highlighted as an efficient method that prioritizes rapid assessment over detailed categorization, which can slow down response efforts. Treatment and Transport Dynamics Effective treatment at the scene of an MCI isn't about delivering comprehensive care but about stabilizing patients enough to ensure they can be transported to definitive care facilities. Protocols like the MARCH (Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia) prioritize interventions crucial for stabilizing patients in the critical initial moments. Managing Resources and Personnel: Proper staging and resource management are essential. Responding units should adhere to established protocols for staging and assignment, which helps prevent self-deployment to the scene and ensures resources are utilized where most needed. This organization is key to avoiding logistical oversights that can hinder transport capabilities. MCIs require a shift from standard medical procedures to a focus on maximizing overall patient survival through streamlined operations and strategic thinking. As Rommie Duckworth emphasizes, the goal in these situations is to manage the chaos effectively, ensuring that emergency services can improve outcomes in these challenging scenarios.

Which one are you? Let us know in the comments.... Infusion or Bolus?

Vasopressor Receptor Physiology