The Trauma Pro

SEPTEMBER 21, 2023

Here’s another abstract with a promising title that suffers from low subject numbers. Whole blood is the new darling of trauma resuscitation. Assembling a unit of whole blood from the components it was broken down into produces an inferior product from the standpoint of resuscitation. It makes sense from a coagulation standpoint, but there are a few pesky issues that need to be considered, such as antibody titers.

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Science Based Medicine

SEPTEMBER 22, 2023

Measles and COVID are different, of course, but they are not categorically different. With both viruses, unvaccinated children suffer the most. Yet, doctors who rightly said "measles can be a devastating childhood illness" also said it was "breathless fear-mongering" to acknowledge that COVID can also be a devastating childhood illness. The post Doctors on Measles: “NEVER Listen to the Anti-Vax Cult When They Say This ‘Natural’ Disease is Harmless”.

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Ken Grauer, MD

SEPTEMBER 15, 2023

The tracing in Figure-1 was sent to me for my interpretation. As per the title of today's Blog post — There is no simple explanation for all that is happening in this challenging tracing. Are YOU up for the challenge? I found that the most challenging part of today's tracing is determining the etiology of beat "X". As I explain below — I think it unlikely that beat "X" represents a single, slightly accelerated junctional beat.

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First 10 EM

SEPTEMBER 18, 2023

Transfusion seems like the simplest intervention in medicine. The patient is losing blood, so let’s put some back in. Not much more complicated than an oil change. Sure, you need to use a specific brand, but as long as the system is topped up, everything should run just fine. Therefore, when someone (to be left […] The post Massive hemorrhage: a very deep dive appeared first on First10EM.

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RebelEM

SEPTEMBER 21, 2023

Bottom Line Up Top: Troponins should not be routinely sent in patients presenting with SVT. Rarely, they may be necessary if the patient has concerning ischemic symptoms that persist after conversion to sinus rhythm. Clinical Scenario: A 44-year-old man presents with palpitations that started 45 minutes ago. He has no medical problems and denies any prior similar symptoms.

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EKG/ECG Sepsis EMS Hospitals 118

Dr. Smith's ECG Blog

SEPTEMBER 15, 2023

I came to work one day and one of my partners said, "Hey, Steve, we had a STEMI this afternoon!" I said, "Cool, can I see the ECG?' Of course he said: "Yes, it was a 60 year old diabetic with Chest pain." So he showed me the ECG recorded in triage: What did I say? "That is not a STEMI. That is Arterial Pulse Tapping Artifact (APTA)." He said: "What?

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EKG/ECG Wellness 139

Medagadget

SEPTEMBER 19, 2023

Researchers at Nanyang Technological University in Singapore have developed a tiny, flexible battery that is intended for use in smart contact lenses. The device is as thin as the human cornea and can be charged by a saline solution, which is particularly useful in the eye, as it is full of salty tears. When the battery-equipped smart lens is not in use, such as at night, then it can be stored in a saline solution, helping to further recharge the battery.

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Research 107

Sensible Medicine

SEPTEMBER 16, 2023

Recently, I saw a tweet from World Lung Conference. A presenter lamented differences in Lung cancer screening rates by race. Black and Hispanic patients had lower rates of lung cancer CT screening than whites, and the speaker argued that we needed targeted efforts to improve this disparity. But lung cancer screening doesn't work, as I described in a prior post.

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Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Case submitted by anonymous. Written by Smith. Ken's piece at the bottom is excellent. A 50-something presented with s udden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest.

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Medagadget

SEPTEMBER 19, 2023

Researchers at ETH Zurich have developed an insulin delivery system that relies on music as a trigger. The unusual technology is based on calcium ion channels that typically reside in the cell membrane. Such channels are sensitive to mechanical deformation and these researchers discovered that sound waves will activate the channels. When insulin-producing cells are genetically modified to express this channel, they will experience an influx in calcium ions when music is played close by, promptin

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Research 101

The Trauma Pro

SEPTEMBER 19, 2023

Worldwide, the proportion of older people is growing. With that is an increase in the number of older folks with medical comorbidities like diabetes, hypertension, and obesity. Trauma professionals recognize these conditions’ negative impact on recovery after injury. But is being young becoming the new old? The trauma group at WakeMed performed a retrospective multi-center study to tease out an estimate of the prevalence of these conditions (plus one more: alcohol/substance use) in injured

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Hospitals 147

Science Based Medicine

SEPTEMBER 18, 2023

This year, cancer quack Dr. Stanislaw Burzynski turned 80. Unfortunately, he doesn't seem to be slowing down charging patients with advanced cancer huge sums for false hope. The post Cancer quack Stanisław Burzynski continues to prey on cancer patients in 2023 first appeared on Science-Based Medicine.

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Sensible Medicine

SEPTEMBER 15, 2023

I released this on my own substack, but honestly think the readers of Sensible Medicine should know this. If your chair tells you to not talk to the press, the chair should be fired. I was recently reading Jay Bhattacharya’s first person account of his treatment at Stanford— the vicious disputes about lockdown in the Spring of 2020— and this jumped out at me.

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Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

Written by Magnus Nossen MD, peer reviewed and edits by Smith, Meyers, Grauer A 60 something previously healthy female smoker sought medical attention after 2-3 days of intermittent chest discomfort. The chest discomfort was described as sharp. Episodes lasting 5-30 minutes. On the day of presentation she experienced another episode of chest discomfort accompanied by vomiting and throat pain.

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EKG/ECG COPD Shock Outcomes 100

Medagadget

SEPTEMBER 19, 2023

Researchers at the University of Colorado Anschutz Medical Campus have developed a technique that may spot the very early signs of Alzheimer’s disease, years before symptoms arise. The method may alert patients and clinicians to an increased risk of the disease, potentially allowing them to take steps to slow the disease progression. The method involves using a simple EEG headband while sleeping.

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The Trauma Pro

SEPTEMBER 18, 2023

Today’s abstract continues the theme of VTE prophylaxis. The authors introduce another timing parameter in this one: the “door-to-prophylaxis” time. Just as it sounds, this is the time interval between admission to the ED and initiating chemo-prophylaxis. Just like some centers struggle with how long to wait to start it after a solid organ injury ( see previous post here ), many find it challenging to get it ordered in the first place.

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Blood Transfusions Resuscitation Hospitals Wellness 147

Core Medical Group

SEPTEMBER 15, 2023

Meet our Allied Team Lead with 2.5 years of dedication and commitment, James. His exceptional journey in the healthcare recruitment world has earned him the role as team lead after his 16 years of service. With an impressive background in the United States Coast Guard and a passion for helping professionals find their perfect healthcare roles, James brings a unique perspective to the world of healthcare recruitment.

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PulmCCM

SEPTEMBER 17, 2023

The Centers for Disease Control and Prevention formally called on hospitals to develop robust sepsis care programs to systematically identify and treat sepsis, track outcomes, and improve care delivery. The guidance comes as a series of recommendations dubbed the Hospital Sepsis Program Core Elements , along with an “assessment tool” that functions as a sort of checklist for compliance.

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Don't Forget the Bubbles

SEPTEMBER 18, 2023

Why do we care about antibiotics? As paediatricians, antibiotics are one of the most common classes of medications that we will end up prescribing. When we do this correctly, antibiotics can save lives. However, prescribing unnecessary antibiotics increases the risk of antimicrobial resistance while exposing children to potential side effects. This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department.

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Science Based Medicine

SEPTEMBER 15, 2023

Did an absurdly spicy chip and a social media challenge kill a Massachusetts teen? His family sure thinks so, and it is possible. But skepticism is appropriate unless further details emerge. Still, these chips aren't for kids. The post Did a Spicy Social Media Challenge Kill a Massachusetts Teen? first appeared on Science-Based Medicine.

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The Trauma Pro

SEPTEMBER 15, 2023

Venous thromboembolic disease (VTE) continues to be a major issue in trauma patients. Most trauma centers have prophylaxis guidelines to try to reduce this problem. These guidelines typically recognize specific injuries that increase the risk of bleeding if anticoagulants are given. Typical ones include hemorrhagic injuries to the brain, pelvic and spine fractures, and solid organ injuries.

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EM Ottawa

SEPTEMBER 21, 2023

Emergency medicine is a fast-paced realm where paramedics and medical professionals must make split-second decisions that often mean the difference between life and death. In this high-stakes environment, understanding and respecting patient preferences while upholding ethical principles are paramount. This article delves into the crucial role of paramedics in ensuring patients’ choices are honoured and […] The post BHP Corner: Respecting Patient Preferences appeared first on EMOttaw

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Emergency Live

SEPTEMBER 15, 2023

Dogs and humans united to save lives in the water The ‘Scuola Italiana Cani da Salvataggio’ (SICS) is an outstanding organisation, both nationally and internationally, dedicated to the training of dog units specialised in water rescue. Founded in 1989 by Ferruccio Pilenga, SICS has contributed significantly to the safety of people in Italian waters and […] The post SICS: A Story of Courage and Dedication appeared first on Emergency Live.

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Don't Forget the Bubbles

SEPTEMBER 20, 2023

The Choosing Wisely ® campaign is an initiative that promotes collaborative conversations between clinicians and families to safely avoid unnecessary and potentially harmful tests. The American Academy of Paediatrics Section on Emergency Medicine (AAP SOEM) created a list of five key recommendations for Paediatric Emergency Medicine after a structured review process and expert consensus opinion.

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Medagadget

SEPTEMBER 20, 2023

Researchers at RMIT in Australia have developed a drug-free approach to kill bacteria and fungi that can infect surfaces on medical implants. Such pathogens can cause serious and difficult-to-treat infections around medical implants, sometimes requiring the removal of the implant. In addition, many microbes are increasingly resistant to common antibiotics, highlighting the need for drug-free approaches.

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Research 73

PEMBlog

SEPTEMBER 20, 2023

This is a blog post designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not. The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Kelly Levasseur, DO Children’s Hospital of Michigan Detr

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Taming the SRU

SEPTEMBER 21, 2023

Driver, B. E., Trent, S. A., Prekker, M. E., Reardon, R. F. & Brown, C. A. Sedative Dose for Rapid Sequence Intubation and Postintubation Hypotension: Is There an Association? Ann. Emerg. Med. (2023) doi:10.1016/j.annemergmed.2023.05.014. Clinical Question: Does the dose of etomidate or ketamine play a role in post-intubation hypotension? Background Rapid sequence intubation (RSI) is frequently performed under emergent conditions in acutely ill patients.

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Emergency Live

SEPTEMBER 21, 2023

Extrication Training Centre in Casiglion Fiorentino: First Dedicated Centre for Rescue Worker Training up and running In the heart of STRASICURAPark, in Casiglion Fiorentino (Arezzo), is a state-of-the-art centre, ready to welcome visitors, experts and rescue professionals specialised in a delicate branch of emergencies: the extrication of victims from crashed vehicles.

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Science Based Medicine

SEPTEMBER 20, 2023

It's not as complicated as you may think. The post Why Is American Healthcare So Expensive? first appeared on Science-Based Medicine.

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Medagadget

SEPTEMBER 20, 2023

Researchers at the Terasaki Institute in Los Angeles have developed a new method to create 3D printed muscle constructs with enhanced muscle cell alignment and maturation. The technique involves creating microparticles loaded with insulin-like growth factor (IGF) using a microfluidic platform. Then, these particles are included in a bioink that also incorporates myoblast cells and a gelatin-based hydrogel.

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Research 66

Don't Forget the Bubbles

SEPTEMBER 16, 2023

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

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Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, y

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Emergency Live

SEPTEMBER 21, 2023

Arson fires: the role of arsonists, economic interests and rescuers We have now seen several fires that have created various disasters: some of these remain world-famous precisely because of the number of hectares burned, the number of victims or their famous circumstances. It is always a drama that has to be dealt with day after […] The post Arson fires: some of the most common reasons appeared first on Emergency Live.

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Burns 69

Maria Yang, MD

SEPTEMBER 20, 2023

To keep the watermelon from rolling off the platform, I placed the bag holding it between my ankles. My fingers tapped words of grief into my phone while I waited at the International District/Chinatown light rail station. Around ten of us were waiting for the next train. “ Ni hao? ” A male voice was asking me this tentative question. My head tilted up; who was talking to me?

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Psychiatric 59

PulmCCM

SEPTEMBER 21, 2023

Blood pressure often rises during acute ischemic strokes, in what is widely held to be a natural protective mechanism: increased blood pressure pushes more blood through and around stenotic blood vessels into areas of injured, oxygen-starved brain. This process is hypothesized to reduce further ischemic injury that would occur if blood pressure were to remain at baseline.

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University of Maryland Department of Emergency Med

SEPTEMBER 16, 2023

This Scandinavian study from the Lancet says yes. They randomized 1800 patients over age 18 to appendectomy either within 8 hours or 24 hou.

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Taming the SRU

SEPTEMBER 20, 2023

EKG QUICK Hits: electrolyte abnormalities - air care grand rounds - pediatric pain and procedural sedation EKG Quick hits: electrolyte abnormalities WITH Dr. Baez Potassium Hyperkalemia Peaked T-waves (there is tall and spiked T-waves, that you “wouldn’t want to sit on”) PR interval increases Widening of the QRS Can lead to a sine wave Hypokalemia T wave widening/flattening T wave inversion and U wave (upward deflection after the T wave) Calcium Hypercalcemia Shortened QT interval Osborn wave (p

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EKG/ECG Pediatrics Administration Wellness 59