The Trauma Pro
OCTOBER 1, 2024
In this day and age of ride-sharing apps like Uber and Lyft, it is possible to get a cheap ride virtually anywhere there is car service and a smartphone. And, of course, some people have used these services for transportation to the hospital instead of an ambulance ride. What might the impact of ride services on patient transport be for both patient and EMS?
RebelEM
OCTOBER 2, 2024
Take Home Points Toxic alcohols generally refer to methanol and ethylene glycol as these substances pose significant metabolic derangement and end-organ damage. Patient who present shortly after ingestion will simply look inebriated – no different than ethanol intoxication. At this point, patients will have an elevated osmolar gap and little to no anion gap.
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Sensible Medicine
OCTOBER 2, 2024
This post continues yesterday’s. If you have not read Part I, I suggest you read it first. Adam Cifu Sensible Medicine is a reader-supported publication. Please consider becoming a free or paid subscriber. There was a time when, right or wrong, there was a consensus within medicine regarding what kind of person would make a good doctor. It was believed that being a doctor meant you had to remember a great number of obscure things, and so we designed tests that heavily weighted memorization
St. Emlyn
SEPTEMBER 26, 2024
St.Emlyn's - Emergency Medicine #FOAMed The diagnosis of subarachnoid haemorrhage in the emergency department is a constant source of anxiety. How do we make sure we pick up everyone with a bleed, but not overinvestigate […] The post The Subarachnoid Haemorrhage in the Emergency Department (SHED) Study appeared first on St.Emlyn's.
Science Based Medicine
OCTOBER 2, 2024
Just recently, in casual conversation, someone commented to me that “they” already have a cure for cancer but are hiding it. This is a claim I frequently encounter. One survey, from 2005, found that 27.3% of those surveyed endorsed this belief. Another survey from 2014 found that 37% of people believe the FDA is suppressing natural cancer cures on behalf of “Big […] The post Conspiracy Thinking And Alternative Medicine first appeared on Science-Based Medicine.
The Trauma Pro
SEPTEMBER 27, 2024
Preparation and planning will get you just so far. But then, you actually have to act. There are four phases in this procedure. I’ll break them down one by one. Patient preparation. The area should be shielded from curious onlookers and to control any airborne contaminants (dust, debris) at the scene. Portable monitors should be attached. Good IV/IO access needs to be in place, and the airway controlled via intubation.
First 10 EM
SEPTEMBER 30, 2024
Some topics come up over and over again, and it may seem somewhat repetitive or wasteful to spend so much time on them, but seeing as so many people are still using outpatient IV antibiotics despite overwhelming evidence that oral antibiotics are just as good, if not better, I will continue to cover papers as […] The post Oral antibiotics are noninferior to IV in pediatric bone and joint infections (obviously) appeared first on First10EM.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
St. Emlyn
SEPTEMBER 29, 2024
St.Emlyn's - Emergency Medicine #FOAMed This blog post reviews a study comparing non-invasive blood pressure (NIBP) and invasive blood pressure (IBP) monitoring in pre-hospital critical care. Using a retrospective cohort design, the study found that NIBP measurements are often inaccurate in patients with haemodynamic instability, particularly in hypotensive and hypertensive states.
Science Based Medicine
SEPTEMBER 27, 2024
Biosafety Now is fine working with a pro-virus, misinformation doctor to prevent a potential pandemic. What about a doctor who worked with patients and countered misinformation during an actual pandemic? The post A “Biosafety” Organization Partnering With Dr. Jay Bhattacharya To Guard Against Viruses Is Like A Zebra Teaming Up With A Lion To Promote Vegetarianism first appeared on Science-Based Medicine.
EMDocs
OCTOBER 2, 2024
Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.
Dr. Smith's ECG Blog
SEPTEMBER 29, 2024
A 50 yo was resuscitated from ventricular fibrillation. He had a prehospital ECG recorded after ROSC: What do you think? This certainly looks like an anterior STEMI (proximal LAD occlusion), with STE and hyperacute T-waves (HATW) in V2-V6 and I and aVL. Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion.
Sensible Medicine
OCTOBER 1, 2024
What is valued in medical education and residency selection has changed enormously since I was a student. We used to value things that were easy to measure even if they had only a tenuous relationship to the ability to doctor. Now, we seem to be unable, or unwilling, to assess what we now value in students. Dr. Van Cleve writes about why letters of recommendation are not helpful in assessing residency applicants.
Taming the SRU
OCTOBER 1, 2024
morbidity and mortality - r3 taming the sru - creating a unique pathway within academic emergency medicine - visual diagnosis - r2 cpc - r1 core content: penile disorders - r4 capstone morbidity and mortality conference WITH dr. shaw Motor Vehicle Accident and Tertiary Examinations A significant number of injuries in trauma patients are missed during the initial trauma assessment All trauma patients should have a structured tertiary exam performed that occurs after the initial resuscitative and
Science Based Medicine
SEPTEMBER 26, 2024
We are more likely to use an ineffective treatment after slight symptom improvement, even when the changes are coincidental. The post Post Hoc Bias in Medicine first appeared on Science-Based Medicine.
EMDocs
SEPTEMBER 30, 2024
Welcome to the emDOCs Videocast – please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today’s video evaluates inhaled corticosteroids (ICS) for asthma in the ED setting. EBM Updates: Inhaled Corticosteroids for Asthma in the ED Background : Asthma is a common ED issue, with patient presentations ranging from needing a medication refill to severe exacerbation in respiratory failure.
Dr. Smith's ECG Blog
OCTOBER 1, 2024
== MY Comment , by K EN G RAUER, MD ( 8/30 /2024 ): == I was sent the ECG shown in Figure-1 — knowing only that the patient was being seen in the ED ( E mergency D epartment ). How would you interpret this tracing? Figure-1: The initial ECG in today's case. MY Initial Thoughts: In my experience — all-too-many emergency providers fail to appreciate the potential contribution that a brief ( 1-to-2 line ) history may convey when interpreting arrhythmias.
Sensible Medicine
SEPTEMBER 27, 2024
A great irony of Twitter/X, a site that epitomizes 21 st century ephemerality, is that it can also engender the persistence, or rebirth, of a work. On the one hand, studies that authors worked on for years, or essays that were wrestled with for weeks, are only tweeted for a day or two before disappearing into our collective amnesia. On the other, articles will sometimes find second life on the site.
EMCrit
SEPTEMBER 29, 2024
The HAPPEN Trial on NIPPV for AECOPD EMCrit Project by Scott Weingart, MD FCCM.
Science Based Medicine
SEPTEMBER 30, 2024
[Editor note: Regular readers might—or might not have—noticed last Monday that, for the first time in more years than I can remember, I failed to post anything and didn’t even repost something from the archives or announce my absence. The explanation is unfortunately all too simple. The Sunday before, I spent something like 13 hours in the hall of at the emergency […] The post The NCCIH embraces the quackery that is “functional medicine” first appeared on Science-Based Medicine.
EMDocs
SEPTEMBER 26, 2024
Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.
Emergency Medicine Cases
OCTOBER 1, 2024
In this ECG Cases blog we look at 5 cases of ECGs falsely labeled 'normal'. Can you spot the critical abnormality? Written by Jesse McLaren; Peer Reviewed and edited by Anton Helman. October 2024 Five patients presented with ECGs labeled ‘normal’. Can you use systematic ECG interpretation to identify the [.] The post ECG Cases 51 – ECGs falsely labeled “normal” appeared first on Emergency Medicine Cases.
Sensible Medicine
SEPTEMBER 26, 2024
This debate stems from a long running conversation between Vinay and Adam. The conversation was provoked by tweets in which doctors shared their mental health struggles. We have seen tweets about anxiety disorders, suicide attempts, and psychiatric drug dosing. What underlies the conversation is a simple question: Should Doctors Voice Their Own Mental Illness?
ALiEM
SEPTEMBER 30, 2024
A 23-year-old healthy male presented to the emergency department with left eye pain, soreness, and blurry vision after being hit in the left eye with a Nerf gun bullet two days prior. He had no prior ophthalmologic history and does not wear corrective lenses. Physical Exam Left eye : Visual acuity 20/30. Intraocular Pressure 17. Pupil 3mm, irregular, minimally reactive.
PEMBlog
OCTOBER 2, 2024
In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience.
ETM Course
OCTOBER 1, 2024
The ETM team has been working hard to get the 2025 course calendar finalised and our 2025 course dates have now been announced. Course dates and registration details are available here. The the vast majority of our courses sell out well in advance. To avoid ending up on a waiting list, book your course place soon to avoid disappointment. To find out more about ETM Course, please visit the course information page here.
Emergency Medicine Cases
OCTOBER 1, 2024
In this EM Cases podcast Anton chats with Dr. Peter Brindley and Dr. Leon Byker who have a deep interest in the Culture of Medicine to explore what culture in medicine is, why culture is so important, and then drive home 10 strategies to improving the culture in our departments emphasizing the importance of human connection, empathy, open communication, and a willingness to learn from mistakes in creating a positive and fulfilling work environment, so that we love our work, we love our departmen
The Skeptics' Guide to EM
SEPTEMBER 28, 2024
Date: September 23, 2024 Reference: Essat et al. Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis. Annals of Emergency Medicine, May 2024 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from Australia who is also an ultrasounder. Case: You are working a busy shift in a rural emergency department (ED) and your excellent Family Medicine trainee presents a case of a 63-year-old woman with chest pain and some intermittent radiation into the inter-s
Emergency Live
SEPTEMBER 30, 2024
Scientists have found that variations in the KCNA3 gene are responsible for some forms of epilepsy A recent research by the Mnesys project has shed light on one of the genetic causes of childhood epilepsy. Scientists have found that variations in a specific gene, called KCNA3, are responsible for some forms of epilepsy that occur […] The post A new piece in the puzzle of childhood epilepsy: the role of the KCNA3 gene appeared first on Emergency Live.
Sensible Medicine
SEPTEMBER 30, 2024
Just a quick note to say that comments are turned back on for today’s and subsequent posts. Yes, we sometimes (strategically) turn off comments. And that’s all I will say about that. JMM Sensible Medicine is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
Emergency Medicine Ireland
SEPTEMBER 30, 2024
Welcome back to the tasty morsels of critical care podcast. Today we look at quite a niche topic, that of chylothorax. We are used to many things in the pleural space, like simple fluid or blood or air but the presence of the myseterious substance chyle is a much more unusual and note worthy event. As a reminder of the basics which I of course knew implicitly and definitely did not have to resort to wikipedia to check… Chyle is largely formed in the small intestine as the gut transports fr
PEMBlog
SEPTEMBER 30, 2024
Cannabis Hyperemesis Syndrome can make habitual smokers miserable! They will got some relief from hot showers – but many need fluids, ondansetron, topical capsaicin, and even Haldol. Lyrics [Chorus] Don’t fear the reefer? Cannabis hyper-emesis syndrome says you do Intractable vomiting, many hot showers What, oh what, will we do? [Verse] You didn’t think this would happen You just decided to smoke Now you’re puking your guts up Is this some sick kind of joke?
Board Bombs
SEPTEMBER 29, 2024
We guarantee you'll be able to treat this condition before ever being able to spell it (not to mention pronounce it). Let's quickly cover a not-so-rare high yield zoonotic infection! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here. Cite this podcast as: Briggs, Blake. 235.
Emergency Live
SEPTEMBER 29, 2024
Sun exposure is possible even if you suffer from vitiligo. However, some precautions are necessary Vitiligo, a skin condition characterized by the appearance of white spots without pigment, can raise many questions, especially in relation to sun exposure. Is it possible to enjoy the sun’s rays even with this condition? And what precautions should be […] The post Can you sunbathe with Vitiligo?
Dr. Mike Sevilla
SEPTEMBER 29, 2024
National Family Medicine Week #FamilyMedicineWeek is from September 29-October 5, 2024. This was announced last week at the American Academy of Family Physicians FMX conference last week in Phoenix. I’d like to recognize and thank all Family Physicians, residents, and medical students for their commitment to improving access to primary care for all.
EB Medicine
SEPTEMBER 29, 2024
In this special episode, Sam Ashoo MD and Rob Orman MD discuss the concept of Maladaptive Perfectionism and its application to emergency medicine. Understanding Maladaptive Perfectionism Case Example and Discussion Adaptive vs Maladaptive Perfectionism Personal Experiences and Legal Challenges Dealing with Negative Outcomes Strategies for Managing Perfectionism in the ED Handling Overwhelming Shifts Managing Expectations in the ED A Soul-Crushing Day in the ED Finding Meaning in Moments of Crisi
PulmCCM
SEPTEMBER 28, 2024
Sometimes it seems like half the ICU revolves around aspiration: accepting patients who’ve just done it, helping others not to, considering it in still others who are deteriorating, etc. Thickening a dysphasic patient’s oral liquids is among the measures commonly employed to prevent aspiration. The rationale: liquids are harder to control than solids because they slip down the throat so quickly and easily.
AED Leader
SEPTEMBER 28, 2024
Looking for defibrillators for sale can be a bit like searching for a needle in a haystack. You want something reliable, easy to use, and—most importantly—affordable. Maybe you’re buying one for your office or considering adding one at home. Either way, the stakes are high. It’s about saving lives, after all. Did you know? AEDs greatly increase the chance of survival during heart attacks.
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