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The Role Of Postop CT Scan In Penetrating Trauma

The Trauma Pro

CT scans are commonly used to aid the workup of patients with blunt trauma. They are occasionally useful in penetrating trauma, specifically when penetration into a body cavity is uncertain, and the patient has no hard signs that would send him or her immediately to the operating room. Is there any role for CT in operative penetrating trauma, after the patient has already been to the OR?

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Waiting Room Medicine

Life in the Fast Lane

Mike Cadogan Waiting Room Medicine With exponential Emergency Department over-crowding and spiraling waiting times, the Utopian College has produced a series of guidelines to assist fondling members.

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If RFK Jr. Turns the CDC Into An Anti-Vaxx Propaganda Outfit, I Don’t Want To Hear a Peep From Some “Respectable” Doctors

Science Based Medicine

Any doctor who is unabashedly pro-vaccine has already spoken up about the normalization of anti-vaxx quackery within our ranks. The post If RFK Jr. Turns the CDC Into An Anti-Vaxx Propaganda Outfit, I Don’t Want To Hear a Peep From Some “Respectable” Doctors first appeared on Science-Based Medicine.

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Delirium revisited

EM Ottawa

Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever, tachypnea, tachycardia, or hypoxia. There is an ED prevalence ranging from 7-24%, with increased mortality rates […] The post Delirium revisited appeared first on EMOttawa Blog.

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The PECARN c-spine rule could cause a lot of harm

First 10 EM

As with everything that comes out of the PECARN group, this is a huge study, and is therefore one that everyone needs to know about. That being said, despite working in two very busy community hospitals with a high percentage of pediatrics visits, c-spine injuries are just not an issue I struggle with. I have […] The post The PECARN c-spine rule could cause a lot of harm appeared first on First10EM.

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Best Practice: The MTP Coordinator

The Trauma Pro

Every trauma center has a massive transfusion protocol (MTP). But every trauma center also does it entirely differently. Ideally, an MTP is designed with the resources available at the hospital in mind. These may include whole blood, the use of O- vs. O+ blood, the number of units of each product per cooler, the different products in different coolers, and personnel available to move those coolers to the correct locations.

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EcoHealth Alliance Fights Back

Science Based Medicine

The organization scapegoated by the lab leak-promoting GOP-led House Covid subcommittee publishes its defense The post EcoHealth Alliance Fights Back first appeared on Science-Based Medicine.

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Prehospital activation: De-activated on ED arrival by Cardiologist because "It's not a STEMI"

Dr. Smith's ECG Blog

This was submitted by a paramedic, Hailey Kennedy A late 50s male called 911 following 2 hours of chest pain that started while working at his desk. He reported the crushing chest pain radiated down his left arm. Pt took an antacid with no relief and decided to call at the request of his wife. Here is his EMS ECG: What do you think? This was sent to me with no clinical information, and my initial impression viewing it on my phone was "It’s a tricky one.

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Quick Draw Anatomy for Medical Students – Joanna Fox

Critical Care North Hampton

“Quick Draw Anatomy for Medical Students” by Joanna Oram Fox is a unique educational book designed to help medical students learn anatomy through drawing. It provides step-by-step instructions on drawing, understanding, and interpreting key anatomical structures. Her fantastic methodology for learning by illustration really impressed us with her first book!

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Training Healthcare Personnel to Better Serve Seniors and Disabled Patients

American Medical Compliance

A survey reveals that falls are the most frequent health issue affecting seniors in long-term care facilities. Interestingly, while 90% of caregivers feel confident in implementing fall prevention measures, only 60% have adequate knowledge to do so effectively. As the aging population grows, so does the demand for specialized healthcare tailored to the unique needs of seniors and individuals with disabilities, posing new challenges and responsibilities for healthcare providers.

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emDOCs Revamp: Left Ventricular Outflow Tract Obstruction

EMDocs

Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA), Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

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Lifestyle, Statins, or Both?

Sensible Medicine

The study of the week will take a short break. I head to Curitiba Brazil tomorrow for the Brazilian EP society meeting. I have five lectures. I will be back next week. And there will be plenty of studies to choose from because we are entering the fall season of medical meetings. This week, Sensible Medicine features a guest column from Zachary R. Caverley, a Cardiology Physician Assistant working in the Northwest coast of Oregon.

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Can you treat Non-STEMI with thrombolytics if it is OMI (Occlusion MI)? Of course!

Dr. Smith's ECG Blog

This case was sent by an old residency friend, Kirk Lufkin. He works in a small hospital in Northern Michigan. Case A 61 year old female. hypertension no other past history presented with 30 minutes of fluctuating non-radiating heaviness in chest, with diaphoresis and nausea. VS normal. No cardiac past history. Here is her ECG: What do you think? There are inferior hyperacute T-waves (diagnostic of inferior OMI), with 1) reciprocal ST depression in aVL, 2) a reciprocally inverted hyperacute T-wa

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Diagnostics and Therapeutics: Pneumomediastinum

Taming the SRU

Pneumomediastinum is defined as the presence of air in the mediastinum after rupture of air-filled structures such as the esophagus or trachea, or small parts of the lung such as alveoli. This can occur spontaneously or after trauma. Pneumomediastinum is often benign and self limited. However, in more serious cases it can require close monitoring and sometimes surgical intervention.

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SAEM Clinical Images Series: Clot in Transit

ALiEM

A 67-year-old male with a past medical history of CHF, MI, hypertension, and diabetes presented to the ED with complaints of headache, chest pain, and dyspnea for the past four days. He stated that he has been without his medications for the past few months due to cost. He denied any past surgical history. He stated that he primarily presented because he felt like “my blood pressure is high” Additional Images Physical Exam Cardiovascular : Tachycardic, 2+ pedal edema bilaterally Re

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August 2024 Round-Up – Goldilocks Moments, Nasal Analgesia, and Public Health in the ED

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed All the best from the blog from August 2024, in our easy to digest podcast. The post August 2024 Round-Up – Goldilocks Moments, Nasal Analgesia, and Public Health in the ED appeared first on St.Emlyn's.

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Screening Can Do Silent Harm

Sensible Medicine

Nick Arroyo is a 65-year-old man without medical problems. He feels well and sees a primary care doctor every three years or so. He had a chest CT for lung cancer screening because he smoked a pack-a-day for 50 years and heard a radio advertisement that said that lung cancer screening would be helpful. The scan detected a 1 cm nodule. A PET scan was positive, and a biopsy diagnosed it as small cell lung cancer.

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Probiotics don’t improve outcomes in children with acute gastroenteritis

PEMBlog

Introduction Acute gastroenteritis affects millions of children in the U.S. every year, leading to emergency department visits and hospitalizations. Probiotics, particularly Lactobacillus rhamnosus GG (LGG), have been commonly used as a treatment, but evidence supporting their effectiveness has been limited. A new study conducted by the Pediatric Emergency Care Applied Research Network (PECARN) aimed to determine whether LGG could reduce the severity of gastroenteritis in children.

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Does First Pass Success Matter? | Best Fever Control

JournalFeed

The JournalFeed podcast for the week of Oct 28 – Nov 1, 2024. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Tuesday Spoon Feed : In this NEAR database study, there was an independent association between increasing number of intubation attempts and risk of complications.

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SAEM Clinical Images Series: Wilma, Take a Look at This!

ALiEM

A 2-year, 11-month-old female with a history of constipation was brought to the ED by her mother for abdominal pain. The mother noticed that the patient’s abdomen had been enlarging for months. When they visited the pediatrician several months ago, the pediatrician also noticed a mildly enlarged abdomen but the patient was asymptomatic at that time.

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A New Tool to Help Screen for Sepsis in Kids?

Taming the SRU

Georgette N, Michelson K, Monuteaux M, Eisenberg MA. Development of a New Screening Tool for Pediatric Septic Shock. Ann Emerg Med 2024; Big Picture Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When utilizing a cut off of ≧ 2 points, the qPS4 was highly sensitive and specific, and

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REBEL Core Cast 130.0 – Omphalitis

RebelEM

Take Home Points Early diagnosis: erythema and warmth of the skin surrounding the umbilicus isn’t normal. Get labs, start abx and get the patient admitted Consult peds surgery on all of these patients as progression to nec fast, while uncommon, is devastating If the patient appears toxic or has systemic symptoms, the simply omphalitis has progressed and aggressive treatment including surgery is likely indicated REBEL Core Cast 130.0 – Omphalitis Click here for Direct Download of the Podcas

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Is There a Role for Vitamins in the Management of Alcohol Use Disorder?

Clinical Correlations

By Chloe Fong Peer Reviewed The correlation between vitamin deficiency and alcohol use disorder (AUD) has been well documented in the literature, with a study from 1963 finding that 70% of patients admitted to the hospital.

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New hope against lung cancer: the revolution of the Veronesi Foundation

Emergency Live

The Umberto Veronesi Foundation has launched a research project dedicated to lung cancer Lung cancer, a formidable opponent, is finally meeting stronger resistance thanks to the relentless work of the scientific community. The Umberto Veronesi Foundation, at the forefront of the fight against cancer, has launched an ambitious five-year research project specifically dedicated to lung […] The post New hope against lung cancer: the revolution of the Veronesi Foundation appeared first on Emerg

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Tranq dope (fentanyl-xylazine combination): A new horizon in opioid withdrawal treatment

ALiEM

‘Dope’ is no longer heroin in an increasing number of our communities. The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2].

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Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants

EM Ottawa

Methodology: 4/5 Usefulness: 4/5 Geraghty LE, et al. N Engl J Med. 2024 May 30;390(20):1885-1894. doi: 10.1056/NEJMoa2402785. Question and Methods: Study aimed to determine if video laryngoscopy improves first-attempt intubation success in neonates compared to direct laryngoscopy through a randomized controlled trial. Findings: 74% first pass success with video laryngoscopy and 45% with direct laryngoscopy […] The post Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infa

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Does preventing fevers after strokes protect the brain?

PulmCCM

A majority of patients with significant strokes experience fever within the first week after their vascular injury. The presence, intensity, and persistence of fevers are associated with worse outcomes after strokes of any type. For example: Patients with ischemic strokes who develop fever within the first 24 hours have more than double the risk of death, compared to patients without fevers.

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Case Report: Cardiac Arrest in a Child’s Structurally Normal Heart

ACEP Now

A 10-year-old male with a past medical history significant for autism spectrum disorder and 15q3 deletion, experienced a cardiac arrest at home. There was no family history of syncope or sudden death. EMS found the patient pulseless and apneic, with an initial rhythm showing ventricular fibrillation (see figure 1). He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation.

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Beyond Medicine: Art and Sport, New Weapons against Parkinson’s

Emergency Live

Art and sport offer powerful tools to improve quality of life and slow disease progression Parkinson’s is not just a disease, it’s a life-changing challenge. Tremor, stiffness, slow movements: symptoms that deeply mark the daily life of those affected. But research does not stop and new avenues open up, offering patients more hope. A holistic […] The post Beyond Medicine: Art and Sport, New Weapons against Parkinson’s appeared first on Emergency Live.

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Chemical Burns

Mind The Bleep

Chemical burns are a unique subset of burns that require specialised management due to the nature of the substances involved. Proper initial management is critical to prevent further tissue damage and systemic complications. The majority of acid burns cause coagulative necrosis and cytotoxicity leading to skin and mucosal changes that limit deeper injury.

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Lab case 451 interpretation

EMergucate

This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days. PH = 7.52, that is moderate alkalaemia. pCO2 = 21 mmHg. So, we have respiratory alkalosis.

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How CMOs can combat workplace violence

NRC Health

Addressing workplace violence is an important element of the CMO role at health systems and hospitals, this associate CMO says. The post How CMOs can combat workplace violence appeared first on NRC Health.

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Case Report: A Male Patient with Iatrogenic Obstruction

ACEP Now

Our patient is a 33-year-old male with spastic quadriparesis due to cerebral palsy with chronic indwelling suprapubic catheter (SPC) who presented to the emergency department (ED) due to concern for Foley catheter obstruction. The patients’ mother has attempted to flush the SPC multiple times unsuccessfully at home. The catheter was reportedly due for an exchange the following week.

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Schiena a rischio: una nuova epidemia

Emergency Live

By 2050, back pain could outnumber Alzheimer’s as the leading cause of disability globally Back pain, a nuisance that accompanies many of us in our daily lives, is taking on ever more alarming proportions. According to recent scientific studies, by 2050 it could outnumber Alzheimer’s as the leading cause of disability globally. This should make […] The post Schiena a rischio: una nuova epidemia appeared first on Emergency Live.

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238. Live from Maine! Envenomation at the beach

Board Bombs

We are live from Maine while at our podcast retreat (yes that’s a thing). Let’s talk about a classic envenomation. Plus we have a surprise guest join us. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 238. Stabbed at the beach?

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Medical Music Mondays: Terror of the Night

PEMBlog

Night terrors are super scary. And the kid doesn’t even remember them! They’re more like sleep walking than nightmares and parents are often worried that it’s a seizure or something more serious. Lyrics [verse] Woke up late at night flailing and crying Couldn’t wake him up though the parents were trying Oh why the unstoppable fussing and screamin’ Could it be a seizure or possession by a demon?

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How CMOs can combat workplace violence

NRC Health

Addressing workplace violence is an important element of the CMO role at health systems and hospitals, this associate CMO says. The post How CMOs can combat workplace violence appeared first on NRC Health.