Sensible Medicine
OCTOBER 10, 2024
I appreciate this essay for its reframing of our debates about cancer screening; viewing them through an ethical lens. The speculation that we might eventually be able to identify individuals harmed by radiographic screening and how this would alter our approach is both intriguing and alarming. Adam Cifu Sensible Medicine is a reader-supported publication.
The Trauma Pro
OCTOBER 11, 2024
I’ve written many posts in the past about the arguments surrounding chest tube size: large bore vs. small bore (pigtail). For the longest time, only a few decent papers were looking into this debate, and subject numbers were small. The best the papers could say was that “small-bore chest tubes are not inferior to large-bore tubes.” Not that this is not the same as saying, “small-bore tubes are better than large-bore tubes.” But finally, after more than ten years, th
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Dr. Smith's ECG Blog
OCTOBER 10, 2024
Written by Pendell Meyers A man in his early sixties with no significant medical history (including a "negative cardiac workup a few years ago" for unclear indication) called 911 for acute chest pain constantly for the past 5 hours. EMS arrived and recorded vital signs within normal limits and the following ECG during active pain: EMS1 @ 0157: What do you think?
Mount Sinai EM
OCTOBER 10, 2024
Many of us–myself included–often find ourselves spending more time on our smartphones than we intend to. One recent survey showed that 57% of Americans feel addicted to their smartphones. Another survey finds that millennials and gen z feel the most addicted. Earlier this year, Dr. Vivek Murthy, the U.S. Surgeon General, called for a warning label on social media platforms in a New York Times guest essay.
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
Ken Grauer, MD
OCTOBER 10, 2024
I was sent the ECG shown in Figure-1 — told only that the patient was a middle-aged man with septicemia. QUESTIONS: Is this rhythm too fast to be sinus tachycardia? Are flutter waves hidden within the QRS and T waves? Are we seeing the retrograde P waves of AVNRT? Is this ATach ( A trial T achycardia )? Figure-1: The initial ECG in today's case. MY Thoughts on Today’s CASE: In my opinion — none of the above answers are optimal to describe the rhythm in Figure-1.
St. Emlyn
OCTOBER 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed Day one report of the Annual Scientific Conference of the Royal College of Emergency Medicine #RCEMASC #FOAMed @stemlyns The post RCEM ASC 2024. appeared first on St.Emlyn's.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Mount Sinai EM
OCTOBER 10, 2024
The Case: A woman in her twenties with no significant medical history presents with one month of progressive frontal headaches radiating to her occiput. Her headaches have been intermittent, however over the past few days she has had a few episodes of vomiting and brief episodes of blurred vision. Her headache is 8/10 currently. Last emesis and blurred vision were both 12 hours prior.
EMCrit
OCTOBER 5, 2024
When you need to temporize orbital compartment syndrome, there is markedly easier way than Lateral Cantholysis EMCrit Project by Scott Weingart, MD FCCM.
EM Ottawa
OCTOBER 7, 2024
Methodology: 2.5/5 Usefulness: 3.5/5d Gaudreau-Simard M, et al. Ultrasound J. 2024 Feb 22;16(1):15. doi: 10.1186/s13089-023-00352-3. Question and Methods: The authors aimed to determine the test characteristics of point-of-care ultrasonography (POCUS) for detecting hydronephrosis in acute kidney injury. Findings: From 65 patients, POCUS had a sensitivity of 85% (95% CI 71-94%), specificity of 78% (95% CI […] The post Test characteristics of point-of-care ultrasonography in patients with ac
St. Emlyn
OCTOBER 10, 2024
St.Emlyn's - Emergency Medicine #FOAMed I’m back at the Sage in Gateshead for day 2 of the conference. David Williams and William Rutherford lectures. These are two prestigious named lectures at ASC. Dr John Ryan […] The post RCEM ASC conference 2024. Day 2. appeared first on St.Emlyn's.
ACEP Now
OCTOBER 10, 2024
Every two years, Americans go to the polls to choose our representatives in Congress and at the state level. Few of the candidates vying to represent us have truly walked in our shoes as emergency physicians. However, seven emergency physicians—some incumbents and a few newcomers—are hoping to represent their communities in Washington, D.C. ACEP Now reached out to Drs.
First 10 EM
OCTOBER 7, 2024
How much blood people need in their body is an ongoing question. Physicians have moved beyond the days of removing blood from their patients, but we still aren’t totally sure when we are supposed to put blood back in. Most studies suggest we should transfuse less, but there are specific populations who, at least theoretically, […] The post Liberal or restrictive transfusion in brain injury (The HEMOTION trial) appeared first on First10EM.
Broome Docs
OCTOBER 6, 2024
Welcome to a special edition of the Journal Club with Justin. This month we recorded live with a bunch of fantastic Broome junior doctors. Justin gate-crashed our local journal club to share his approach to “reading a paper” ( Video version here) and then we dived into a bunch of new papers… and one really old one. Thanks to Drs Emily Wishart, Josh Briotti and Will Arnott who were brave enough to join the chaos and unscripted nerd fest that we put on every month or two.
St. Emlyn
OCTOBER 6, 2024
St.Emlyn's - Emergency Medicine #FOAMed All the best from the blog from July 2024, in our easy to digest podcast. The post Podcast – July 2024 Round-Up appeared first on St.Emlyn's.
Mount Sinai EM
OCTOBER 11, 2024
A peritonsillar abscess (PTA) is an abscess in the peritonsillar space between the tonsillar capsule, superior constrictor, and palatopharyngeus muscles. If on your initial primary survey, you have concern for airway compromise: drooling, stridor, hypoxia, sniffing position, increased work of breathing, or tripoding–secure the airway. It may be a difficult intubation.
Life in the Fast Lane
OCTOBER 7, 2024
Jeremy Rogers and Mike Cadogan Blood Gas Interpretation The blood gas is used to rapidly assess ventilatory function and identify acid-base disorders – and will also generally provide point-of-care testing of a number of values such as electrolytes, blood glucose and haemoglobin.
PulmCCM
OCTOBER 7, 2024
Midodrine A 75-year-old woman seems to have recovered from septic shock, but each time her norepinephrine infusion is reduced from 0.05 to 0.04 mcg/kg/min, her mean arterial pressure falls below 65 mm Hg. Midodrine is started at 10 mg orally t.i.d. Later, the patient’s daughter asks the physician, “What is that new medicine Mom’s on?
EMCrit
OCTOBER 10, 2024
Dirty epi is dumb and still unstudied EMCrit Project by Scott Weingart, MD FCCM.
EB Medicine
OCTOBER 11, 2024
In this special episode Sam Ashoo, MD interviews Ryan Johnson, Pharm. D. who shares strategies to address the recent IV fluid shortage caused by Hurricane Helene. 00:00 Introduction and Episode Overview 01:10 Meet Ryan Johnson: Clinical Pharmacist 02:06 Role of Clinical Pharmacists in Emergency Medicine 05:03 IV Fluid Shortage: Causes and Impact 05:56 Institutional Strategies to Mitigate IV Fluid Shortages 14:52 Provider-Level Solutions for Fluid Conservation 22:11 Pharmacy and Nursing Staff Rol
Dr. Smith's ECG Blog
OCTOBER 6, 2024
This patient had the onset of chest pain 24 hours before arrival to the ED. An ECG was recorded immediately at triage and, at this hospital, the Queen of Hearts is routinely used to determine cath lab activation. Here is that ECG: Original ECG What do you think? There is ST depression maximal in V1-V4, which is diagnostic of posterior OMI. There is some ST Elevation and slightly hyperacute T-wave in V6.
PulmCCM
OCTOBER 8, 2024
Particle Health, a health tech startup, sued Epic Systems in federal court for the Southern District of New York, accusing the giant EHR vendor of monopolistic behavior outlawed by the Sherman Act. The allegations arose from a business dispute between the two firms dating back months. Besides providing insight into Epic’s business practices, the lawsuit will shine a spotlight on the intense but largely secret battle for control of patient data in healthcare.
EM Ottawa
OCTOBER 10, 2024
We often talk about PoCUS for first-trimester bleeding. Is there an IUP? NDIUP? IDK? Yet one of the most common questions patients ask is; “Can you see the heartbeat?” While measuring fetal heart rate is not always our top priority, I’m here to convince you of the following: Measuring it still has clinical value. […] The post PoCUS Pearl – Measuring Fetal Heart Rate appeared first on EMOttawa Blog.
EB Medicine
OCTOBER 7, 2024
In this episode, Dr. Julia Draper shares her firsthand account of managing a crisis during a hurricane in Asheville, North Carolina. As the area faced unprecedented flooding, Dr. Draper describes the challenges faced at Mission Hospital, including loss of power and water. She details the innovative solutions the hospital implemented and highlights the tireless efforts of staff during a natural disaster of this magnitude. 00:00 Introduction to Dr.
Don't Forget the Bubbles
OCTOBER 10, 2024
With millions of journal articles published yearly, it is impossible to keep up. This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis.
ALiEM
OCTOBER 7, 2024
A 52-year-old female with a past medical history of hypertension and prediabetes presented to the emergency department with double vision that started one day prior to arrival. She stated that her double vision improved when she closed one eye. She denied trauma, headache, neck pain, dizziness, dysphagia, numbness, tingling, weakness, or gait instability.
EM Ottawa
OCTOBER 10, 2024
Ever tried injecting local anesthetic into the bottom of someone’s foot? If you have, you’ll understand the incredible pain and difficulty in trying to anesthetize this region. Fortunately, there’s a better way to anesthetize the plantar foot, and avoid getting kicked in the face or causing a needle-stick injury: performing an ultrasound-guided tibial nerve block.1 […] The post PoCUS Pearl – Tibial Nerve Block appeared first on EMOttawa Blog.
Thinking Critical Care
OCTOBER 5, 2024
Here, Sara Crager takes a few minutes to discuss the hemodynamic interfaces with me. Over the next months, I’ll be picking the brains of my co-authors for the fantastic angles they can all bring to our “Trilogy in 4 Parts” (creative title by of course @EMnerd) which we all feel can be a really useful mental model for both learners and veterans and even better for patients!
NRC Health
OCTOBER 10, 2024
As we step into October, it’s time to spotlight an often-overlooked yet crucial topic: cybersecurity. While Cybersecurity Awareness Month may feel like a made-up holiday, it’s actually a vital reminder of the ongoing efforts required to protect our digital world, especially in healthcare. At NRC Health, we are proud to be a champion organization with an unwavering commitment to safeguarding sensitive information.
ALiEM
OCTOBER 11, 2024
A 76-year-old female presented with a lingering cough and an oral lesion to the left lower cheek. She reported ten days of improving flu-like symptoms but had a persistent cough and nasal congestion. On the day of presentation, she developed a painful, intermittently bleeding “blood blister” to the left lower cheek that had increased in size, as well as new red spots on her arms and legs.
Total Medical ComplianceHIPAA
OCTOBER 9, 2024
Following the aftermath of Hurricane Helene, and any other disaster, one of the many challenges that medical and dental facilities will face is reopening. This article’s purpose is to provide some guidance for all facilities to open safely and to ensure a sanitary environment for both employees and patients. There are several concerns that will need to be addressed when reopening following a prolonged shutdown.
Emergency Live
OCTOBER 11, 2024
The EU has allocated €1.3 million to combat the flight of nurses and support specific action plans The shortage of nursing staff is not a problem confined to Italy, but afflicts many European countries. Our country, however, is experiencing a real emergency, with an exodus of professionals that puts at risk the quality of care […] The post EUR 1.3 million against the nursing crisis: a European alert appeared first on Emergency Live.
ACEP Now
OCTOBER 11, 2024
Physician leadership is a priority for ACEP President Aisha T. Terry, MD, MPH, FACEP. She’s approaching the issue from all sides. As she builds a programmatic approach within ACEP to identify and cultivate leaders, she is strengthening the “pipeline” and creating opportunities for newer physicians to thrive. In this spotlight. Dr. Terry interviews CVS Health’s Vice President and Chief Health Equity Officer Joneigh S.
Thrive Employer Blog
OCTOBER 8, 2024
This is the second blog in a multiple-blog series in response to recent publications about the state of education of nurse practitioners in the United States.
EMergucate
OCTOBER 8, 2024
The following chest x-ray is from a patient with chest pain. What can be noticed? Answer will be posted later.
Emergency Live
OCTOBER 10, 2024
Its ability to influence a wide range of biological functions makes it a real “pleiotropic hormone” Vitamin D, often associated with bone health and childhood rickets, is a multifaceted nutrient that has profound impacts on many aspects of our health. In recent years, scientific research has shown that this vitamin plays an increasingly central role […] The post Vitamin D: benefits beyond bones appeared first on Emergency Live.
ACEP Now
OCTOBER 11, 2024
5-year-old child involved in a motor vehicle crash (MVC) presents with altered mental status and a Glasgow Coma Scale (GCS) of 8. Her vital signs are: 76 over 43, heart rate of 170, respiratory rate of 6. Her breathing is irregular. What is the most appropriate treatment at this time? Introduction Pediatric intubations in the emergency department (ED) occur at only a tenth the frequency of adult intubations. 1 Pediatric rapid sequence intubation (RSI) in the ED is associated with a higher freque
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