Ken Grauer, MD

MAY 28, 2024

I recently recorded a series of 4 podcasts regarding KEY concepts in ECG interpretation. Easy LINKS — tinyurl.com/KG-ECG-Podcasts — [link] — Other ECG Audio PEARLS I previously made for my ECG Blog can be found in the right column of each page on this blog just below this icon — under, "ECG Audio PEARLS". My New E CG P odcasts ( 5/28/2024 ): These podcasts are part of the Mayo Clinic Cardiovascular CME Podcasts Series ( "Making Waves" ) — hosted by Dr.

EKG/ECG 277

EKG/ECG Wellness 277

The Trauma Pro

MAY 28, 2024

I’ve covered the problem of performing MRI on patients with external fixators. This is typically a problem that arises in head-injured patients with extremity or pelvic fixators for concomitant fractures. MRI is an indispensable tool for the evaluation of head, spine, and soft tissue trauma. However, a great deal of effort is required to ensure that any patient scheduled for this test is “MRI compatible.

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Fractures Hospitals 256

Sensible Medicine

MAY 28, 2024

Regardless of the reason for a primary care visit in the United States, patients are routinely asked how often they feel “hopeless” or "like a failure” These questions come from the PHQ-9. The PHQ-9 has since been validated and is now widely used to screen for depression. Since the United States Preventive Services Task Force (USPSTF) first recommended depression screening 22 years ago, the practice has become standard in primary care despite an absence of evidence.

Outcomes 137

Outcomes Military Psychiatric Wellness 137

Science Based Medicine

MAY 27, 2024

I've long argued that antivax beliefs, indeed all science denial, is conspiracy theory. Leave it to The Brownstone Institute's Jeffery Tucker to make my point better for me than I ever could. Of course, Brownstone was always going to "go there." The post The ultimate COVID-19 antivax conspiracy theory, courtesy of The Brownstone Institute and Jeffery Tucker first appeared on Science-Based Medicine.

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RebelEM

MAY 27, 2024

Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). MVM exaggerates venous return to the heart and increases vagal outflow by elevating the patient’s legs.

Outcomes 116

Outcomes Research Hospitals Operations 116

Dr. Smith's ECG Blog

MAY 27, 2024

Written by Jesse McLaren, with a very few edits by Smith A 60-year-old presented with chest pain. The ECG did not meet STEMI criteria, and the final cardiology interpretation was “ST and T wave abnormality, consider anterior ischemia”. But are there any other signs of Occlusion MI? There’s only minimal ST elevation in III, which does not meet STEMI criteria of 1mm in two contiguous leads.

EKG/ECG 105

EKG/ECG Documentation/Coding Emergency Department 105

Emergency Medicine Journal

MAY 28, 2024

Clinical introduction An octogenarian presented to the hospital post-fall from a bed, sustaining left facial and chest bruises without consciousness loss. He had diabetes, hypertension, stroke and atrial fibrillation, and was on aspirin 100 mg and edoxaban 30 mg daily. Vital signs were stable. Examination showed left periorbital swelling and anterior thoracic bruising.

Stroke 98

Stroke Fractures Hospitals 98

First 10 EM

MAY 27, 2024

We have previously discussed the many pharmaceutical advertisements published by the New England Journal of Medicine, thinly disguised as science, such as the original open label uncontrolled look at andexanet alfa. (Connolly 2019) At that point, I concluded that andexanet alfa should clearly not be used (although our pharmacies didn’t listen and wasted a lot […] The post Andexanet alfa: expensive and harmful?

EMS 100

EMS 100

St. Emlyn

MAY 30, 2024

St.Emlyn's - Emergency Medicine #FOAMed Measles is a highly contagious viral disease making a resurgence due to declining vaccination rates. It presents with initial symptoms like high fever and coryza, followed by a rash. Rapid isolation and appropriate use of PPE are critical for suspected cases. The post Measles – An Ancient Foe in Modern Times appeared first on St.Emlyn's.

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PPE Infectious Diseases 88

Science Based Medicine

MAY 31, 2024

"May he be forever riddled with guilt. May he suffer the loss of a loved one in the same manner. May he die alone." The post What’s So “Wonderful!” About an Article That Provoked Hateful Revenge Fantasies Against Frontline Doctors and Public Health Officials? first appeared on Science-Based Medicine.

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Emergency Live

MAY 30, 2024

Understanding Multiple Sclerosis: Understanding the Disease Multiple sclerosis (MS) is a chronic disease in which the immune system attacks nerve fibers in the brain and spinal cord. MS affects the myelin sheath that covers nerve fibers, resulting in a variety of different effects in terms of neurological symptoms. Among the most common outcomes are vision […] The post World Multiple Sclerosis Day appeared first on Emergency Live.

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Outcomes 80

RebelEM

MAY 29, 2024

Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit to a place with a higher level of monitoring. REBEL Core Cast 123.0 – Posterior Epistaxis Click here for Direct Download of the Podcast.

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PPE EMS Hospitals Wellness 83

EM Literature of Note

MAY 27, 2024

Hearkening back to my former life as the chair of an Institutional Review Board: you do not promise or imply a potential for benefit to clinical trial participants. Why? Because clinical trials aren’t designed to benefit participants. Participants may be randomized to the “standard of care” arm. The trial drug may not have any improvement in efficacy over the “standard of care” Worse, the trial drug may, in fact, have greater toxicity than the current options.

Outcomes 87

Outcomes 87

St. Emlyn

MAY 27, 2024

St.Emlyn's - Emergency Medicine #FOAMed This JC from St Emlyn's looks at a paper from SJTRM and explores the association between first-pass success (FPS) during pre-hospital intubation and 30-day mortality in patients treated by Finnish helicopter emergency medical services (HEMS). The post JC: Is First Pass Success an important outcome in PHEA research?

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Research Outcomes Hospitals 90

NIOSH Science Blog

MAY 29, 2024

Workplace violence impacts the mental health and wellbeing of the healthcare workforce. The negative outcomes not only affect the healthcare worker but can trickle down to patient safety and satisfaction. It is important that healthcare institutions implement workplace violence prevention programs that benefit the entire healthcare workforce. This blog post highlights current efforts across government and industry to address this critical issue.

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Patient Safety Outcomes 88

Emergency Live

MAY 30, 2024

The Importance of Ongoing and Quality Training For first responders, advanced and continuous training is essential to maintain high skills and provide effective responses to emergencies. Through such training, they can not only update previously acquired techniques but also learn about new technologies and innovate their methods of use. Specialized Training Programs A wide range […] The post Advanced Training for Rescue Professionals appeared first on Emergency Live.

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Dr. Smith's ECG Blog

MAY 29, 2024

Written by Pendell Meyers Two patients with acute chest pain. Do either, neither, or both have OMI and need reperfusion? Patient 1: Patient 2: Patient 1: A man in his 40s with minimal medical history presented with acute chest pain radiating to his R shoulder. Triage ECG: Click here to sign up for Queen of Hearts Access Three serial troponins were all undetectable.

EKG/ECG 75

EKG/ECG 75

EMDocs

MAY 28, 2024

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover part 2 of acute chest syndrome. Episode 101: Acute Chest Syndrome Part 2 Background SCD is an autosomal recessive condition that results in the formation of hemoglobin S (HbS). HbS has reduced solubility in the setting of hypoxia, leading to sickling of the RBCs. Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis.

Blood Transfusions 74

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 74

33 Charts

MAY 30, 2024

For most of history, medical diagnosis came through a series of chaotic steps. Patients experienced a string of studies, samples, and images coupled with a doctor’s judgment offering a best-guess answer. Or, in many cases, just a guess. Increasingly, diagnosis is being be reduced to simple transactions. Clean point-of-care testing based on molecular and marker diagnosis.

Point-of-Care Testing 69

Point-of-Care Testing Hospitals 69

Taming the SRU

MAY 27, 2024

Shortness of breath is one of the most common complaints presenting to emergency departments. Although the etiology is varied, in this post we will examine one specific cause – pleural effusions – in addition to management of pleural effusions with the thoracentesis procedure. Overview - what is a pleural effusion and how can i fix it? The pleural cavity is a potential space between the lung and chest wall.

Emergency Department 76

Emergency Department Ultrasounds Radiology Radiology 76

Emergency Live

MAY 30, 2024

How Case Studies Can Improve Rescue Operations Some successfully handled incident case studies can serve as excellent foundations for better preparing future rescues and organizing updates and new guidelines for rescuers. Let’s analyze some. Case Study 1: High Mountain Rescue In January 2023, a high-altitude specialized team intervened on a rocky mountain where a group […] The post Analysis of Incidents: Case Studies of Successful Rescue appeared first on Emergency Live.

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Operations 68

EM Ottawa

MAY 30, 2024

In this month’s PTM Journal Club, we explored the most recent literature on trauma care in the pre-hospital setting. If you missed last months PTM Journal Club, make sure to check-it out by clicking HERE. Ketamine vs Morphine for Out-Of-Hospital Traumatic Pain Background and Objectives Inadequate analgesia is a common challenge in the out-of-hospital treatment […] The post PTM Journal Club: Trauma Care appeared first on EMOttawa Blog.

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Hospitals Ultrasounds 64

Emergency Medicine Cases

MAY 28, 2024

Dr. Howard Ovens reflects on the role of leader in the EM in this 2nd part of a 2-part Waiting to Be Seen blog series on EM leadership. He touches on mentoring, being committed, aligning with patients' interests, being a role model and a few quick takes on some controversial issues in EM. The post WTBS 30 Lessons on Emergency Medicine Leadership: The Role of The Leader appeared first on Emergency Medicine Cases.

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Leadership EMS 69

Science Based Medicine

MAY 29, 2024

Many countries (such as Kenya’s recent regulatory changes regarding Muguka use) are struggling with the dilemma of how to regulate drug use by its citizens. There are many psychoactive drugs (we seem to be good at discovering them) with a variety of effects. Often there may be subjectively desirable effects in the short term, but long term addiction, the potential for withdrawal, […] The post Khat and Muguka Use in East Africa first appeared on Science-Based Medicine.

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Sensible Medicine

MAY 31, 2024

JD is a 67-year-old man admitted with a community acquired pneumonia and a small parapneumonic effusion. The medical team admits him and performs a diagnostic thoracentesis, the results of which reveal a complicated parapneumonic effusion (pH = 7.11). A thoracic surgery consultation is called for a chest tube to be placed. Sensible Medicine is a reader-supported publication.

Operations 66

Operations Wellness Academics Ultrasounds 66

Emergency Live

MAY 30, 2024

Record Heat in New Delhi At this moment, the city of New Delhi is experiencing an exceptional drought, with temperatures reaching increasingly higher records month by month. Since the beginning of May, maximum temperatures have been steadily rising at the Mungeshpur weather station, reaching 52.3 degrees Celsius. This peak has raised alarm and shown severe […] The post Extreme Heatwave in New Delhi appeared first on Emergency Live.

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EM Ottawa

MAY 30, 2024

At this month’s PTM Journal Club, we explored the use of high-dose glucocorticoid on hemodynamics in the prehospital setting; in particular, the STEROHCA trial conducted in Denmark. Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial Background and Objectives Out-of-hospital cardiac arrest (OHCA) carries […] The post PTM Journal Club Recap: Glucocorticoid and Hemodynamics appe

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Resuscitation Hospitals Shock 61

Dr. Smith's ECG Blog

MAY 30, 2024

Written by Magnus Nossen, with some edits by Smith This ECG was transmitted electronically by EMS for evaluation. The patient is a 70 something female with chest discomfort and dyspnea. How would you interpret the ST changes seen in this ECG? Will you accept this patient for emergent coronary angiogram based on the ECG changes? Does the ECG represent STEMI-negative OMI findings?

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EKG/ECG COPD EMS 62

NRC Health

MAY 28, 2024

Check out the breakout sessions and poster presentation details for NRC Health's 30th annual conference, Human Understanding Beyond | HUB24. Get the details and register today! The post Connect with healthcare experience leaders and innovators at HUB24 appeared first on NRC Health.

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PDC Healthcare

MAY 30, 2024

Efficient autoclave processes are essential for maintaining sterile environments in healthcare settings. Unfortunately, the autoclave process can often be time-consuming and resource-intensive if not managed properly. That’s why finding simple yet effective ways to streamline and enhance this process can make a significant difference in both operational efficiency and patient care quality.

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Operations Patient Safety 52

Emergency Live

MAY 30, 2024

How First Aid Training Saves Lives and Enhances Safety Training in first aid is essential to ensure the safety and well-being of individuals in emergency situations. This type of training not only equips individuals with the skills to effectively handle emergency situations but also adds confidence and tactical ability to their repertoire when they need […] The post The Importance of First Aid Training appeared first on Emergency Live.

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Wellness 61

EMCrit

MAY 28, 2024

Do we need ETCO2 for PSA in the ED? EMCrit Project by Scott Weingart, MD FCCM.

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American Medical Compliance

MAY 28, 2024

The Opioid Addiction Training for Dental Healthcare Professionals educates dental healthcare professionals (DHCP) on the issue of opioid addiction. Opioid addiction is a pressing public health crisis, and dental healthcare professionals are at the forefront of this battle. Dentists and oral surgeons frequently prescribe opioids for pain management, particularly after surgical procedures.

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Best Practices 52

Emergency Medicine Cases

MAY 28, 2024

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr.

Outcomes 52

Outcomes EMS Seizures Resuscitation 52

Emergency Medicine Journal

MAY 28, 2024

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Research 52

Research 52

Don't Forget the Bubbles

MAY 28, 2024

Having been the neonatal SHO for a few weeks now, you feel in your element, grunting baby reviews? Done! Screened baby for infections? Also done, deliveries? You have lost track of how many you have attended. So, when you get the call to attend a forceps delivery due to prolonged labour and meconium-stained liquor, you walk into the labour ward with a smile, ready to go.

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Sepsis Ultrasounds Pediatrics Research 52

Board Bombs

MAY 27, 2024

This podcast is earresistible. Let's chat about this classic, nasty HEENT infection. There are only 3 major key points you need to know for this one so let's crush it. 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; Husain, Ilitfat. 224.

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