Mon.Dec 18, 2023

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For obese kids, the USPSTF recommends diet and exercise; the American Academy of Pediatrics recommends surgery and ozempic

Sensible Medicine

Good morning all. This Monday, I take a day off. For the study of the week, Vinay Prasad contrasts the different recommendations on the treatment of childhood obesity. The USPSTF or United States Preventive Services Task Force is an independent volunteer panel of experts in disease prevention and evidence-based medicine. They are as close to neutral judges of medical evidence as it gets.

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RFK Jr. and his “I’m not anti-vaccine” rejoinder to being confronted with his past antivax statements: A primer

Science Based Medicine

On Friday, CNN host Kasie Hunt interviewed antivax presidential candidate Robert F. Kennedy, Jr. Although she did better than most journalists confronting him for his past antivax statements in that she played a clip of one of his antivax statements, she clearly hadn't anticipated his response, which should have been very predictable given that he's been using it for at least 15 years.

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When ROSC feels wrong

Don't Forget the Bubbles

“Okay team, we’ve been following the APLS algorithm for 30 minutes and have considered all reversible causes. This child has been in cardiac arrest for at least an hour and none of the interventions we have carried out have made a difference. The blood gas is incompatible with life. I think we should stop resuscitation. Does anyone have any objections?

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AFL WITH 2:1 CONDUCTION IN A PATIENT WITH PREEXISTING RBBB + LAFB

ECG Guru

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

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Button Battery Update 3.0

Life in the Fast Lane

Neil Long Button Battery Update 3.0 Want to know the latest on button battery management, prevention and immediate care? Look no further than our latest tox offering.

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How to create a focused and answerable research question

First 10 EM

This is a guest post by Dr. Ross Prager. It was actually the first blog post on a new FOAMed project – SimpleSage – and I asked to cross-post it here because I think that, based on the quality, readers of First10EM will almost certainly be interested in following this new evidence based medicine project. […] The post How to create a focused and answerable research question appeared first on First10EM.

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Crisis in Sudan: the challenges of relief

Emergency Live

An analysis of the difficulties faced by rescuers The Humanitarian Crisis in Sudan Sudan, a country marked by decades of conflicts and political instability, is facing one of the most severe humanitarian crises of our time. Internal conflict, exacerbated by economic factors and political tensions, has created a situation where millions of people require urgent […] The post Crisis in Sudan: the challenges of relief appeared first on Emergency Live.

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Emergency and Innovation: AI in Automotive Rescue

Emergency Live

How Artificial Intelligence is Revolutionizing Rescue Vehicles AI in Rescue: A Leap Forward The evolution of artificial intelligence (AI) in the automotive sector is opening new frontiers, especially in rescue vehicles. This technology is transforming emergency vehicles such as ambulances and fire trucks, making them more efficient and responsive. Through the use of AI, these […] The post Emergency and Innovation: AI in Automotive Rescue appeared first on Emergency Live.

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SAEM Clinical Images Series: Rapidly Spreading Rash

ALiEM

A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. Two days prior to presentation she began to experience fevers with a Tmax of 103°F. One day before presentation she developed a rash that began on her face and slowly spread down her body, now involving her palms. The patient endorsed associated pruritus and cervical lymphadenopathy with the rash.

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BLS Protocol: An Essential Guide

Emergency Live

Understanding the Basics of Basic Life Support Introduction to the BLS Protocol Basic Life Support (BLS) is a level of medical care used for patients until advanced medical assistance arrives. BLS is crucial in emergency situations, such as cardiac or respiratory arrest, and can be performed by trained responders and non-medical personnel. The BLS protocol […] The post BLS Protocol: An Essential Guide appeared first on Emergency Live.

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Atrial Flutter With Right Bundle Branch Block and Left Anterior Fascicular Block In a Patient With Preexisting RBBB + LAFB

ECG Guru

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

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Economic Inequalities in Healthcare in the USA

Emergency Live

Exploring the Challenges of the EMS System in the Context of Income Disparity The Economic and Personnel Crisis in EMS In the United States, medical emergencies are managed through the Emergency Medical Services (EMS) system, which faces significant economic and personal challenges. One crucial aspect of this system is funding, which primarily relies on two […] The post Economic Inequalities in Healthcare in the USA appeared first on Emergency Live.

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Troubleshooting Foley Caths and Suprapubic Caths

Taming the SRU

Key History and Physical Exam After determining your patient has a clear indication for foley placement, it’s important for the clinician to determine if the patient has any history or conditions that increase the difficulty of foley insertion (See Table 1 below). Knowing before attempts whether you anticipate the catheterization will be challenging allows the clinician to appropriately plan methods, gather supplies, and call for help if needed.

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Space Rescues: Interventions on the ISS

Emergency Live

An Analysis of Emergency Protocols on the International Space Station Preparation for Emergencies on the ISS The International Space Station (ISS), an orbiting laboratory and home for astronauts, is equipped with specific procedures and equipment to handle emergencies. Given the distance from Earth and the unique space environment, preparation and training for emergencies are crucial. […] The post Space Rescues: Interventions on the ISS appeared first on Emergency Live.

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Rosh Review EM Scholar Monthly Question

RebelEM

A 55-year-old woman with a history of end-stage kidney disease on peritoneal dialysis presents due to abdominal pain. She has had pain and redness at the site of her catheter exit site. Physical examination is notable for 3 cm of erythema around the catheter exit, located in the lateral left lower quadrant, along with tenderness to palpation in a straight line extending medially 5 cm from the catheter exit site.

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Back Pain and Office Work

Emergency Live

Strategies for Prevention and Management The Impact of Office Work on Back Pain Back pain is one of the most common complaints among office workers, primarily stemming from long hours spent sitting in a static posture. This situation is exacerbated by non-ergonomic workstations, which can lead to muscle tension and spinal problems. Office workers often […] The post Back Pain and Office Work appeared first on Emergency Live.

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PTM Journal Club Recap: Hypoglycemia and NSTEMI Care

EM Ottawa

At this month’s PTM Journal Club, two topics were covered; the use of intranasal (IN) glucagon for hypoglycemia and preshospital triage of chest pain patients. Haamid et al. The post PTM Journal Club Recap: Hypoglycemia and NSTEMI Care appeared first on EMOttawa Blog.

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Revolutionizing Emergency Care: The Rise of Smart Ambulances

Emergency Live

Exploring Innovations in Emergency Medical Services for Enhanced Patient Care Emergency medical care faces an ongoing challenge against time, with an increasing need for efficiency amid a shrinking EMS workforce. The 2022 American Ambulance Association study, as reported by CBS News, revealed a significant shortage of qualified candidates for EMT and paramedic positions, emphasizing the […] The post Revolutionizing Emergency Care: The Rise of Smart Ambulances appeared first on Emergency Li

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Ventricular Tachycardia. Unsuccessful Antitachycardia Pacing in an ICD Patient

ECG Guru

If ventricular tachycardia occurs in an Implantable Cardioverter Defibrillator (ICD) wearer, the ICD can combat this with 2 different forms of therapy, provided these are activated (which can be done using a programming device). First, the ICD attempts to override the tachycardia. The fastest pacemaker gets control of the heart. If this is not successful, the defibrillator function is used.

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Modification of the GRACE Risk Score for Risk Prediction in Patients With Acute Coronary Syndromes

EM Ottawa

Methodology: 3/5 Usefulness: 1/5 Georgiopoulos G, et al. JAMA Cardiol. 2023 Oct 1;8(10):946-956 Question: Does the modified GRACE score incorporating continuous troponin improve ACS risk prediction? Methods: Retrospective. The post Modification of the GRACE Risk Score for Risk Prediction in Patients With Acute Coronary Syndromes appeared first on EMOttawa Blog.

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Understanding and Fighting Testicular Cancer

Emergency Live

Essential Information and the Importance of Self-Examination Understanding Testicular Cancer Testicular cancer is a relatively rare but significant form of cancer that primarily affects young adults and teenage males. It is more common between the ages of 20 and 34, and although its exact causes are unknown, some risk factors include having an undescended testicle, […] The post Understanding and Fighting Testicular Cancer appeared first on Emergency Live.

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VT, UNSUCCESSFUL ATP (ICD PATIENT)

ECG Guru

If ventricular tachycardia occurs in an ICD wearer, the ICD can combat this with 2 different forms of therapy, provided these are activated (which can be done using a programming device). First, the ICD attempts to overstimulate the tachycardia. If this is not successful, the defibrillator function is used. Here you can see the limb leads. Initially there is a relatively slow ventricular tachycardia with a heart rate of approx. 125 bpm.

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Sweta Mangal Ziqitza – The Role of Exercise in Winter Wellness

Ziqitza HealthCare Ltd

As winter’s chill se­ttles in, many people find it difficult to maintain the­ir exercise routine­s. The colder tempe­ratures and darker days can make staying active­ less appealing. Howeve­r, it’s important to prioritize physical activity during winter for overall we­ll-being. In this blog, we’ll explore­ the significance of exe­rcise in winter wellne­ss and share insightful ideas and tips.

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PENG Block

Ultrasound Gel

Have you been PENG attention? This block is everywhere! In this episode, we talk about the preliminary data for the PEricapsular Nerve Group (PENG) block used for analgesia of acute hip fractures in the emergency department. Mike and Creagh weigh in on whether this option is going to replace the fascia iliaca compartment block. Have you been PENG attention?

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Lab case 431 interpretation

EMergucate

Answers: Question 1: PH = 7.58, that is severe alkalaemia. pCO2 = 20 mmHg, so we have respiratory alkalosis. Next we need to calculate the compensation.

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2023 Critical Care Year in Review (Part 2)

PulmCCM

Intubation and mechanical ventilation Video laryngoscopy was superior to direct laryngoscopy in first-pass success among ED residents and CCM fellows intubating critically ill patients (DEVICE trial). Besides confirming video laryngoscopy’s shorter learning curve, this result may also in part represent the decay in direct laryngoscopy skills in the post-video era.

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Sepsis Updates Relevant to the Emergency Physician

EMDocs

Authors: Maiya Cowan, MD (EM Resident Physician, Brown University/Rhode Island Hospital) and Andrew Beck, MD (EM Attending Physician, Brown University/Rhode Island Hospital) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 72-year-old female with a past medical history of hypertension and dementia presents to the ED (emergency department) via EMS (emergency medical services) with altered me

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