Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., PEWS). Vital signs outside the normal range are used as a proxy for the severity of illness and are also used in evaluating the risk for serious bacterial infection or risk for sepsis in children and young people (CYP).

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

ALiEM

AUGUST 7, 2023

A 10-year-old male with no past medical history presents to the Emergency Department (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree. He complains of sharp right shoulder and chest pain that worsens with movement of his right upper extremity and he arrives wearing a sling to immobilize the arm.

Dislocations 98

Dislocations Academics Fractures Emergency Department 98

Science Based Medicine

AUGUST 7, 2023

Last week, I wrote about how COVID-19 has exposed the toothlessness of state medical boards. Last week, the American Board of Internal Medicine announced that it was going to permanently revoke the board certifications of two COVID-19 contrarian doctors, Drs. Paul Marik and Pierre Kory. Can medical specialty boards make up for the failure of state medical boards, at least partially?

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Emergency Live

AUGUST 7, 2023

Lessons from the earthquake in Turkey and Syria and the importance of earthquake-resistant structures Six months have passed since the earthquake that struck Turkey and Syria on 6 February 2023, claiming tens of thousands of victims. There has been a lot of help from around the world to find and rescue many people trapped under […] The post Earthquake in Turkey and Syria - What could have been done to avoid disaster appeared first on Emergency Live.

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RebelEM

AUGUST 7, 2023

Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation. The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge.

Head Injuries 85

Head Injuries Outcomes Airway Management Burns 85

Taming the SRU

AUGUST 7, 2023

Sick vs Not Sick - Ruptured Ovarian Cyst - Stroke Updates - AV BlockS - Over-Testing in the ED - Research Sick vs. Not Sick WITH Dr. knight “The eye cannot see what the mind does not know” There is a middle ground between minimalist and risk-averse evaluation of patient EM physicians can use system 1 thinking pretty accurately to describe disposition for patients based off of initial gestalt “What do I see when I walk in the room?

Stroke 84

Stroke Outcomes EKG/ECG Research 84

Sensible Medicine

AUGUST 7, 2023

In Chapter 1 of this mini-series, I explained the disruption wrought by the COURAGE trial. Seriously? Stenting severe coronary lesions did not improve survival over simple tablets? Chapter 2 added to the oodles of studies showing how much doctors can be fooled by the placebo effect. The ORBITA trial demonstrated that the caring signal of placing a stent is massive.

Shock 82

Shock Outcomes Hospitals Wellness 82

Medagadget

AUGUST 7, 2023

Researchers at the Harvard Wyss Institute have developed an anti-cancer biomaterial treatment that combines adoptive T cell therapy and cancer vaccine technology to treat solid tumors. The researchers have called their technique SIVET, which is short for “synergistic in situ vaccination enhanced T cell”. The approach combines local delivery of cytotoxic T cells with longer lasting cancer vaccine technology that engages with the immune system more broadly for long lasting anticancer action.

Research 76

Research 76

EMDocs

AUGUST 7, 2023

Authors: Lauren Willoughby, MD (Education Fellow, University of Wisconsin); Benjamin H. Schnapp, MD, MEd (Associate Program Director, University of Wisconsin) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF), Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 36-year-old pregnant woman at 21 weeks gestation presents to the ED with chest pain.

EMS 67

EMS Wellness Emergency Department 67

Medagadget

AUGUST 7, 2023

Researchers at the Institute of Science and Technology Austria have developed a brain imaging technique called Live Information Optimized Nanoscopy Enabling Saturated Segmentation (LIONESS). The method lets the researchers create high-resolution 3D images of living brain tissue that reveal its cellular complexity, and even how it changes over time, allowing for monitoring of neural plasticity.

Research 67

Research Radiology Radiology 67

Emergency Live

AUGUST 7, 2023

How Firefighters Combat Record Heat Consequences and Provide Prevention Solutions With the increase in extreme weather phenomena due to climate change, record heat events are becoming more frequent and intense in many parts of the world. The impact of these heatwaves is not limited to human discomfort: they involve serious hydrogeological hazards, including droughts, drying […] The post The Role of the Firefighters in Dealing with Climate Emergencies appeared first on Emergency Live.

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PEMBlog

AUGUST 7, 2023

There are many infants and children that have sleep apnea – categorized as obstructive, central, and a mix of both. The cumulative risk of untreated sleep apnea is an increase in neurobehavioral deficits and cardiovascular morbidity. Management is based on data assessed via the apnea-hypopnea index (AHI) which is the combined average number of apneas and hypopneas that occur per hour of sleep during a polysomnography (sleep study).

Pediatrics 52

Pediatrics 52

Medical Law

AUGUST 7, 2023

Riding a bike is a wonderful activity that the whole family can enjoy, and there’s no better place to ride than Santa Barbara, CA. There are beautiful beaches, exquisite views, a temperate climate, and endless sunny days. Santa Barbara County is also home to several spectacular bike trails. Our team at NordstrandBlack PC loves residing in Santa Barbara, and we consider it a privilege to give back to our community whenever possible.

Head Injuries 52

Head Injuries 52

University of Maryland Department of Emergency Med

AUGUST 7, 2023

Targeted Therapeutic Mild Hypercapnia after Resuscitated Cardiac Arrest (TAME) Current guidelines recommend normocapnia for out-of-hospital card.

Hospitals 57

Hospitals Resuscitation 57

RebelEM

AUGUST 7, 2023

Background Information: Delirium is a common and serious condition in patients in the intensive care unit (ICU). It is estimated to affect 30-50% of patients in the ICU and haloperidol is the most frequently used agent in treatment (3). One of the most common methods of assessing delirium in the ICU is using the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) which has been found to have a sensitivity of 80% and a specificity of 95.9% (6).

Outcomes 52

Outcomes Hospitals EMS Administration 52

PulmCCM

AUGUST 7, 2023

Between one in 3,000 and one in 20,000 healthy boys and men aged 12-24 vaccinated against SARS-CoV-2 experienced myocarditis severe enough to require hospitalization , often in the ICU, and a minority still had symptoms and abnormal cardiac MRIs at the time of discharge. It’s unknown how many more experienced myocarditis not severe enough to result in hospitalization.

CDC 98

CDC Hospitals Administration Research 98