Mon.Nov 06, 2023

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Non-significant Studies Can Teach A Lot

Sensible Medicine

Many doctors believe that closing the left atrial appendage (with a device) will help reduce stroke and bleeding. The idea behind stroke reduction is that occluding the appendage takes away a common area where clots form. The reason for less bleeding is that patients with proper occlusion can often be taken off anticoagulant drugs. These are nice ideas.

Stroke 128
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Robert F. Kennedy Jr. comes home to his antivax roots…again

Science Based Medicine

Robert F. Kennedy Jr. gave the keynote speech at the second annual meeting of his antivax organization, Children's Health Defense. Once again, he demonstrated that not only is he still antivax as hell, but that his proposals are even more bizarre than before. Truly, it was a homecoming for him. The post Robert F. Kennedy Jr. comes home to his antivax roots…again first appeared on Science-Based Medicine.

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The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial

EM Ottawa

Methodology: 4/5 Usefulness: 4/5 Ma L, et al. Lancet 2023 Jul 1;402(10395):27-40. Question and Methods: Do 6 month outcomes improve after implementation of a goal-directed care bundle that corrects prognostically poor physiological abnormalities (systolic hypertension, fever, hyperglycemia, abnormal anticoagulation) for acute intracranial hemorrhage?

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The Latest in Critical Care, 11/6/23 (Issue #19)

PulmCCM

Convalescent plasma for ARDS due to Covid-19 Convalescent plasma, donated by patients after recovering from Covid-19 and distributed by the Red Cross, represented one of the many ethical and policy controversies generated by the pandemic. The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation).

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. Top 10 Take Home Pearls 1. Treatment of cardiac arrest and life-threatening toxicity due to poisoning often requires specialized treatments that most clinicians do not use frequentl

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Bravery Under Fire: Scottish Firefighters Face Hostile Attacks on Bonfire Night

Emergency Live

Emergency Response Challenged: The SFRS Condemns Attacks and Maintains Community Protection Amidst Firework Frenzy As the skies of Scotland were illuminated with the vibrant displays of Bonfire Night, a darker narrative unfolded on the ground. Firefighters, the very symbols of safety and aid, found themselves under siege, not from the flames they are trained to […] The post Bravery Under Fire: Scottish Firefighters Face Hostile Attacks on Bonfire Night appeared first on Emergency Live.

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The power of children’s books

Don't Forget the Bubbles

Starting conversations with stories There’s something about a bookshop – a calm and comforting sense that I am surrounded by stories. The knowledge that within each beautiful book are words, illustrations, and photographs from which I can learn so much. I gently run my fingers over the front cover of a book that I know my daughter will like. Turning it over, I scan the back.

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SAEM Clinical Images Series: Wolf in Sheep’s Clothing

ALiEM

A 55-year-old female with a history of hyperlipidemia presents after a syncopal episode. She had mild nausea and diarrhea on the morning of presentation but otherwise had no prodromal symptoms before suddenly losing consciousness in a grocery store. Of note, she recalls a similar syncopal episode in the remote past, also preceded by gastrointestinal symptoms at that time.

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Research Roundup: Old article dump

First 10 EM

One of the downsides of subscribing to more than 50 journal feeds is the huge number of interesting papers that I flag for later, but never find time to return to. I have started clearing out old PDFs for papers I never found time to fully appraise, but I figured that if the titles caught […] The post Research Roundup: Old article dump appeared first on First10EM.

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Common traumatic pathologies 

Mind The Bleep

This article is the second of two articles about traumatic eye injuries. The first is called Basics of Eye Trauma with Emergency Pathologies and covers the relevant anatomy, history, examination and emergency sight-threatening pathologies. The pathologies discussed in this article are important to identify but are less of an emergency. Corneal abrasion Please refer to Red Eye article Very common with ocular trauma Superficial corneal epithelial defect Seen with the use of fluorescein drops and a

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Prehospital tracheal intubations by anaesthetist-staffed critical care teams: a prospective observational multicentre study – British Journal of Anaesthesia

PHARM

Prehospital tracheal intubations by anaesthetist-staffed critical care teams: a prospective observational multicentre study – British Journal of Anaesthesia — Read on www.bjanaesthesia.

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Basics of eye trauma with emergency pathologies

Mind The Bleep

This article is the first of two articles about traumatic eye injuries. This article covers the relevant anatomy, history, examination and emergency sight-threatening pathologies to enable you to refer to ophthalmology specialists. The second is called Common Traumatic Pathologies and covers injuries that are important to identify but are less of an emergency.

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Induction of pre-hospital emergency anaesthesia i-PHEA: a national survey of UK HEMS practice – PMC

PHARM

Induction of pre-hospital emergency anaesthesia i-PHEA: a national survey of UK HEMS practice – PMC — Read on www.ncbi.nlm.nih.

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Hydroxycobalamin vs Methylene Blue for Vasoplegic Shock from Cardiopulmonary Bypass

RebelEM

Background Information: Vasoplegic shock is defined as hypotension with normal or increased cardiac output and can commonly occur in post-cardiac surgery patients having received cardiopulmonary bypass. This dysregulation of vasodilation is associated with a mortality of close to 25%. After catecholamine vasopressors, treatment options include angiotensin II, corticosteroids, methylene blue and hydroxocobalamin.

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Ketamine in Trauma: A Literature Review and Administration Guidelines – PMC

PHARM

Ketamine in Trauma: A Literature Review and Administration Guidelines – PMC — Read on www.ncbi.nlm.nih.