Mon.Feb 19, 2024

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Another Study on Peripheral Vasopressors

RebelEM

Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. Historically the administration of vasopressors was restricted to central venous catheters (CVC) due to concerns for local tissue injury resulting from vasoconstriction if extravasation occurred from a peripheral IV.

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The NINJA trial: Do you replace the fingernail after nail bed repair?

First 10 EM

Nail bed injuries aren’t quite common enough to cause the same debates as TXA, or IV antibiotics, or tPa, but talk to 10 different emergency doctors and you are likely to get 10 different opinions about the management of these injuries. Therefore, even though the NINJA study doesn’t answer the most important question (in my […] The post The NINJA trial: Do you replace the fingernail after nail bed repair?

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Building Healthier Relationships With Gaming

Don't Forget the Bubbles

In a world where gaming addiction is on the rise, and at the same time, we see the benefits of gaming and grassroots Esports, you can see how confusing and contradictory the different narratives are around gaming. Despite becoming more mainstream in the last decade, there is plenty of misunderstanding from parents and professionals if they don’t play, and a lack of understanding from many young people who do.

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Diagnostics and Therapeutics: Arterial Lines and Invasive Blood Pressure Monitoring

Taming the SRU

Blood pressure monitoring is an important but frequently misunderstood cornerstone of emergency medicine. There are many opinions swirling around the complexities of accuracy, logistics, and practice patterns regarding invasive arterial blood pressure (IABP) monitoring and noninvasive blood pressure (NIBP) or cuff measurements. This post will not cover how to insert arterial lines ( see this prior Taming the SRU post by Dr Baez ) , instead we will cover the utility, mechanics, and pitfalls of IA

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Bridging Innovation & Patient Care: The Growing Role of AI

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!

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On Mental Endurance.

Maria Yang, MD

Although “mental endurance” is more wordy than “grit”, I prefer the extra syllables. “Grit” sounds difficult and uncomfortable: Jaws clenched, the jagged surfaces of molars grinding together, or granules of sand scratching the surface of your eyeball. “Grit” also suggests firmness and unyielding. It doesn’t matter what the conditions are: I will not change my strategy or tactics.

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Everything You Wanted To Know About Q Waves, By Dr. Jerry Jones, MD

ECG Guru

Follow this link to an article by Dr. Jerry Jones, MD, FACEP, FAAEM. This is a preview of Dr. Jones's next book, "Getting Acquainted With Ischemia and Infarction" In his very readable style, Dr. Jones will answer your questions about the different types of Q waves, their causes, and their meanings.

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The Latest in Critical Care, 2/19/24 (Issue #30)

PulmCCM

Let Families Activate Rapid Response Teams, Says SCCM The Society of Critical Care Medicine (SCCM) issued a new guideline on how hospitals and care teams should respond to emergencies outside the ICU or ED (i.e., on the medical and surgical wards). Read it here. Most of the advice is uncontroversial (e.g., collect timely and accurate vital signs, train team members on how to recognize deteriorating patients, etc).

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Imaging Case of the Week 583 Answer

EMergucate

There is a cavity in the left hilum.

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No, We Should Not Denounce Digoxin

Sensible Medicine

William Withering first used digitalis in 1798. Wikipedia describes it as the beginning of modern therapeutics. FDA approved digoxin for use in 1998. Since then there has been controversy over its use. The only time I’ve ever been a protagonist in a debate, has been my defense of digoxin as a useful drug. Subscribe now In recent years, a large number of observational studies have been published—most of which associate dig use with increased death rates.

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