August, 2023

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Three Ways for Emergency Medicine Docs to Practice Mindfulness

ACEP Now

Emergency medicine is stressful. There are charged moments of powerful highs and lows. In one shift, you may achieve return of spontaneous circulation in a college student with a massive pulmonary embolism, who will survive neurologically intact. The next shift you may feel inadequate as you realize the antibiotics you prescribe will never be picked up by your patient.

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Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Pediatric EM Morsels

In the age of Ozempic, everyone seems to be losing weight! This seems to have had an overall positive benefit on the health of many. Losing weight is a good thing, until it is a bad thing! Too much of a good thing is a bad thing. Of course, there can be many complications of rapid weight loss including gallstones , malnutrition , and electrolyte imbalances.

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The Decision To Stop In Geriatric Trauma

The Trauma Pro

Traumatic injury is a continuum ranging from very minor to immediately fatal. The mortality rate along that continuum rises exponentially as the Injury Severity Score (ISS) increases. We long ago moved away from the philosophy of keeping someone alive at all costs to embracing the concept of quality of life. We have become more thoughtful about considering patient and family input in difficult cases.

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Supraorbital block, Avir’s Decision-Making Gospel

Mount Sinai EM

Today is a 2 parter: 1) The Supraorbital (+supratrochlear) block for forehead lacs and 2) Comments on decision-making TNF at Ethyl’s 84th and 2nd again, 8 PM TLDR: The Supraorbital block will save you time and make your life easier/patient happier – WATCH THE 3 MIN VID ; We are DECISION MAKERS – make decisions, learn from them, READ THE ATTACHMENT, get amped THE SUPRAORBITAL/TROCHLEAR FOREHEAD BLOCK A must-have in your Elmhurst tool belt.

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Peptoid Oligomers Target Viral Membranes

Medagadget

Researchers at New York University have developed a new method to target many viruses that cause disease. For viruses with a lipid membrane, which includes many that commonly cause disease, this new technique could prove to be fatal. By targeting the lipid membrane, the approach may circumvent the treatment resistance that arises when viruses mutate to alter their surface proteins, which are the most common targets for conventional anti-viral drugs.

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Workplace Safety and Health in a Barbie World

NIOSH Science Blog

As the occupational safety and health community continues to combat very real and serious hazards, we are closing out the summer with a little fun. This summer Barbie and friends have recaptured national attention breaking box office records with movie ticket sales exceeding one billion dollars in just a few weeks. While Barbie’s first “job” in 1960 was as a fashion designer, she went on to hold over 200 jobs[1] across various industries (of course with the corresponding outfits and accessories)

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Jet Lag and Residency: Long Distance Relationships in Medicine

SheMD

When I started looking at where I wanted to spend my residency during the fourth year of medical school, I considered numerous factors, as every student does. Many of them are quite similar: location, quality or style of learning, fellowship options, benefits, personality fit, etc. However, not everyone is at the same place in life when they are matching.

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New EAST Practice Guideline: Spleen Vaccines After Angioembolization

The Trauma Pro

I am trying to figure out how I missed it! The Eastern Association for the Surgery of Trauma (EAST) snuck a new practice management guideline into the Injury journal last fall. And it desperately tries to answer a question that has been hanging around for several years. Do we vaccinate spleen injury patients who undergo angioembolization or not? I’ve been pondering this for some time and have reached my own conclusion based on some very old literature.

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The Pause- a recognition of a life

Don't Forget the Bubbles

Siren and blue lights. Team allocated and primed. Voices command, ears listen, and hands swiftly execute. Monitors beep—loops of communication. As the second hand sweeps, loud voices grow quieter, and pulse checks fall into an unfortunate pattern. Realisation, its time, knowing looks, a shake of the head, a pain, heaviness. Winding down…. “Time of Death 10:43”.

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Dayton Children’s uses innovative sensory tools to humanize pediatric surgery

NRC Health

A team at Dayton Children’s, led by pediatric anesthesiologist Sean Antosh, MD, believed there was a better way to humanize care and environments for patients, particularly for children with Autism Spectrum Disorder or other special needs like ADHD or high anxiety. The post Dayton Children’s uses innovative sensory tools to humanize pediatric surgery appeared first on NRC Health.

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Drug Rashes

EM Ottawa

Drug rashes are fairly common, but like much of dermatology, diagnostic clarification can be hard to achieve. Here, we present a standardized approach to drug rashes in the Emergency Department. Differential Diagnosis Clinical Approach Assessment History Distribution and progression, recent exposures, new meds Physical Exam Dangerous features: abnormal vital signs; […] The post Drug Rashes appeared first on EMOttawa Blog.

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What to know about Covid EG.5.1 or "Eris"

PulmCCM

What is EG.5.1? Don’t worry about it. But what is it? There are many circulating strains of SARS-CoV-2; all are genomic subvariants of Omicron. EG.5.1 is one of these Omicron subvariants. You don’t need to worry about it. Can I worry about it, though? Well … EG.5.1 is the genomic subvariant of Omicron that is rising fastest as a proportion of viruses detected by genomic surveillance of wastewater.

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Gradually Circling Around the GRACE Project’s “Reasonable Practice”

ACEP Now

There is no shortage of guidelines, protocols, or quality measures across emergency medicine. Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. A common limitation to many of these guidelines, however, is the lack of recognition of available resources or the unique challenges of certain patient groups.

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The Ohio State Medical Board has finally suspended the medical license of antivax quack Sherri Tenpenny

Science Based Medicine

Last week, the Ohio State Medical Board suspended the medical license of Dr. Sherri Tenpenny, a longtime antivax quack. The only question is: What took them so long, and why did it take the pandemic for them to act? Also, is there less to this action than meets the eye? The post The Ohio State Medical Board has finally suspended the medical license of antivax quack Sherri Tenpenny first appeared on Science-Based Medicine.

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Subclinical hypothyroidism

Don't Forget the Bubbles

You’ve sent some bloods on a child with lethargy. Their free T4 is normal but their TSH is raised. What does this mean? Do they have subclinical hypothyroidism? Subclinical hypothyroidism is a hormonal condition. Thyroid-stimulating hormone (TSH) serum levels are raised, while free T4 (FT4) values are normal. We’ll use some cases to think about the different causes of subacute hypothyroidism, but first, let’s explore what it is.

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PEM POCUS Series: Pediatric Lung Ultrasound

ALiEM

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric lung ultrasound. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Take the ALiEMU PEM POCUS: Pediatric Lung Ultrasound Quiz Module Goals List indications for performing a pediatric lung point-of-care ultrasound (POCUS).

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Precipitous Birth in the ED

Life in the Fast Lane

James Miers, John Mackenzie and Amanda Beech Precipitous Birth in the ED Emergency Procedure: Precipitous Birth in the ED. Let’s face it, the three births you attended as a medical student don't really prepare you for this.

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The Top 7 Things I Learned While Applying to Medical School

SheMD

Are you applying to medical school? This can be one of the most stressful times of you life, but sheMD is here to help! Student Doctor Andrea D. shares with us some lessons she's learned while applying to medical school! 1) It’s expensive! Applying to medical school is so expensive! You must budget for primary apps (AMCAS, AACOMAS, TMDSAS), secondary apps, transcript fees, MCAT, CASPer (depending on the school), and interview-related expenses.

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BHP Corner: Decision Points in Cardiac Arrest

EM Ottawa

Case You and your partner arrive at a scene where a 67-year-old male had a witnessed collapse 5 minutes ago and CPR is in progress; he is in cardiac arrest. The initial rhythm is ventricular fibrillation. You continue CPR with a King LT and provide 3 shocks, along with a dose of epinephrine remembering that […] The post BHP Corner: Decision Points in Cardiac Arrest appeared first on EMOttawa Blog.

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Building Loyalty into the Patient Experience

NRC Health

In this episode we talk with John Berg, Marketing Director and AVP of UF Health, and Ryan Donohue, Strategic Advisor at NRC Health. The post Building Loyalty into the Patient Experience appeared first on NRC Health.

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Reference ranges of paediatric heart rate and respiratory rate

Don't Forget the Bubbles

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).

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SAEM Clinical Images Series: Back Yard Football Injury

ALiEM

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.

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What’s really in that sports supplement?

Science Based Medicine

A new analysis of sports supplements shows that you cannot trust the label to tell you what's actually in the bottle. The post What’s really in that sports supplement? first appeared on Science-Based Medicine.

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Pulmonary Embolism with Al Sacchettii, MD

EB Medicine

In this episode, Sam Ashoo, MD, and TR Eckler, MD, interview Al Sacchetti, MD, about the August 2023 Emergency Medicine Practice article, Evidence-Based Management of Pulmonary Embolism in the Emergency Department Etiology/pathophysiology Risk factors Differential diagnosis Prehospital care ED history and physical exam Diagnostic scoring systems Pregnant patients Diagnostic studies ECG D-Dimer Troponin & BNP Chest x-ray CT V/Q scans MRI US Treatment IV fluids Anticoagulation Vasopressor

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Welcome to Medical School: Part 2

SheMD

Are you pre-med and starting medical school this fall? Are you a new medical student wondering how to navigate the waters of medical school? Student Doctor Briana Christophers is sharing some advice in this three part letter to incoming medical students. Be sure to not miss the part 1 and part 3 ! Dear incoming medical student, First off: congratulations on starting medical school!

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2023 ACEP Elections Preview: Meet the President-Elect and Council Officer Candidates

ACEP Now

Each year, ACEP’s Council elects new leaders for the College at its meeting. The Council, which represents all 53 chapters, 40 sections of membership, the Association of Academic Chairs of Emergency Medicine, the Council of Emergency Medicine Residency Directors, the Emergency Medicine Residents’ Association, and the Society for Academic Emergency Medicine, will elect four members to the ACEP Board of Directors when it meets in October, along with a new President-Elect, Council Speaker and Counc

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The emergency management of mediastinal masses

Don't Forget the Bubbles

Depending on the location of the mediastinal mass, lying a child flat or using a rapid sequence induction protocol may cause cardiorespiratory arrest. As clinicians, we need to be prepared. What causes a mediastinal mass? The mediastinum is the segment of the thorax that includes structures vital to life – the heart, major blood vessels, and the airway.

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Fighting Water with Water: A Revolutionary Solution to Flooding

Emergency Live

Rapid H2O Flood Barriers: A New and Innovative Solution to Flood Control They say that sometimes you have to fight fire with fire. But what about fighting water with water? In the realm of innovative flood control, the Rapid H2O flood barriers are making waves in the UK market. This ingenious system utilizes water as […] The post Fighting Water with Water: A Revolutionary Solution to Flooding appeared first on Emergency Live.

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The American Board of Internal Medicine finally acts against two misinformation-spreading doctors

Science Based Medicine

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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Two Decades of Honest Impact: Ted's Experience in Healthcare Recruitment

Core Medical Group

The right match can make all the difference in the healthcare world. Today, we’ll learn the experiences and insights of a remarkable figure in this field, Ted. A Senior Recruiter in the Travel Nursing Division with a tenure of 20 years at CoreMedical Group. With a passion for fitness, a commitment to accessibility, and dedication to his work, he has not only excelled but also left an indelible mark on the industry.

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Sensible Medicine x Vaccine Curious: Tracy Beth Høeg and Christine Stabell Benn compare US & Danish COVID-19 response and child vaccination policy

Sensible Medicine

Listen now | An introduction to a podcast series comparing US and Danish public policy, with a focus on the many differences in COVID-19 response and vaccination policies

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Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain

ACEP Now

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. She has a history of similar episodes. There are no other concerning aspects to her examination. Routine bloodwork was ordered in triage.

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Febrile Seizures

Don't Forget the Bubbles

Topic Febrile Seizures Author Lakshmi Shenoy Duration Up to 2 hrs Facilitator Level Senior trainee/ANP equivalent + Learner level Most useful for those experience seeing paediatric patients regularly: FY1+, band 5+ nurses Equipment Required None Outline Pre-reading Basics Case: generalized tonic-clonic seizure Generalized tonic-clonic seizure: Discussion Case: simple febrile seizure Simple febrile seizure: Discussion Advanced Case: complex febrile seizure Complex febrile seizure: Discussion Adva

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Stress cardiomyopathy: broken heart syndrome (or Takotsubo syndrome)

Emergency Live

Takotsubo syndrome, also known as stress cardiomyopathy, is a temporary non-ischaemic cardiomyopathy that results from stressful and emotionally intense situations The post Stress cardiomyopathy: broken heart syndrome (or Takotsubo syndrome) appeared first on Emergency Live.

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The World Health Organization promotes quackery yet again

Science Based Medicine

The World Health Organization held the First WHO Traditional Medicine Global Summit this weekend. Unfortunately, its claims of being "evidence-based" aside, the conference followed the WHO's usual pattern of serving as propaganda, not science. The summit was one-sided, organized by believers with the only speakers being believers, to promote a predetermined policy goal of promoting traditional medicine and justify "integrating" it with science-based medicine.

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mRNA Immunotherapy Targets Cancer

Medagadget

Researchers at the Mount Sinai Hospital have developed an mRNA-based treatment for cancer. The approach combines the delivery of mRNA therapy in lipid nanoparticles and also involves co-delivering dendritic cells that have also been primed through treatment with lipid-encased mRNA. The technology aims to overcome some of the immune evasive tricks that tumors use to circumvent the immune system, some of which can hamper more traditional immunotherapies.

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Could we do worse than the PSA for prostate cancer screening?

Sensible Medicine

Last week a friend sent me a link to an article in The Financial Times titled, MRI scan more accurate than blood test at diagnosing prostate cancer, UK study finds. I read the article, skeptically, thinking MRI as a screening test, come on. I thought it was a piece of churnalism until I read the study itself from BMJ oncology and realized that the real story was research article.