Emergency Live
NOVEMBER 20, 2023
Specialized Solutions for the Safety of Small Passengers During Emergency Transport Transporting children by ambulance requires special care and precautions. In emergency situations, ensuring the safety of young patients is a top priority. This article explores international regulations and technological innovations that help make pediatric ambulance transport safe and effective.
The Trauma Pro
NOVEMBER 17, 2023
Ever been in a trauma activation where it seems like the first thing that happens is that someone steps up to the patient with the ultrasound probe in hand? And then it takes 5 minutes of pushing and prodding to get the exam done? Well, it’s not supposed to be that way. The whole point of adhering to the usual ATLS protocol is to ensure that the patient stays alive through and well after your exam.
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Broome Docs
NOVEMBER 17, 2023
This is another lecture by the always amazing Dr Justin Morgenstern from the series of talks he delivered on his tour of Perth in September 2023. In this talk I challenged Justin to go on a very deep dive into the literature around the modern management of the massively bleeding trauma patient. What is the best way to resuscitate and replace all those blood products in these severely unwell people?
Ken Grauer, MD
NOVEMBER 10, 2023
== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. HOW would you interpret this tracing?
Sensible Medicine
NOVEMBER 10, 2023
The CDC has just reported that more parents than ever are getting vaccine exemptions for their children entering Kindergarten. For many of us who have witnessed the CDC’s repeated blunders with kids COVID19 vaccines, this result is entirely predictable. The CDC has lost the trust of the American people, and it will keep getting worse. First, let me say, I warned them.
Science Based Medicine
NOVEMBER 13, 2023
Over the weekend, Jeffrey Tucker, founder of the Brownstone Institute, crowed about how the Great Barrington Declaration and its recommendation of a "natural herd immunity" approach to the pandemic changed everything three years ago. Unfortunately, as the John Snow Project pointed out last week, the "natural herd immunity" approach has done what could be irreparable damage to public health science and, more importantly, the political and social will to promote public health practices not just fo
Don't Forget the Bubbles
NOVEMBER 27, 2023
Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. He presented tachycardic and hypotensive with a capillary refill time of 5 seconds. After 40ml/kg of IV 0.9% NaCl, his HR came down a little, but the effect was short-lived. He has an HR of 190/min, and his BP is 85/35 mmHg. The CRT is unchanged.
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Greater Sydney Area HEMS
NOVEMBER 4, 2023
Airway Registry learning points reflect the challenges described and wisdom shared by Sydney HEMS personnel and guests at the Clinical Governance Airway Registry presentations. Cases are discussed non-contemporaneously, anonymised and amalgamated over a period of time to draw together unifying take-home messages. Details of specific cases are removed and/or changed, such that any similarity to real-life patients or scenarios is coincidental.
Ken Grauer, MD
NOVEMBER 25, 2023
== CLICK HERE — for a V ideo presentation of this case! ( 19:40 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #191 — == The 2-lead rhythm strip shown in Figure-1 was obtained from an elderly woman who presented to the ED following a syncopal episode. On the basis of this rhythm strip — she was diagnosed as being in complete AV Block.
Sensible Medicine
NOVEMBER 2, 2023
Doctors and ‘experts’ who got COVID policy wrong are asking for forgiveness. Their errors hurt children— resulting in massive learning losses— and caused broader destabilization to the economy, work life, social communities and more. Do they deserve forgiveness? And, why did they err in the first place? Recently Scott Galloway, the NYU professor, appeared on Bill Maher.
Science Based Medicine
NOVEMBER 27, 2023
Recent evidence shows that public trust in science and vaccines has declined markedly since the pandemic. Why is this, and is there anything we can do about it? The post Trust in science and vaccines continues to decline. Why? first appeared on Science-Based Medicine.
St. Emlyn
NOVEMBER 14, 2023
St.Emlyn's - Emergency Medicine #FOAMed Simplifying urgent care data translation is essential for hospital flow improvement. This post provides a perspective on how to achieve this. The post Speaking urgent care flow fluently appeared first on St.Emlyn's.
NIOSH Science Blog
NOVEMBER 8, 2023
Despite legislation and improved technology, data from Massachusetts hospitals show that sharps injuries have increased in the operating room (OR) [1]. These injuries place healthcare workers at risk of exposure to bloodborne pathogens (BBPs). There is an urgent need to renew efforts to protect healthcare workers inside the operating room. The Massachusetts data highlight a gap and the need to establish a national surveillance program that would help hospitals develop further measures to prevent
Don't Forget the Bubbles
NOVEMBER 22, 2023
One-liner… Although commonly used, Propofol can have severe adverse effects. Propofol Infusion Syndrome (PRIS) can lead to significant morbidity and mortality in children. What is Propofol? Commonly referred to as “the milk of amnesia”, propofol is a drug used for induction and maintenance of general anaesthesia and for procedural sedation. Propofol is prepared in a lipid emulsion, giving it a characteristic milky white appearance, and due to its ability to dissolve in fats, it is rapidly redist
Ken Grauer, MD
NOVEMBER 4, 2023
You are told that the patient next door is in the regular SVT ( S upra V entricular T achycardia ) rhythm shown in Figure-1. QUESTIONS: Is the rhythm AVNRT or AVRT? Is Adenosine likely to convert this rhythm? Figure-1: How would YOU interpret this ECG? MY Thoughts on the ECG in Figure-1: When faced with a challenging cardiac arrhythmia — It is a "luxury" to have access to a long lead rhythm strip containing 3 simultaneously -recorded leads.
Sensible Medicine
NOVEMBER 7, 2023
When I first met Teppo Järvinen, it felt like I was meeting a celebrity (not like a Mick Jagger celebrity, more like a David Sackett celebrity). Teppo is the senior author on the NEJM article, Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear. For anyone interested in medical reversal, this article is up there with CAST , the WHI , and the vertebroplasty articles as landmark articles.
Science Based Medicine
NOVEMBER 20, 2023
The BMJ, once a bastion of evidence-based medicine, has become disturbingly susceptible to publishing biased "investigations" that feed antivax narratives. Its latest report on VAERS by Jennifer Block, who in the past has defended Gwyneth Paltrow and Goop and whose history is not one of supporting science, is just another example of this deterioration.
Life in the Fast Lane
NOVEMBER 13, 2023
Sheralyn Guilleminot and Mike Cadogan How to Make a Logo using AI AI in healthcare: A review of the AI tools Midjourney and DALL•E•3 to create logos and images; their unique features, differences, and the importance of effective instruction (prompting).
The Skeptics' Guide to EM
NOVEMBER 25, 2023
Date: November 22, 2023 Reference: Stopyra et al. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. AEM November 2023. Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She is the cofounder of FOAMcast and a […] The post SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area?
Don't Forget the Bubbles
NOVEMBER 20, 2023
Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Thorough history taking and detailed examination can aid in diagnosis. Causes of paediatric neck lumps can be broadly divided into three categories – congenital , inflammatory and neoplastic.
Ken Grauer, MD
NOVEMBER 18, 2023
== — CLICK HERE — for a V ideo presentation of this case! ( 15 minutes ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #344 — == How would YOU interpret the lead II rhythm strip shown in Figure-1 ? Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? Or — Is it “ something else ”? Figure-1: How would YOU interpret this lead II rhythm strip?
Sensible Medicine
NOVEMBER 5, 2023
Years ago, I was late to a dinner party at a new, trendy downtown restaurant. I had been working as an attending on the bone marrow transplant service, and the day got away from me. I had to take care of a patient who had a serious adverse reaction when she received her stem cell infusion. Another patient was suffering from a catastrophic fungal infection, and graft versus host disease threatened the life of a third.
Science Based Medicine
NOVEMBER 12, 2023
"Many were fine with exposing kids (and school workers) to a deadly virus, with no vaccine or treatment, in the name of herd immunity. That’s a fact."- Dr. Jerome Adams The post Dr. Jerome Adams Was Right. They Wanted Them Infected. That’s a Fact. first appeared on Science-Based Medicine.
EM Ottawa
NOVEMBER 2, 2023
Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1) These injuries can be debilitating requiring surgical intervention, debridement or amputation in the most severe cases.
Life in the Fast Lane
NOVEMBER 27, 2023
Sheralyn Guilleminot and Mike Cadogan Innovative Applications of AI in Healthcare 4 Innovative Applications of AI in Healthcare (and 2 Important Precautions!) AI is a tool to complement your expertise, but that it shouldn’t be used as a substitute for your own good judgement.
Stop and Think
NOVEMBER 19, 2023
I had thoughts. Maybe you did too. There were just so many media reports of cardiac arrest in athletes. This is a column about two things—a medical problem (cardiac arrest) and the way our brains work. During the pandemic we learned that the vaccine against SARS-CoV-2 could cause myocarditis—or inflammation of the heart. Young males had the highest risk of this adverse effect.
Medagadget
NOVEMBER 9, 2023
A team at the University of Technology Sydney has developed an assistive technology for blind people and those with low vision. The system consists of glasses that can view their surroundings through an on-board camera, appraise the objects nearby using computer vision technology, and then play a sound that provides a cue for the wearer as to their surroundings.
Sensible Medicine
NOVEMBER 6, 2023
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.
Science Based Medicine
NOVEMBER 14, 2023
After 41 years of private practice as a chiropractor and 60 years of writing books and articles, the age of 94 finds me rethinking my career, wondering if my contributions to the literature justify the path I took. The post The Swan Song of a Chiropractic Heretic first appeared on Science-Based Medicine.
ALiEM
NOVEMBER 22, 2023
The toxin from the golden poison dart frog most resembles which of the following in its mechanism of action? Botulinum toxin Bufotoxin Grayanotoxin Palytoxin Tetrodotoxin Photo adapted from Wilfried Berns (Wikimedia Commons) Reveal the Answer 3. Grayanotoxin – a sodium channel opener Background The golden poison dart frog ( Phyllobates terribilis ), often considered one of the most poisonous animals on the planet, secretes onto its skin the lipophilic alkaloid batrachotoxin , which irreversibly
Life in the Fast Lane
NOVEMBER 20, 2023
Sheralyn Guilleminot and Mike Cadogan What is AI and How Does it Work? We review two important aspects of AI, natural language processing and machine learning, that provide key insights into how AI works.
Stop and Think
NOVEMBER 26, 2023
I have changed my mind about a lot of things over the past two decades of practice. No change has been bigger than how I feel about preventing heart disease. The medical jargon here is primary prevention. (Re: preventing a first cardiac event). I will tell this story in three chapters. Chapter 1: What I used to think about primary prevention In years past, I interpreted the studies of primary prevention as only slightly positive.
First 10 EM
NOVEMBER 27, 2023
Evidentiary amnesia is a term I use to describe the phenomenon I frequently encounter in which evidence seems to be forgotten over time. When I hear people lecture about the management of intracranial hemorrhage, and even when I invite incredibly smart people to write about neurologic emergencies, blood pressure management is always recommended. But why?
Sensible Medicine
NOVEMBER 21, 2023
A few years ago, Dr. Richard T. Bosshardt waded into a minefield. He had been a Fellow of the American College of Surgeons (ACS) for over thirty years when he expressed his opinion that the ACS’s diversity, equity, and inclusion initiatives were threatening their dedication to excellence. Dr. Bosshardt has garnered support for his objections and has published his opinions in The Wall Street Journal, City Journal, and National Review.
Science Based Medicine
NOVEMBER 25, 2023
Dr. Prasad didn't predict this sad outcome, he worked tirelessly to cause it. So did many other doctors. The post I Agree with Dr. Vinay Prasad: It’s Entirely Predictable That More Parents Don’t Want Routine Vaccination for Their Kids first appeared on Science-Based Medicine.
Medagadget
NOVEMBER 20, 2023
A research team at the University of California San Diego have developed a smartphone attachment that can provide information on changes in pupil size, which can be used to assess neurological phenomena, such as traumatic brain injury and Alzheimer’s disease. Such changes in pupil size have been difficult to characterize in the past in those with a dark iris, which is more common in people with darker skin tones, because it can be challenging to distinguish between the iris and the pupil.
Life in the Fast Lane
NOVEMBER 21, 2023
Chris Nickson Come join the 2024 Clinician Educator Incubator! If you want to develop as a Clinician Educator and help lead 21st century critical care education, join the 2024 Clinician Educator Incubator!
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