October, 2022

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EMCrit 335 – APRV TCAV for Lung Rescue Made Simple with Rory Spiegel

EMCrit

Every Resus doc should be able to crash a patient on to APRV for lung rescue. EMCrit Project by Scott Weingart, MD FCCM.

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How Breast Centers are Improving Patient Experience

PDC Healthcare

Due to increasing scrutiny around patient satisfaction and what it may mean for reimbursement, patient volume, and quality standards, it’s no surprise that patient experience is at the forefront of breast centers’ priorities. We spoke with many of our top breast health professionals about the top priorities for their facilities. As expected, improving patient experience […].

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First10EM Journal Club: October 2022

Broome Docs

Ketamine vs etomidate in ICU intubation ? Matchett G, Gasanova I, Riccio CA, Nasir D, Sunna MC, Bravenec BJ, Azizad O, Farrell B, Minhajuddin A, Stewart JW, Liang LW, Moon TS, Fox PE, Ebeling CG, Smith MN, Trousdale D, Ogunnaike BO; EvK Clinical Trial Collaborators. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial.

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I'm so sorry when medics get abused for activating the cath lab

Dr. Smith's ECG Blog

Cortland Ashbrook from Spokane County, Washington, sent this message: Hey doctor Smith, I wondered if you’d give me your opinion on these ECG tracings I took as a paramedic in the field? Case: The call was an elderly gentleman who was at home when he experienced a sudden onset of vague chest discomfort along with nausea, and left arm aching. It started while walking, and began to decrease at rest but never fully resolved.

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The Hidden Faces in Medicine - Clinical Correlations

Clinical Correlations

By Amber Whitley, MD What comes to mind when you hear the word physician? Male, intelligent, arrogant, medicine, white, surgeon, healer, etc. Do you think of me, a black female physician in medicine? The number.

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6 Reasons to Trust a Staffing Partner to Help You Find Your Interim Healthcare Leadership Position

Core Medical Group

As a leader in healthcare, you’ve climbed the ladder this far, so you’re probably used to finding jobs on your own. Whether you subscribe to career search engines, scroll endlessly on job sites, or rely on your well-connected network to notify you of openings, finding a new position that feels like the right fit in the right location at the right time can be a challenge.

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EMCrit 334 – CV-EMCrit – Concise HeartMate 3 LVAD Overview

EMCrit

A review on dealing with HeartMate 3 (most common LVAD you will see) Emergencies. EMCrit Project by Katrina Augustin.

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Emergency Medicine - AI based ECG interpretation

Eolas Medical

Work illustrations by Storyset" class="hs-featured-image" style="width:auto !important; max-width:50%; float:left; margin:0 15px 15px 0;"> AI in the Emergency Department - past, present and future Since Willem Einthoven stuck his hands and feet into buckets of salty water and began recording the electrics of the heart at the beginning of the 20th century, the ECG has become an indispensable part of emergency medicine.

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Ep 175 Emergency Orthopedics Differential: SCARED OF Mnemonic – When X-rays Lie

Emergency Medicine Cases

In this main episode podcast, Dr. Arun Sayal creator of the CASTED course and Dr. Yatin Chadha a radiologist with a fellowship in MSK radiology, join Anton for Part 1 of 2 podcasts on Emergency Orthopedic Injuries. This episode focuses on a differential diagnosis of MSK injuries that are occult to X-ray with the help of the SCARED OF mnemonic. It ensures we pick up all the “can’t miss” diagnoses that can be easily overlooked when we do not integrate a pointed history and physical exam with the X

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Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

Written by Bobby Nicholson MD, with edits by Meyers, Smith, Grauer A woman in her early 40s presented to the emergency department for evaluation of palpitations. She reported that she has been experiencing this since she was diagnosed with COVID a little over 1 week ago. She reported a prior history of SVT and has previously performed vagal maneuvers at home with symptom resolution.

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Pneumoperitoneum

Ultrasound Gel

Pneumoperitoneum is usually bad news for patients, and it would be great to have a quick way to make this diagnosis. These authors ingeniously used ultrasound contrast software (without any contrast) to boost the accuracy of ultrasound for this pathology! [link] [link] Pneumoperitoneum is usually bad news for patients, and it would be great to have a quick way to make this diagnosis.

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NeuroEMCrit – Team NeuroEMCrit’s H&R Conference Talk, Part 1

EMCrit

3 great cases from the NeuroEMCrit Team. EMCrit Project by NeuroEMCrit Team (Casey & Neha).

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Aerosol terapia durante ventilazione meccanica. Parte 2

Trigger Lab

A cura di Alice Galesi Nella prima parte dell’articolo, (clicca qui per il rimando alla parte 1), sono stati descritti i sistemi di nebulizzazione. Oggi, si presentano i fattori relativi al ventilatore e al circuito del ventilatore per capire come questi influenzano l’erogazione di aerosol durante la ventilazione meccanica. Fattori relativi al ventilatore Le … Leggi tutto Aerosol terapia durante ventilazione meccanica.

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Emergency Medicine - MDCalc and other must have Apps

Eolas Medical

Our top 5 Apps you should never start an ED shift without Ever yearn for ye olden days of clinical medicine, where every treatment plan read either “chop it off” or “stick leeches on it”? In an age where published medical evidence is growing exponentially, expectations of medical professionals are correspondingly higher. In a modern ED, you can encounter pretty much any ailment known to mankind, and you’re expected to deal with them all quickly and effectively.

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151. Ectopic Pregnancy: Ticking Timebomb

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Marlena joins us again, but to NOT talk about parasites. Don't worry. Its time to cover an absolute classic women's health pathology, one of the top 10 can't-miss-diagnoses in the ED. We cover risks, presentation, diagnosis, and management.

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What Causes Carbon Monoxide Poisoning?

Medical Law

According to the CDC, over 400 people die every year from unintentional Carbon monoxide poisoning. It also results in over 20,000 emergency rooms visits. Carbon monoxide (CO) is a poisonous gas that can be fatal when inhaled. CO has no odor. The only way to know if CO is present is by installing an electronic CO detector. CO is produced whenever a material burns.

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SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR?

The Skeptics' Guide to EM

Date: October 18th, 2022 Reference: Moore et al. Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival. Resuscitation 2022 Guest Skeptic: Clay Odell is a Paramedic, Firefighter, and registered nurse (RN). Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying […] The post SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR?

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EMCrit Wee – Is there Evidence of Harm for Nitroglycerin in Right Ventricular MI? #Dogmalysis

EMCrit

Is there evidence for the classically taught nix on this medication? EMCrit Project by Scott Weingart, MD FCCM.

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What is this rhythm? Back to basics.

Dr. Smith's ECG Blog

Submitted by Dr. Arjun J V in India, An elderly patient presented to the ED with multiple complaints. An ECG was recorded in triage: What do you think? Classic for those who have seen it before. The ECG shows a regular narrow complex rhythm which is difficult to see amongst the very severe high voltage artifact which is occurring with a frequency of approximately 300 cycles per minute.

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Pros and Cons of Travel Nursing in 2022

Core Medical Group

There are many different factors that draw nurses to careers as travelers. However, there are also some aspects of the travel nursing lifestyle that may not be for everyone. While we encourage all nurses interested in travel careers to talk to someone before making a decision, we thought it might be useful to list a few of the so-called pros and cons of travel nursing.

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5 Ways Flu Shot Stickers Can Help You Prepare for This Flu Season  

PDC Healthcare

Spread the word and not the flu! PDC’s Flu Shot Stickers can help your facility meet compliance while encouraging staff and patients to get vaccinated annually. Flu season can be a hectic time for healthcare facilities, and a full staff is vital to maintaining an efficient workflow. According to the Centers for Disease Control and […]. The post 5 Ways Flu Shot Stickers Can Help You Prepare for This Flu Season appeared first on connectID - PDC Healthcare Blog.

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Bronchiolitis

EM SIM Cases

This case is courtesy of Dr. Qadeem Salehmohamed. Qadeem is a 4th year EM resident at the University of British Columbia – Kelowna Site. He has an interest in medical education / simulation and critical care. WHY IT MATTERS Heading into the fall season is always a good time to review the management of various pediatric respiratory presentations. Bronchiolitis is no exception.

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The Medicare Part D Coverage Gap (“Donut Hole”) Explained - Clinical Correlations

Clinical Correlations

By Michael Papazian Peer Reviewed Let’s start with a case. Mr. B is a 67-year-old male with a history of hypertension, type 2 diabetes, and coronary artery disease. As his primary care physician, you.

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REBEL Core Cast 88.0 – Hypocalcemia

RebelEM

Take Home Points Severe hypocalcemia can cause hypotension and QTc prolongation leading to Torsades de Pointes. Treat moderate to severe symptoms and any EKG changes with IV calcium salts Always search for and treat the underlying cause of hypocalcemia REBEL Core Cast 88.0 – Hypocalcemia Click here for Direct Download of the Podcast Definition: A serum calcium level < 8.5 mg/dL or an ionized calcium level < 2.0 mEq/L Background Exists in two states Free ionized form (approx.

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Emergency (ED placement) Transvenous Pacer appears to be working perfectly. What might go wrong?

Dr. Smith's ECG Blog

Thanks to our Electrophysiologists Omar Iqbal and Rehan Karim for the below strips and the explanations I will be giving on this post. A patient had 3rd degree AV block in the ED. A transvenous pacer was placed in the Emergency Department by the emergency physicians. Capture was obtained and a 12-lead ECG was recorded: What do you see here and what complication can occur?

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Career Disillusionment

EB Medicine

In this episode of EMplify: Conversation, Sam Ashoo, MD talks with Rob Orman, MD, founder of Orman Physician Coaching , about career disillusionment. Career Disillusionment: What is it? How do we combat it? Should we combat it? A frog in boiling water. Burnout Two questions to ask yourself How coaching can help The advice trap A framework to explore your career and life goals More at Orman Physician Coaching.

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What Does Patient-Centered Care Matter in Healthcare?

Advanced Medical Reviews

Research shows that public trust in medical practitioners has fluctuated significantly over the years. Still, these individuals remain some of the most trusted professionals in America. As the focus on patient-centered care in healthcare increases, that confidence is likely to increase even further.

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150. Rhabdomyolysis: it doesn't have to be complicated

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Iltifat and Blake tackle this ACEP PEER Board Question on Rhabdomyolysis and simplify this disease into just 2 critical management pearls. It doesn't have to be so complicated. Oh, and mannitol and furosemide aren't part of it in case you were wondering.

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OCR Right Of Access Enforcements – A Message to Dental Practices

Total Medical ComplianceHIPAA

The HHS Office for Civil Rights (OCR) recently settled three more investigations in the Right of Access Initiative it started in 2019. All three of the new enforcements involved dental practices, bringing the total number of access initiative enforcements to 41. The enforcements also come with a message directly to all dental practices from the OCR Director, Melanie Fontes Rainer, “These three right of access actions send an important message to dental practices of all sizes that are covered by

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Eolas Journeys - From Emergency Department to a Medical Tech Company

Eolas Medical

Hi, I’m Luke. I am the Chief Medical Officer at Eolas Medical. That might sound like a very fancy title but any of you who have worked in a tech startup before will know that titles often don’t mean much! Order of the day is often wearing many different hats and working on a range of different tasks within the business.

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Is there Terminal QRS Distortion?

Dr. Smith's ECG Blog

This ECG has ST Elevation in multiple leads. Is it normal STE? Or is it ischemic STE? What do you think? This ECG is interesting because it mimics TQRSD. There are no S-waves in V2 and V3. BUT look at the very prominent J-waves (J point notching)!! It is several mm high! This is a normal ECG. This patient had CO poisoning but did not have myocardial injury or OMI.

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ECG Cases 36 – PACER Mnemonic for Approach to Pacemaker Patients

Emergency Medicine Cases

In this month's ECG Cases blog Dr. McLaren explains the PACER mnemonic approach to patients with pacemakers: Pacemaker spike: is it appropriately presence/absent, is there pacemaker-mediated tachycardia (apply magnet) or is there failure to pace (apply magnet to stop sensing, cardio consult)? Aware (sensing): is it normal, is there oversensing (underpacing: apply magnet) or undersensing (treat reversible causes, cardio consult).

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SGEM #379 Heigh Ho High Flow versus CPAP in Acutely Ill Children

The Skeptics' Guide to EM

Date: September 15, 2022 Reference: Ramnarayan P et al. Effect of high-flow nasal cannula therapy vs continuous positive airway pressure therapy on liberation from respiratory support in acutely ill children admitted to pediatric critical care units: a randomized clinical trial. JAMA July 2022 Guest Skeptic: Dr. Spyridon Karageorgos is a Pediatric Resident at Aghia Sophia […] The post SGEM #379 Heigh Ho High Flow versus CPAP in Acutely Ill Children first appeared on The Skeptics Guide to Emerge

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149. BONUS at ACEP22! More pinworms.more nightmares

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. 2 episodes in ONE WEEK! You’d think its a gift… until you listen to this one. You thought the last episode was bad? Anal pruritus, tape test, and ACEP22. Someone has to cover this stuff, I guess its going to be us.

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Characteristics of Typical Atrial Flutter

Kings County Downstate EM

Author: Alec Feuerbach Peer Editor: Nicole Anthony Faculty Editor: Mark Silverberg This week we have two ECGs to examine. The first is the ECG of a 50-year-old woman who presented to the ED after experiencing uncomfortable palpitations and lightheadedness. ECG 1: This ECG shows a rapid ventricular rate of […] The post Characteristics of Typical Atrial Flutter appeared first on County EM.

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REBEL Core Cast 87.0 – Hypercalcemia

RebelEM

Take Home Points Patients with severe hypercalcemia (> 14 mg/dL) are at risk for severe cardiac dysrhythmias and cardiac collapse Treatment centers on volume repletion with normal saline with consideration for the addition of loop diuretics AFTER volume reexpansion is complete As the patient begins to diurese, continually monitor electrolytes REBEL Core Cast 87.0 – Hypercalcemia Click here for Direct Download of the Podcast Definition: A serum calcium level > 10.5 mg/dL.

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Precordial Swirl -- 20 cases of Swirl or Look-Alikes

Dr. Smith's ECG Blog

Pendell (Pendell Meyers, of course), with a little help from Smith, coined a new LAD Occlusion pattern "Precordial Swirl," in which there is rightward STE vector, with STE in V1 and aVR, with reciprocal STD in V5 and V6. It is due to transmural ischemia not only of the anterior wall and apex, but due to transmural ischemia of the septum, usually due to occlusion proximal to the first septal perforator.

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