Cook County EM Blog
APRIL 27, 2022
Background : Droperidol is primarily D2 antagonist used for nausea/vomiting, agitation, headache, and pain. Previously droperidol was a commonly used medication in the ED until it received a black box warning for concerns related to QT-prolongation and risk of potential fatal arrhythmias. Shortly after, the use of droperidol greatly decreased, however there is continued debate over its safety.
Emergency Medicine Cases
APRIL 26, 2022
Computer interpretation of the ECG has been called a double-edged sword: when correct, it increases physician accuracy, but when incorrect it increases errors. This is especially problematic in the emergency department, where computer accuracy drops as clinical significance increases—with common errors for arrhythmias and ischemia. Jesse McLaren guides us through 10 cases where the computer interpretation misguides us and how to avoid these pitfalls.
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Critical Care Now
APRIL 26, 2022
Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director. His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. Find him on Twitter @HagahmedMD The Pre-brief A 19-year-old female suddenly collapsed at the mall where she was in the company of her friends.
Northwestern EM Blog
APRIL 25, 2022
Written by: Parisa Kermani, MD (NUEM ‘23) Edited by: Alex Herndon, MD (NUEM ‘21) Expert Commentary by : Matt Levine, MD Case: A 25-year-old male comes into the ER after a saw accident at work. The patient was using a circular saw to cut wood when it slipped and the saw touched up against his knee. The patient has a 10cm linear vertical laceration over the anterior surface of his left knee (Figure 1).
Dr. Smith's ECG Blog
APRIL 24, 2022
Case sent by Magnus Nossen MD, edits by Meyers A previously healthy woman in her 60s presented to an outpatient clinic for palpitations. Vitals were within normal limits other than heart rate. The ECG there reportedly showed an irregular tachycardia, and the patient was immediately referred to the emergency room. Here is her ECG on arrival: There is a wide complex tachycardia that is irregularly irregular (this is difficult to determine at these very high rates).
Board Bombs
APRIL 24, 2022
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Why doesn’t a BMP or CMP come with a magnesium level? And who do you order these magnesiums on? Let’s talk about how hypomagnesemia is more hidden than you think… Cite this podcast as: Husain, I.
The Skeptics' Guide to EM
APRIL 23, 2022
Date: April 19th, 2022 Guest Skeptic: Sarah Mojarad is a Lecturer in Advanced Writing, #SciComm, & Mis/disinfo topics • Kavli Fellow • Reed Awardee. This is an SGEM Xtra episode. When planning a brief trip to Los Angeles for the EMRAP One Conference, I remembered that Sarah is from LA. I thought to myself, perhaps […] The post SGEM Xtra: She Blinded Me with Science Communication first appeared on The Skeptics Guide to Emergency Medicine.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Ultrasound Gel
APRIL 22, 2022
In this episode, Mike and Jacob dive into an important intersection of musculoskeletal and procedural ultrasound - the ultrasound-guided arthrocentesis. People have been doing arthrocentesis without the help of ultrasound for a while, and most would agree it is feasible. BUT what about those smaller joints - like the wrist, elbow, and ankle? Perhaps that is where the greatest benefit would be in making sure your needle gets to the right place.
Critical Care Now
APRIL 21, 2022
Reading Time: 3 minutes Nishika Patel Critical care pharmacist with a fondness for cats, wine, and all things vintage. Also an insta-nerd who likes to teach ICU tidbits on her IG page @dr.scriptsndrips. The Pre-brief Renal replacement therapy (RRT) in the critical care setting is common. Due to issues with hemodynamic instability, patients are often unable to receive hemodialysis (HD) and instead must be placed on continuous renal replacement therapy (CRRT).
EMergucate
APRIL 20, 2022
The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. He presents to ED complaining of increasing shortness of breath and leg swelling.
Board Bombs
APRIL 17, 2022
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. If you could invent a drug that caused the biggest constellation of bad juju. it would already be invented because it's called a TCA. These are scary overdoses. Let's talk about presentation, diagnoses, and management of TCA toxicity.
Cook County EM Blog
APRIL 14, 2022
This week we’ll be covering the LOMAGHI trial and use of magnesium in atrial fibrillation (AF) with RVR Background : AF with RVR is a common arrhythmia encountered in the emergency department. Typical initial rate control agents include beta blockers (BB) or calcium channel blockers (CCB), but what is the role of magnesium sulfate (MgSO4) as an adjunct in the treatment of AF with RVR?
Trigger Lab
APRIL 13, 2022
A cura di Alice Galesi Background La somministrazione di farmaci aerosolizzati è comunemente utilizzata per il trattamento di malattie polmonari [1], (ad esempio, asma, disturbi polmonari ostruttivi, fibrosi cistica, ipertensione arteriosa polmonare, malattia polmonare infettiva) [2]. L’uso dell’aerosolterapia durante la ventilazione meccanica è frequente per la somministrazione di broncodilatatori e steroidi nella broncopneumopatia ostruttiva e … Leggi tutto Aerosol terapia du
Emergency Medicine Cases
APRIL 12, 2022
Tahara Bhate's new QI corner Quick Hits series, Hans Rosenberg & Michael Gottlieb on the evidence around ED diagnosis and management of skin abscesses using PoCUS, Anand Swaminathan on what the oxygen saturation monitor can tell you besides oxygen saturation, Sarah Reid on how to pick up infantile spasms and prevent poor neurologic outcomes, Elisha Targonsky on battle of the ED rate control medications for rapid atrial fibrillation.
PHEM Cast
APRIL 11, 2022
This is the book Jon quotes, “Pain is a symphony…” The International Association for the Study of Pain’s revised definition of pain is available here. If you’d like to read more about ‘nocebo’ i.e. the non-pharmacological adverse effects of an intervention, have a look at this article. Penthrox For more information on Penthrox, you can read about it in the BNF , The Emergency Medicines Compendium and on the manufacturers own website.
Medical Law
APRIL 11, 2022
A roundabout is an alternative to a traditional intersection. Using a roundabout can be confusing because it has no traffic lights or stops signs. Also known as a traffic circle , the traffic in a roundabout flows continuously in a counterclockwise direction. Roundabouts are common in Europe, and they are growing in popularity across the United States, including in Santa Barbara.
Dr. Smith's ECG Blog
APRIL 8, 2022
Case written and submitted by Brandon Fetterolf MD, edits by Meyers A woman in her early 30s with multiple autoimmune disorders including vasculitis presented with 2-3 hours of mid-left side chest discomfort with radiation to neck and left arm and associated with nausea, diaphoresis and dizziness. Initial ECG on presentation at 1554 (no prior for comparison): What do you think is happening to his 30s woman?
Cook County EM Blog
APRIL 7, 2022
Background: A 43-year-old otherwise healthy man presented to the ED with ankle pain and swelling. Patient was playing basketball 5 days ago and twisted his left ankle. He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. He presented to our ED for worsening pain and swelling of his lower leg.
Ultrasound Gel
APRIL 7, 2022
Intussusception is a big deal and an area where POCUS can potentially make a difference. The literature has been promising, but there hasn't been any definitive studies.until now? The GEL Jr hosts dive into this impressive prospective, multicenter, non-inferiority study and (much like an air enema) they try to get to the bottom of this question to reduce our impacted uncertainty.
Core Medical Group
APRIL 6, 2022
Whether you’re already a nurse or studying to become a nurse, you’ve undoubtedly heard about travel nursing. It’s gained enormous popularity in recent years, and it’s become a hot topic in the medical field due to the variety of benefits it offers.
Board Bombs
APRIL 3, 2022
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Dr. O’Brien joins us again this week to change the way you think about abdominal pain. This podcast isn’t very board relevant, but who cares. Clinical practice changing? Yep you betcha. Want to experience the greatest in board studying?
The Skeptics' Guide to EM
APRIL 2, 2022
Date: March 31st, 2022 Reference: Butt et al. Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She is the cofounder of FOAMcast and is a pulmonary embolism […] The post SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety fir
EB Medicine
APRIL 1, 2022
Episode 68 -- Emergency Department Management of Adults With Infectious Meningitis and Encephalitis – An Interview with Dr. Andrew Hogan EMplify -- April 2022 Interview with the Author: Andrew N. Hogan, MD 1.Meningitis vs encephalitis Why this topic? What do the words mean? What's the difference? 2.Bacterial meningitis How common is it in the US? Is it more common in third world countries?
EMergucate
APRIL 16, 2022
The chest x-ray shows : There is consolidation involving the left upper lobe with silhouetting of the left cardiac border … Continue reading →
JournalFeed
APRIL 30, 2022
The JournalFeed podcast for the week of April 25-29, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. CTPA Incidentals Spoon Feed: Computed tomography pulmonary angiography (CTPA) yields an alternative diagnosis to pulmonary embolism (PE) in ~40% of patients with a negative PE study.
Emergency Medicine Education
APRIL 25, 2022
Does Anterior-Posterior electrode pad work better than the Anterior-Lateral position? A multicenter Danish study in 468 patients with atrial fibrillation showed the Ant-Lat position was more effective than AP for biphasic cardioversion and converting to sinus rhythm. There was no safety concern between these 2 methods.
ER Nurses
APRIL 24, 2022
Are you overworked? Working double 12 hour shifts? COVID got you working 2 years of overtime? What are you doing, or your unit, to ensure nurses and doctors are well rested and prepared for their shifts? Or what could be done to improve work place conditions?
Cook County EM Blog
APRIL 22, 2022
The Case: A 68-year-old male with a history of CHF, COPD, CAD s/p stenting, HTN, and DM presents to the emergency department with worsening dyspnea and bilateral lower extremity edema for one week with associated orthopnea, and increased home oxygen requirement. VS: T 36.6, HR 95, BP 114/85, RR 28, O2 97% on 3L nasal cannula (home O2 settings) On examination, the patient is tachypneic and diaphoretic.
Total Medical ComplianceHIPAA
APRIL 21, 2022
The HIPAA Privacy Rule grants patients the right to access their health information in a way that is easy and affordable for them. Providers are required to give patients access to their health information. There are some exceptions, of course, so getting the process right can be as confusing as being in a house of mirrors. Patients are entitled to receive all information a provider maintains about them in one or more designated record sets.
EMergucate
APRIL 6, 2022
A 67 year old female is BIBA as a priority 1 OHCA. There is limited history from the paramedics. They report the husband found the patient unresponsive.
JournalFeed
APRIL 23, 2022
The JournalFeed podcast for the week of April 18-22, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. RV Assessment in PE Spoon Feed: Among patients with symptomatic PE who are low risk by sPESI, the addition of right ventricular assessment predictors (echo, CT, troponin, and BNP) significantly improved prognostication for clinical deterioration within 5 days.
The Skeptics' Guide to EM
APRIL 16, 2022
Date: April 16th, 2022 Reference: Blom et al. Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence. BMJ 2021 Guest Skeptic: Dr. Matt Schmitz, Pediatric Orthopedics, Adolescent Sports Medicine and Young Adult Hip Preservation Surgeon at San Antonio Military Medical Center in Texas. Disclaimer: The views and opinions of this blog […] The post SGEM#365: Stop!
ER Nurses
APRIL 20, 2022
The global pandemic, which still continues, has forced many healthcare professionals including nurses to work under the constant and unrelenting pressures of overtime and patient loss. That conicides with a work culture and system that often works to undermine alleviating workload for frontline healthcare professionals.
Stop and Think
APRIL 12, 2022
I have recently written and spoken about a number of published studies. Some of these papers brought good news; some have been flawed. And, as always, the randomized controlled trial has shown its awesome power to inform clinicians and patients alike. Earlier this month, the American College of Cardiology held its annual meeting in Washington DC. That 11,000 people attended in-person was a hopeful sign.
Emergency Medicine Education
APRIL 11, 2022
The choice of vasopressor is always a topic of controversy regarding post cardiac arrest patients. Intensive Care Medicine recently published an article with focus on “Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock” This study was in Paris metropolitan region. They included 766 patients and they found using Epi in OHCA post cardiac arrest resuscitation was associated with higher all-cause of mortality compared with Norepi!
EMergucate
APRIL 29, 2022
The wrist x-ray shows 2 injuries. Radial styloid fracture (Chauffeur’s fracture) & scapholunate dissociation (Terry Thomas Sign).
JournalFeed
APRIL 16, 2022
The JournalFeed podcast for the week of April 4-8, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Deadly Delays Spoon Feed: This large study shows that all-cause 30-day mortality increases with delayed hospital admission from the ED, starting at 5 hours after patient arrival.
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