Ken Grauer, MD
JULY 22, 2023
The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. Unlike his "usual" anginal episodes — this chest discomfort was not relieved by NTG. Some amount of time passed at home — during which his chest discomfort persisted The patient was hemodynamically stable at the time he was seen by EMS, when ECG #1 was recorded.
Mount Sinai EM
JULY 27, 2023
Fever in the Asplenic Patient Why we care Fever in a patient with impaired splenic function = early sign of sepsis Infections in this population can develop precipitously with very minimal antecedent symptoms, and can become fulminant and fatal within hours of symptom onset DIC can occur early in the course Patient population Anatomic Asplenia (post-splenectomy, congenital asplenia) Functional Asplenia (e.g. sickle cell anemia) Hyposplenia (from atrophy, infarction, engorgement, or infiltration
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Pediatric EM Morsels
JULY 7, 2023
In the past, we have discussed several causes of Knee Pain in children. Some of those causes are benign (ex, Osgood Schlatter’s Disease ) while others are scary (ex, osteosarcoma ). Evaluating the limping child , though, requires us to ponder not only the common (ex, Toddler’s Fracture ), but also to be vigilant for the severe (ex, Septic Arthritis ).
Speaker: Dr. Christine Gall, DrPH, MS, BSN, RN
The promise of virtual care is no longer theoretical and is now a critical solution to many of healthcare’s most urgent challenges. Yet many healthcare leaders remain unsure how to build a business case for investment and launching the right program at the right time can be the difference between value and failure. For organizations seeking a financially sound, clinically effective entry point, Virtual Patient Observation (VPO) offers a compelling case to lead with.
RebelEM
JULY 5, 2023
Take Home Points Provider assessment of how the patient looks is extremely important. If it looks and feels like a STEMI clinically, get serial ECGs and consult Cardiology immediately. POCUS has been a phenomenal tool in the management and early diagnosis of a lot of abnormal ECG and chest pain presentations. Isolated elevation in aVR with diffuse ST depressions can be a sign of Left Main occlusion.
The Trauma Pro
JULY 28, 2023
As a followup to my hip dislocation post on Tuesday, here is a short 5 minute video that goes through the entire process of reducing hip dislocations. There are lots of little tips and tricks. Enjoy! In the next post, a novel variant of the hip reduction technique, the Captain Morgan. Originally shown at Trauma Education: The Next Generation 2013 in St.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Mount Sinai EM
JULY 21, 2023
Why is this a pearl? We get G-tube dislodgments quite often at Sinai, and they can be an easy patient encounter with a quick note and quick dispo. But they made me so nervous as an intern and early 2! Now I love ‘em and you can love ‘em too! ** GJ-tubes or J-tubes do not get replaced in the ED. Tell me about the PEG tube. Gastrostomy tube (G-tube) or Percutaneous Endoscopic Gastrostomy tube (PEG tube) is a tube placed in the stomach for long-term enteral nutritional support.
Emergency Live
JULY 4, 2023
Telangiectasias are caused by enlarged blood vessels. This condition is much more common than you think and you will probably have come across this problem at least once in your life The post Teleangiectasias: what are they? appeared first on Emergency Live.
St. Emlyn
JULY 2, 2023
St.Emlyn's - Emergency Medicine #FOAMed Zaf Qasim @resusone reviews the UKREBOA trial. No benefit shown, but is this really the end of REBOA in trauma? #FOAMed @stemlyns The post JC: The UK-REBOA trial. Has the balloon popped? St Emlyn’s appeared first on St.Emlyn's.
First 10 EM
JULY 3, 2023
The pace of these literature summaries has decreased over the years, but perhaps that means that quality has increased? I think there is an interesting variety of papers this time around, from sepsis, to b t, to patient access to their own results online. A few huge papers dropped in the past few weeks, including RCTs […] The post Research Roundup (July 2023) appeared first on First10EM.
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!
The Trauma Pro
JULY 25, 2023
Although posterior hip dislocation is an uncommon injury, the consequences of delayed recognition or treatment can be dire. The majority are caused by head-on car crashes, and 90% of these are posterior dislocations. The femoral head is forced across the back wall of the acetabulum, either by the knee striking the dash, or by forces moving up the leg when the knee is locked.
Ken Grauer, MD
JULY 9, 2023
The ECG in Figure-1 was obtained from a 60-year old woman — who presented to the ED ( E mergency D epartment ) for “palpitations”. Her vital signs were normal at the time this triage ECG was recorded. Blood was drawn , and the patient was promptly placed in a room to be seen — but on entering, the ED physician found her unresponsive in cardiac arrest.
Mount Sinai EM
JULY 30, 2023
TR Pearl: Thyroid Storm Management Endocrine emergency: severe clinical manifestations of thyrotoxicosis Mortality rate of thyroid storm is 10-30% Often precipitated in patients with hx of hyperthyroidism by an acute event such as surgery (thyroid or non-thyroidal surgery), trauma, infection, acute iodine load (including amiodarone), or parturition Risk factor includes irregular use or discontinuation of antithyroid drugs Diagnosing Thyroid Storm : The distinction between severe thyrotoxicosis a
Emergency Live
JULY 1, 2023
Water retention is a problem that affects most women. However, most people confuse water retention and cellulite The post Water retention, how to deal with it appeared first on Emergency Live.
The Skeptics' Guide to EM
JULY 8, 2023
Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM.
The Bottom Line
JULY 1, 2023
What’s new in the Critical Care literature – monthly updates
SheMD
JULY 30, 2023
Disclaimer: This post was written before the COVID-19 pandemic. Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Hello premeds! ,, AMCAS , ,, AACOMAS , and ,, TMDSAS all opened in the beginning of May. We are kicking it into high-gear with premeds so they can turn in their medical school applications as soon as they are able.
Dr. Smith's ECG Blog
JULY 17, 2023
This is a middle aged male who was in police custody for 45 minutes when he had what was described as a seizure. Prior to the seizure, the patient had reported nausea and not feeling well. He went into PEA arrest in the ED, with ROSC. It is unclear to me if the first ECG was before or after the arrest. The K was 4.0 mEq/L, pH 6.50, pCO2 145, bicarb 11, and lactate 25.
Mount Sinai EM
JULY 24, 2023
This week, I wanted to touch a bit on Meconium Aspirators as apart of our GI Bleed intubation tool kit. At some point during second year, many of my fellow classmates and I started throwing these into airway boxes at Elmhurst. Especially in cardiac/resus, I think knowing to reach for one when you need one is critical, though I don’t think they need to be in every airway box.
Emergency Live
JULY 3, 2023
Schizophrenia comes from the Greek and literally means “separate mind”: those affected struggle to distinguish reality from imagination It is a psychiatric disorder that seriously compromises self-perception. In addition to negatively affecting social relationships and the performance of normal daily activities. This disease also affects perception, memory, attention, learning and emotions.
The Trauma Pro
JULY 21, 2023
In the last post, I discussed what to do if your hospital is thinking about switching to an electronic trauma flow sheet (eTFS). Today I’ll give you some tips on what to do if the cat’s already out of the bag and it’s already been implemented. The number one priority is to show the impact of the eTFS on the trauma program. This involves the same two components I’ve already written about: Accuracy.
Emergency Medicine News
JULY 31, 2023
An abstract is unavailable.
PulmCCM
JULY 31, 2023
New Practice Guidelines for Diagnosis and Management of Acute Respiratory Distress Syndrome As mentioned here previously , a group of U.S. and European experts arrived at a consensus of new recommendations for the management of acute respiratory distress syndrome (ARDS), now publishing their guidance in JAMA. The highlights include: A trial of high-flow nasal cannula oxygen was advised before intubating patients.
EM Ottawa
JULY 27, 2023
Acute scrotal pain is a common in emergency departments, comprising ~ 0.5% of all presentations. However, torsion is another very time sensitive diagnosis that is ubiquitous across all ages as seen by this Rosen’s table. Incidence / Epidemiology Unfortunately, epidemiological data is poor. Acute scrotal complaints make up approximately 0.5% of all ED visits […] The post Testicular Torsion appeared first on EMOttawa Blog.
Sensible Medicine
JULY 26, 2023
We are two practicing physicians who strongly support a petition gaining traction on Change.org to eliminate the American Board of Internal Medicine’s Maintenance of Certification (MOC) requirement. From our perspective, MOC is a financial product made to enrich a professional organization that has no credible data that it ensures better physicians.
Emergency Live
JULY 3, 2023
Bladder cancer is a malignant transformation of the cells - mainly those called transitional cells - which cover the inner walls of the bladder, the organ responsible for collecting and expelling urine once it has been filtered by the kidneys The post Bladder cancer: what is it? appeared first on Emergency Live.
The Trauma Pro
JULY 18, 2023
I’ve spent several posts showing you the major problems inherent in using an electronic trauma flow sheet (eTFS). It boils down to Garbage In / Garbage Out and time. It costs a lot of money and weakens an otherwise robust trauma performance improvement process. Here’s the real bottom line: ” A hospital using an electronic trauma flow sheet is paying a lot of money for a product that forces them to pay even more money for people to essentially transcribe inaccurate data back on
The Skeptics' Guide to EM
JULY 29, 2023
Date: July 21, 2023 Reference: McDonald et al. Patterns of change in prehospital spinal motion restriction: a retrospective database review. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.
RebelEM
JULY 24, 2023
Background: Rapid Sequence Intubation (RSI) is a procedure fraught with potential complications including hypotension which, in turn, can result in cardiovascular collapse. While there are numerous potential causes of hypotension peri-RSI, induction medications represent an important, modifiable variable. Over the last decade, airway experts have advocated for reduced induction agent dosing to lessen the risk of hypotension particularly in at risk patients.
ECG Guru
JULY 24, 2023
This is a "classic" ECG of very good quality for you to use in a classroom setting. The Patient: A 57-year-old man who complains of a sudden onset of "sharp" chest pain while on a long bike ride. The pain does not radiate, and nothing makes it worse or better. He is pale, cool, and diaphoretic. His medical history is unknown. The ECG: This ECG could be considered "classic" for an inferior wall ST elevation M.I. caused by occlusion of the right coronary artery.
Emergency Medicine Journal
JULY 24, 2023
Background Endotracheal tube (ETT) malposition is frequent in paediatric intubation. The current recommendations for ETT insertion depths are based on formulae that hold various limitations. This study aimed to develop age-based, weight-based and height-based curve charts and tables for ETT insertion depth recommendations in children. Methods In this retrospective single-centre study, we determined the individual optimal ETT insertion depths in paediatric patients by evaluating postintubation ra
Emergency Live
JULY 4, 2023
The aircraft was carrying five people, prompt rescue, all survived A helicopter, involved in the route between the high altitude refuges Capanna Gnifetti and Regina Margherita on Monte Rosa, crashed in the area of the municipality of Alagna Valsesia. The helicopter was performing its usual service connecting the two refuges, offering tourists and climbers, all […] The post Helicopter crashes on Monte Rosa, no fatalities appeared first on Emergency Live.
The Trauma Pro
JULY 13, 2023
In my last post, I wrote about how the electronic trauma flow sheet (eTFS) practically assures a garbage in situation. Today, I’ll dig into what happens on the back end, and how it also creates a garbage out situation. There are two ways to view the eTFS on the back end (abstraction phase): read a paper report (timeline), or view it live in the electronic health record (EHR).
Don't Forget the Bubbles
JULY 24, 2023
Discitis is an inflammatory condition involving the intervertebral discs and end plates of vertebral bodies. It encompasses a spectrum of conditions that includes discitis , spondylodiscitis , and vertebral osteomyelitis. Discitis is uncommon. However, there is a bimodal peak in children, those under 6 years and adolescents. Neonates can also be affected.
SheMD
JULY 23, 2023
Disclaimer: This post was written before the COVID-19 pandemic. Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Now that it’s the heart of interview season for both medical school applicants and residency applicants, I wanted to share some tips on how to answer commonly asked interview questions.
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