The Trauma Pro

FEBRUARY 14, 2025

The Advanced Trauma Life Support course lists “classes of hemorrhage”, and various other sources list a similar classification for shock. I’ve not been able to pinpoint where these concepts came from, exactly. But I am sure of one thing: you will be tested on it at some point in your lifetime. Here’s the table used by the ATLS course: The question you will always be asked is: What class of hemorrhage (or what % of blood volume loss) is the first to demonstrate systolic hy

Shock 158

Shock Resuscitation 158

PulmCCM

FEBRUARY 5, 2025

Neurologists’ job just got harder. Patients who present with ischemic stroke more than 4.5 hours after symptom onset generally do not receive intravenous thrombolytics (tPA or TNK). That’s because outside that accepted window, the risk of intracranial hemorrhage was believed to outweigh the benefits of thrombolytics in restoring blood flow to at-risk brain tissue.

Stroke 101

Stroke Documentation/Coding Outcomes 101

Mind The Bleep

FEBRUARY 2, 2025

As a new F1 in August, it can feel like quite a daunting task to verify a death, particularly if you have never seen this done before. This step by step guide will take you through the process of death verification to help make this task easier as you settle into your new role. Verifying a Death You will usually be asked to verify a death by nursing staff from the ward the patient is on.

Documentation/Coding 105

Documentation/Coding Resuscitation Hospitals EKG/ECG 105

EM Ottawa

FEBRUARY 6, 2025

Medicine often carries an aura of mystiquea profession elevated by society as a noble calling, a higher pursuit. But for those of us in the trenches, the reality is far simpler (: medicine is a job. A demanding, high-stakes, and sometimes unforgiving job, but a job nonetheless. This isnt a dismissal of its importance but […] The post There IS Beauty in Medicine appeared first on EMOttawa Blog.

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Sensible Medicine

FEBRUARY 17, 2025

John is sick, so I have big shoes to fill. Today’s study of the week is a cancer trial. I know many of you aren’t cancer doctors, and you are thinking about skipping this essay. Let me assure you: you will learn something. The trial has issues with control arm, skewed randomization (2:1), drop out and endpoints. It is a rollercoaster ride of critical appraisal.

Hospice 100

Hospice Wellness Research 100

St. Emlyn

FEBRUARY 23, 2025

St.Emlyn's - Emergency Medicine #FOAMed What does it truly mean to be dead? In 2025, updates to Death by Neurological Criteria (DNC) challenge long-standing medical definitions, raising new ethical and practical questions. This post explores the latest AOMRC guidelines, the evolving role of brainstem death, and how these changes impact emergency and intensive care medicine.

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The Trauma Pro

FEBRUARY 24, 2025

There are two broad categories of things that kill trauma patients. No, Im not talking about violent penetrating injury, falls, car crashes, or any other specific mechanisms. I am referring to the end events (on a macro scale) that take their lives. These two basic killers are: hemorrhage and brain injury. The vast majority of the time, a dying trauma patient has either suffered a catastrophic brain injury, or has ongoing and uncontrolled bleeding.

Operations 136

Operations Shock 136

Mind The Bleep

FEBRUARY 2, 2025

This guide is designed to help you identify the key areas you need to focus on when clerking a surgical patient. There are several differences when compared to clerking a medical patient, namely getting a more extensive surgical past medical history, examination and assessing frailty. Your clerking needs to be succint, pertinent and clear. Presenting Complaint This needs to be clear and brief – a headline to tell any reader why that patient has presented: Good example: “1/7 colicky R

Documentation/Coding 95

Documentation/Coding COPD EKG/ECG Wellness 95

The Skeptics' Guide to EM

FEBRUARY 1, 2025

Reference: Leonard JC et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. June 2024. Date: Oct 15, 2024 Dr. Tabitha Cheng Guest Skeptic: Dr. Tabitha Cheng is a Southern California native and board-certified emergency medicine physician and completed an EMS fellowship as well.

Pediatrics 83

Pediatrics EMS Emergency Department Research 83

Sensible Medicine

FEBRUARY 18, 2025

For decades, the treatment of acute appendicitis was appendectomy. Nobody even questioned this treatment approach. The appendix was acutely inflamed, at risk of perforation, it needed to be removed. The idea that there could be a simple, non-surgical management could not have been imagined. But, eventually evidence would accumulate casting doubt on this paradigm.

Outcomes 91

Outcomes Research Emergency Department Pediatrics 91

RebelEM

FEBRUARY 24, 2025

Background In 1979, Hiroshi Natori was the first to appreciate the sonographic changes that occur in the inferior vena cava (IVC)s diameter with ventilation in spontaneously breathing patients, mechanically ventilated patients, and those with carcinogenic and tuberculoid cardiac tamponade. 1 They noticed how spontaneously breathing patients had their IVC collapse with inspiration; and ventilated patients had their IVC dilate during positive pressure ventilation.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

The Trauma Pro

FEBRUARY 7, 2025

In my last post, I wrote about the usual reasons for delayed diagnosis: insufficient diagnostic technique or insufficient recognition. What about the time of day? An interesting paper looked at the correlation between admission time and the rate of missed injuries. The work was done at a large teaching hospital and Level I trauma center in Australia.

Hospitals 121

Hospitals 121

St. Emlyn

FEBRUARY 7, 2025

St.Emlyn's - Emergency Medicine #FOAMed This blog post provides concise summaries of recent critical care trials, including HEMOTION, PREOXI, BLING III, CLASSIC, EVIDENCE, VICTOR, and PARAMEDIC-3. Each trial is examined for its key findings, strengths, limitations, and practical implications for clinical practice. The post aims to inform healthcare professionals about the latest evidence-based practices in critical care.

Evidence-Based Practice 76

Evidence-Based Practice Research Resuscitation 76

Mind The Bleep

FEBRUARY 2, 2025

Often one of the scariest things you can do as you will most likely be speaking to a more senior colleague in an unfamiliar speciality. However, as an F1, you may well know the patient best and therefore you may be best placed to refer the patient. Our Webinar Introduce yourself and say on whose behalf you are making the referral Remember, you hold all the information about the patient and are therefore in the driving seat Use the SBAR approach and you wont go far wrong Know why you are referrin

Radiology 96

Radiology Radiology Sepsis Documentation/Coding 96

Emergency Medicine Cases

FEBRUARY 18, 2025

Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Only one in 246 patients who screen positive for an eating disorder at triage have a chief complaint suggesting it. These patients dont always fit the stereotypemany appear healthy, have normal BMI, or present with vague GI, cardiac, or neurological symptoms.

Psychiatric 87

Psychiatric Emergency Department EMS Outcomes 87

Northwestern EM Blog

FEBRUARY 4, 2025

Written by: Dean Hayes (NUEM 27) Edited by: Andrew Long (NUEM 25 ) Expert Commentary by: Rafael Lima, MD A mid 20s male presents to the ED after seizure-like activity. Per the patient's partner at bedside, he had a 2-3 minute convulsive episode and the description is consistent with a likely seizure. The patient has never had a seizure before and is A&Ox4 upon arrival to the ED with reassuring examination.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

Sensible Medicine

FEBRUARY 27, 2025

As many readers know, I hold a highly skeptical view of CAC scans. Andrew Foy and I have made the case against CAC scans for any use. In today’s guest post, Zachary Robert Caverley argues that CAC scans should remain uncovered by medical insurance. JMM The coronary artery calcium (CAC) score – an estimation of coronary atherosclerotic plaque via calcium build-up on CT – has been promoted as a powerful predictive tool for estimating the chance of future cardiovascular (CV) event

Radiology 68

Radiology Radiology EKG/ECG Hospitals 68

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Reference: Agnello et al. Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Clinical Chemistry and Laboratory Medicine 2022; 60(5):786-792 Clin Chem Lab Med. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Sepsis 61

Sepsis Infectious Diseases Emergency Department Pediatrics 61

St. Emlyn

FEBRUARY 11, 2025

St.Emlyn's - Emergency Medicine #FOAMed This months St Emlyns podcast wraps up Season 11 with a review of key emergency medicine topics. We cover new evidence on chest trauma management, intraosseous access safety, pediatric imaging updates, AI in medicine, toxic alcohol poisoning, and airway management. Plus, insights from major conferences like EUSEM 2024.

Airway Management 73

Airway Management Poisoning Pediatrics Resuscitation 73

Mind The Bleep

FEBRUARY 2, 2025

This is a tricky area to cover as it can be challenging to us both personally and professionally when things dont go well with a colleague, particularly when we know that this might impact patient care and/or our own mental health. The longer these negative interactions go on, the more likely they are to significantly impact on outcomes for our patients, our colleagues and ourselves.

Documentation/Coding 98

Documentation/Coding Outcomes Burns Wellness 98

EB Medicine

FEBRUARY 5, 2025

In this episode, Sam Ashoo, MD interviews Erin D'Agostino, MD about the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department Pathophysiology Types of Traumatic Brain Injuries Pre-Hospital Care Critical History and Physical Examination Neurological Assessment and Monitoring Laboratory and Imaging Studies Emergency Department Treatment Surgical Interventions and Considerations Patient DemographicsSummary of major points disc

Emergency Department 69

Emergency Department Hospitals 69

First 10 EM

FEBRUARY 24, 2025

I have covered calcium channel blockers for atrial fibrillation a number of times. If you are pursuing a rate control approach, calcium channel blockers probably result in more rapid control. Thus, if you are trying to send these patients home, they might be a good choice. However, for long term management, cardiologists seem to prefer […] The post Diltiazem for atrial fibrillation: does calcium pretreatment help?

EMS 66

EMS 66

EMDocs

FEBRUARY 12, 2025

Authors: Ahmed Mashal (Emergency Medicine Resident, Atrium Healths Carolinas Medical Center); Ann-Jeannette Geib, MD (Emergency Medicine Attending, Medical Toxicologist, Atrium Healths Carolinas Medical Center) // Reviewed by: Christopher Counts, MD (Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); Cynthia Santos, MD (Emergency Medicine Attending, Medical Toxicologist, Rutgers New Jersey Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case: A

Best Practices 56

Best Practices Documentation/Coding Radiology Radiology 56

PulmCCM

FEBRUARY 24, 2025

Although cardiopulmonary resuscitation (CPR) is performed on more than 250,000 people in U.S. hospitals each year, physicians receive no formal guidance or training on how, when, or why it should be made. This results in a wide variation in practice—a quarter of unsuccessful resuscitations are stopped before 15 minutes, while a quarter go longer than 30 minutes.

CPR 52

CPR Hospitals Resuscitation Outcomes 52

St. Emlyn

FEBRUARY 25, 2025

St.Emlyn's - Emergency Medicine #FOAMed Discover how the GoodSAM app is revolutionizing emergency response, from cardiac arrest alerts to real-time video triage and crime prevention. Learn how you can get involved today. The post Podcast – GoodSam App Update with Mark Wilson at LTC appeared first on St.Emlyn's.

Resuscitation 82

Resuscitation 82

Mind The Bleep

FEBRUARY 2, 2025

As a resident doctor, you will have face situations where you have to convey potentially distressing information, whether it is explaining a diagnosis or blood results to a patient or giving difficult news to relatives. Breaking bad news well is an essential communication skill which can strengthen the relationship between a patient and a doctor and create an environment where the patient and/or their families feel respected and supported.

Wellness 98

Wellness 98

Don't Forget the Bubbles

FEBRUARY 5, 2025

Topic Major Trauma – Injuries by Assault Author Hannah Downing Expert Reviewer Vicki Currie Facilitator Level ST4+ Learner Level Foundation doctors, ANPs, core and middle grade level paediatric/ED trainees Outline Pre-reading Background Basic Case 1: Kick to the Head Case 1: Discussion Basic Case 2: Stab Wound to the Chest Case 2: Discussion Advanced Case 3: Non-Fatal Strangulation Case 3: Discussion Advanced Case 4: Gunshot Wound to the Abdomen Case 4: Discussion Simulation Quiz Take Home

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

JournalFeed

FEBRUARY 22, 2025

The JournalFeed podcast for the week of Feb 17-21, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Monday Spoon Feed: This RCT found that just-in-time coaching increased first pass success prior to infant intubations by inexperienced clinicians in the operating room.

Operations 52

Operations 52

ACEP Now

FEBRUARY 18, 2025

Emergency medical services (EMS) were called to the home of a 22-year-old woman after a syncopal episode and seizure-like activity. The patient reported consuming plant needles obtained online in a suicide attempt several hours prior. On EMS arrival, the patient was alert, pulse was fluctuating between 40 and 130 beats/min, and manual systolic blood pressure was 60 mmHg.

EKG/ECG 52

EKG/ECG Seizures Emergency Department EMS 52

American Medical Compliance

FEBRUARY 24, 2025

This Women’s Health and Birth Control Training for Healthcare Personnel equips healthcare providers with essential knowledge on women’s health, covering common health conditions and birth control options. Providers explore various birth control methods, their effectiveness, and best counseling practices. The course debunks myths and misconceptions, ensuring accurate patient education.

Outcomes 52

Outcomes Research Wellness 52

St. Emlyn

FEBRUARY 4, 2025

St.Emlyn's - Emergency Medicine #FOAMed Emergency medicine demands constant practice, yet many clinicians experience skills fade due to lack of exposure. Nathalie Pattyn explores how this decline occurs, why its a systemic issue rather than an individual failure, and what changes are needed to maintain competency. The post Podcast – Skills Fade with Nathalie Pattyn at Tactical Trauma 24 appeared first on St.Emlyn's.

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Mind The Bleep

FEBRUARY 2, 2025

Here we assume you know the basics , and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients but the underlying principles are of great value if youre doing an FY1-led ward round. Be Thorough The expectation is that you are slow and thorough if you rush you can make mistakes & you end up spending more time worrying than seeing patients.

Dehydration 97

Dehydration Documentation/Coding Wellness 97

First 10 EM

FEBRUARY 17, 2025

The decision between mechanical thrombectomy and catheter directed thrombolysis for pulmonary embolism is not one that most emergency physicians are making. Most (like me) probably dont even have access to such therapies, which might be a good thing, as both therapies remain completely unproven. However, I thought I would share the PEERLESS trial as a […] The post PEERLESS: Interventional therapies for pulmonary embolism appeared first on First10EM.

EMS 52

EMS 52

JournalFeed

FEBRUARY 1, 2025

The JournalFeed podcast for the week of Jan 27-31, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Tuesday Spoon Feed: There was no difference in patient centered outcomes between trauma patients who received either restrictive or liberal oxygen therapy in this RCT.

Hospitals 52

Hospitals Outcomes 52

PEMBlog

FEBRUARY 10, 2025

Ketamine is an amazing drug for procedural sedation in the Emergency Department. Kids also look wild when they’re on it – some people call that look the “K-Hole.” Imagine a creepy industrial metal song about that… go ahead… I’ll wait. Lyrics Welcome to the K hole Now you’re deep inside Not responding to stimuli But your eyes are open wide We can reduce your fracture straight no pain without a wait side effects include emesis laryngospasm, agitation

Fractures 52

Fractures Emergency Department 52

American Medical Compliance

FEBRUARY 24, 2025

This course equips healthcare providers with techniques to improve patient interactions and outcomes. Participants master active listening and communication strategies to understand patient needs and convey empathy. The course addresses cultural, language, and literacy challenges to help providers connect with diverse patients. Honing these skills boosts patient satisfaction, trust, and creates a more inclusive, efficient healthcare environment.

Teamwork 52

Teamwork Outcomes 52

St. Emlyn

FEBRUARY 23, 2025

St.Emlyn's - Emergency Medicine #FOAMed What does it truly mean to be dead? In 2025, updates to Death by Neurological Criteria (DNC) challenge long-standing medical definitions, raising new ethical and practical questions. This post explores the latest AOMRC guidelines, the evolving role of brainstem death, and how these changes impact emergency and intensive care medicine.

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