Ken Grauer, MD
FEBRUARY 1, 2025
I was sent the ECG in Figure-1 obtained from a previously healthy man his 60s, who contacted EMS ( E mergency M edical S ervices ) for new-onset severe burning CP ( C hest P ain ) that radiated to the jaw and throat. On seeing the ECG in Figure-1 the EMS crew activated the cath lab. QUESTION: Do you agree with this decision by the EMS crew to activate the cath lab?
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
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St. Emlyn
FEBRUARY 6, 2025
St.Emlyn's - Emergency Medicine #FOAMed We are back at the TBS (The Big Sick) Conference in Zermatt, exploring key research papers that challenge critical care practices. Highlights include arterial blood pressure monitoring, intra-arrest DBP in cardiac arrest, SAPBs for rib fractures, the DanGer shock trial, and double sequential defibrillation timing.
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.
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!
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.
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.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
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.
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
Dr. Smith's ECG Blog
FEBRUARY 2, 2025
Written by Pendell Meyers A man in his 60s presented with acute chest pain. Here is his triage ECG: What do you think? There is sinus rhythm with clear LVH. Leads V5-6 are suspicious for upright, enlarged T waves that are possibly inappropriate for the QRS complex, especially V6. But without a baseline for comparison, it would be difficult for me to say that it is specific and diagnostic for OMI.
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.
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.
PulmCCM
FEBRUARY 27, 2025
Balanced crystalloids are considered to be probably superior to normal saline as a resuscitation fluid in critically ill patients. But there are multiple balanced crystalloid products available, with varying compositions. Does the choice of balanced solution make a difference in patient outcomes from critical illness? Balanced solutions are formulated with electrolyte and solute concentrations closer to plasma’s, compared to normal saline’s simple composition of sodium and chloride (
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.
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.
Dr. Smith's ECG Blog
FEBRUARY 10, 2025
Written by Jesse McLaren An 80 year old patient with diabetes/hypertension/ cirrhosis had a recent increase in candesartan for their hypertension, and was also on spirolactone and nadolol. They presented to a hospital clinic for routine paracentesis, after which they developed nausea and syncope attributed to a vasovagal episode from the procedure. Labs showed a non-hemolyzed potassium of 6.2, normal glucose, and mild acute on chronic renal failure (Creatinine from 140 to 170 umol/L), and the fo
Sensible Medicine
FEBRUARY 20, 2025
As always, we are happy to feature articles that expand on ideas discussed on Sensible Medicine – even when the author agrees more with Dr. Prasad than with me. Today, we welcome back Dr. Raudasoja, who last published with us about a year ago. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.
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.
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.
EMDocs
FEBRUARY 6, 2025
Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.
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.
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?
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
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.
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.
American Medical Compliance
FEBRUARY 11, 2025
Patients who receive restorative nursing care are 32% less likely to be readmitted to the hospital than those receiving standard care, as reported in the Journal of the American Geriatrics Society. This is because the principles of restorative nursing go beyond basic medical careit actively engages patients in their recovery through mobility training, self-care support, and personalized rehabilitation.
Mind The Bleep
FEBRUARY 2, 2025
It is important for resident doctors to understand what the discharge planning process involves so you can have an active role in multidisciplinary team meetings. This article focuses on discharging home with an appropriate package of care but discharge planning also involves discharging to different types of homes ( which is discussed in another article ).
Cook County EM Blog
FEBRUARY 14, 2025
Figure 1. Procedural sedation agents (courtesy of EMRA). Procedural sedation is a unique skill that is frequently utilized by Emergency Medicine (EM) trained physicians. Depending on the indication and patient’s clinical status, it can be both stressful and time consuming, but ultimately a procedure that must be mastered to facilitate safe and effective care for our patients.
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.
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.
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.
American Medical Compliance
FEBRUARY 14, 2025
image source: [link] Workplace harassment is a widespread issue, and healthcare is no exception. In healthcare settings, harassment not only impacts employees but also affects patient care and safety. A global survey by ILO-Lloyds Register Foundation-Gallup found that 17.9% of workers have experienced psychological harassment, 8.5% have faced physical harassment, and 6.3% reported experiencing sexual harassment, with women being particularly vulnerable.
EMCrit
FEBRUARY 23, 2025
The Stellate Ganglion Block for Electrical Storm EMCrit Project by Scott Weingart, MD FCCM.
Cook County EM Blog
FEBRUARY 7, 2025
Figure 1. Index ECG. A 63-year-old male with a past medical history of epilepsy, hypertension, and papillary thyroid carcinoma s/p left hemithyroidectomy presents with nausea and vomiting. The patient reports that, around 2:00 AM, he woke up from his sleep and began sweating and vomiting. These symptoms have continued intermittently since then, and the patient presents with his wife around 5:00 PM.
Sensible Medicine
FEBRUARY 14, 2025
Pitchers and catchers. George Vecsey probably said it best. Just say it out loud, the mantra that gets some of us through the winter. Pitchers and catchers, pitchers and catchers. Like NPR republishing Susan Stamberg's cranberry relish recipe or every dance school putting on The Nutcracker each December, I think Sensible Medicine needs a tradition. So here, in honor of the start of spring training, when pitchers and catchers report for duty, a Friday Reflection that I first posted on Feb 17, 202
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.
EMDocs
FEBRUARY 1, 2025
We always work hard, but we may not have time to read through a bunch of journals. Its time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Can We Use PERC-35 to Rule Out PE in Younger Patients? Spoon Feed In a meta-analysis of patients with septic shock, starting norepinephrine earlier had no mortality benefit, though heterogeneity and bias limit clinic
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