Sat.Nov 09, 2024 - Fri.Nov 15, 2024

article thumbnail

Why Is Your Hospital’s Pediatric Readiness Score Important?

The Trauma Pro

The Pediatric Readiness Score (PRS) is a new(er) metric that is now required for all US trauma centers verified by the American College Surgeons. There is no specific threshold that must be met, but the value must be reported for review at the time of the site visit. What is the PRS? It is a measure introduced by the National Pediatric Readiness Project.

article thumbnail

ECG Blog #456 — Acute MI or Something Else?

Ken Grauer, MD

Today's case was contributed by Dr. Magnus Nossen ( from Fredrikstad, Norway ). Dr. Nossen was at his computer — reviewing ECGs from patients recently admitted to his group's hospital service. He came across the ECG shown in Figure-1 — obtained from a woman in her 70s who was admitted to the hospital for new CP ( C hest P ain ). QUESTION: How would YOU interpret the ECG in Figure-1 ?

EKG/ECG 413
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Trending Sources

article thumbnail

BECTS (Benign Epilepsy with CentroTemporal Spikes) Seizures / Benign Rolandic Epilepsy of Childhood

Pediatric EM Morsels

Seizures are super scary for a parent to witness, but not all seizures mean danger. There is actually a diagnosis of seizures that has “ BENIGN” in the name! Have you ever had that feeling of falling that rapidly wakes you from sleep? While it’s unlikely that you were having Benign Epilepsy with CentroTemporal Spikes (BECTS) seizures or a benign Rolandic seizure, that tenuous state between sleeping and waking is a time when some odd neurologic things can happen, including BECTS.

Seizures 152
article thumbnail

IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO)

First 10 EM

In the most recent BroomeDocs podcast, we talk about an attempt to use the IM route to give cardiac arrest victims epinephrine faster. (The podcast and Research Roundups blog post might actually come out next week.) I was skeptical about the outcomes, partly because the evidence that epinephrine helps at all in cardiac arrest is […] The post IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO) appeared first on First10EM.

Research 132
article thumbnail

If You Sanewashed RFK Jr., Or If You Sanewashed Doctors Who Did, You Own the Next 4 Years

Science Based Medicine

When RFK Jr. does to the U.S. what he did to Samoa, doctors will say they are horrified, that they love vaccines, blah blah blah. But it will be too late. The post If You Sanewashed RFK Jr., Or If You Sanewashed Doctors Who Did, You Own the Next 4 Years first appeared on Science-Based Medicine.

119
119
article thumbnail

ECG Blog #455 — VT Until Proven Otherwise?

Ken Grauer, MD

I was asked to interpret the ECG in Figure-1 — told only that this 30-ish year old man had a history of having undergone a number of operations for CHD ( C ongenital H eart D isease ) as a child. QUESTIONS: In Figure-1 — Is the rhythm VT — or — SVT with aberrant conduction — or — potentially neither of these possibilities? IF told that this patient was hypotensive in association with the rhythm in Figure-1 — Does It Matter what the specific etiology of this rhythm is?

EKG/ECG 412
article thumbnail

Prehospital Cath Lab Activation. What happened when the medics and patient arrived at this Academic ED?

Dr. Smith's ECG Blog

This was texted to me by a paramedic while I was out running one day: "54 yo male chest pain started at 1pm. History of diabetes type II and stent placement in 2018. I’m seeing hyperacute T waves III, aVF, down sloping depression I and aVL. Thoughts?" What do you think? I responded: "Definite inferior OMI. And Right Ventricular. Activated the Cath Lab.

Academics 120

More Trending

article thumbnail

Dr. Vinay Prasad: “I Don’t Believe in Forgiveness Because in My Opinion These Pieces of S**t Are Still Lying.”

Science Based Medicine

Mass purges and prosecutions of scientists have happened before. We shouldn't pretend they can't happen here. The post Dr. Vinay Prasad: “I Don’t Believe in Forgiveness Because in My Opinion These Pieces of S**t Are Still Lying.” first appeared on Science-Based Medicine.

110
110
article thumbnail

REBEL Core Cast 131.0 – Traumatic Arthrotomy

RebelEM

Take Home points : Always suspect an open joint if there is a laceration, regardless of size, the lies over joint CT scan of the affected joint is widely considered to be the standard approach to evaluation but the saline load test may be useful in certain circumstances. Obtain emergency orthopedics consultation for all open joints and administer antibiotics and update tetanus in all patients REBEL Core Cast 131.0 – Traumatic Arthrotomy Click here for Direct Download of the Podcast.

article thumbnail

Ep 199 Trauma Airway and Airway Trauma

Emergency Medicine Cases

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma?

article thumbnail

PulmCrit Wee: Why MedTwitter should move to Bluesky

EMCrit

Medtwitter was great. We met amazing people and exchanged ideas. There were endless arguments about electrolytes and intubation. But the strength of Medtwitter was never the platform – it was the people. Twitter has been deteriorating for years. For example, the algorithm is horrific, the blocking feature has been largely removed, posts from paid users […] EMCrit Project by Josh Farkas.

100
100
article thumbnail

Meta-analysis: Leg ergometry helps vented patients in ICUs worldwide

PulmCCM

Critically ill patients receiving mechanical ventilation are highly prone to developing severe weakness and long-term disability. Although early mobilization and physical therapy for vented patients would intuitively seem to have indisputable benefits, early mobility programs have failed to consistently show improvements in meaningful patient-centered outcomes (e.g, increased functional independence or exercise ability after ICU discharge).

Hospitals 101
article thumbnail

What kind of a doctor are you?

Sensible Medicine

“What kind of a doctor are you?” “I’m a general internist.” “Like an intern?” Laughing, “Don’t you think I’m too old to be an intern? No, I do general internal medicine, mostly outpatient primary care, but I do some inpatient general medicine as well.” “Oh, so you’re like a GP.” “Sort of… ” Sensible Medicine is a reader-supported publication.

article thumbnail

Addressing Vaccine Hesitancy Through Pediatric Immunization Training 

American Medical Compliance

Defined by the World Health Organization as the reluctance or refusal to vaccinate despite the availability of vaccines, vaccine hesitancy is influenced by complex factors including misinformation, cultural beliefs, and fear of adverse effects. To help address this growing concern, pediatric immunization training equips healthcare providers with the skills, knowledge, and empathy necessary to effectively address vaccine hesitancy.

article thumbnail

Podcast – Care in the Hot Zone with Claire Park at Tactical Trauma 2024

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Emergency medicine is shaped by our ability to respond effectively to both routine cases and extreme, high-stakes incidents. While civilian incidents dominate prehospital care, the intersection of civilian and military […] The post Podcast – Care in the Hot Zone with Claire Park at Tactical Trauma 2024 appeared first on St.Emlyn's.

article thumbnail

More data on Impella complications emerge

PulmCCM

The DanGer-Shock randomized trial allowed interventional cardiologists to breathe a bit easier, knowing that the Impella device resulted in improved survival 6 months after ST-elevation myocardial infarction with cardiogenic shock: The trial also underscored the high risks associated with the Impella device: Many more patients with Impellas required renal replacement therapy (41.9% vs 26.7%).

Shock 86
article thumbnail

The EARLY TAVR Trial Exposes the Main Tension in Medical Science

Sensible Medicine

We learn in high school that the purpose of science is to ask and answer questions about nature--through experiments. Scientists don’t know the results of an experiment beforehand, so, any result, negative or positive, adds knowledge. Medical science should work the same way. Medical scientists would design and conduct experiments to answer important questions, say, whether a drug or surgery, improves an outcome.

Stroke 91
article thumbnail

Grand Rounds Recap 11.6.24

Taming the SRU

R1 Core Content: ms - r4 Capstone : ableism - Ultrasound grand rounds : MSK R1 Core content: multiple sclerosis WITH Dr. boggust MS is a demyelinating disease affecting young people, with females more frequently affected MS can present with a variety of neurologic symptoms. Those affecting the limbs, bladder, bowels and eyes are most common. Evaluation is most commonly with MRI of the brain and spinal cord with and without contrast after exclusion of other life-threatening conditions.

article thumbnail

ECG Pointers: A Dynamic Approach to Tachydysrhythmias Part 3

EMDocs

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.

EKG/ECG 79
article thumbnail

Physician Misinformation

Science Based Medicine

When physicians spread medical misinformation, the potential harm to health is far greater than their direct patient care. And yet, in a recent study, medical boards rarely discipline physicians for spreading misinformation. The JAMA article looked at 3128 medical board disciplinary proceedings involving physicians. Spreading misinformation to the community was the least common reason, at 0.1%.

79
article thumbnail

Buying What SELECT is Selling: Semaglutide

Sensible Medicine

I am huge of fan of the The Skeptical Cardiologist, who I will refer to as TSC. His opinions are often ones I hope I would have come to if I was thinking about the same topic. His substack and twitter feed are totally worth following. I read his post last week on Sensible Medicine and agreed with pretty much everything he said. I also was left with a different conclusion.

Stroke 87
article thumbnail

What does a final diagnosis of STEMI vs. NSTEMI depend upon?

Dr. Smith's ECG Blog

Written by Pendell Meyers, few edits by Smith A woman in her 70s was woken from sleep by midsternal chest pain radiating to left arm with nausea. EMS arrived and recorded this ECG: What do you think? Queen of hearts explainability image. Overall High confidence OMI. Smith : this is an "Active OMI". The artery is occluded at this point in time. The ECG shows sinus rhythm, normal QRS, and signs of inferoposterolateral OMI.

EKG/ECG 81
article thumbnail

emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the literature on evaluation and management of primary SBP. Episode 110: Primary Spontaneous Bacterial Peritonitis Background: End-stage liver disease with cirrhosis and ascites is a major cause of death worldwide. Primary spontaneous bacterial peritonitis (SBP) is one of the most common infections in those with cirrhosis and ascites.

article thumbnail

INTERESTING HOLTER-STRIP

ECG Guru

Sometimes you see an ECG and feel overwhelmed at first. This ECG rhythm strip is challenging at first glance. However, if you take a systematic approach to the analysis, it is usually possible to decipher the case.

EKG/ECG 78
article thumbnail

Blurred Lines: The Ethical Pitfalls of Urine Drug Screens

EM Ottawa

Urine drug (or toxicologic) screens are a fairly standard tool used in addictions, psychiatry and the Emergency Department (ED), often employed to detect substance use in patients presenting with altered mental status, trauma, psychiatric or abnormal behaviour. Yet, the reliance on these screens is fraught with inaccuracies, clinical irrelevance, and significant ethical concerns, particularly from […] The post Blurred Lines: The Ethical Pitfalls of Urine Drug Screens appeared first on EMOt

article thumbnail

MAHA and Medical Conservatism

Sensible Medicine

What does our philosophy have to do with RFK Jr and MAHA?

120
120
article thumbnail

Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. It’s 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: Large- or Small-Bore Chest Tubes for Hemothorax? Spoon Feed While there was concern for selection bias in a number of included studies, this systematic review and meta-analysis found that small–bore thoracostomy tub

COPD 79
article thumbnail

WHY IS THIS A PVC?

ECG Guru

The answer to the question is relatively simple. A PAC is usually characterized by the occurrence of a premature P wave, if it is conducted it is followed by a premature QRS complex. A PVC is usually a premature beat from the ventricles with a wide QRS komplex. Either there is no P wave before it, or it is not premature, or the P wave is hidden in the QRS complex or follows it.

72
article thumbnail

2nd degree AV block: is this Mobitz I or II? And why the varying P-P intervals?

Dr. Smith's ECG Blog

Written by Willy Frick A middle aged man presented for elective outpatient surgery. The following ECG was obtained in the preoperative area. What do you think? The ECG shows sinus rhythm with a rate of about 78 and 2:1 AV conduction along with right bundle branch block and left anterior fascicular block. The PR interval on the conducted beats is prolonged, about 220 ms.

EKG/ECG 71
article thumbnail

Low Back Pain

EB Medicine

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence Prevalence and Importance of Back Pain in the ED Differential Diagnosis and Serious Pathologies Patient Expectations and Management Strategies Missed Serious Pathologies and Their Implications Conflicting Evidence and Treatment Protocols Pathologies Causing Low Back Pain Mechanical and Infe

article thumbnail

239. Torsades & Charcuterie

Board Bombs

We're seeing a lot of "bespoke" things lately. but there's only one true bespoke cure for Torsades. Let's cover this HARD board-style question. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 239. Torsades & Charcuterie.

52
article thumbnail

ATRIAL TACHYCARDIA WITH PARTLY ABERRANT CONDUCTION

ECG Guru

This ECG comes from Germany, where unfortunately recording is still often done at 50 mm/s. Nevertheless, I believe that you can easily recognize the important changes in this ECG, even if you are not familiar with this recording format. The first two beats are the limb leads, the other beats are the precordial leads.

EKG/ECG 64
article thumbnail

Procedure: Radial Arterial Line

Life in the Fast Lane

James Miers and Daniel Gaetani Procedure: Radial Arterial Line Emergency Procedure: Radial Arterial Line, with a guide made in partnership with a recent publication in Emergency medicine Australasia

article thumbnail

Lightning Talks

Ultrasound Gel

GEL x SCUF back again! This year at the annual meeting of the Society of Clinical Ultrasound Fellowships, the GEL team interviews several up-and-coming leaders in POCUS about a variety of fascinating topics. [link] GEL x SCUF back again! This year at the annual meeting of the Society of Clinical Ultrasound Fellowships, the GEL team interviews several up-and-coming leaders in POCUS about a variety of fascinating topics.

article thumbnail

Designing the future of healthcare: Elevating patient and staff experience

NRC Health

In today's episode, Lukas Voss chats with Jennifer Baron, Chief Experience Officer at NRC Health, and Dr. Reg Blaber, EVP and Chief Clinical Officer at Virtua Health. They delve into the concept of "experiences by design" and its crucial role in healthcare. The post Designing the future of healthcare: Elevating patient and staff experience appeared first on NRC Health.

52
article thumbnail

NON CONDUCTED PAC

ECG Guru

Especially in the social media, one sees again and again similar EKGS like the one shown here with the question: What type of AV block is present here? 2nd degree AVB block type I (Wenckebach) or type II (Mobitz)? It is neither one nor the other! Here, a PAC can be seen under the blue arrow, which is not conduced because the AV node is still refractory (the refractory period of the AV node depends on the preceding heart rate).

EKG/ECG 52
article thumbnail

Much Ado About Diet and Lifestyle, for Good Reason

Clinical Correlations

By Enoch Jiang Peer Reviewed “Counseled patient on diet and lifestyle.” Over the past few weeks on my Ambulatory Care rotation, this phrase has rapidly shot to the top of my internal gestalt of a prototypical.

52