Sat.Apr 27, 2024 - Fri.May 03, 2024

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Preperitoneal Packing Vs Angioembolization: Part 3

The Trauma Pro

In the previous post in this series, I described an early review article summarizing several older studies comparing these two hemorrhage control techniques for pelvic fractures. Today, I’ll review another paper fresh off the press, published just this month. This paper comes from the orthopedics and neurosurgical groups at the University of Texas-San Antonio.

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Ketamine in the ED - An Interview with Reuben Strayer, MD

EB Medicine

In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Reuben J. Strayer, MD, author of the May 2024 Emergency Medicine Practice article, Current Concepts in Ketamine Therapy in the Emergency Department Diving Into Ketamine Use in Emergency Medicine Understanding Ketamine: From Origins to Emergency Use Exploring the Ketamine Brain Continuum Ketamine Dosing and Administration Techniques Combining Ketamine with Neuroleptic Medications Practical Approaches to Ketamine for Pain Management In

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Once a Doctor Has Minimized Literal Death for Young People, Should We Value Their Opinion on Any Topic Less Consequential Than Literal Death?

Science Based Medicine

Is potential death worse than real death? The post Once a Doctor Has Minimized Literal Death for Young People, Should We Value Their Opinion on Any Topic Less Consequential Than Literal Death? first appeared on Science-Based Medicine.

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A Discussion with Dr. Dena Zeraatkar regarding analytic flexibility in observational studies

Sensible Medicine

Gosh was this a great conversation about her recent paper on specification curve analysis of nutritional observational studies. Here is Dr. Zeraatkar’s bio: Dena Zeraatkar, PhD is an Assistant Professor in the Departments of Anesthesia and Health Research Methods, Evidence, and Impact (HEI) at McMaster University. She earned her doctoral degree at McMaster University in the Health Research Methodology graduate program.

Research 112
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Preperitoneal Packing Vs Angioembolization: Part 2

The Trauma Pro

In my last post, I reviewed an early paper on preperitoneal packing (PPP). Today, I’ll look at an earlier review article summarizing some smaller studies comparing it to angioembolization. In the next post, I’ll look at a brand new paper that includes a cost analysis as well. Interestingly, the use of AE and PPP vary geographically. Angioembolization has been a mainstay in the US for some time, and PPP has been more commonly used in Europe.

Radiology 147
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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line. If you are not familiar with this term, it’s the act of rapidly trying to place a central line (usually femoral), placing the needle for access over strict sterile pr

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Woke Washing the Pandemic: If You Really Were Progressive, You’d Want Them Infected

Science Based Medicine

Genuine concern is consistent concern. The post Woke Washing the Pandemic: If You Really Were Progressive, You’d Want Them Infected first appeared on Science-Based Medicine.

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GCS 8 obviously doesn’t mean intubate (in tox or otherwise)

First 10 EM

Although it made a bit of a splash when published, this article really didn’t interest me. Obviously, GCS 8 doesn’t mean intubate. I didn’t think anyone was simplistic enough to practice medicine based on a jingle. Clearly trajectory matters. If a patient’s GCS hit 8 and they are on a clinical course where you expect […] The post GCS 8 obviously doesn’t mean intubate (in tox or otherwise) appeared first on First10EM.

EMS 100
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The History and Decline of the Fire Pole

Emergency Live

From time-saving innovation to safety risk, the evolution of the fire pole in Fire Departments Origins and Function of the Fire Pole The firefighter’s pole, technically termed the “fire pole“, is a tool associated with the profession and was invented in 1878 by David Kenyon in Chicago to help Firefighters reach emergencies more quickly.

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Tonics, Tinctures and Toxicology: Naturopathy

EM Ottawa

In the pursuit of holistic health and wellness, individuals often turn to naturopathy as a beacon of alternative medicine, seeking relief and healing outside the realm of conventional treatments. Yet, amidst the allure of natural remedies and lifestyle adjustments, there is a concerning degree of possible iatrogenic harm. This post seeks to address the use […] The post Tonics, Tinctures and Toxicology: Naturopathy appeared first on EMOttawa Blog.

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We finally learn from TACT2 what we should have known two decades ago: Chelation therapy doesn’t work for heart disease

Science Based Medicine

At SBM, we've long argued that chelation therapy for heart disease is quackery. An abstract presented recently finally confirmed that. Why did it take so long? The post We finally learn from TACT2 what we should have known two decades ago: Chelation therapy doesn’t work for heart disease first appeared on Science-Based Medicine.

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SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?

The Skeptics' Guide to EM

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. February 2024. Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community College paramedic program.

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In Dubai, one of the world's largest ambulances

Emergency Live

An innovation in the medical field that transforms emergency response and healthcare When we think of ambulances, the classic van-shaped vehicle typically comes to mind. However, there’s one much larger, the size of a bus. It’s the world’s largest ambulance, a groundbreaking project in the field of emergency healthcare, developed and deployed by the Dubai […] The post In Dubai, one of the world's largest ambulances appeared first on Emergency Live.

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What is the rhythm?

Dr. Smith's ECG Blog

A patient was found down approximately 30 minutes after taking methamphetamine. Bystander CPR. Medics found patient in PEA arrest. He was resuscitated into a perfusing rhythm. He went in and out of arrest until arrival at the ED. Here is the only prehospital 12-lead: Sinus tachycardia, somewhat wide QRS, Ischemia Here is the first ED ECG: What is the rhythm here?

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Kava and Liver Damage

Science Based Medicine

Kava is an herbal supplement used mainly for its calming psychoactive effects. It is a traditional drink in Oceania that has been used for centuries. It has also been linked to liver toxicity and cases of liver failure and even death. However, the liver toxicity of kava is extremely controversial – this controversy, however, reflects the various narratives that we see surrounding […] The post Kava and Liver Damage first appeared on Science-Based Medicine.

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First10EM Journal Club: May 2024

Broome Docs

Another month and another batch of fascinating papers from the Morgenstern vaults. This month is heavy on dermatology for some reason… but still plenty of EBM, Crit care and laughs. Join Justin and I for a sold 80 minutes of nerdy evidence-based ED care. As always, the free PDF version of each of the papers discussed is linked below – so you can check it out for yourself.

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Erythrocyte sedimentation rate (ESR): A fundamental test

Emergency Live

Exploring the Importance of ESR in Diagnosing Inflammatory Conditions What is ESR? The erythrocyte sedimentation rate (ESR) test is a blood test. It detects inflammation in the body. It checks the rate at which red blood cells fall in a tube filled with blood over an hour. The test is nonspecific, but it tells us […] The post Erythrocyte sedimentation rate (ESR): A fundamental test appeared first on Emergency Live.

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Tasty Morsels of Critical Care 079 | Hyponatraemia – management

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Last time i was butchering my way through a diagnostic approach to hyponatraemia, particularly the forms likely to end up in the critical care end of the hospital. This time we’ll take a punt at how you might approach management. In an ideal world of course you would have all of the diagnostic tests back and you’ve been able to make a very solid diagnosis of the cause of hyponatraemia and you would institute a bespoke treatm

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The First10EM monthly wrap-up for April 2024

First 10 EM

The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the format means the focus is mostly on content I have found, but I hope […] The post The First10EM monthly wrap-up for April 2024 appeared first on First10EM.

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Improving Your Critical Appraisal Skills #4

Sensible Medicine

If RCTs are the most useful study design, and articles about case control studies are my favorite to read, the use and interpretation of diagnostic tests and the articles that define test characteristics are my favorite to think about, talk about, and teach. I think this is because diagnosis is so core to what a general internist brings to health care.

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The Mysterious World of Viruses

Emergency Live

Let’s discover what viruses are and how they impact life on Earth What is a Virus? A virus is a small infectious agent. It can only grow inside living cells of organisms like animals, plants, and bacteria. Although they are small, viruses are everywhere on our planet. They are the most abundant biological entities. Viruses […] The post The Mysterious World of Viruses appeared first on Emergency Live.

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Shifting the Paradigm: Macro to Micro – Grand Rounds for Lennox Hill, April 2024. #FOAMed

Thinking Critical Care

Had the honour of being invited to give grand rounds by Dr. Paul Mayo and share some thoughts on fluid tolerance and venous congestion. Starts around the 17min mark – sorry I have no editing capabilities!

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Exploring AI and tech to enhance the patient experience

NRC Health

As the healthcare industry engages more with AI and technological solutions, measuring whether it advances Human Understanding, the gold standard for patient experience care, is imperative. The post Exploring AI and tech to enhance the patient experience appeared first on NRC Health.

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SVT in infants

Don't Forget the Bubbles

Carly is a 9-month-old who was brought in by her parents because she had been unsettled and not feeding well for a day. At triage, she has a pulse of 277 and is brought straight to resus. What happens in a normal heart? The sino-atrial ( SA ) node is the pacemaker of the heart. It is situated in the right atrium and generates an electrical impulse that conducts through the whole heart and causes it to contract.

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Sarcomas: Rare and Complex Cancer

Emergency Live

An in-depth look at sarcomas, rare tumors that arise from connective tissues What is Sarcoma? Sarcoma is a highly dangerous type of tumor. It originates from the body’s connective tissues such as muscles, bones, nerves, fatty tissues, blood vessels, and fibrous tissue can be starting points. There are over 70 variants of sarcomas. They are […] The post Sarcomas: Rare and Complex Cancer appeared first on Emergency Live.

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The Importance of Travel AEDs for Ensuring Safety on the Go

AED Leader

In today’s fast-paced world, travel has become integral to our lives. Whether for business or leisure, more people are constantly on the move, exploring new destinations and experiencing different cultures. However, amidst the excitement and adventure, it’s crucial to prioritize safety, especially in medical emergencies. That’s where Travel AEDs (Automated External Defibrillators) come into play.

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Bougies to increase first-pass intubation success

PulmCCM

Bougies (flexible tracheal tube introducers) are commonly used to facilitate endotracheal intubation, especially when the vocal cords and glottis are poorly seen. Their effectiveness and benefits may seem obvious to airway experts, but there has been limited evidence to support their use or best define the situations in which bougies are most helpful. von Hellmann et al conducted a meta-analysis of 18 studies, including 12 randomized trials testing the use of bougies in emergent (9 studies, 8,07

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Getting Ready for a Safe Pregnancy: A Checklist

Ziqitza HealthCare Ltd

Starting a family can be a daunting process. The long pregnancy journey can be life changing and exciting at the same time. However, before you conceive, you must remember to keep your health in check. The health of the mother is crucial for the conception and growth of the fetus. Through proper pre pregnancy planning, you can make sure that your health and the health of your future baby are in a good place.

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Allison for Firefighter Training in Germany

Emergency Live

Baden-Württemberg State Firefighters School Acquires Atego with Allison Fully Automatic Transmission for Training Fleet The Landesfeuerwehrschule Baden-Württemberg, the state firefighter training center, has procured six new rescue firefighting vehicles on a Mercedes Atego chassis for fire department manager driver training. All six vehicles, equipped with Allison 3000 Series™ fully automatic transmissions, entered service in October […] The post Allison for Firefighter Training in Germany

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The Importance of Having the Best AED for Churches: How to Ensure Safety and Be Prepared for Emergencies

AED Leader

In today’s world, every public space must prioritize safety and be prepared for emergencies. Churches, being places where large gatherings occur, are no exception. Having the best Automated External Defibrillator (AED) in a church can significantly save lives during cardiac emergencies. In this article, we will explore the importance of having the best AED for churches and provide essential guidelines on ensuring safety and being prepared for emergencies.

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Corticosteroids for ischemic stroke (MARVEL trial)

PulmCCM

While outcomes from acute ischemic stroke due to large vessel occlusion in the anterior circulation have improved substantially in the era of thrombolytics and mechanical thrombectomy, overall outcomes remain poor. Studies in animal models have suggested corticosteroids might reduce infarct size or extension of subsequent cerebral edema. When tested previously, steroids failed to show any improvement in outcomes after ischemic stroke, resulting in papers with confident titles like “Steroid

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Recognizing Fatty Liver: Signs and Treatment Options

Ziqitza HealthCare Ltd

With busier lives and changing lifestyles, health can take a backseat. Consumption of an unhealthy diet, especially fast food, a sedentary lifestyle from a desk job, stress, smoking, and alcohol consumption all contribute to a condition called fatty liver disease. The liver is the biggest organ in the human body, responsible for blood filtering, detoxification, and energy storage and regulation.

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Italian Red Cross: open fundraiser for Tanzania

Emergency Live

Italian Red Cross, Tanzania emergency: 10,000 families affected. Valastro: “The emergency is spreading. CRI team on the ground. Fundraising campaign open” The incessant rains of the past weeks and the resulting floods have caused the death of 58 people in Tanzania. Seven regions are currently submerged in an emergency that affects 10,000 families, totaling around […] The post Italian Red Cross: open fundraiser for Tanzania appeared first on Emergency Live.

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Things to Consider When Purchasing a Refurbished AED Defibrillator

AED Leader

Consider several vital factors before purchasing if you’re in the market for a refurbished AED defibrillator. AEDs (Automated External Defibrillators) are life-saving devices that can be used to treat sudden cardiac arrest, a condition that affects millions of people worldwide. Having a refurbished AED on hand can ensure that you are prepared to respond quickly and effectively in a cardiac emergency.

CPR 52
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Candida auris: What to know

PulmCCM

Candida auris is a multi-drug resistant fungus discovered in 2009 in Japan. The fungus spread across Asia, the Mideast, and Africa before arriving in the U.S. in 2015. Since 2018, C. auris cases have required reporting to public health officials, allowing more effective tracking. Although there were only 5,000 total recorded cases in 28 US states as of 2022, the rate of increase in C. auris cases has been accelerating.

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Tents.

Maria Yang, MD

A tent in the woods is a symbol of defiance. Whether among towering trees, on a rocky beach, or next to an icy lake, it is a marker of someone intruding upon the natural world. Even if the tent and its occupants leave no trace, the tent itself is a trace, a brightly colored sign of someone who is passing through and does not naturally belong there. A tent on a cracked sidewalk, underneath a concrete bridge, or tucked into the corner of a parking lot is a symbol of resignation.

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Piero's Diary - The Advanced Medical Posts (AMPs)

Emergency Live

The Adaptability of Advanced Medical Posts (AMPs) in the Emergency Medical Plan: An Anticipation of the Modern Out-of-Hospital Medical Rescue System Having solved the problem of medical responders, about 280 (doctors, nurses, rescue volunteers, military stretcher bearers, radio operators) and the 18 ambulances, it was necessary to identify places to collect patients and give them […] The post Piero's Diary - The Advanced Medical Posts (AMPs) appeared first on Emergency Live.