Sat.Jun 22, 2024 - Fri.Jun 28, 2024

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ECG Blog #435 — Did Cath Show Acute Ischemia?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from a middle-aged woman with positional tachycardia and diaphoresis with change of position from suprine to sitting. Although CP ( C hest P ain ) was not a prominent symptom — ACS ( A cute C oronary S yndrome ) was suspected from the chest lead T wave inversion seen on this ECG. QUESTIONS: How would YOU interpret the ECG in Figure-1 ?

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10 Things That Will Get You Sued – Part 1

The Trauma Pro

Many trauma professionals believe that they can only be sued if they make a medical error and some harm occurs. Unfortunately, this is not entirely true. Yes, this is one obvious way to spark a suit or claim. Unfortunately, it goes beyond that. Your patient may sue you if they even believe that they were harmed in some way, or think that something untoward happened while you were providing care.

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Why is The New York Times now promoting an anti-science agenda?

Science Based Medicine

This essay stems from concerns about two editorials published in The New York Times recently. We felt that they were problematic in that the past is viewed through a blurred prism to produce revisionist history. The post Why is The New York Times now promoting an anti-science agenda? first appeared on Science-Based Medicine.

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The pediatric can’t intubate can’t oxygenate scenario (Use a knife)

First 10 EM

A can’t intubate can’t oxygenate scenario will always be scary, but after years of mental rehearsal and some real world experience, the idea of surgical front of neck access in an adult doesn’t bother me much. (I think that is an important mental space for emergency physicians to find if you want to be able […] The post The pediatric can’t intubate can’t oxygenate scenario (Use a knife) appeared first on First10EM.

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ECG Blog #436 — Bigeminy or Alternans?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from an older man with known coronary disease. He was on a number of medications — including antiplatelet agents, a statin drug and Digoxin. The patient presented to the ED ( E mergency D epartment ) for an episode of syncope. He developed cardiac arrest shortly after the ECG in Figure-1 was recorded. QUESTIONS: How would YOU interpret the ECG in Figure-1 ?

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The ETM Course Podcast is back! The Trauma Physician with Chris Bowles

ETM Course

We are excited to announce that after a hibernation period, the ETM Course podcast is back! In our first episode of the new podcast we talk to Dr Christine Bowles, Emergency Physician and Trauma Physician at St George Hospital, one of Sydney’s Major Trauma Centres. Also available on Apple Spotify YouTube iHeart Podchaser PlayerFM In this episode we talk in detail about the evolution of the “Trauma Physician” role and Emergency Physicians working on inpatient trauma services, th

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The Lab Leak Theory and the Complicit Media

Science Based Medicine

How the media's need for tales of intrigue and villains fosters the political weaponization of uncertainty The post The Lab Leak Theory and the Complicit Media first appeared on Science-Based Medicine.

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More Trending

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Spinal Immobilization: a Twisted Tale

EM Ottawa

For decades, “spinal immobilization”, or spinal motion restriction (SMR) using backboards and cervical collars has been a “cornerstone of EMS protocols, aimed at minimizing secondary spinal cord injuries during trauma patient management. Originating in the 1960s, this practice was propelled by anecdotal evidence and early case reports suggesting that un-immobilized cervical spine injuries could worsen […] The post Spinal Immobilization: a Twisted Tale appeared first on EM

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A Discussion with Professor Venk Murthy on Coronary Artery Disease

Sensible Medicine

When I type the words coronary artery disease I bet that you picture angiograms with stenotic lesions— blockages in colloquial language. Indeed a high grade plaque from atherosclerosis in the inside of a coronary artery can limit flow to the heart muscle. But. But. Not as much as you think. You know why? Because there is something called the coronary microcirculation.

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Did I Lie About My Conference Invitation? How Bad Faith Engagement Functions As A Distraction and Silencing Technique.

Science Based Medicine

It's important to honestly and explicitly call out bad faith engagement for what it is and recognize how it functions as a common, but powerful rhetorical device. The post Did I Lie About My Conference Invitation? How Bad Faith Engagement Functions As A Distraction and Silencing Technique. first appeared on Science-Based Medicine.

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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

Written by Willy Frick A man in his 50s was at home with his family when they heard a thud and rushed into the room to find him unconscious with agonal respirations. His daughter immediately started CPR and another family member called EMS. When EMS arrived the patient was in ventricular fibrillation. They shocked him twice before return of spontaneous circulation.

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EM Match Advice 44: Approaching your EM sub-internship clerkship – “Just gotta roll with it”

ALiEM

Dr. Sara Krzyzaniak (podcast host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale University Clerkship Director and 2024 CDEM Clerkship Director of the Year award winner) in this episode to discuss how one might approach their emergency medicine sub-internship. Dr. Bod shares her her wealth of experience and wisdom to provide not only general advice but also answers more detailed questions like: What are some things NOT to do on a rotatio

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JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite emergency medical services (EMS) interventions. Patients presenting […] The post JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.

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“‘Panel stacking”: John Ioannidis versus a Delphi consensus statement on COVID-19

Science Based Medicine

My former science idol John Ioannidis has published a paper citing a Delphi consensus statement on COVID-19 as evidence that the scientific community is "biased" against his anti-"lockdown" pro-virus views. His descent continues apace. The post “‘Panel stacking”: John Ioannidis versus a Delphi consensus statement on COVID-19 first appeared on Science-Based Medicine.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

Authors: Kyle Smiley, MD (EM Resident Physician, San Antonio, TX) and Brit Long, MD (@long_brit, EM Attending Physician) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital); Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

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Guidelines would (erroneously) say that this patient who was defibrillated and resuscitated does not need emergent angiography

Dr. Smith's ECG Blog

A patient had a cardiac arrest with ventricular fibrillation and was successfully defibrillated. Here was his initial ED ECG: Formal interpretation by interventional cardiologist: There is "Non-diagnostic" ST Elevation in V2-V4 and aVL. Therefore, according to ACC/AHA guidelines based on the COACT and TOMAHAWK trials, this patient should not go emergently to angiography.

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Friday Reflection 41: Sometimes I Just Need to Complain

Sensible Medicine

A 76-year-old woman presents to a community hospital after waking with garbled speech and right-sided weakness. She is admitted with suspected stroke. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber. I love my job. If I had it all to do again, there is no doubt that I would choose medicine in general and academic general internal medicine in particular, but occasionally we all have a bad week.

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Firearms as a Public Health Crisis

Science Based Medicine

The US Surgeon General, Vivek Murthy, recently put out a 40 page report titled: “Firearm Violence: A Public Health Crisis in America.” The report is entirely informational, without any policy force, but Murthy is hoping it will have the same long term cultural effect as the Surgeon General’s warning about the health risks of tobacco.

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HEMOTION – transfusion thresholds in TBI

The Bottom Line

Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury Turgeson AF. NEJM June 13 2024; doi:10.

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Podcast – May 2024 Monthly Round Up – RCEM conference highlights, being EPIC and more

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed The latest St Emlyn's monthly podcast with all the best from the blog in May 2024. The post Podcast – May 2024 Monthly Round Up – RCEM conference highlights, being EPIC and more appeared first on St.Emlyn's.

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Therapeutics: Pacing Through Skin and Vein

Taming the SRU

Cardiac Pacing, both transcutaneous and transvenous, is a critical skill of the EM physician but also can be a black box of when to trigger action and escalation, we will cover both below… When to Pace: Bradycardia AHA Bradycardia algorithm - full guidelines at [link] Bradycardia can often be seen in patients following acute myocardial infarction (MI), most commonly in inferior or anterior MIs.

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An Open Letter to Dr. Stefan Baral: Let’s Revisit Your Article “Covid Vaccines for Children Should Not Get Emergency Use Authorization.”

Science Based Medicine

"I value criticism and my collaborations are based on the ability to openly criticize other's ideas as a means of finding the 'right' answer." The post An Open Letter to Dr. Stefan Baral: Let’s Revisit Your Article “Covid Vaccines for Children Should Not Get Emergency Use Authorization.” first appeared on Science-Based Medicine.

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PulmCrit Wee: Rational selection of infusion rate based on loading dose

EMCrit

Sometimes I encounter basic pharmacokinetic questions that don't seem to be readily answered in the immediately available literature. I've found FOAMed to be a useful way to make sure I'm doing this right (e.g., see a prior discussion of the appropriate loading dose based on intermittent maintenance dosing and half-life here). Today I want to […] EMCrit Project by Josh Farkas.

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The best medical schools in the world

Emergency Live

The Most Prestigious Medical Schools Globally When choosing a university for medical studies, education quality and university reputation are crucial factors. In this article, we’ll explore some of the world’s top medical faculties, providing an overview of their distinctive features and excellence programs. North America: Harvard University (USA) Harvard Medical School, located in Boston, is […] The post The best medical schools in the world appeared first on Emergency Live.

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Instructors' Collection ECG: Hyperacute T Waves: de Winter T Waves

ECG Guru

The Patient This ECG is from a 57-year-old man complaining of sub-sternal chest pain for 30 minutes. EMS found him pale, diaphoretic, and anxious. We don't have other clinical information or past medical history. The ECG The rhythm is normal sinus rhythm at 98 bpm. The QRS is narrow, and the PR and QTc intervals are within normal limits. In precordial leads V2 through V4, ST segments begin at a J point that is below the baseline by one small block (the computer reads all precordial leads a

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

Author: Kyle Smiley, MD (EM Resident Physician / San Antonio, TX); Jon athan Henderson, MD (PEM Attending, Washington, DC) Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital); Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

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Meet Our QA Team: Behind the Scenes of Healthcare Staffing (Part 1)

Core Medical Group

At CoreMedical Group , our QA team is the backbone of your job placement journey. From finding travel nursing and therapy opportunities to getting you started in new locations, our QA experts, alongside your recruiter, ensure everything is top-notch. Whether it’s your first or fiftieth assignment , we’ve got your back with personalized service, helping with applications, licensing, housing, and even some local tips for your new destination.

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Cannabis and health: between legalization and medical use

Emergency Live

Legalization, Medical Uses, and Health Impacts: Cannabis in the Global Debate Cannabis, a plant with multifaceted aspects, is gaining global traction both in medical and recreational contexts. While some countries have embarked on full legalization, others regulate its therapeutic use, offering new perspectives and raising questions about its safety.

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FDA Advisory Committee Recommends approval of new Alzheimer’s drug Donanemab

Science Based Medicine

If approved, donanemab would be the third FDA approved disease-modifying beta-amyloid treatment for Alzheimer’s disease. The post FDA Advisory Committee Recommends approval of new Alzheimer’s drug Donanemab first appeared on Science-Based Medicine.

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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the evaluation and management of the patient with a burn injury. Episode 103: Thermal Burn Injury Initial evaluation of thermal burns Range of burn severities and types: minor sunburns to full thickness burns and severe inhalation injury. Immediate goals are addressing the airway and hemodynamic instability.

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JC: The impact of double sequential external defibrillation timing on outcomes during refractory out-of-hospital cardiac arrest

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background – What is Double Sequential External Defibrillation? Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite […] The post JC: The impact of double sequential external defibrillation timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.

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The Essential Qualities for Becoming an Ambulance Drivers

Emergency Live

Driving, Managing, Collaborating: Key Skills for Ambulance Drivers Driving Safely and Swiftly The ambulance driver is one of the crucial members of the rescue team. This professional, also known as an emergency medical technician (EMT) driver, is responsible for safely and swiftly driving the ambulance to the location where emergency assistance is needed, enabling medical […] The post The Essential Qualities for Becoming an Ambulance Drivers appeared first on Emergency Live.

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Shock Differently - Out of Hospital Cardiac Arrest

Taming the SRU

Background Out of hospital cardiac arrest (OOHCA) represents a great cause of morbidity and mortality. Approximately 350,000 cardiac arrests occur in North America annually and 20% can be attributed to Ventricular tachydysrhythmias (i.e. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse).(1,2,3) While overall survival to hospital discharge remains poor in OOHCA, approximately 10%,(2,3) patients in v fib/v tach have greater survival.(4) This higher likelihood of

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EMCrit Wee – Adaptive Support Ventilation (ASV)

EMCrit

a unique ventilatory mode unfortunately only available on Hamilton vents EMCrit Project by Scott Weingart, MD FCCM.

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JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality globally, with a survival rate of less than 10% despite emergency medical services (EMS) interventions. Patients presenting […] The post JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.

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REBEL Core Cast 125.0 – Hyperkalemia

RebelEM

Take Home Points Always obtain an EKG in patients with ESRD upon presentation Always obtain an EKG in patients with hyperkalemia as pseudohyperkalemia is the number one cause If the patient with hyperkalemia is unstable or has significant EKG changes (wide QRS, sine wave) rapidly administer calcium salts In patients who are anuric, early mobilization of dialysis resources is critical REBEL Core Cast 125.0 – Hyperkalemia Click here for Direct Download of the Podcast.

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Leaders will reveal healthcare experience innovations at HUB24

NRC Health

Jason Hahn, Chief Revenue Officer; Jennifer Baron, Chief Experience Officer; and Vinitha Ramnathan, Chief Product Officer—will discuss accelerating innovation to meet the growing demand for insights and solutions in the healthcare sector—and specifically what that means for Human Understanding now and in the future. The post Leaders will reveal healthcare experience innovations at HUB24 appeared first on NRC Health.

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