Mount Sinai EM

NOVEMBER 14, 2022

Intro For this week’s teaching pearl, I wanted to go back and cover a medical pearl. We always hear the word “ECMO” thrown around but I want to today go into a very brief overview of what ECMO is and why it is being used more commonly. I am going to provide the pearl in a Q/A format to make it easier to process. Disclaimer : This is only a very brief overview of ECMO just so everyone at least has a basic understanding of what the technology is and what the circuit looks like.

Shock 130

Shock Wellness 130

EMCrit

NOVEMBER 18, 2022

Lumbar Puncture This seemingly simple procedure seems to be the Achilles's heel or many resus docs! If you have a good baseline knowledge of how to do the lumbar puncture correctly, it is super easy. If you have bad habits, then you will make your poor patient look like a pin cushion. EMCrit Project by Scott Weingart, MD FCCM.

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Medical Law

NOVEMBER 17, 2022

The power of nature is amazing. It’s hard to believe that a plant could be strong enough to damage a concrete sidewalk, but we see it happening all the time. Over time, steadily growing tree roots can extend underneath a sidewalk. As the roots grow and expand, they will eventually disrupt the surface of the sidewalk. This creates substantially uneven surfaces that may cause pedestrians to fall and be seriously injured.

Head Injuries 52

Head Injuries Fractures 52

RebelEM

NOVEMBER 16, 2022

Take Home Points Methemoglobinemia can result from exposure to a number of different medications. The most common are dapsone and topical anesthetic agents (i.e. benzocaine) Consider the diagnosis in any patient with cyanosis and hypoxia that doesn’t respond to oxygen administration Administer methylene blue to any patient with abnormal vital signs, metabolic acidosis, end organ dysfunction or, a serum level > 25% REBEL Core Cast 90.0 – Methemoglobinemia Click here for Direct Download

Seizures 52

Seizures Administration Airway Management COPD 52

Mount Sinai EM

NOVEMBER 14, 2022

Intro Raise your hand if you ever struggled obtaining a CSF sample from a Lumbar Puncture. I “virtually” see that most if not all of you at one point in your career struggled with this. This pearl is inspired by an overnight Elmhurst A-side shift I had several months ago with a patient requiring a Lumbar Puncture. I waved off my senior/attending and told them “No worries, I got this.

Ultrasounds 130

Ultrasounds Wellness 130

American Medical Compliance

NOVEMBER 16, 2022

Healthcare worker violence is increasing at an alarming rate, making providers’ jobs of looking after patients incredibly challenging. The pandemic has largely fueled this increase in violence. The uptick in healthcare worker violence has been substantial and affects all types of care providers. Of registered nurses, 44% reported being victims of physical violence, while 68% suffered verbal abuse while on the job.

Hospitals 52

Hospitals 52

EM SIM Cases

NOVEMBER 15, 2022

This case comes from Major Alex Koo. Since leaving the military, Dr. Koo works as an Emergency Physician and Assistant Professor of Emergency Medicine at MedStar Health and Georgetown University. He previously served as Deputy Medical Director at Andersen Simulation Center, the largest simulation center in the US Army as well as the Simulation Director for Madigan Army Medical Center’s Department of Emergency Medicine Residency.

COPD 52

COPD Military Emergency Department EMS 52

Board Bombs

NOVEMBER 13, 2022

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. What lurks beneath? Scary, scary infections. Time to change the way you think about Nec/Fas! Sobering stats, key pitfalls, but some really great learning points on this episode. Cite this podcast as: Briggs, Blake.

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Dr. Smith's ECG Blog

NOVEMBER 13, 2022

Written by Emre Aslanger. Emre is a new Editor of the Blog. He is an interventionalist in Turkey. A 50 something-year-old man with a history of newly diagnosed hypertension and diabetes, for which he did not take any medication, presented a non-PCI-capable center with a vague, but central chest pain. His vitals were normal and his first ECG was as shown below: There is obvious ST segment elevation (STE) in anterior leads.

EKG/ECG 52

EKG/ECG Burns Documentation/Coding Hospitals 52

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Date: November 10th, 2022 Reference: de-Madaria E et al. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). NEJM 2022. Guest Skeptic: Dr. Salim R. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

EMergucate

NOVEMBER 15, 2022

The following ECG was obtained from an independent 78 year old woman at 11pm who complained of left sided shooting jaw ache that had commenced earlier that morning.

EKG/ECG 52

EKG/ECG EMS 52

CasesBlog

NOVEMBER 18, 2022

Several studies have explore the effects of religious changes, such as OM, on physiological parameters such as heart rate, blood pressure and heat rate variability (HRV). Overall, the effects were considered beneficial. For example, a brief chanting of OM (5 min) might enhance parasympathetic nervous system activity, promote relaxation, and provide calmness.

Research 40

Research 40

JournalFeed

NOVEMBER 12, 2022

The JournalFeed podcast for the week of Nov 7-11, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Cranial EZ-IO Spoon Feed The EZ-IO may be considered as a temporizing measure for trepanation of an epidural hematoma (EDH) in rural ED settings.

Seizures 40

Seizures 40

University of Maryland Department of Emergency Med

NOVEMBER 17, 2022

This small study looked at patients with penetrating neck injuries and tried to determine in those with "hard signs" of injury (hemorrhage, ex.

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EMergucate

NOVEMBER 15, 2022

The following CT abdomen axial slice is from a 55 year old with sudden onset of left loin pain. CT was done to rule out a ureteric stone. What can be seen?

EMS 52

EMS 52

EM SIM Cases

NOVEMBER 12, 2022

This case as written by Drs. Stephen Jensen, Brandon Bowdoin, and Kristen Whitworth as well as Spring Lutzen. Stephen Jensen is a third-year emergency medicine resident at Spectrum Health Lakeland. He is completing a longitudinal track in Medical Education during his residency with a focus in simulation and curriculum development. Brandon Bowdoin is the Chief Resident at Spectrum Health Lakeland.

Resuscitation 40

Resuscitation Stroke EKG/ECG Fractures 40

EMergucate

NOVEMBER 15, 2022

The most obvious abnormality is ST segment elevation in lead aVR with diffuse ST depression in most other leads (least … Continue reading →

EKG/ECG 40

EKG/ECG 40

University of Maryland Department of Emergency Med

NOVEMBER 17, 2022

Research in the pediatric trauma patient has finally shown that crystalloid volume should be limited and blood products should be used ea.

Pediatrics 40

Pediatrics Research 40

University of Maryland Department of Emergency Med

NOVEMBER 14, 2022

This was a cross-sectional survey for the Diversity-Related Research Committee of the Women in Critical Care (WICC) Interest Group of.

Wellness 40

Wellness Research 40

EMergucate

NOVEMBER 14, 2022

Answers: Question 1: PH = 7.344, that is mild acidaemia. HCO3 = 18.4 mmol/L (less than 24).

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EMergucate

NOVEMBER 14, 2022

85 years old lady with history of COPD, brought to ED with low GCS after VF cardiac arrest followed by return of spontaneous circulation after 3 minutes of CPR and a single DC shock.

COPD 40

COPD CPR Shock 40