NIOSH Science Blog

NOVEMBER 8, 2023

Despite legislation and improved technology, data from Massachusetts hospitals show that sharps injuries have increased in the operating room (OR) [1]. These injuries place healthcare workers at risk of exposure to bloodborne pathogens (BBPs). There is an urgent need to renew efforts to protect healthcare workers inside the operating room. The Massachusetts data highlight a gap and the need to establish a national surveillance program that would help hospitals develop further measures to prevent

Operations 128

Operations Hospitals 128

Ken Grauer, MD

NOVEMBER 10, 2023

== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. HOW would you interpret this tracing?

EKG/ECG 443

EKG/ECG Emergency Department 443

Sensible Medicine

NOVEMBER 10, 2023

The CDC has just reported that more parents than ever are getting vaccine exemptions for their children entering Kindergarten. For many of us who have witnessed the CDC’s repeated blunders with kids COVID19 vaccines, this result is entirely predictable. The CDC has lost the trust of the American people, and it will keep getting worse. First, let me say, I warned them.

CDC 145

CDC Pediatrics Poisoning Hospitals 145

Greater Sydney Area HEMS

NOVEMBER 4, 2023

Airway Registry learning points reflect the challenges described and wisdom shared by Sydney HEMS personnel and guests at the Clinical Governance Airway Registry presentations. Cases are discussed non-contemporaneously, anonymised and amalgamated over a period of time to draw together unifying take-home messages. Details of specific cases are removed and/or changed, such that any similarity to real-life patients or scenarios is coincidental.

Burns 144

Burns Airway Management Operations Resuscitation 144

The Trauma Pro

NOVEMBER 10, 2023

My last two posts were dedicated to the use of consultants for your trauma patients. Here are my thoughts on best practices in using their services. Trauma surgeons often rely on consultants to assist in the care of their patients. Orthopedic surgeons and neurosurgeons are some of the more frequent consultants, but various other surgical and medical specialists may be needed.

Documentation/Coding 147

Documentation/Coding Best Practices 147

Ken Grauer, MD

NOVEMBER 4, 2023

You are told that the patient next door is in the regular SVT ( S upra V entricular T achycardia ) rhythm shown in Figure-1. QUESTIONS: Is the rhythm AVNRT or AVRT? Is Adenosine likely to convert this rhythm? Figure-1: How would YOU interpret this ECG? MY Thoughts on the ECG in Figure-1: When faced with a challenging cardiac arrhythmia — It is a "luxury" to have access to a long lead rhythm strip containing 3 simultaneously -recorded leads.

EKG/ECG 371

EKG/ECG Wellness 371

Sensible Medicine

NOVEMBER 7, 2023

When I first met Teppo Järvinen, it felt like I was meeting a celebrity (not like a Mick Jagger celebrity, more like a David Sackett celebrity). Teppo is the senior author on the NEJM article, Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear. For anyone interested in medical reversal, this article is up there with CAST , the WHI , and the vertebroplasty articles as landmark articles.

Fractures 131

Fractures Research Hospitals 131

Medagadget

NOVEMBER 9, 2023

A team at the University of Technology Sydney has developed an assistive technology for blind people and those with low vision. The system consists of glasses that can view their surroundings through an on-board camera, appraise the objects nearby using computer vision technology, and then play a sound that provides a cue for the wearer as to their surroundings.

Research 114

Research 114

EM Ottawa

NOVEMBER 6, 2023

Methodology: 4/5 Usefulness: 4/5 Ma L, et al. Lancet 2023 Jul 1;402(10395):27-40. Question and Methods: Do 6 month outcomes improve after implementation of a goal-directed care bundle that corrects prognostically poor physiological abnormalities (systolic hypertension, fever, hyperglycemia, abnormal anticoagulation) for acute intracranial hemorrhage?

Outcomes 106

Outcomes 106

Sensible Medicine

NOVEMBER 5, 2023

Years ago, I was late to a dinner party at a new, trendy downtown restaurant. I had been working as an attending on the bone marrow transplant service, and the day got away from me. I had to take care of a patient who had a serious adverse reaction when she received her stem cell infusion. Another patient was suffering from a catastrophic fungal infection, and graft versus host disease threatened the life of a third.

Hospitals 128

Hospitals Wellness 128

Science Based Medicine

NOVEMBER 9, 2023

There's no evidence flushing coffee into your rectum is safe or effective, despite what you may see on TikTok. The post Coffee enemas: This TikTok trend can be deadly first appeared on Science-Based Medicine.

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Medagadget

NOVEMBER 7, 2023

Researchers at North Carolina State University have developed a robotic prosthetic ankle that can provide stability for lower limb amputees. The ankle uses electromyographic sensors placed on the sites of muscles in the residual limb that then convey the intentions of the wearer with regard to movement. So far, the system has been shown to assist with postural control, which in this context refers to the many complex and unconscious movements that the muscles in our legs make to maintain balance

Research 105

Research 105

Emergency Medicine Cases

NOVEMBER 7, 2023

You diagnose uncomplicated appendicitis in the ED. The on call General Surgery team wants to wait until the next morning to perform an appendectomy. Is your patient at risk for appendiceal perforation with a delay to surgery? Dr. Rohit Mohindra and Dr. Shelley McLeod analyze the latest RCT that attempts to answer this question, the PERFECT study, on this EM Cases Journal Club.

EMS 99

EMS 99

Sensible Medicine

NOVEMBER 6, 2023

Many doctors believe that closing the left atrial appendage (with a device) will help reduce stroke and bleeding. The idea behind stroke reduction is that occluding the appendage takes away a common area where clots form. The reason for less bleeding is that patients with proper occlusion can often be taken off anticoagulant drugs. These are nice ideas.

Stroke 128

Stroke Outcomes Ultrasounds Wellness 128

ACEP Now

NOVEMBER 7, 2023

ACEP Calls Out Insurer Abuses During Surprise Billing Congressional Hearing ACEP member Seth Bleier, MD, FACEP, testified in front of the influential House Ways and Means Committee during a public hearing in October to call out insurers and advocate for fixes to the severely flawed implementation of the No Surprises Act. Dr. Bleier raised concerns that the Independent Dispute Resolution process has been virtually inaccessible for smaller practices and called out cases where physician groups were

Leadership 98

Leadership Administration Research Risk Management 98

Medagadget

NOVEMBER 9, 2023

Researchers at the National University of Singapore have developed a magneto-responsive hydrogel wound dressing that also contains two different regenerative cell types. The hydrogel is also embedded with magnetic particles that can be stimulated using an external magnetic field. The action of the magnetic field on the gel-encapsulated particles causes mechanical stresses within the gel to act on the cells, stimulating them to grow and enhancing their regenerative potential.

Research 102

Research 102

Broome Docs

NOVEMBER 8, 2023

Controversial title… courtesy of Dr Justin Morgenstern. In this podcast Justin tells me about the evidentiary basis for our modern obsession with clinical decision rules and tools. We discuss the reasons that these tools may seem like a great idea, the reality of practice and how we may be able to do better in the future. So if you have ever used a decision tool in the ED – Wells, Ottawa, PECARN, San Francisco, HEART… or any other acronym you need to stop and have a listen to u

Wellness 109

Wellness 109

Emergency Live

NOVEMBER 10, 2023

Deciphering the Language of Vomiting: A Guide for Disease Recognition in Emergencies Vomiting is the body’s response to a wide range of disorders and diseases, and is often a sign of medical emergency. Learning to decipher the language of vomiting can be critical for timely diagnosis and effective medical intervention. So let’s try to understand […] The post What Vomiting Tells Us in Urgent Medical Situations appeared first on Emergency Live.

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PulmCCM

NOVEMBER 6, 2023

Convalescent plasma for ARDS due to Covid-19 Convalescent plasma, donated by patients after recovering from Covid-19 and distributed by the Red Cross, represented one of the many ethical and policy controversies generated by the pandemic. The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation).

Operations 98

Operations Blood Transfusions Resuscitation Infectious Diseases 98

Science Based Medicine

NOVEMBER 10, 2023

Recently published CDC data has revealed an increase in the number of infant deaths in 2022, the first in two decades. The United States continues to struggle with serious healthcare disparities and to lag behind other countries when it comes to keeping young children alive. The post U.S. Infant Mortality Increases for First Time in 20 Years first appeared on Science-Based Medicine.

CDC 92

CDC 92

EMDocs

NOVEMBER 6, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. Top 10 Take Home Pearls 1. Treatment of cardiac arrest and life-threatening toxicity due to poisoning often requires specialized treatments that most clinicians do not use frequentl

Poisoning 92

Poisoning Hyperthermia / Hypothermia Seizures Administration 92

Emergency Live

NOVEMBER 10, 2023

Discover Key Hospitals in Addis Ababa for Emergency Care and First Aid Services Addis Ababa, the capital city of Ethiopia, is home to a growing population and a diverse healthcare system. First aid services play a crucial role in providing immediate medical care and initial support to individuals in need of urgent assistance. In this […] The post Which Hospitals in Addis Ababa Have a First Aid Service?

Hospitals 93

Hospitals 93

Dr. Smith's ECG Blog

NOVEMBER 5, 2023

By Magnus Nossen, edits by Grauer and Smith The patient is a 70-something female with DMII, HTN and an extensive prior history of coronary artery disease and myocardial infarctions. She's had multiple PCI procedures. She also has sick sinus syndrome (SSS) and intermittent high grade AV block for which she had a dual chamber pacemaker implanted. On the day of presentation she complained of typical chest pain, and stated it feels like prior MI.

EKG/ECG 91

EKG/ECG Wellness 91

Emergency Medicine Cases

NOVEMBER 7, 2023

Key principles and approach to management of both non-massive and massive hemoptysis with Dr. Scott Weingart and Dr. Bourke Tillmann, who answer questions such as: What are the factors to consider in the decision to intubate patients with massive hemoptysis? How can one reliably distinguish hemoptysis from pseudohemoptysis? What is the evidence for tranexamic acid in patients with hemoptysis?

Resuscitation 89

Resuscitation EMS 89

Don't Forget the Bubbles

NOVEMBER 6, 2023

Starting conversations with stories There’s something about a bookshop – a calm and comforting sense that I am surrounded by stories. The knowledge that within each beautiful book are words, illustrations, and photographs from which I can learn so much. I gently run my fingers over the front cover of a book that I know my daughter will like. Turning it over, I scan the back.

Wellness 86

Wellness 86

Emergency Live

NOVEMBER 7, 2023

Specific protections for wounded and medical personnel according to IHL standards during wars In the context of tragic theaters of war, international humanitarian law (IHL) emerges as a beacon of civilization, offering protection to the defenseless and those working to provide relief and treatment. Health facilities and units, including hospitals, according to IHL, should not […] The post Protecting Hospitals in Armed Conflict: The Directives of International Humanitarian Law appeared firs

Hospitals 91

Hospitals 91

Science Based Medicine

NOVEMBER 8, 2023

Ozone therapy sits in the border zone between science and pseudoscience. The post Ozone Therapy first appeared on Science-Based Medicine.

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100

EMDocs

NOVEMBER 7, 2023

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we discuss the controversy of antibiotics for patients with uncomplicated diverticulitis. For more on the ED evaluation of diverticulitis, please see Part 1. Episode 89: Antibiotics for Uncomplicated Diverticulitis Background: Previously antibiotics were utilized for all patients with diverticulitis.

Sepsis 86

Sepsis Best Practices Hospitals Outcomes 86

EMCrit

NOVEMBER 4, 2023

AHA Guidelines on Critical Care Toxicology EMCrit Project by Scott Weingart, MD FCCM.

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Emergency Live

NOVEMBER 7, 2023

Exploring the Cutting-Edge Medical Facilities Aboard These Lifesaving Vessels Hospital ships are a beacon of hope in times of disaster, conflict, and humanitarian crises. These seafaring medical facilities are equipped with state-of-the-art technology and skilled medical professionals ready to provide critical care and surgical interventions. In this article, we will explore some of the most […] The post Setting Sail to Save Lives: The World's Most Advanced Hospital Ships appeared fir

Hospitals 90

Hospitals 90

Medagadget

NOVEMBER 7, 2023

Charco Neurotech , a medtech company based in the United Kingdom, has developed CUE1, a non-invasive wearable that is intended to assist those with Parkinson’s disease to manage their motor symptoms. The device is typically affixed to the sternum, and provides vibratory action in a focused region of the body. The technology is based on the observation of a doctor in the early 1800s, who noticed that their patients’ motor symptoms were significantly reduced when they traveled to their appoi

Research 82

Research 82

ALiEM

NOVEMBER 6, 2023

A 55-year-old female with a history of hyperlipidemia presents after a syncopal episode. She had mild nausea and diarrhea on the morning of presentation but otherwise had no prodromal symptoms before suddenly losing consciousness in a grocery store. Of note, she recalls a similar syncopal episode in the remote past, also preceded by gastrointestinal symptoms at that time.

EKG/ECG 78

EKG/ECG Academics Outcomes Wellness 78

PDC Healthcare

NOVEMBER 9, 2023

Children’s Hospital of Philadelphia Uses Time-Expiring Visitor Badges to Improve Safety and Peace of Mind for Patients, Parents and Employees Visitor identification is vital to the security of all healthcare facilities, but perhaps the most important within children’s hospitals, where vulnerable, young patients are being cared for around the clock. We chatted with Candice Tate, […] The post How Visitor Identification Plays a Vital Role in Security at Children’s Hospitals appeared first on

Hospitals 74

Hospitals Patient Safety 74

Emergency Live

NOVEMBER 6, 2023

Emergency Response Challenged: The SFRS Condemns Attacks and Maintains Community Protection Amidst Firework Frenzy As the skies of Scotland were illuminated with the vibrant displays of Bonfire Night, a darker narrative unfolded on the ground. Firefighters, the very symbols of safety and aid, found themselves under siege, not from the flames they are trained to […] The post Bravery Under Fire: Scottish Firefighters Face Hostile Attacks on Bonfire Night appeared first on Emergency Live.

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Taming the SRU

NOVEMBER 4, 2023

Morbidity & Mortality - Global Health - MAHA - Imaging Decision Rules - BRASH - R4 Capstone Morbidity & Mortality WITH Dr. Yates Foot Infection NSTIs are rare but deadly pathology that need to be considered with any soft tissue infection NSTI is a clinical diagnosis, but there are many imaging and laboratory assessments to help increase clinical suspicion Expedited disposition to the OR for NSTIs under 12 hours from ED presentation significantly decreases mortality Emesis Transaminitis i

Hyperthermia / Hypothermia 74

Hyperthermia / Hypothermia Resuscitation Burns Emergency Department 74

Dr. Smith's ECG Blog

NOVEMBER 9, 2023

A 60-something yo female presented w/ exertional chest pain for 3 days. She had a recent positive stress test about one week ago. Pain was 8/10 and constant. She has been experiencing progressively worsening exertional dyspnea and chest tightness mostly when climbing up flights of stairs since early September. She underwent exercise echocardiogram in mid October where she exercised for nearly 7 minutes on the standard Bruce protocol and had typical anginal pain and shortness of breath.

EKG/ECG 73

EKG/ECG Wellness 73

Science Based Medicine

NOVEMBER 4, 2023

The novel serialization continues with chapter 2b. Or not 2b. Is that a question. The post Skeptics in the Pub. Cholera. Chapter 2b. first appeared on Science-Based Medicine.

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