Sat.Apr 01, 2023 - Fri.Apr 07, 2023

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TB in the ED

Mount Sinai EM

Tuberculosis in the ED Patient presents to Elmhurst ED with cough, hemoptysis, night sweats and fatigue – quick, what’s the first diagnosis that comes to mind? This is the classic presentation for tuberculosis. But several times now I have been surprised by less typical symptoms of TB. So I thought it might be helpful to review how TB might present in the ED, especially since some estimates say that ⅓ of the world’s population is infected.

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Sickle Cell Disease and Stroke

Pediatric EM Morsels

There are many conditions that we would like to think belong only to the “ adult patient problem DDx; ” however, as we have discussed several times previously, pediatric patients can experience many “adult conditions” (see, Aortic Dissection , Kidney Stones , and Cholecystitis ). Those conditions usually have a substantial risk factor and one of the most risky of risk factors is Sickle Cell Disease !

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PulmCrit Blogitorial – Why we will never know how to manage stress hyperglycemia

EMCrit

(Blogitorials are short, informal blogs that are written in the spirit of a tweetorial). Stress hyperglycemia is an everyday occurence in the ICU, but we hardly know how to treat it. I've been waiting years for this topic to be clarified… but I've realized that such clarity will probably never be reached. Why? The traditional […] EMCrit Project by Josh Farkas.

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REBEL Core Cast 99.0 – Bundle Branch Blocks

RebelEM

REBEL Core Cast 99.0 – Bundle Branch Blocks Click here for Direct Download of the Podcast Cardiac Conduction System (LITFL) Definition: Interruption of the normal conduction system leading to aberrant conduction and an abnormal QRS morphology Anatomy: At the AV node, conduction splits into the right and left bundle branches. The left bundle branch is composed of anterior and posterior branches.

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Asthma and Redlining

Mount Sinai EM

“Take a deep breath and hold it. Now without exhaling, try to breathe in again.” We were in the cardiac room, discussing a young man that had died a few hours before we came onto our shift. He had been brought in after he was found in the subway with albuterol inhalers all around him. And Dr. Cherkas, in his infinite wisdom, was helping me understand what it’d be like to have an asthma exacerbation.

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Patient ID Performance You Can Rely On

PDC Healthcare

PDC Thermal Wristbands are Lab Tested to Perform in Demanding Healthcare Environment Healthcare providers are constantly evaluating patient safety standards to improve methods to reduce medical errors. Identification plays an important role here, specifically with the use of barcode technology to ensure a patient is receiving the correct care at the correct time.

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EMCrit RACC Lit Review for March 2023

EMCrit

RACC Lit Review for March 2023 EMCrit Project by Scott Weingart, MD FCCM.

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More Trending

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National Dog Bite Prevention Week Is in April

Medical Law

There are over 85 million dogs kept as pets in this country. Dogs provide their owners with love and companionship, and they’re a wonderful addition to many households. It’s important to remember that dogs are animals that may react violently in certain situations. But there are several things we can do to help prevent dogs from biting people. That’s why April 9 through April 15 has been declared National Dog Bite Prevention Week.

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Are Hypertrophic Cardiomyopathy Exercise Restrictions Necessary?

AED Leader

At the 36th Bethesda Conference in 2005, a panel of cardiology experts developed guidelines restricting exercise for people with hypertrophic cardiomyopathy with the aim of reducing sudden cardiac death. Now, more recent evidence indicates that these restrictions probably didn’t reduce death rates and may have caused secondary problems associated with inactivity.

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Nursing Diploma Fraud

American Medical Compliance

In January 2023, federal investigators convicted twenty-five people in Miami as part of a scheme to get counterfeit nursing school degrees and find jobs for aspiring nurses. Associated Charges According to recently unsealed federal grand jury charges, the defendants were involved in a scam that involved the sale of more than 7,600 counterfeit nursing degree credentials from three Florida-based nursing programs.

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2023 Pediatric Experience Perspective details insights, trends, and strategies for healthcare organizations

NRC Health

2023 Pediatric Experience Perspective details new data, trends, and strategies for healthcare organizations. The post 2023 Pediatric Experience Perspective details insights, trends, and strategies for healthcare organizations appeared first on NRC Health.

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Ultrasound of the Month: Severe Hydronephrosis in a patient with Horseshoe Kidney

Taming the SRU

THE CASE An elderly female patient presents to the emergency department (ED) with 1 week of generalized weakness leading to numerous falls. She denies any fevers, abdominal pain, nausea, or vomiting. She has a history of previous episodes of nephrolithiasis, frequent urinary tract infections, and states she takes gabapentin for overactive bladder. She denies any current dysuria or hematuria.

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Defining “High-Quality” When it Comes to Your Patient ID Bands

PDC Healthcare

PDC Thermal Wristbands are Lab Tested to Perform in Demanding Healthcare Environment Healthcare providers are constantly evaluating patient safety standards to improve methods to reduce medical errors. Identification plays an important role here, specifically with the use of barcode technology to ensure a patient is receiving the correct care at the correct time.

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Instructors' Collection ECG: Acute Anterior M.I. and Ventricular Fibrillation

ECG Guru

The Patient: This series of ECGs is from a 65-year-old woman who was complaining of a sudden onset of chest pain, nausea, and weakness. She stated that the pain increased on inspiration. She reported a history of non-insulin-dependent diabetes mellitus (NIDDM). ECG No. 1, 14:46: This ECG includes V4Right, V8 and V9 in place of V4, V5, and V6.

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70-year-old with acute chest pain, STEMI negative: just an old infarct?

Dr. Smith's ECG Blog

Submitted by Dr. Dennis Cho (@DennisCho), written by Jesse McLaren A 70-year-old with no cardiac history presented with 2 hours of chest pain radiating to the neck, associated with shortness of breath. What do you think? There’s normal sinus rhythm, first-degree AV block, normal axis and voltages. R wave progression is abnormal: there are Q waves in aVL/V2-3 and loss of R wave in V2.

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CCEDRRN Infographic: Patient-reported health outcomes of SARS-CoV-2

Canadian EM

Although some COVID-19 survivors report persistent symptoms months after resolution of the acute infection, we do not know much about their long-term physical and psychological health outcomes. We sought to understand which patient factors are associated with poor patient-reported health outcomes to inform the development and prioritization of health interventions to improve the health of COVID-19 survivors.​1​ We used data from 22 CCEDRRN EDs across 5 provinces between March 2020 to July 2021.

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Human Understanding Beyond | HUB23 Preview: “Elevating Experience”

NRC Health

At HUB23, you’ll find expanded, dynamic programming focused on bringing impact to your organization. The post Human Understanding Beyond | HUB23 Preview: “Elevating Experience” appeared first on NRC Health.

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171. Cerebral Venous Thrombosis: Sneaky Strokes

Board Bombs

What if we told you there was a type of stroke that affected young people, caused more seizures than "typical arterial strokes", and the typical ED imaging does not diagnose it. Scared yet? You should be. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com.

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MOC and the Demise of CME

Dr. Wes

With the ongoing forcing of participation in Maintenance of Certification (MOC) of US physicians by the American Board of Medical Specialties (ABMS)and its 24 member boards, we are seeing the slow demise of physician-selected Continuing Medical Education (CME) in America. Attendance at specialty society meetings is at an all-time low.

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Yes Flu, No Abx | Robot Assisted Reductions

JournalFeed

The JournalFeed podcast for the week of March 27-30, 2023. 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. Yes Flu, No Abx Spoon Feed Patients at two separate urgent care locations—one with rapid influenza diagnostic testing (RIDT) and one without—were compared on several parameters.

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Comms Lab: SCARF

Life in the Fast Lane

Hayden Richards Comms Lab: SCARF Comms Lab 46: SCARF: The Greatest Communication Tool You've Never Heard Of.? A brained based model for understanding and managing conflict.

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Imaging Case of the Week 546 Answer

EMergucate

The pelvic X-ray shows. Ischial tuberosity avulsion fracture on the left side. This is due to hamstring pull.

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The OMI Quizzes

Dr. Smith's ECG Blog

There are 4 quizzes here on OMI ECG diagnosis: Beginner Novice Intermediate Advanced The first link on the page is to an ECG guide as a primer on OMI ECG diagnosis. These quizzes were written by Gregory Yates (an "FY 2 doctor" in the UK), Maddy Kahle (who is just finishing her 4th year of medical school at the U of MN), and aided by Romi Lee (another U of MN med student).

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Top 10 Coffee and Cases Snippets from April 2023

Greater Sydney Area HEMS

In infants, a blood pressure cuff can be used as an effective pelvic splint. Post-RSI sedation in paediatrics is cognitively challenging. Take the time to sense-check the dosing strategy you are using. The NETS calculator might be a useful resource if you are looking for one…but get familiar prior to using it on a job. Suspension trauma leads to orthostatic cardiac arrest – lots of case reports of patients dying after climbing accidents where they are suspended, but without apparent

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Mastering Intensive Care 078 with Chris Nickson

Life in the Fast Lane

Andrew Davies Mastering Intensive Care 078 with Chris Nickson Modern & innovative clinician education.

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Imaging Case of the Week 547

EMergucate

The following chest x-ray is from a critically unwell patient. What can be seen? Answer will be posted later.

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Grand Rounds Recap 3.29.23

Taming the SRU

Resuscitative hysterotomy - brash syndrome - R4 Capstone - HIV Screening in the ED R3 Taming the sru: resuscitative hysterotomy w/ Dr. stark Indications: Maternal cardiac arrest > 20 weeks (at or above umbilicus) Ideally, perform within 4 minutes of arrest One study showed that this may be able to be extended to 10 minutes Increases maternal cardiac output by 30% No studies have proven improved maternal survival Procedure: Incision from umbilicus to pubic symphysis Expose the uterus and retr

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What Immunity Do Breast Milk Antibodies Confer?

Pediatric Education

Patient Presentation A 6-month-old male came to clinic for his health supervision visit. He had been relatively well except for one ear infection and two upper respiratory infections since starting childcare. His mother was concerned about also giving influenza and COVID vaccines in addition to his regular vaccines. The pertinent physical exam showed a healthy, smiling infant with growth parameters at the 10% for height and 50% for weight and head circumference.

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Intranasal Dexmedetomidine Use in Pediatric Patients for Anxiolysis in the Emergency Department

University of Maryland Department of Emergency Med

Background: Intranasal dexmedetomidine has seen usage in the anesthesia and sedation realms over the past few years, with an increasing interest in usage in t.

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Imaging Case of the Week 545 Answer

EMergucate

The chest X-ray shows. Right upper lobe collapse.

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Clinical Governance Day – Wed 12 Apr 2023

Greater Sydney Area HEMS

Visit the post for more.

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Wound Care at Home

Pediatric Emergency Playbook

[link]

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Steroids in Severe CAP

University of Maryland Department of Emergency Med

Background: The use of steroids in pneumonia has long been controversial with conflicting data, and the recent ESCAPe randomized controll.

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Lab case 401 interpretation

EMergucate

Answers: Question 1: pH 7.62 that is moderate to severe alkalaemia HCO3 36mmol/L, so we have metabolic alkalosis.

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ECG Blog #372 — PVCs or Aberrant?

Ken Grauer, MD

I was asked for my interpretation of this tracing. No history was provided. How would YOU interpret this long lead II rhythm strip? Are the different-looking beats PVCs or supraventricular impulses conducted with aberration? — or — Something else? Figure-1: The long lead II rhythm strip for today’s case. No history was available. ( To improve visualization — I've digitized the original ECG using PMcardio ).

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RBBB and LAFB. Is it trifascicular block? The complexities of Wenckebach, with Ken Grauer analysis.

Dr. Smith's ECG Blog

This patient presented with complications of his dialysis fistula. Medical history: History of Ischemic Heart Disease History of Congestive Heart Failure Diabetes Mellitus requiring treatment with insulin Pre-operative serum creatinine >2 mg/dL He had this ECG recorded: What do you think? There is AV 2nd degree AV Block (Mobitz I, Wenckebach) with RBBB and LAFB The physicians recognized the RBBB and LAFB, but not the Wenckebach.

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Treatment of lower back pain without opioids

University of Maryland Department of Emergency Med

Acute lower back pain is a very common emergency department presenting complaint. Over the last several years there has been impetus to.