Emergency Live

JANUARY 24, 2024

A Look at Current Trends in Medical Specialization The field of medicine is constantly evolving, and with it, the need for specialization. In 2024, some medical specializations have stood out for their demand in the healthcare sector. Prominent Specializations According to data from 2023, some medical specializations filled quickly even during the initial allocation period, […] The post The most in-demand medical specialties of 2024 appeared first on Emergency Live.

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Ken Grauer, MD

JANUARY 20, 2024

I was sent the tracing shown in Figure-1 — told only that this was a preoperative ECG obtained from an asymptomatic older woman scheduled for non-cardiac surgery. How would YOU interpret this ECG? Would you approve her for surgery if the procedure was nonemergent? Figure-1: Preoperative ECG from an asymptomatic older woman scheduled for non-cardiac surgery.

EKG/ECG 231

EKG/ECG 231

The Trauma Pro

JANUARY 22, 2024

The blood pressure cuff is one of those devices trauma professionals don’t give a second thought to. Old timers like me remember using the cuff with a sphygmomanometer and stethoscope to get manual blood pressures. I’ve had to do this twice in recent months on airplanes, and I had forgotten how much work this is. But technology makes things easier for us.

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EM Ottawa

JANUARY 25, 2024

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience, this post acts as a quick […] The post Mechanical Ventilation Basics appeared first on EMOttawa Blog.

EMS 142

EMS 142

Critical Care North Hampton

JANUARY 25, 2024

Many thanks to Dr Manoj Wickramsinghe for his review of this fabulous POCUS textbook. He is a trainee in Anaesthesia and ICM, based in Leeds, and one of the CCN editorial team. About the book authors Editors; Hatem Soliman-Aboumarie, Marcelo Haertel Miglioranza, Luna Gargani, Giovanni Volpicelli. The authors and editors of this book include some.

Ultrasounds 140

Ultrasounds 140

Science Based Medicine

JANUARY 23, 2024

Many chiropractors continue to claim that vertebral subluxations can affect organ function by interfering with nerve flow in spinal nerves, a view that is scientifically indefensible. The post Chiropractic Subluxation Theory: Science or Gobbledegook? first appeared on Science-Based Medicine.

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EMCrit

JANUARY 22, 2024

background: ANTHARTIC trial Prophylaxis against VAP (ventilator associated pneumonia) has is already supported by a few studies in the literature, perhaps most notably the ANTHARTIC trial. That was a multi-center RCT evaluating 48 hours of therapy with ampicillin-sulbactam for patients intubated following cardiac arrest. Antibiotic therapy reduced early-onset VAP, with a trend towards more ventilator-free […] EMCrit Project by Josh Farkas.

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American Medical Compliance

JANUARY 25, 2024

The year 2024 marks another significant chapter in the healthcare industry’s ongoing battle against infectious diseases, and the numbers speak volumes. The CDC’s FluSurv-NET system, a sentinel network of healthcare facilities, documented over 104,000 flu-related hospitalizations across 13 states during past flu seasons. As healthcare heroes continue their unwavering service on the front lines, the spotlight remains firmly fixed on the importance of personal protective equipment (PP

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Infectious Diseases PPE CDC Documentation/Coding 111

Science Based Medicine

JANUARY 22, 2024

Wakefield redux? Antivax scientist Byram Bridle just took the "new school" antivax movement old school by implying that COVID-19 vaccines might cause an "epidemic of autism." Everything old is new again, sort of. The post “New school” antivax goes old school as Byram Bridle asks if COVID-19 vaccines will drive an “epidemic” of autism first appeared on Science-Based Medicine.

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First 10 EM

JANUARY 22, 2024

Over the last few years, I have seen a steady increase in the number of non-inferiority trials being published. This makes some sense, as they generally require fewer participants, and are therefore cheaper and easier to run. However, it presents a problem, as most of us (including myself) don’t really understand the statistics being performed, […] The post You don’t understand non-inferiority trials (and neither do I) appeared first on First10EM.

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Sensible Medicine

JANUARY 26, 2024

What happens to doctors who run unethical clinical trials? Ans: they get praised and promoted In this essay, I am going to explain to you why the recent study CONTACT-2— presented now at a cancer conference— is a problematic trial. Next, I am going to discuss why these trials persist. The reason is that the investigators are rewarded not punished.

Documentation/Coding 117

Documentation/Coding 117

EM Ottawa

JANUARY 22, 2024

Methodology: 3.5/5 Usefulness: 4/5 Friedman BW, et al. Neurology. 2023 Oct 3;101(14):e1448-e1454. Question and Methods: This double-blinded RCT of 209 patients presenting to the ED with moderate to severe migraines compared high- to low- dose dexamethasone (16 mg vs 4 mg) on sustained headache relief 48 hours post discharge. Findings: There was no significant difference in sustained […] The post Randomized Trial Comparing Low- vs High-Dose IV Dexamethasone for Patients With Moderate to

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Canadian EM

JANUARY 23, 2024

?Calling all photography enthusiasts and advocates for diverse representation in healthcare!? What it is: A first-ever CAEP photography competition designed to promote equity, representation, and inclusivity in emergency medicine education by showcasing images that reflect the diversity of healthcare providers and patients in Canada. Accepted photographs will be showcased in CAEP’s new open access Images in Emergency Medicine webpage.

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Science Based Medicine

JANUARY 24, 2024

Despite massive efforts to reduce the disease burden of malaria, it remains a significant cause of disease and death in parts of the world, most notably Sub-Saharan Africa. Now we have a new tool in the fight against malaria – two safe and effective vaccines. Cameroon is just beginning a program to give the vaccine for free to children in four doses […] The post Cameroon Begins First Malaria Vaccine Program first appeared on Science-Based Medicine.

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Emergency Medicine Cases

JANUARY 23, 2024

Olivia Ostrow on the management of button battery ingestions, Brit Long on C difficile infection, Jesse McLaren on an approach to ECG's in the tox patient, Joe Mullally on the identification and treatment of bed bug bites, Andrew Petrosoniak on fibrinogen replacement in bleeding trauma patients, Justin Morganstern on Cold Air for Croup. The post EM Quick Hits 54 Button Battery Ingestion, C. difficile, ECG in Tox, Bed Bugs, Fibrinogen in Trauma, Cold Air for Croup appeared first on Emergency Medi

EMS 100

EMS EKG/ECG Pediatrics 100

Emergency Live

JANUARY 24, 2024

From the Unification of Italy to the Modern Emergency Management System The Roots of Civil Protection The history of Civil Protection in Italy has its roots in solidarity and civic assistance. Even in post-unification Italy, emergency relief efforts were not considered a priority of the state but rather entrusted to the military and volunteer organizations. […] The post Civil Protection in Italy: a history of solidarity and innovation appeared first on Emergency Live.

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Military 91

EMDocs

JANUARY 23, 2024

Today on the emDOCs cast we cover BRASH syndrome and what you need to know regarding diagnosis and treatment. Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. Patients at risk of renal insufficiency are the primary population, as well as those on certain medications: AV nodal blockers : any of this class but specifically atenolol, nadolol, labetalol ACE-I and ARBS : increase risk of hyperkalemia and renal d

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Shock Dehydration Sepsis EKG/ECG 86

Science Based Medicine

JANUARY 20, 2024

If Dr. Adam Cifu were genuinely concerned about vaccine hesitancy, I would strongly encourage him to learn about the anti-vaccine movement. He'll discover that it is fueled not by a lack of "robust data" on COVID boosters, but rather by exactly the sort of mistrust and anti-vaccine misinformation spread by his own blog and collaborators. The post Dr.

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PulmCCM

JANUARY 22, 2024

Targeted temperature management post-cardiac arrest is no more New guidelines from the American Heart Association have effectively ended the two decade era of cooling comatose patients post-cardiac arrest. The new advisement : prevent fevers by keeping core temperature ≤37.5° C; cooling below that is optional. Read on for details. PulmCCM is not affiliated with AHA or ILCOR.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Emergency Live

JANUARY 22, 2024

The Ambulance That Transformed Military Emergencies The Origins of a Revolutionary Innovation The introduction of the Fiat Type 2 ambulance in 1911 marked a crucial transitional era in the field of military rescue. Its birth during the Libyan campaign was not only a technological advancement but also a breakthrough in the strategy of rescue in […] The post Fiat Type 2: evolution of battlefield rescue appeared first on Emergency Live.

Military 91

Military 91

Taming the SRU

JANUARY 24, 2024

Leadership curriculum: recruiting & building a team r4 Case follow-up - r3 small groups Leadership curriculum: recruiting & building a team WITH Drs. fermann and lAfollette The best leaders understand that the critical component to their success as a leader is building a great team around them This involves getting the right people involved in your organization and empowering them to do their job well Recruitment is not a one person job and should involve the entire team recruiting other

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Fractures Leadership Resuscitation Dislocations 78

Science Based Medicine

JANUARY 26, 2024

I warned you this would happen. The post Science Based Satire: The CDC’s Unyielding, Unscientific Push to Vaccinate Children Against COVID Caused a Measles Outbreak in Europe first appeared on Science-Based Medicine.

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RebelEM

JANUARY 24, 2024

Take Home Points Achilles tendon rupture is a clinical diagnosis. The Thompson Test should be applied in all suspected cases. Remember to brace or splint a rupture, even if suspected, in the resting equinus position for optimal healing and prevention of further injury. Schedule follow up with orthopedics within 1 week for discussion of operative management vs early rehab protocols.

Operations 74

Operations Ultrasounds Outcomes Fractures 74

Emergency Live

JANUARY 23, 2024

An In-Depth Look at Essential Firefighter Gear Technology and Materials in Helmet Manufacturing Firefighter helmets are designed to provide maximum protection in extreme conditions. The materials used in their construction, such as thermoplastic or fiberglass, are chosen for their ability to protect firefighters in high heat situations. Fiberglass, for example, is composed of thermosetting resins […] The post Fire department helmets: engineering and design for safety appeared first on Emer

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ALiEM

JANUARY 26, 2024

An 88-year-old female presented to the ER with a chief complaint of cough, vague abdominal pain, and a rash. The patient stated that she was started on Cipro eyedrops 1 or 2 days prior to presentation for a possible eye infection. A day prior to presentation she developed a purple purpuric rash on her lower extremities that gradually progressed up her legs, and was present on her buttocks thighs, and lower legs.

Documentation/Coding 73

Documentation/Coding Academics EMS Hospitals 73

Core Medical Group

JANUARY 23, 2024

Adina Love is a CoreMedical Group travel nurse who lives in Indiana with her husband and two kids. Once a well-paid factory worker who could predict her days down to the hour, Adina’s career took a turn when she experienced a layoff. Having been a hospice volunteer where she ultimately served for 11 years, Adina applied her compassion and commitment to patient care to the next level by diving into nursing school at age 36.

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Hospice Wellness 73

RCEM Learning

JANUARY 23, 2024

Prof. Ceri Battle, Honorary Professor in Trauma and Emergency Care and Consultant Critical Care Physiotherapist, Swansea University Applying for a grant during the second wave of a global pandemic, to complete my first multi-centre, randomised controlled trial (RCT) was never going to be my brightest idea. But I wanted to continue with my research work, improving the care of patients with blunt chest trauma.

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Research Wellness Outcomes Documentation/Coding 72

Emergency Live

JANUARY 23, 2024

A Guide to Stroke Symptoms and Actions to Take Recognizing Stroke Signs: Symptoms Not to Ignore A stroke, or cerebrovascular accident, is a serious medical condition that occurs when the blood flow to a part of the brain is interrupted or reduced, depriving the brain tissues of oxygen and nutrients. Stroke symptoms can vary depending […] The post Understanding and intervening in stroke cases appeared first on Emergency Live.

Stroke 89

Stroke 89

Dr. Smith's ECG Blog

JANUARY 25, 2024

A 40-something with severe diabetes on dialysis and with known coronary disease presented with acute crushing chest pain. Here is his ED ECG: What do you think? There is a flat and downsloping ST segment in V2 and V3. This could be due to posterior OMI. Is there an old ECG for comparison? Here is the most recent previous ECG: Indeed, there was some normal ST elevation in V2 and V3 , discordant to a relatively deep S-wave which could be due to some LVH.

EKG/ECG 71

EKG/ECG 71

EMDocs

JANUARY 25, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

Poisoning 71

Poisoning Documentation/Coding Patient Safety Hospitals 71

Emergency Medicine Journal

JANUARY 22, 2024

Objectives Sympathetic crashing acute pulmonary edema (SCAPE) is a subset of heart failure with a dramatic presentation. The unique physiology of this condition requires a different management strategy from the conventional practice. The trial objective was to compare the efficacy of high-dose and low-dose GTN in patients with SCAPE. Methods This was an open-label randomised control trial conducted in a tertiary care teaching hospital in India from 11 November 2021 to 30 November 2022.

Outcomes 75

Outcomes Hospitals 75

Emergency Live

JANUARY 20, 2024

Innovative Therapies Open New Paths in the Fight Against Diabetes Introduction: A Continuous and Innovative Battle Type 1 diabetes, a chronic autoimmune condition affecting millions of individuals worldwide, requires constant and careful management. This disease, characterized by the destruction of insulin-producing beta cells in the pancreas, imposes the need for daily insulin injections and frequent […] The post Revolutionary Advances in the Management of Type 1 Diabetes appeared first o

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The Skeptics' Guide to EM

JANUARY 20, 2024

Reference: Zaoutis T, et al. Short-course Therapy for Urinary Tract Infections in Children: the SCOUT randomized clinical trial. JAMA Pediatr. Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University […] The post SGEM #427: I Want a Treatment with a Short Course…for Pediatric Urinary Tract Infections first

Pediatrics 67

Pediatrics Anaphylaxis Emergency Department Outcomes 67

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. Fever was documented to be 102°F and was not associated with any chills or rigors. The patient also complained of shortness of breath for one week associated with a dry cough, as well as an altered sensorium for one day.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

Taming the SRU

JANUARY 26, 2024

Morbidity & MOrtality - Mini Lit Blitz - Post-Rosc Care - Qi/KT Morbidity & Mortality WITH Dr. Yates Case 1: Stroke and Stroke Mimics Early diagnosis of stroke improves stroke outcomes, where misdiagnosis is associated with an upwards of 4-time higher likelihood of mortality Missed strokes most often occur with atypical symptoms, in younger aged patients, those with posterior strokes, and those with lower NIH scores It can be difficult to discern between stroke mimics and the symptoms as

Stroke 59

Stroke EKG/ECG Outcomes Seizures 59

Emergency Live

JANUARY 22, 2024

From British Origins to Global Modernization From British Waterguard to the modern organization The history of the Coast Guard begins in the United Kingdom in 1809 with the creation of the Waterguard, a department of the British customs authority originally dedicated to preventing smuggling. This initiative was in response to the need to combat the […] The post Coast Guard: a global maritime safety story appeared first on Emergency Live.

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NRC Health

JANUARY 24, 2024

The NRC Health 2024 Pediatric Collaborative is truly a can’t-miss experience, with exceptional presentations that will stir innovative ideas. Check out a preview of the opening workshop! The post Pediatric Collab Preview: Navigating the complexities of pediatric care access appeared first on NRC Health.

Pediatrics 59

Pediatrics 59