The Trauma Pro
JUNE 9, 2023
Diaphragm injury from blunt trauma is uncommon, occurring in only a few percent of patients after high-energy mechanisms. They usually occur on the left side and are more frequently seen after t-bone type car crashes and in pedestrians struck by a car. Blunt diaphragm injury on the right side is very unusual. Even so, it is more easily detected due to obvious displacement of the liver that can be seen on chest x-ray.
Pediatric EM Morsels
JUNE 9, 2023
When we think of severe hemorrhage in children, we typically think about trauma. Maybe injuries to the spleen or kidney come to mind. Perhaps thoughts of pelvic injuries or severe head injury dominate our considerations. Of course, we all have a healthy respect for post-tonsillectomy hemorrhage and we like to talk about Damage Control Resuscitation.
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Science Based Medicine
JUNE 4, 2023
My critics lack the courage to accurately quote me. That tells you everything about them and nothing about me. The post Dr. Jay Bhattacharya Responds to Words I Never Said first appeared on Science-Based Medicine.
Medagadget
JUNE 6, 2023
Researchers at the University of California San Diego have created a wearable ultrasound system that can monitor deep tissues, as far as 16.5 cm (6.5 inches) below the surface of the body. Moreover, the team employed a machine learning algorithm to reduce the noise associated with movement, helping to obtain reliable readings while the wearer goes about their day.
The Trauma Pro
JUNE 6, 2023
In today’s post, I will review the diaphragmatic injury practice guidelines published by the Eastern Association for the Surgery of Trauma (EAST). I will follow this up on Friday with an interesting delayed diaphragm injury case. Diaphragm injury is a troublesome one to diagnose. It is essentially an elliptical sheet of muscle that is doubly curved, so it does not lend itself well to diagnosis by axial imaging.
Emergency Live
JUNE 8, 2023
The skin of the abdomen is divided into 9 regions, called abdominals: 3 median (epigastrium, peri-umbilical region and hypogastrium) and 3 lateral (hypochondrium, flank and iliac fossa) The post Abdominal regions: semeiotics, anatomy and contained organs appeared first on Emergency Live.
Science Based Medicine
JUNE 7, 2023
Monoclonal antibodies are the medical scientific breakthrough you may never have heard of. The post The Monoclonal Antibody Revolution first appeared on Science-Based Medicine.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
ALiEM
JUNE 5, 2023
Which of the following is the most likely explanation for this skin lesion in a worker handling sheep hides? Bacillus anthracis Group A streptococcus Pseudomonas aeruginosa Staphylococcus aureus (Photo credit: CDC/ James H. Steele, Public domain via Wikimedia Commons) Reveal the Answer Answer: 1. Bacillus anthracis This patient has cutaneous anthrax.
Emergency Live
JUNE 9, 2023
Cardiac tones are short, transient acoustic events, produced by the opening and closing of valves; they are divided into systolic and diastolic tones The post Semeiotics of the heart and cardiac tone: the 4 cardiac tones and the added tones appeared first on Emergency Live.
Medagadget
JUNE 8, 2023
The iLet Bionic Pancreas for use by type 1 diabetes patients has been cleared by the FDA and is now available commercially. The device is offered by Beta Bionics , a medtech company based in Massachusetts and California, but the underlying technology originally developed by researchers at Boston University. The system can be paired with a Bluetooth glucose monitor to deliver personalized insulin dosing every five minutes, and calculates doses based on past and current glucose levels and its expe
Science Based Medicine
JUNE 9, 2023
The surge in viral infections last year appears to be to blame for a significant increase in cases of brain abscesses in children. They remain rare, and panic is not warranted, but they are a life-threatening complication of common bacterial infections that should be taken seriously. The post A Perhaps Not-So-Unexpected Spike in Pediatric Brain Abscesses first appeared on Science-Based Medicine.
EM Ottawa
JUNE 5, 2023
Methodology: 4.5/5 Usefulness: 5/5 Beno S, al. CJEM. 2022 Aug;24(5):535-543. Editorial: Reducing overuse of CT imaging in pediatric trauma: a model example of the Model for Improvement. Question and Methods: The aim of this QI project was to reduce unnecessary CT abdomen on pediatric trauma activations who were identified as being low risk of IAI.
Emergency Live
JUNE 8, 2023
If it is the patient's first time performing an electrocardiogram (ECG), the rescuer, doctor, or nurse should explain to the patient - in words appropriate to his/her level of understanding - the steps and usefulness of the electrocardiogram The post Electrocardiogram: initial procedures, ECG electrode placement and some tips appeared first on Emergency Live.
PHARM
JUNE 3, 2023
Photo by Karolina Grabowska on Pexels.com This recent Northern Territory coroners inquest report into the death of a young woman from a pulmonary embolism during hospital care for acute mental health condition highlights the risks of sedation and restraint. She had risk factors for thrombosis and was subjected to multiple episodes of chemical and mechanical restraint leading up to a final admission to Alice Springs Hospital ICU where she was intubated and anaesthetised for aeromedical transfer t
Science Based Medicine
JUNE 5, 2023
Tech bro turned COVID-19 misinformation superspreader and antivaxxer has now fully embraced "old school" vaccine-autism conspiracy theories, demonstrating how anti-COVID-19 vaccine antivaxxers frequently become just antivaxxers. The post Steve Kirsch: How “anti-COVID-19 vaccine” antivax often becomes radicalized and just plain antivaccine first appeared on Science-Based Medicine.
ACEP Now
JUNE 6, 2023
When considering an optimized environment for compassionate patient communication, the chaotic emergency department (ED) probably gives some clinicians pause. EDs, filled with alarms, frequent interruptions, hurried paramedics and consultants, hallway beds, and the looming sense that clinicians are out of time, is rarely thought of as a place for empathetic communication.
Emergency Live
JUNE 8, 2023
Let's talk about hip replacement, and specifically the anterior access approach: in general, this procedure relieves pain and restores mobility in people whose joints have been damaged by trauma or degenerative diseases such as hip arthrosis The post Anterior access hip replacement: an overview of advantages and disadvantages appeared first on Emergency Live.
EM Ottawa
JUNE 8, 2023
Preamble: This Grand Rounds was inspired in part by a conversation I had with Dr. Andrew Petrosoniak during my time at St. Michael’s Hospital where we discussed the growing concern of excessive ED wait times and the limited concerted effort on addressing the waiting experience itself. In this blogpost, we will explore the concept of […] The post Psychology and Science of Waiting appeared first on EMOttawa Blog.
PulmCCM
JUNE 5, 2023
Corticosteroids for community-acquired pneumonia have been studied with inconclusive results, and expert guidelines currently advise against their use except in patients with refractory septic shock. Only a few trials have tested the utility of steroids for pneumonia in ICU patients; one of the largest and most recent ones enrolling 586 patients at U.S. veterans’ hospitals did not show a mortality reduction from low-dose methylprednisolone.
Emergency Medicine Cases
JUNE 6, 2023
In this ECG Cases blog we look at 10 patients with shortness of breath, and discuss how the ECG can be used to help diagnose cardiac, respiratory and metabolic emergencies. We discover that for STEMI/OMI vs subendocardial ischemia, we should look for STEMI(-)OMI, subacute OMI, and OMI in the presence of LBBB and RBBB, and consider the differential for diffuse ST depression with reciprocal ST elevation in aVR.
Emergency Live
JUNE 6, 2023
Dissection, or dissection, of the aorta is a cause of acute chest pain; it is uncommon but represents severe severity with regard to the clinical picture The post Chest pain: when can it be aortic dissection (or dissection)? appeared first on Emergency Live.
Sensible Medicine
JUNE 5, 2023
Editors note: The writer—me—inverted results of one of the trials used as an example. This post now contains the proper results. Thanks to an astute reader. The NEJM published this month a study on an important medical question that may upend the way we use medical evidence. This has nothing to do with the specific medical question. It has everything to do with how we interpret the results.
Medagadget
JUNE 8, 2023
Engineers at the University of Colorado at Boulder have developed a medical microrobot that is powered by acoustic waves. The tiny devices, which are 20 micrometers wide and considerably smaller than the width of a human hair, can move incredibly fast for their size, achieving a speed of 3 millimeters per second. To put this in context, if a microrobot and a cheetah the same size had a race, the microrobot would win comfortably.
ACEP Now
JUNE 6, 2023
A 50-year-old female develops chest pain radiating to the neck and left arm. ECG, CXR, and troponin are negative. She is given morphine for pain. Four hours later she develops back pain and bilateral leg paresthesias. CT angiography shows aortic dissection which is treated surgically, but she is left with paraplegia. Notoriously elusive, with a high misdiagnosis rate, thoracic aortic dissection (AD) can mimic many conditions, including acute coronary syndrome (ACS, the most common), gastroesopha
Emergency Live
JUNE 7, 2023
Acute abdomen (in English "acute abdomen") is a clinical picture with sudden and violent onset, characterized by very intense pain that appears in the abdomen in a specific or widespread point The post Acute abdomen: causes, symptoms, diagnosis, exploratory laparotomy, therapies appeared first on Emergency Live.
Science Based Medicine
JUNE 8, 2023
Artificial Intelligence can't make pseudoscience real The post Homeopathy + AI = Still Nonsense first appeared on Science-Based Medicine.
RebelEM
JUNE 7, 2023
Take Home Points Caustics are substances that injure tissue upon physical contact. Caustic potential is not purely a function of pH. The decision to admit is dependent on the history and physical. Vomiting, drooling, and stridor are concerning. Stridor alone or 2/3 symptoms should warrant admission and gastroenterology consultation for potential endoscopy.
EMDocs
JUNE 7, 2023
Authors: Daniel Escobar, MD (Emergency Physician, Mercy Hospital Northwest Arkansas, Rogers, Arkansas); Ann-Jeannette Geib, MD (Emergency Medicine Attending; Medical Toxicologist, Carolinas Medical Center, Charlotte, NC) // Reviewed by: James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case: A 22-year-old female presents to the Emergency Department (ED) in respirat
Emergency Live
JUNE 9, 2023
Unlike astigmatism, nearsightedness, and farsightedness, presbyopia is not a refractive error. Instead, it is a physiological reduction of the accommodative amplitude and, therefore, of the maximum level of accommodation that an eye corrected for any refractive errors can produce with voluntary effort The post Visual defects, let's talk about presbyopia appeared first on Emergency Live.
PDC Healthcare
JUNE 8, 2023
In March of 2023, the U.S. Food and Drug Administration (FDA) published updates to their mammography regulations to facilitate better reporting of information and an improved experience for patients. The announcement means change is imminent for many healthcare providers, who will need to adjust policies and make updates to equipment to be compliant.
Emergency Medicine Cases
JUNE 6, 2023
On this month's EM Quick HIts podcast: Anand Swaminathan on EVT for large vessel occlusion strokes, Sarah Reid on picking up intussusception, Andrew Petrosoniak on 5 Penetrating Trauma Tips, Peter Toth on using a slit lamp to manage skin foreign body hack, Nour Khatib and Jonathan Wallace on CT Radiation Risk and Matt Poyner on setting up an emergency fund.
ACEP Now
JUNE 7, 2023
If you’re wondering about the hype with chatbots in medicine, perhaps it’s because they’re nothing new: the first medical chatbot, after all, was developed back in 1964. Using a simple pattern-matching and reflection script entitled DOCTOR, the ELIZA program simulated a Rogerian psychotherapist. Even this basic initial experiment evoked unique responses from those interacting with the software, and a new field of human-computer interaction was born.
Emergency Live
JUNE 8, 2023
The Rovsing maneuver is a maneuver used in medical semiotics to investigate the presence of abdominal pain The post Maneuver and positive or negative Rovsing sign: what are they and what do they indicate? appeared first on Emergency Live.
Medagadget
JUNE 6, 2023
Engineers at Ecole Polytechnique Fédérale de Lausanne (EPFL) in Switzerland have developed a new technology that can provide temperature feedback for amputees using a prosthetic limb. Excitingly, the device makes it feel as if the temperature sensation is experienced in the phantom limb, providing a realistic experience of touching something cold or hot with the missing limb.
University of Maryland Department of Emergency Med
JUNE 4, 2023
Pt presents to the emergency department with knee pain. You decide to ultrasound the proximal knee. You place your ultrasound probe.
EMDocs
JUNE 8, 2023
Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles. This week we cover the EXTEND trial looking at thrombolysis up to 9 hours after stroke onset. Author: Christiaan van Nispen, MD (Resident, Emergency Medicine Physician, San Antonio, TX); B rannon Inman, MD (Chief Resident, Emergency Medicine Physician, San Antonio, TX) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Thrombolysis Guided by Perfusion Imaging up
Emergency Live
JUNE 9, 2023
Coronary angioplasty is the procedure by which an obstructed blood vessel is dilated using a balloon placed where the problem arises; it is inflated to recreate the space needed for blood to flow The post Heart disease: what are coronary angioplasty, stents and bypasses appeared first on Emergency Live.
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