Sat.Mar 11, 2023 - Fri.Mar 17, 2023

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Snake Bites and Children

Pediatric EM Morsels

There are lots of animals that bite. Since we all inhabit the same beautiful world , and sometimes we humans overtake previous habitats of animals, we inevitably will cross paths with an animal that bites us. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ). Sometimes they bite because that’s how they feed (ie, mosquitoes Eastern Equine Encephalitis ).

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Critical Steps Your Workplace Can Take Today to Prevent Suicide

NIOSH Science Blog

Employers can play a vital role in suicide prevention. Historically, suicide, mental health, and well-being have been underrepresented in workplace health and safety efforts, but this is changing. In some European countries, there are workplace standards for workplace psychosocial hazards that put workers at risk for suicide. Additionally, in France, employers have been made accountable for toxic workplaces and management practices that contributed to worker suicides.[1] Some of the latest workp

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EMCrit Wee – A New Form of ED Critical Care for Rural Environments – EMSTAT with Eric Klotz

EMCrit

A new format of ED Critical Care perfectly suited to rural environments EMCrit Project by Scott Weingart, MD FCCM.

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HIPAA and the letter excusing a return to the workplace

Total Medical ComplianceHIPAA

With the pandemic drawing to a close in May , many employers are requiring their workers to return to the physical workplace. Patients that are afraid that their medical situation makes that return too risky at this time are requesting a letter from the doctor preventing that return. If the doctor believes this to be valid, they generate the letter.

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A woman in her 50s with chest pain and dyspnea

Dr. Smith's ECG Blog

Submitted by anonymous, written by Pendell Meyers A woman in her 50s presented to the Emergency Department with chest pain and shortness of breath that woke her from sleep, with diaphoresis. She had a prior history of "NSTEMI" one month ago, during which she had a coronary angiogram reportedly showing no stenosis in any coronary artery. Her vitals were within normal limits.

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Are an Irregular Heartbeat and GI Problems Related?

AED Leader

Many people experience heart palpitations after eating certain foods or a heavy meal, and for some, the co-occurrence of an irregular heartbeat and gastrointestinal problems is even more pronounced. But if your heart pounds, races, does flip flops, or appears to miss beats, how do you know if you have a structural heart disease or Read More "Are an Irregular Heartbeat and GI Problems Related?

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Diagnostic Error | MDI for Croup

JournalFeed

The JournalFeed podcast for the week of March 6-10, 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. Diagnostic Error Spoon Feed Diagnostic errors in the ED occur at rates similar to those in other clinical settings. Not all errors have human causes, and not all are inevitable – this article suggests systems-level opportunities for improvement.

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Human Understanding Beyond | HUB23 preview: Compelling presentations planned for Executive Track sessions

NRC Health

NRC Health's 29th annual conference, Human Understanding Beyond | HUB23, is set to take place August 9–11, 2023, in Boston. The post Human Understanding Beyond | HUB23 preview: Compelling presentations planned for Executive Track sessions appeared first on NRC Health.

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Diagnostics: The Shunt Series

Taming the SRU

Introduction Hydrocephalus is an accumulation of cerebrospinal fluid (CSF) in the cerebral ventricular system secondary to a mismatch between CSF production and resorption. Excessive production of CSF is rare and occurs with choroid plexus papillomas or other tumors. Impaired drainage or resorption of CSF is a far more common cause of hydrocephalus and can occur due to congenital malformations, tumors, trauma, or infection.

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Getting Started in General Practice

Mind The Bleep

Many FY2 doctors spend time in General Practice as part of the Foundation Programme. It is a valuable experience even for those who do not intend to pursue GP as a career. This article offers advice on what to expect during the post and some suggestions on where to look for help when you need it. If you are a GP ST1 or ST2 preparing to start a General Practice placement, much of the following will also apply to you.

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What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

This middle-aged patient has a remote history of cardiac surgery as a young child for a "heart murmur". Her Apple Watch suddenly told her that she is in atrial fibrillation. She did notice something slightly wrong subjectively, but had no palpitations, chest pain, or SOB, or any other symptom. Exam was completely normal except for an irregular heart rate.

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The Fierce Reflux Cascade by GPT4

33 Charts

In the caverns of our bellies, a tempest brews, A fiery storm, a fierce cascade, acid reflux ensues. With burning rage, it surges forth, a churning tide, A searing pain, a bitter plight, we cannot hide. The tender walls of esophagus, its armor frail, Beneath the onslaught of the beast, it quakes and flails. A burning pyre, a molten flood, our throats besiege, In silent prayer, we seek reprieve, a moment’s peace.

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Ep 180 Acetaminophen Poisoning – Pitfalls in Assessment and Management

Emergency Medicine Cases

In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes?

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Rapid Cycle Deliberate Practice

EM SIM Cases

This primer on Rapid Cycle Deliberate Practice was written by academic pediatric emergency medicine specialist and simulation guru Dr. Quang Ngo. He is a staff physian at McMaster Children’s Hospital, scholar with the McMaster Education Research, Innovation and Theory (MERIT) program and Founding Program Director for the Pediatric Emergency Medicine subspecialty residency program.

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When futuristic innovations meet empathy and Human Understanding

NRC Health

Author, inventor, and entrepreneur Paul Coyne shares his perspective on nursing collaboration and technology innovation in the latest episode of NRC Health’s Patient No Longer podcast. The post When futuristic innovations meet empathy and Human Understanding appeared first on NRC Health.

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Diaphragmatic Dysfunction

Ultrasound Gel

Can looking at the diaphragm with ultrasound help us understand a patient's respiratory status? This is one of the first papers to look at this question in an emergency department population. [link] [link] Can looking at the diaphragm with ultrasound help us understand a patient's respiratory status? This is one of the first papers to look at this question in an emergency department population.

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Suture: Laceration Repair App

Life in the Fast Lane

Hugo Thomas and Mike Cadogan Suture: Laceration Repair App Ever needed a helping hand with suturing? Suture: Laceration Repair App is a fantastic, simple and effective app created by emergency physician Tom Fadial with videos from Brian Lin of closing the gap.

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Tasty Morsels of Critical Care 070 | CRRT Modes

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Today we’re covering the ambitious topic of CRRT in the ICU. Something that occupies a central part of the daily job, but also occupies Oh Chapter 48, Irwin and Rippe chapter 201 and a few other review papers thrown in for good measure. We’re only going to get so far as the modes today so let’s not get too carried away.

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Severe Chest Pain on ED Arrival, after Wellens' waves Seen on Prehospital ECG

Dr. Smith's ECG Blog

A 40-something woman called 911 in the middle of the night for Chest pain that was intermittent. On arrival, she complained of severe pain. The medics had recorded this ECG and were uncertain whether it was recorded during chest pain: Let's get a better image with use of the PM Cardio app : What do you think? There is deep T-wave inversion in proximal LAD territory (V2-V4, I, aVL) that is all but diagnostic of Wellens'.

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How can you overcome diuretic resistance in patients with heart failure - Clinical Correlations

Clinical Correlations

By Joshua Novack, MD Peer Reviewed Case: 74 year old male with a history of heart failure with reduced ejection fraction (EF 20%) diagnosed 10 years ago comes in with subacute progressive lower extremity edema, orthopnea,

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169. Swallowed a truckload of cocaine?

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Don’t you hate it when that happens? Cocaine Bear may teach you a few life lessons about this, but we’re going to tell you in this sneak peek Rapid Bomb how to suspect and diagnose these patients.

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Dozens of Defendants Charged with Healthcare Fraud

American Medical Compliance

The United States Department of Justice charged 36 defendants for healthcare fraud that amounted to over $1 Billion. The fraudulent actions included telemedicine, cancer and cardiovascular testing, and fraudulent durable medical equipment. The individuals charged ranged in positions from medical company executives to medical professionals. Many of these individuals targeted elderly patients who receive Medicare benefits.

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My 'Medical Conservative' Talk in San Diego

Stop and Think

This post remains free to all readers. But thanks to all that have chosen to support my work. I am surprised and grateful. JMM This week I traveled to San Diego to give cardiology rounds at the UCSD. Most ‘cardiology rounds’ come from famous professors who speak about a specific area in cardiology. Mine was different. I was not teaching any one thing.

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SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking

The Skeptics' Guide to EM

Date: March 8, 2023 Reference: Smida et al. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital Emergency Care 2023 Guest Skeptic: Dr. Chris Root is a third-year resident physician in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM. […] The post SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking f

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Imaging Case of the Week 543 Answer

EMergucate

The elbow x-ray shows Small irregular densities suggestive of avulsion fractures posterior to the elbow associated with soft tissue swelling.

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Grand Rounds Recap 3.8.23

Taming the SRU

Ultrasound Guided Nerve Blocks in the ED - CPC w/ Dr. Harward - Pediatric Simulation: Seizure Ultrasound guided nerve blocks in the ed WITH Dr. Arun Nagdev Visit [link] for in depth discussion of each block with accompanying ultrasound and anatomy images Best practices for pain management in the ED Active Non-siloed Should be available 24/7 Multimodal Blocks, ketamine, NSAIDs, APAP Goal is not 100% resolution with blocks, 50% is success with multi-modal treatment Ketamine assisted blocks: 25mg k

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Stable, Wide-Complex Tachyarrhythmia: Should you even consider SVT with Aberrancy?

Kings County Downstate EM

Co-authors: Paul Lavadera and Esteban Davila Peer Editor: Alec Feuerbach Faculty Editor: Mark Silverberg The Case A 65-year-old male with a history of hypertension, hyperlipidemia, diabetes, hypertrophic cardiomyopathy, recent stroke, and atrial fibrillation (AF) (+anticoagulation) presented to the ED for syncope. EMS noted a wide-complex tachycardia.

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Thoracic trauma as a predictor of 30 day mortality

University of Maryland Department of Emergency Med

This study from Sweden looked at 2397 trauma patients and identified 768 with thoracic injury. Those with thoracic injury had a 30-day mortal.

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shoulder dystocia sim report

EMergucate

The case: 33 year old primip with shoulder dystocia and subsequent PPH, neonate requiring resuscitation initially by attending pediatrician.

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ECG Blog #368 — Why So Fast?

Ken Grauer, MD

I start today’s case with the ECG shown in Figure-1 — obtained from a 30-something year old man, who presented with palpitations. How would YOU interpret the ECG in Figure-1 ? Treatment? What is unusual about this arrhythmia? = NOTE: The ECG in Figure-1 has been recorded at the usual 25mm/second speed — but with the Cabrera format ( Please see my Editorial Note near the top of the page in ECG Blog #365 for review of the basics of this recording system ). = Figure-1: The initial ECG in today’s ca

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Prehospital Traumatic Cardiac Arrest: A Systematic Review and Meta-analysis

RebelEM

Background : Traumatic cardiac arrest in the prehospital setting carries an extremely high mortality rate. Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the gold standards of trauma care in and out of the hospital and are effectively the criterion by which we measure outcomes in the trauma literature.

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Is croup caused by COVID more severe compared to other etiologies?

University of Maryland Department of Emergency Med

Patients with croup often present with a "barky" cough, stridor, and trouble breathing, traditionally worse at night. The mains.

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Imaging Case of the Week 544 Answer

EMergucate

The chest x-ray shows an incidental finding of Azygous lobe.

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