Sat.Jul 20, 2024 - Fri.Jul 26, 2024

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Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

We have discussed many causes of encephalitis and encephalopathy previously (ex, Eastern Equine Encephalitis , Posterior Reversible Encephalopathy , FIRES , Reye’s Syndrome ) and have highlighted the fact that they can be challenging to diagnose early. An irritated brain can lead to such a wide array of symptoms. It is even more challenging when the initial symptoms seem to align with what we perceive as psychiatric concerns.

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What Is: A Hinge Fracture Of The Skull?

The Trauma Pro

Although very few things in medicine are new, I love it when I learn about something I’ve never heard of before. Recently, while reading an autopsy report, I ran across the term “hinge fracture of the skull.” What? Maybe if I were a neurosurgeon, I would have recognized the term. This was the perfect excuse to hit the books (or, more accurately, the internet).

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Money in Medical Education Makes Me Sad

Sensible Medicine

I call it therapeutic fashion. Practice patterns. Beliefs. Ways of doing things. Examples: patients with new heart failure get coronary angiography; patients with chest pain without evidence of heart attack get stress tests; certain drugs and devices become favored over generics. The curious thing about many therapeutic fashions is their lack of evidentiary support.

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Resuscitated from ventricular fibrillation. Should the cath lab be activated?

Dr. Smith's ECG Blog

This patient was witnessed by bystanders to collapse. They started CPR. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% sodium bicarbonate.

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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JC: Evaluation of Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background As I think I have mentioned before, I spend some of my time as a major trauma consultant on the major trauma ward (MTW). You may be shocked to […] The post JC: Evaluation of Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study appeared first on St.Emlyn's.

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Mastering Minor Care: Knee Arthrocentesis

Taming the SRU

INDICATIONS Arthrocentesis is a common procedure performed in the Emergency Department, in which a needle is inserted into a joint to withdraw fluid from the joint capsule. This procedure may be performed for diagnostic and/or therapeutic purposes [1]. Diagnostic arthrocentesis is often performed to distinguish between septic arthritis and other common causes of acute monoarthritis including hemarthrosis, crystal arthropathies (gout, psedogout), and autoimmune arthropathies (SLE, RA, etc.) [2].

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A prehospital ECG in a patient with chest pain. The paramedics tell me it is normal.

Dr. Smith's ECG Blog

I was working at triage when the medics brought this patient who is 65 yo and has had chest pain for 12 hours. They recorded a prehospital ECG at 2112 and said that it was “normal”. It had already been crumpled up and put in the waste basket. So I uncrumpled it: What do you think? You need to click on it to enlarge it to view it well I was suspicious for inferior and posterior OMI (Large T-wave in aVF, slight STE in lead III with inverted T-wave in aVL, and a slightly downsloping ST with negativ

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Podcast – Positive and Negative Predictive Values: Critical Appraisal Nugget

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Welcome back to another instalment of our Critical Appraisal Nugget series with Rick Body and Greg Yates here at St Emlyn’s. In our previous podcast, we delved into the concepts […] The post Podcast – Positive and Negative Predictive Values: Critical Appraisal Nugget appeared first on St.Emlyn's.

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Sniffing out Sepsis - Vibes vs Scoring Systems?

Taming the SRU

Knack SKS, Scott N, Driver BE, et al. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world.

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Risks of naloxone: a local service evaluation

Emergency Medicine Journal

Naloxone is a potent opioid receptor antagonist that reliably reverses life-threatening respiratory depression in opioid overdose but can precipitate severe withdrawal in opioid-dependent individuals. 1 Guidelines recommend naloxone specifically for respiratory depression and not for reduced level of consciousness alone, with lower doses recommended in patients who may be opioid-dependent. 2 3 The extent to which such guidelines are applied in practice has received little attention.

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Posterior Reversible Encephalopathy Syndrome (PRES)

Northwestern EM Blog

Written by : Jilan Shimberg, MD (NUEM ‘26) Edited by : Michael Tandlich, MD (NUEM ‘24) Expert Commentary by : Matthew B Maas, MD MS Expert Commentary Posterior Reversible Encephalopathy Syndrome (PRES) is a potentially catastrophic but frequently overlooked diagnosis. It often coexists in a pathophysiological spectrum with Reversible Cerebral Vasoconstriction Syndrome (RCVS).

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Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background I spend some of my time as a major trauma consultant on the major trauma ward (MTW). You may be shocked to hear that an Emergency Medicine doctor such […] The post Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study appeared first on St.Emlyn's.

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Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Does Stress Ulcer Prophylaxis with a PPI Work? Spoon Feed An international, multi-center RCT found that administering pantoprazole to intubated ICU patients lowered the rate of upper GI bleeding compared to placebo.

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Meet Our QA Team: Behind the Scenes of Healthcare Staffing (Part 2)

Core Medical Group

At CoreMedical Group , our QA team is the backbone of your job placement journey. From finding travel nursing and therapy opportunities to getting you started in new locations, our QA experts, alongside your recruiter, ensure everything is top-notch. Whether it’s your first or fifteenth assignment , we’ve got your back with personalized service, helping with applications, licensing, housing, and even some local tips for your new destination.

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PVCs and their relationship to P waves, some examples

ECG Guru

In order to differentiate supraventricular extrasystoles/tachycardias with aberrant conduction from ventricular extrasystoles/tachycardias, the search for P waves is often very important. Here are some examples of how the P waves can be positioned around the ventricular extrasystoles.

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The REBEL Lit Distillery at ResusX

RebelEM

Do you know what the latest evidence in critical care/resuscitation? If this question makes you uncomfortable or you just don’t have time to keep up with the literature, you should sign up for the REBEL Lit Distillery at the ResusX Conference in Philly. Let us help you keep up to date. -Workshop: Sept 17 th , 2024 -Location: Philadelphia, PA -20 to 25 Critical Care/Resuscitation Papers Reviewed -Direct Link: [link] The post The REBEL Lit Distillery at ResusX appeared first on REBEL EM - Emergen

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A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI Detection

Critical Care Now

Reading Time: 3 minutes Article Herman R, Meyers HP, Smith SW, et al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit Health. 2023;5(2):123-133. Published 2023 Nov 28. PMID: 38505483 Cath lab activation based on ST-elevation myocardial infarction (STEMI) criteria relies on outdated data and needs modernization.

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Novel Airway Training Tool that Simulates Vomiting: Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) System – PMC

PHARM

Novel Airway Training Tool that Simulates Vomiting: Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) System – PMC — Read on www.ncbi.nlm.nih.

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Complete Right Bundle Branch Block With AV Block and More

ECG Guru

This is the ECG of a 50-year-old man with a congenital heart defect (we do not have exact details). To interpret an ECG with several different abnormalities, you have to proceed systematically. You can see my comments in the second picture. Perhaps Dawn would like to add something?

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The Retirement of Dr. Mark Siegler

Sensible Medicine

I once had a section chief who was fond of telling me to “make it count twice.” If I was doing work for one part of my job, she suggested that I try to use it for something else. If I worked hard on a lecture for our students, maybe I could turn it into a paper or a workshop to give at a meeting. If research into a patient’s problem raised some interesting questions, maybe I could try to answer these questions as part of a research project.

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The Rise of Telemedicine: A Comprehensive Guide for Patients and Providers

Ziqitza HealthCare Ltd

A key component of modern healthcare, telemedicine utilizes technology to make medical services accessible despite many barriers and challenges. Telemedicine services make it easier for people to access medical services and treatment and get essential and timely healthcare. Telemedicine is making different medical services available to people virtually.

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Suction Assisted Laryngoscopy and Airway Decontamination (SALAD): A technique for improved emergency airway management – PMC

PHARM

Suction Assisted Laryngoscopy and Airway Decontamination (SALAD): A technique for improved emergency airway management – PMC — Read on www.ncbi.nlm.nih.

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CRBBB and AVB and more

ECG Guru

This is the ECG of a 50-year-old man with a congenital heart defect (we do not have exact details). To interpret an ECG with several different abnormalities, you have to proceed systematically. You can see my comments in the second picture. Perhaps Dawn would like to add something?

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Clinical Governance Day – Wed 31st Jul

Greater Sydney Area HEMS

Visit the post for more.

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ACEP Now Wins APEX Award for Writing Excellence

ACEP Now

ACEP Now has received an APEX Award of Excellence for writing for “Space Medicine: Emergency Physicians Voyage Into the Final Frontier ” (July 2023). You can read the award-winning article. The annual APEX Awards are given by Communication Concepts to recognize excellence in writing, digital content, graphic design, social media, public relations, and marketing.

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The suction-assisted laryngoscopy assisted decontamination technique toward successful intubation during massive vomiting simulation – PMC

PHARM

The suction-assisted laryngoscopy assisted decontamination technique toward successful intubation during massive vomiting simulation – PMC — Read on www.ncbi.nlm.nih.

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ECG Podcasts on 12-Lead & Arrhythmias — Pearls, Pitfalls, OMI & AI and Lots More

Dr. Smith's ECG Blog

I recently recorded a series of 4 podcasts regarding KEY concepts in ECG interpretation. Easy LINK — [link] — My New E CG P odcasts ( 5/28/2024 ): These podcasts are part of the Mayo Clinic Cardiovascular CME Podcasts Series ( "Making Waves" ) — hosted by Dr. Anthony Kashou. They are found on the Mayo Clinic Cardiovasciular CME site. You can adjust the speed of the recording ( If the speed is "slow" for you — increasing to 1.25 speed should be optimal for you!

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HiQuiPs: Dashboards Demystified Part 2 – Designing Your Dashboard

Canadian EM

Your meeting with hospital stakeholders on designing a dashboard to better care for COVID-19 patients who are experiencing homelessness was a resounding success. Everyone was engaged and helped craft a problem statement, KPIs, and OKRs that you then presented to your hospital IT team. Luckily, IT has the bandwidth available to support developing this dashboard—but they need your help through the process.

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Imaging Case of the Week 598

EMergucate

The following chest x-ray is from a child with cough & fever. What can be seen?

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230. PE & Pregnancy

Board Bombs

PE workup? Sure. Oh by the way they're pregnant.yep. Let's discuss how this is workup needs to be simplified and not feared. Also, say goodbye to VQ scans. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 230. PE and Pregnancy.

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Information Blocking Rule Final Disincentives for Healthcare Providers Released

Total Medical ComplianceHIPAA

Health and Human Services (HHS) has finalized disincentives for Information Blocking and healthcare providers. Here is a summary: The HHS rule impacts the Merit-based Incentive Payment System (MIPS) by penalizing clinicians who engage in information blocking. MIPS eligible clinicians found to be information blockers by the HHS Office of Inspector General will receive a zero score in the Promoting Interoperability performance category for the year in which the violation occurs.

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Medical Music Mondays: Stones Ahead

PEMBlog

Bogus man! Kids can get kidney stones too. This alt-rock homage discusses imaging, pain control, and more. Lyrics Everyone knows that kidney stones cause so much pain colicky anguish radiation to the flank and symptoms all the same toradol is the first choice along with fluids if you’re a nice doc an ultrasound can show hydronephrosis if a stone’s blocked [chorus] kidney stones can happen in children think about the pain, the pee, the ultrasound if you feel me don’t forget to c

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On the invisible power of language

Emergency Medicine Journal

As the attending physician in the ED, I have already heard the case presentation from the resident. "Doctor," the patient says, "there’s something wrong with my blood." I notice the patient’s gestures, his hand movements. His filler words are ‘eh ’ and ‘esto ’ rather than ‘um’ or ‘well’, the melody of his speech not unlike the sounds of my own childhood.

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Endometriosis: new study reveals fourfold increased risk of ovarian cancer

Emergency Live

Women with Endometriosis have a higher risk of developing ovarian cancer, according to a study What is Endometriosis? Endometriosis is a chronic gynecological disease that affects women, most frequently of childbearing age. It is caused by the abnormal presence of endometrial cells (the tissue lining the inner wall of the uterus) in organs other than […] The post Endometriosis: new study reveals fourfold increased risk of ovarian cancer appeared first on Emergency Live.

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230. PE & Pregnancy

Board Bombs

PE workup? Sure. Oh by the way they're pregnant.yep. Let's discuss how this is workup needs to be simplified and not feared. Also, say goodbye to VQ scans. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 230. PE and Pregnancy.

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A Winning Hand in Cardiology: Queen of Hearts AI Model Enhances OMI Detection

Critical Care Now

Reading Time: 3 minutes Article Herman R, Meyers HP, Smith SW, et al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit Health. 2023;5(2):123-133. Published 2023 Nov 28. PMID: 38505483 Cath lab activation based on ST-elevation myocardial infarction (STEMI) criteria relies on outdated data and needs modernization.

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