Sat.Sep 21, 2024 - Fri.Sep 27, 2024

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Field Amputation Part 5: The Equipment

The Trauma Pro

We’ve covered all the preparation for field amputation. Now, it’s time to do it! But wait, exactly what equipment is needed? There are two principles that you must adhere to: figure it all out in advance, and keep it simple. It is crucial that the trauma program design and assemble equipment and drug packs in advance, otherwise critical equipment may not make it to the field.

Hospitals 224
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The Subarachnoid Haemorrhage in the Emergency Department (SHED) Study

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed The diagnosis of subarachnoid haemorrhage in the emergency department is a constant source of anxiety. How do we make sure we pick up everyone with a bleed, but not overinvestigate […] The post The Subarachnoid Haemorrhage in the Emergency Department (SHED) Study appeared first on St.Emlyn's.

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Open Letter to Pamela Paul of the New York Times: Watch Some Interviews With Dr. Marty Makary. They Are More Important Than Peanut Allergies.

Science Based Medicine

I think some respected newspapers could do a better job of being honest with their readers about some pretty basic and pretty important things. The post Open Letter to Pamela Paul of the New York Times: Watch Some Interviews With Dr. Marty Makary. They Are More Important Than Peanut Allergies. first appeared on Science-Based Medicine.

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A (re)Visit to an Old-Fashioned Doctor

Sensible Medicine

A great irony of Twitter/X, a site that epitomizes 21 st century ephemerality, is that it can also engender the persistence, or rebirth, of a work. On the one hand, studies that authors worked on for years, or essays that were wrestled with for weeks, are only tweeted for a day or two before disappearing into our collective amnesia. On the other, articles will sometimes find second life on the site.

Radiology 107
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Field Amputation Part 6: The Procedure

The Trauma Pro

Preparation and planning will get you just so far. But then, you actually have to act. There are four phases in this procedure. I’ll break them down one by one. Patient preparation. The area should be shielded from curious onlookers and to control any airborne contaminants (dust, debris) at the scene. Portable monitors should be attached. Good IV/IO access needs to be in place, and the airway controlled via intubation.

EMS 182
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The Computer and Overreading Cardiologist call this completely normal. Is it?

Dr. Smith's ECG Blog

This is another case sent by the undergraduate (who is applying to med school) who works as an EKG tech. The undergraduate is now willing to identify himself: Hans Helseth. A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion.

EKG/ECG 110
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A “Biosafety” Organization Partnering With Dr. Jay Bhattacharya To Guard Against Viruses Is Like A Zebra Teaming Up With A Lion To Promote Vegetarianism

Science Based Medicine

Biosafety Now is fine working with a pro-virus, misinformation doctor to prevent a potential pandemic. What about a doctor who worked with patients and countered misinformation during an actual pandemic? The post A “Biosafety” Organization Partnering With Dr. Jay Bhattacharya To Guard Against Viruses Is Like A Zebra Teaming Up With A Lion To Promote Vegetarianism first appeared on Science-Based Medicine.

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HEMS Debrief #15 – PreCare (ECPR) Trial: Update and reflections

Greater Sydney Area HEMS

Hello and welcome back to The Sydney HEMS Debrief, episode 15! It has been a while since our last episode, and today we are back with the Pre-Care team to discuss this world-leading trial. Joining us are Nat, Jackie, Andrew and Pete. Together, we will discuss the experiences of clinicians involved in this trial, specifically highlighting the importance of maintaining good ALS prior to the arrival of, as well as during the presence of, the pre-care team as well as how the pre-care trial is impact

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NONSUSTAINED VT

ECG Guru

Extract from a Holter ECG, 2 continuous strips, recorded at 25 mm/s. At the top you can see a broad complex tachycardia without recognizable P waves, which ends spontaneously after 2 beats in the lower section. This is a VT. The very first beat in the 1st strip is most probably a fusion beat. After the end of the VT in the 2nd strip, a narrow QRS complex appears, here you can also recognize that atrial fibrillation is present.

EKG/ECG 90
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Post Hoc Bias in Medicine

Science Based Medicine

We are more likely to use an ineffective treatment after slight symptom improvement, even when the changes are coincidental. The post Post Hoc Bias in Medicine first appeared on Science-Based Medicine.

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Managing Stress for Caregivers in Assisted Living

American Medical Compliance

Caregiving is an inherently demanding profession, especially within assisted living facilities, where caregivers must balance the dual responsibilities of delivering high-quality care and managing their own emotional and physical well-being. The Alzheimer’s Association’s 2024 Alzheimer’s Disease Facts and Figures report highlights that 70% of dementia caregivers find coordinating care to be a significant source of stress.

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BIPAP IPAP: Higher is Better?

EM Literature of Note

The cornerstone of treatment for severe exacerbations of chronic obstructive pulmonary disease remains non-invasive positive pressure ventilation. Typically, this involves bi-level positive pressure settings, preventing alveolar collapse while assisting with inspiration and gas exchange. This works – most of the time. When it doesn’t work – endotracheal intubation.

COPD 83
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SGEM#453: I Can’t Go For That – No, No Narcan for Out-of-Hospital Cardiac Arrests

The Skeptics' Guide to EM

Date: September 18, 2024 Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Before attending medical school, he was a New York City Paramedic.

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Myopia Epidemic

Science Based Medicine

Myopia, or near-sightedness, has been steadily on the rise over the last half-century. A recent systematic review updates the literature on the extent and nature of this epidemic. Let’s get straight to the findings and then discuss what this means. The reviews includes: “276 studies, involving a total of 5,410,945 participants from 50 countries across all six continents.” The researchers find a […] The post Myopia Epidemic first appeared on Science-Based Medicine.

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Should Doctors Voice Their Own Mental Illness Publicly?

Sensible Medicine

This debate stems from a long running conversation between Vinay and Adam. The conversation was provoked by tweets in which doctors shared their mental health struggles. We have seen tweets about anxiety disorders, suicide attempts, and psychiatric drug dosing. What underlies the conversation is a simple question: Should Doctors Voice Their Own Mental Illness?

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emDOCs Podcast – Episode 107: Eclampsia

EMDocs

Today on the emDOCs cast with Brit Long ( @long_brit) , we cover eclampsia. Episode 107: Eclampsia Definition: Severe hypertensive disease of pregnancy (HDP) with new onset tonic-clonic, focal, or multifocal seizures or unexplained altered mental status in a patient who is pregnant or postpartum and there’s no other causative etiologies. Eclampsia can occur during or after the 20th week of pregnancy and up to 6 weeks postpartum. 60% of cases occur during the antepartum period, 20% intrapartum, a

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Smoking cessation in the emergency department (The COSTED trial)

First 10 EM

If I am honest, on most of my shifts, other substances seem to be far more destructive than nicotine. I spend a lot of time talking to patients about suboxone, or dealing with the consequences of alcohol. I definitely talk to people about smoking, but aside from brief counseling and occasionally prescribing nicotine replacement for […] The post Smoking cessation in the emergency department (The COSTED trial) appeared first on First10EM.

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I Might Have Been Wrong About Pulsed Field Ablation for Atrial Fibrillation

Stop and Think

Hi everyone. I’ve been stunned about all the new subscribers. I am not sure what happened, but thank you for signing up. I’ve had a busy late summer writing and podcasting—as well as practicing electrophysiology here in beautiful Louisville Kentucky. Let’s start with a (possible) change of opinion. I wrote in July of this year that my colleagues in heart rhythm medicine might be too easily impressed with new technology.

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When Trials Are Stopped Early for Benefit.

Sensible Medicine

We often forget this but clinical trials are experiments on humans. To minimize risks to participants, trials have independent oversight boards that make recommendations on stopping trials early. A typical example is when one group in the trial shows obviously better results. The group of experts judge whether it would be ethical to continue the trial—because if the effect is so much better in one arm of the trial, the other arm is getting inferior care.

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Medical Malpractice Insights: Radiology over-reads – Who’s responsible?

EMDocs

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.

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Healthy 45-year-old with chest pain: early repolarization, pericarditis or injury?

Dr. Smith's ECG Blog

Submitted by Dr. George Mastoras (Twitter @georgemastoras), written by Jesse McLaren It’s a busy day in the ED when you’re sent another ECG to sign off from a patient at triage. A healthy 45-year-old female presented with chest pain, with normal vitals. The computer interpretation was “ST elevation, consider early repolarization, pericarditis or injury.

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ATRIAL FIBRILLATION

ECG Guru

Unfortunately, I can't remember who the author of this ECG is. Perhaps he/she will get in touch with me. However, the ECG is very nice (despite the less than optimal recording quality) and that's why I want to post it. I don't know the history. In the first section of the ECG we see coarse fibrillation waves and QRS complexes with very different RR intervals, which is why this is atrial fibrillation.

EKG/ECG 72
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EMCrit 384 – The Vascular Guy on Vascular Access

EMCrit

All things Vascular Access with the Vascular Guy EMCrit Project by Scott Weingart, MD FCCM.

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EM @3AM: Phalanx Dislocation

EMDocs

Authors: Jose Gomez, MD (EM Resident Physician, UTSW – Dallas, TX); Dustin Harris, MD, FACEP, CAQSM (Assistant Professor of EM/ Attending Physician, UTSW- Dallas, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA), Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinica

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Emergency Evidence Updates – August 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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AI and the future of Human Understanding in healthcare

NRC Health

A recent NRC Health webcast discussed the intersection of artificial intelligence (AI) and empathy in healthcare. Check out the key takeaways and watch the webcast on demand today. The post AI and the future of Human Understanding in healthcare appeared first on NRC Health.

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EmergiQuiz 2024 Online Case Presentations

PEMBlog

EmergiQuiz is an annual case-based presentation sponsored by the AAP Section on Emergency Medicine that challenges the audience to think through the differential diagnosis for four amazing cases. Traditionally these cases are presented live at the AAP National Conference and Exhibition. Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com.

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Diagnosis on Sight: “Stabbing Belly Pain”

ALiEM

A 24-year-old male with a history of microscopic hematuria presented to the emergency department (ED) with left lower quadrant abdominal pain. His pain started about two weeks ago and has been intermittent. He describes the pain as stabbing. He decided to come to the ED today because of the persistent nature of the pain. He denies chest pain, cough, shortness of breath, fevers, nausea, vomiting, diarrhea, constipation, rectal bleeding, dysuria, and increased urinary frequency.

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Critical Care Evidence Updates – August 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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Why defibrillation is important for cardiac arrest survival

AED Leader

Imagine this scenario: your day is unfolding as usual, when suddenly, someone near you falls down. Their heart has ceased to function properly – they’re undergoing cardiac arrest. It’s an alarming proposition, right? However, it’s an incident that could occur to anyone, at any place. Hence, understanding the significance of defibrillation could be a life-altering factor.

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PEMPix 2024 Online Case #1: Mission: SPACE

PEMBlog

PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the first of the four cases. This case was submitted by Dr.

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Withdrawal of lots of iceberg salad: risk of listeriosis

Emergency Live

Alarm issued concerning several lots of iceberg salad, with presence of Listeria monocytogenes The Ministry of Health recently issued an alert concerning several lots of iceberg salad, urging consumers to return their purchased products. The cause of this measure is the presence of Listeria monocytogenes, a pathogenic bacterium known to contaminate food and cause serious […] The post Withdrawal of lots of iceberg salad: risk of listeriosis appeared first on Emergency Live.

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Navigating generational experience gaps in modern healthcare

NRC Health

In this episode of the Becker's Healthcare Podcast, host Lukas Voss sits down with Jennifer Baron, Chief Experience Officer at NRC Health, to explore the challenges and opportunities arising from the generational divide in healthcare. The post Navigating generational experience gaps in modern healthcare appeared first on NRC Health.

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How a defibrillator can save lives in public spaces and beyond

AED Leader

Imagine you’re at a busy mall, enjoying your day, when suddenly someone collapses possibly due to a heart problem. Panic sets in. What if I told you there’s a hero hidden in plain sight? Yes, a defibrillator. This device can shock the heart back into rhythm. Defibrillators aren’t just for doctors anymore. They come in types that anyone can use them 3even you!

Shock 52
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EmergiQuiz 2024 Online Case Diagnoses Revealed

PEMBlog

EmergiQuiz is an annual case-based presentation sponsored by the AAP Section on Emergency Medicine that challenges the audience to think through the differential diagnosis for four amazing cases. Traditionally these cases are presented live at the AAP National Conference and Exhibition. Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com.

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New surveys on diet and type 1 diabetes

Emergency Live

Possible link between some common foods and the development of type 1 diabetes in children A recent Finnish study has put the spotlight on a possible link between some common foods and the development of type 1 diabetes in children. Researchers have analysed the eating habits of thousands of children genetically predisposed to the disease, […] The post New surveys on diet and type 1 diabetes appeared first on Emergency Live.

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Developing leaders in emergency medicine

Emergency Medicine Journal

Leadership in emergency medicine is a routine part of day-to-day practice. Being a trauma team leader, emergency physician in charge or clinical lead all look very different and require a range of skills, but are all certainly forms of leadership that have a significant impact on the running of an emergency department, patient outcomes and, as is increasingly being recognised, staff well-being. 1 The EMLeaders programme was launched in 2018 as a collaboration between the Royal College of Emergen