Sat.Nov 02, 2024 - Fri.Nov 08, 2024

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Everything You Wanted To Know About: Cranial Bone Flaps

The Trauma Pro

Patients with severe TBI frequently undergo surgical procedures to remove clot or decompress the brain. Most of the time, they undergo a craniotomy, in which a bone flap is raised temporarily and then replaced at the end of the procedure. But in decompressive surgery, the bone flap cannot be replaced because doing so may increase intracranial pressure.

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Robert Kennedy Jr. & His Doctor Friends May Just Be Getting Started

Science Based Medicine

Doctors who are concerned about members of our profession enabling powerful anti-vaxx disinformation agents should speak up before it's too late. But its probably too late already. The post Robert Kennedy Jr. & His Doctor Friends May Just Be Getting Started first appeared on Science-Based Medicine.

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Semaglutide (Wegovy) Is Not a Knee Pain Drug

Sensible Medicine

Nearly a thousand news outlets covered the recent publication of the positive results of the STEP-9 trial of semaglutide vs placebo for the treatment of knee pain due to osteoarthritis in patients with obesity. Twitter overflowed with positive messages after the New England Journal of Medicine publication. I am not sold on the trial. STEP-9 had many flaws but one fatal flaw.

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Building a Learning Culture in the ED: Why It Matters and How to Make It Happen.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Creating a learning culture in the emergency department (ED) fosters psychological safety, open communication, and continuous improvement. This approach supports team resilience, enhances patient care, and reduces burnout. Learn practical steps to build a strong learning culture in your ED, promoting growth and collaborative excellence in emergency medicine.

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Intraosseous vs intravenous access: which is better during resuscitation?

PulmCCM

During cardiac arrest, every second matters (at least potentially). For out-of-hospital cardiac arrest in particular, intravenous access can be difficult to establish, delaying the administration of epinephrine and other drugs and possibly worsening outcomes. Intraosseous (IO) devices—inserted by punching a needle loaded on a trocar into the tibia or femur—can be placed more easily than IV catheters, leading to faster injection of epinephrine.

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A Chat with Native American Emergency Physicians

ACEP Now

Native American emergency physicians make up 0.1 percent of physicians in U.S. emergency departments, according to research published in 2020 in Annals of Emergency Medicine. Three Native American emergency physicians in Oklahoma—three of five in the state—discussed with ACEP Now their approach to health care and how their careers in medicine began.

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Postacute Sequelae of SARS-CoV-2 Infection in the Pre-Delta, Delta, and Omicron Eras: A Critical Appraisal

Sensible Medicine

A few month ago, we were pleased to publish a critical appraisal written by a group of students at the Wayne State University School of Medicine. The group is back with another piece about a recent article. I am enjoying this way of encouraging critical appraisal in undergraduate medical education and generating good content for Sensible Medicine. As below, please take this opportunity to appraise the appraisers.

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Podcast – Prehospital eCPR with Alice Hutin at Tactical Trauma 2024

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed At the Tactical Trauma 24 conference in Sundsvall, Sweden, St Emlyn’s hosts Iain Beardsell and Liz Crowe had the opportunity to speak with Alice Hutin, an emergency physician with Service […] The post Podcast – Prehospital eCPR with Alice Hutin at Tactical Trauma 2024 appeared first on St.Emlyn's.

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Neonatal Resuscitation Tips

ACEP Now

A gravid woman presents to your emergency department (ED). Before you can obtain any history, she gives birth in your waiting room. The neonate is apneic and has a heart rate of 48. How do you stabilize this patient? Neonatal resuscitation is common; 10 percent of the four million newborns in the U.S. each year will require at least some intervention. 1 However, one percent of births will require advanced interventions, including chest compressions, intubation, and medications. 2 These rare scen

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Screening Can Do Silent Harm Part II

Sensible Medicine

I was pretty proud of my post last Friday, Screening Can Do Silent Harm. I described five cases that demonstrated the silent harms of screening. Unfortunately, unless you were both REALLY clued into the potential harms of screening AND basically live inside my head, the post left something to be desired. Reactions on twitter and in the comments were well-represented by these two: “It’s an odd article as people not already in the know won’t realise what it’s about !

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Waiting Room Medicine

Life in the Fast Lane

Mike Cadogan Waiting Room Medicine With exponential Emergency Department over-crowding and spiraling waiting times, the Utopian College has produced a series of guidelines to assist fondling members.

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SGEM#458: Hurt So Good –Ketamine Can Make the Hurt so Good – If used as an Adjunct to Opioids for Acute Pain in the Emergency Department

The Skeptics' Guide to EM

Date: October 29, 2024 Reference: Galili et al. Low dose ketamine as an adjunct to morphine: a randomized controlled trial among patients with and without current opioid use. AEM Oct 2024. Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department and Program Director of the EM residency program at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County.

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Reducing Legal Risks Through Proper Injury Reporting 

American Medical Compliance

In healthcare settings, injuries among staff and patients are unfortunately not uncommon. According to a National Institutes of Health article , there are 34.1 total injury incidences for all professions per 1,000 healthcare workers. Additionally, according to the World Health Organization, around 1 in every 10 patients is harmed in health care. Incidents can happen even with the best protocols in place.

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Potassium supplements to reduce arrhythmias in the ICU: Review

PulmCCM

“I can’t prove it was the reason, but we kept everyone’s K over 4 and Mag over 2 and we didn’t have a single code this month.” – my senior resident on an internal medicine rotation, circa 2005 As many as one-fifth of hospitalized patients develop hypokalemia, commonly defined as serum potassium less than 3.5 mEq/L.

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Get the “Human-Out-Of-The-Way”

EM Literature of Note

It is clear LLMs have an uncanny ability to find associations between salient features, and to subsequently use those associations to generate accurate probabilistic lists of medical diagnoses. On top of that, it can take those diagnoses and use its same probabilistic functions to mimic the explanations it has seen in its training set. A powerful tool – clearly an asset to patient care?

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Quick Draw Anatomy for Medical Students – Joanna Fox

Critical Care North Hampton

“Quick Draw Anatomy for Medical Students” by Joanna Oram Fox is a unique educational book designed to help medical students learn anatomy through drawing. It provides step-by-step instructions on drawing, understanding, and interpreting key anatomical structures. Her fantastic methodology for learning by illustration really impressed us with her first book!

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Baseline wander. But what else do you see?

Dr. Smith's ECG Blog

Written by Magnus Nossen The below ECG was obtained from a 65 year old man with ongoing chest pain. He has a history of hypertension an d tobacco use. He is otherwise healthy. There is no prior ECG for comparison. What do you think? ECG #1 Interpretation: The quality of the above ECG is not optimal. There is significant baseline wander that does make it more challenging to interpret ischemic changes.

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ToxCard: Tetanus and Strychnine – Expanding the Differential for Severe Muscle Spasm

EMDocs

Authors: Robert Nicholson, MD (EM Resident Physician, Carolinas Medical Center, Charlotte, NC) and Ann-Jeannette Geib, MD (EM Attending Physician, 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); Anthony Spadaro, MD (@TSpadaro91, Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); Alex Koyfman, MD (@EMHighAK); Brit Long

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Inhalation Injuries: The Answers You’ve Been LUNGing For

EM Ottawa

Inhalational injuries are a critical yet often overlooked aspect of trauma care, with far-reaching consequences in emergency medicine. These injuries can arise from various sources, including thermal injuries from fires, recreational activities such as smoke exposure during camping or outdoor events, and chemical inhalation in both industrial and household settings.

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A Skeptical Take of Semaglutide for Cardiac Protection

Sensible Medicine

When the New England Journal of Medicine published the placebo-controlled SELECT trial of semaglutide in patients with established vascular disease, I had thought cardiology had discovered another disease-modifying drug. SELECT found a statistically significant and clinically meaningful lowering of a composite endpoint with semaglutide. My former partner, who writes under the pseudonym, the Skeptical Cardiologist, has a different take.

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AHA and Red Cross Life Support Certifications Should Both Be Accepted

ACEP Now

For decades, only one major organization—the American Heart Association (AHA)—provided standardized training and certifications in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS). This changed in 2019 when the American Red Cross rolled out a suite of courses that teach the same science and skills in a more learner-centered way.

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A Global Review of Advanced Practice Nursing in the Emergency Department

AENJ: Current Issue

As demands in the way of healthcare delivery increase, nurse practitioners have become essential components in optimizing access to healthcare and improving outcomes around the globe. The authors recognize the vital role nurse practitioners play globally and that education, practice, and credentialing differ significantly across countries. Many countries have a wide variation in educational requirements, resulting in a lack of adequate advanced practice nursing training and regulation of practic

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Liberal or restrictive transfusion in brain injury part 2 (The TRAIN trial)

First 10 EM

It is pretty rare for the phrase “we need more research” to be immediately followed by more research, but that seems to have happened here.v On October 7 I published my post about the HEMOTION trial, looking at transfusion thresholds in traumatic brain injury, and concluding that despite being a statistically negative trial, the results […] The post Liberal or restrictive transfusion in brain injury part 2 (The TRAIN trial) appeared first on First10EM.

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Electrophysiological curiosity. Can you spot it?

Dr. Smith's ECG Blog

Written by Magnus Nossen ( with comments and laddergram by Ken Grauer ) The patient in today’s case is a man in his 60s — who presented with palpitations and lightheadedness. He had no history of syncope. The patient had hypertension, but was otherwise healthy. Due to the reported symptoms, he was admitted for observation and put on telemetry monitoring.

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Settling the Cefepime versus Piperacillin-Tazobactam Debate

ACEP Now

If you work in the emergency department, you’re out there in the trenches “suspecting sepsis” on a daily basis. Adhering to guideline recommendations, considered by some hand in hand with “quality,” requires prudent empiric antibiotic coverage. Vancomycin remains the typical straightforward choice for patients in whom methicillin-resistant Staphylococcus aureus coverage is indicated.

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The History of Clinical Nurse Specialists in Emergency Care

AENJ: Current Issue

The Clinical Nurse Specialist (CNS) role has been instrumental in advancing nursing practice, healthcare delivery, and patient outcomes across various specialties, particularly in emergency care. This manuscript provides an extensive review of the history of CNSs in emergency settings, exploring the development of the practice model, the challenges encountered, and their impact on patient and organizational outcomes.

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#Oatzempic – The viral oat-based alternative to Ozempic?

Science Based Medicine

Can the Oatzempic diet deliver Ozempic-like weight loss? The post #Oatzempic – The viral oat-based alternative to Ozempic? first appeared on Science-Based Medicine.

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Elbow Dislocations

RebelEM

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (80%) Demographics Most commonly affects patients between ages 10-20 years old As age increases, elbow dislocation rates tend to d

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A Potential Solution to America’s Psychiatric Boarding Crisis

ACEP Now

Dr. Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. The emergency department (ED) was frequently overwhelmed by suicidal adolescents who needed inpatient psychiatric treatment but couldn’t be admitted, because the hospital had no free beds.

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Bubble Wrap PLUS – November ’26

Don't Forget the Bubbles

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

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OCR’s Expectations for Preventing Ransomware in Healthcare

Total Medical ComplianceHIPAA

Key Lessons from the Cascade Eye and Skin Centers Settlement The recent settlement between the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and Cascade Eye and Skin Centers underscores OCR’s expectations for healthcare providers regarding cybersecurity under the HIPAA Security Rule. Following a ransomware attack that compromised nearly 291,000 patient records, Cascade agreed to a $250,000 settlement and a corrective action plan.

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Funtabulously Frivolous Friday Five 361

Life in the Fast Lane

Mark Corden Funtabulously Frivolous Friday Five 361 Funtabulously Frivolous Friday Five 360 - Just when you thought your brain could unwind, enter the medical trivia of FFFF.

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Compassionate Care for Neurodivergent Patients in the Emergency Dept.

ACEP Now

The quick-moving, high-stress practice of emergency medicine means health care professionals need to be prepared for anything. Among emergency physicians’ diverse patient populations, neurodivergent individuals represent a unique group with distinct challenges and requirements. Neurodivergence is an umbrella term that refers to a variety of neurological differences (not deficits), including autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and dyslexia, among other

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Building a Learning Culture in the ED: Why It Matters and How to Make It Happen.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Creating a learning culture in the emergency department (ED) fosters psychological safety, open communication, and continuous improvement. The post Building a Learning Culture in the ED: Why It Matters and How to Make It Happen. appeared first on St.Emlyn's.

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Sarno, mayor gives up allowance to make city Cardioprotected

Emergency Live

A project realized not only through the allowance I gave up, but thanks to the citizens of Sarnia who wanted me to be mayor of this city by giving me their trust So said Sarno Mayor Francesco Squillante during the presentation of the “Sarno Cardioprotected City” project. With the inauguration of the first defibrillator placed […] The post Sarno, mayor gives up allowance to make city Cardioprotected appeared first on Emergency Live.

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COVID-19 Resources

Life in the Fast Lane

Sheralyn Guilleminot and Mike Cadogan COVID-19 Resources The COVID-19 resource pack you need to keep up with the constant stream of new variants, new research, and changing guidelines!

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How to Best Inspect, Protect, and Dress Wounds in the Emergency Dept.

ACEP Now

This is the second visit in two weeks for an elderly gentleman who is concerned about his legs being red and swollen. During the first visit, he was diagnosed with cellulitis and placed on cephalexin. Today, he notes worsening swelling and a blister forming near his left ankle. The pain makes it difficult for him to ambulate unassisted through his home.

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