Sat.May 11, 2024 - Fri.May 17, 2024

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Artificial Platelets Under Development!

The Trauma Pro

Uncontrolled bleeding is the bane of trauma professionals everywhere. Early in a resuscitation, we focus on identifying potential sources. We’ve developed numerous techniques for plugging them up. And we have processes in place to replace the blood that’s been lost. Unfortunately, blood products are a perishable item. Packed red blood cells have a typical shelf-life of 42 days.

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Pro-Infection Doctors Didn’t Just Want Kids in School. They Wanted Them There Unvaccinated, Untested, and Unmasked. They Wanted Them Infected.

Science Based Medicine

The virus massively disrupted schools around the world, and those of us who did nothing more than acknowledge this obvious reality were absurdly blamed for it. The post Pro-Infection Doctors Didn’t Just Want Kids in School. They Wanted Them There Unvaccinated, Untested, and Unmasked. They Wanted Them Infected. first appeared on Science-Based Medicine.

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Friday Reflection #39: What to Expect When You Are Aging

Sensible Medicine

MM is 94 years old. Her only active medical issues are hypertension and vitamin D deficiency. She takes only 20 mg of lisinopril and 1000 units of vitamin D3 each day. She has no cognitive decline and gardens every day if the Chicago weather allows. Her Friday afternoon appointment is the doctor’s last of the week. Sensible Medicine is a reader-supported publication.

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Effect of Bougie Use on First-Attempt Success in Tracheal Intubations: A Systematic Review and Meta-Analysis

EM Ottawa

Methodology: 4/5 Usefulness: 3/5 von Hellmann R, et al. Ann Emerg Med. 2024 Feb;83(2):132-144. Question and Methods: Systematic review of 18 studies (12 RCT) of adult patients comparing bougie use vs standard of care in tracheal intubations to evaluate first-attempt success. Findings: Bougie was associated with increased first-attempt intubation success overall (RR 1.11 95%CI 1.06 […] The post Effect of Bougie Use on First-Attempt Success in Tracheal Intubations: A Systematic Review and M

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The “Backward Finochietto” Problem

The Trauma Pro

Resuscitative thoracotomy is a (sometimes) life-saving procedure reserved for trauma patients in extremis. Thankfully, most trauma centers do very few of these a year. However, that makes it one of those “high severity – low frequency” procedures that generate many, many quality improvement problems. Many of these issues are due to operator unfamiliarity or equipment availability.

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PulmCrit: Why the new study associating piptazo with increased mortality is wrong

EMCrit

Piperacillin-tazobactam is an antibiotic that a lot of people love to hate. Combine this with the conservatism that often (rightfully) surrounds drug safety, and it creates a lot of volatility. Before going further, we should review some recent history regarding piptazo. In the early 2010's, a series of retrospective correlational studies found that patients treated […] EMCrit Project by Josh Farkas.

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Medical Student Accommodations

Sensible Medicine

Recently, I learned about a student on their clinical rotations who had to be sent home at precisely 9 hours. No matter how busy the day or service, the student would leave at the 9 hour mark. The reason? The student had a disability accommodation because he suffered from attention deficit hyperactivity disorder. Subscribe now In medicine there is a tension.

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Early repol or anterior OMI?

Dr. Smith's ECG Blog

Chest Pain – Benign Early Repol or OMI? Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. He reported substernal chest pressure with radiation to his left arm that started at work several hours prior to arrival and had somewhat improved since onset.

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Racemic Epinephrine is on a national shortage in the United States (May 2024)

PEMBlog

Racepinephrine (Racemic epinephrine) is used for croup patients who have stridor at rest and post extubation stridor. It is currently on national shortage and many facilities have a very limited supply of the nebules on hand. In times of shortage, intravenous EPINEPHRINE 1 mg/mL can be utilized as a nebulized solution in place of racepinephrine using the dosing of 0.5 mg/kg to a max of 5 mg.

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Ep 194 Subarachnoid Hemorrhage – Recognition, Workup and Diagnosis Deep Dive

Emergency Medicine Cases

Anton is joined by the world's leading EM researcher in subarachnoid hemorrhage diagnosis Dr. Jeff Perry and EM-Stroke team clinician Dr. Katie Lin for a deep dive into why we still miss this life-threatening diagnosis, the key clinical clues, proper use of decision tools, indications for CT, indications for CTA, indications for LP and CSF interpretation for the sometimes elusive diagnosis of subarachnoid hemorrhage.

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Dr. Vinay Prasad Pretends to Admit Error: I Was Optimistic That Vaccination Would Halt the Spread of the Virus—I Was Wrong. 

Science Based Medicine

While admitting error is never easy and should always be applauded, the first step is to honestly admit error. The post Dr. Vinay Prasad Pretends to Admit Error: I Was Optimistic That Vaccination Would Halt the Spread of the Virus—I Was Wrong. first appeared on Science-Based Medicine.

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Tasty Morsels of Critical Care 080 | Pulmonary Hypertension Overview

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. This time we’re looking at pulmonary hypertension. Mainly cause I recently had to give a talk on it so it’s fresh in my rapidly diminishing brain cells and thought I should get it all written down before I forget it. We’re going to try it as a 2 parter. Part 1 will cover a broad overview of pulmonary hypertension and part 2 will focus on management strategies for a PH patient in the ICU.

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JC – Chat GPT and AI vs Humans in medical assessment – is there a difference?

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Can ChatGPT write clinical cases and MCQs unrecognisable from those written by humans? The post JC – Chat GPT and AI vs Humans in medical assessment – is there a difference? appeared first on St.Emlyn's.

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Anesthesiologists at Cedars-Sinai unionize

PulmCCM

Anesthesiologists employed by Cedars-Sinai formed a union, representing the latest in a series of unionizations by physicians in the U.S. According to physician union leaders quoted in news reports, Cedars-Sinai proposed an update to a 2020 contract that amounted to a 10% pay cut, and then broke off negotiations with the group. The anesthesiologists cited understaffing and patient care concerns as other key factors driving the breakdown.

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Sardinia Triumphs at DIU National Competition

Emergency Live

The event, held at the National Committee of the Italian Red Cross, saw over 140 students engage in discussions on humanitarian scenarios, with Sardinia clinching the top spot Over the weekend in Rome, the third edition of the National Humanitarian Law Competition took place, an event hosted by the National Committee of the Italian Red […] The post Sardinia Triumphs at DIU National Competition appeared first on Emergency Live.

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The Washington Post publishes an advertorial on IV drips

Science Based Medicine

Last week, I had a choice between two poorly framed articles on health to discuss. I wrote about the one on "vaccine injury." But the second one about IV drips kept nagging at me. Why do journalists do so poorly on issues like this? The post The Washington Post publishes an advertorial on IV drips first appeared on Science-Based Medicine.

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Annals of B Pod: Stump Appendicitis

Taming the SRU

HISTORY OF PRESENT ILLNESS A male in his 50s presents with right lower quadrant pain. The pain developed one day prior to presentation and was gradual in onset. He describes the pain as constant and sharp without radiation, rated at an 8/10. The pain has been worsening since symptom onset and has not been relieved with acetaminophen or ibuprofen. Of note, the patient had a prior appendectomy three months prior due to an acute suppurative appendicitis that was otherwise uncomplicated.

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EM@3AM: Brainstem Strokes

EMDocs

Authors: Ernesto Hernandez, MD (EM Resident Physician, Advocate Christ Medical Center, Oak Lawn, IL); Jennifer Woodruff, MD (EM Attending Physician, Advocate Christ Medical Center, Oak Lawn, IL) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clini

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New Biomarkers in Blood for Early Cancer Diagnosis

Emergency Live

Discovery of 618 Cancer-Associated Proteins for 19 Types of Cancer Thanks to two studies led by the University of Oxford and published in Nature Communications, a total of 618 proteins in the blood have been identified that may indicate the presence of 19 different types of tumors. Among these, 107 could reveal the risk of […] The post New Biomarkers in Blood for Early Cancer Diagnosis appeared first on Emergency Live.

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Action Is The Antidote For Rumination - An Interview with Rob Orman, MD

EB Medicine

In this episode, Sam Ashoo, MD interviews Rob Orman, MD, founder of Orman Physician Coaching , about routine examination of our careers in emergency medicine. Understanding Career Cycles and Embracing Change The Importance of Career Reflection and Making Trades Navigating Career Satisfaction and Preventing Burnout Proactive Career Management and Reflection Strategies Exploring Career Alternatives and Rediscovering Joy in Medicine Balancing Work, Love, Play, and Health for a Satisfying Life When

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Grand Rounds 5.8.24

Taming the SRU

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery. Have a high suspicion for infection in transplant patients.

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Senior Account Manager's Insights: A Decade in Healthcare Recruitment with Josh

Core Medical Group

Josh, a seasoned professional with over a decade of experience in healthcare recruitment at CoreMedical Group, brings a wealth of expertise to his role. Starting in sourcing and advancing to perm recruiting, he has excelled as a recruiter, team leader, and now as a Senior Account Manager. Known for his strong relationships and continuous improvement mindset, Josh is dedicated to making a positive impact by connecting healthcare professionals with their dream opportunities.

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Exploring the Different Shapes of Ambulances

Emergency Live

A World of Variety for Every Emergency Ambulances, vital vehicles for emergency medical transport, come in a wide array of shapes and sizes, designed to meet the diverse needs of both patients and emergencies. From standard ambulances to highly specialized units, the variety of these vehicles is astounding. Here’s an overview of the main types […] The post Exploring the Different Shapes of Ambulances appeared first on Emergency Live.

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EBM bibliography updates – May 2024

First 10 EM

If you haven’t seen it yet, I have a collection of important evidence based medicine articles that will really help you understand the science behind your medical practice. I constantly update it with new papers I read, and occasionally publish summaries of those updates. This update contains a lot about non-inferiority trials, which is probably […] The post EBM bibliography updates – May 2024 appeared first on First10EM.

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover acute chest syndrome part 1. Episode 100: Acute Chest Syndrome Part 1 Background SCD is an autosomal recessive condition that results in the formation of hemoglobin S (HbS). HbS has reduced solubility in the setting of hypoxia, leading to sickling of the RBCs. Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased

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Dermatology in Skin of Colour: Pigment, Perception, and Rash Decisions

EM Ottawa

Skin conditions affect approximately one-third of the world’s population and are the 4th most common cause of disease.1,2. As the largest organ in the human body, the skin frequently manifests early signs of various diseases, serving as a pivotal clue in the diagnostic process. Think of Lyme disease as an example: when we recognize the […] The post Dermatology in Skin of Colour: Pigment, Perception, and Rash Decisions appeared first on EMOttawa Blog.

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Improving the qualities of ventilations during CPR

Emergency Live

The ventilation maneuver during cardiopulmonary resuscitation (CPR) is a complex intervention influenced by various factors related to the patient, the operator, and the environment. Therefore, researchers have highlighted the importance of objectively and reliably measuring the quality of ventilation during CPR through a scientific study The objective of the study, conducted by Dr.

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Time to trash proximal tibia and 15 mm IO needle in adult & paediatric cardiac arrest!

MEDEST118

References: Kwong S, Kothary S, Poncinelli LL. Skeletal development of the proximal humerus in the pediatric population: MRI features. AJR Am J Roentgenol. 2014 Feb;202(2):418-25. doi: 10.2214/AJR.13.10711. PMID: 24450686. Reid C, Fogg T, Healy G. Deformation of a humeral intraosseous catheter due to positioning for thoracostomy. Clin Exp Emerg Med. 2018 Sep;5(3):208-209. doi: 10.15441/ceem.17.243.

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Be a mirror: Elevate experience and transform healthcare interactions

NRC Health

Healthcare leaders who understand that people need to feel validated, supported, and loved will have more meaningful healthcare interactions. The post Be a mirror: Elevate experience and transform healthcare interactions appeared first on NRC Health.

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EMCrit 375 – Vasopressors for Early Hemorrhage?

EMCrit

Today we talk about the debate over whether to give vasopressors as part of a balanced resuscitation in early exsanguination. EMCrit Project by Scott Weingart, MD FCCM.

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Segmental cystectomy: what it is and what it is used for

Emergency Live

Surgical Solution for Bladder Cancer A commonly used surgical approach in this regard is represented by segmental cystectomy, which involves the removal of a portion of the bladder where cancer cells are present. This procedure is mainly performed for patients with low-grade bladder tumors concentrated in a very limited area of the bladder. Compared to […] The post Segmental cystectomy: what it is and what it is used for appeared first on Emergency Live.

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PEM POCUS Series: Soft Tissue Ultrasound

ALiEM

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric soft tissue ultrasonography. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Take the ALiEMU PEM POCUS: Soft Tissue Quiz Case Goals List the indications of performing a pediatric soft tissue point-of-care ultrasound (POCUS).

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Explain This One to Me

Sensible Medicine

Next weekend at the Heart Rhythm Society meeting I will debate left atrial appendage occlusion. I’ve lost track of how many times I have tried to convince my colleagues that the evidence supporting this procedure is weak. The makers of one of the more popular devices, called Watchman, advertise on their website that 400,000 devices have been implanted worldwide.

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Transfusion-associated lung injury (TRALI): Review

PulmCCM

Transfusion-associated lung injury (TRALI) is a form of non-cardiogenic pulmonary edema and acute hypoxemic respiratory failure (PaO2/FiO2 <300) that develops during or soon after transfusion with blood products. It thus can also be thought of as acute respiratory distress syndrome (ARDS) precipitated by transfusion. The diagnosis of TRALI is clinical: there is no laboratory or other testing for TRALI (beyond a chest radiograph).

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Understanding the Emergency Medical System in the United States

Emergency Live

The Complexity of the American Emergency Medical Services (EMS) System In the United States, the Emergency Medical Service (EMS) system is highly diversified and decentralized, designed to respond to a wide range of medical emergencies. The American EMS is a network coordinated by various entities; alongside emergency management organizations, there are also healthcare service providers […] The post Understanding the Emergency Medical System in the United States appeared first on Emergency

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Club CoreMed 2025: A New Oasis

Core Medical Group

Guess what? We've been keeping a secret, but the time has come to spill the beans! Club CoreMed 2025 has found its home at the brand new Margaritaville Island Reserve Resort Riviera Maya, saying goodbye to our beloved El Dorado venue after nine amazing years. Let's dive into the details.

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ADHD in children

Mind The Bleep

Background ADHD is a neurodevelopmental disorder that begins in childhood, and is formed of the following core features: 1. Inattention: difficulty finishing tasks difficulty focussing on one task forgetting or misplacing things not paying attention to details being easily distracted and constantly ‘daydreaming’ difficulty following multi-step instructions struggling to concentrate 2.