Sat.Jun 15, 2024 - Fri.Jun 21, 2024

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The VIP Syndrome In Healthcare (Very Important Person)

The Trauma Pro

The VIP syndrome occurs in healthcare when a celebrity or other well-connected “important” person receives a level of care that the average person does not. This situation was first documented in a paper published in the 1960s, which noted that VIP patients have worse outcomes. Who is a VIP? It may be a celebrity. A family member. Or even a colleague.

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Topical Therapies for Pediatric Burns

Pediatric EM Morsels

The management of pediatric thermal burns always seems to be a hot topic , whether we are caring for a little future chef who splashed a scalding microwaved noodle cup on himself, or a toddling youngster who pulled a pot of boiling water on herself. Or maybe you have the adventurous adolescent who was a little too aggressive with the lighter fluid before igniting the campfire.

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I’ve Been Silenced, Censored, and Cancelled. The Reason Why Matters.

Science Based Medicine

When conference organizers told me not to make my talk "political", they were really saying there were certain people and ideas I wasn't allowed to criticize. I didn't get it at the time. I get it now. The post I’ve Been Silenced, Censored, and Cancelled. The Reason Why Matters. first appeared on Science-Based Medicine.

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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. What do you think? If this EKG were handed to you to screen from triage without any clinical information, what would you think?

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Should women in their 40’s be screened for breast cancer?

Sensible Medicine

I met Dr. Karsten Juhl Jørgensen at Forward’s innovative “4words24” conference in April. I was struck by Karsten’s deep knowledge of the medical literature, critical appraisal skills, and thoughtful approach to decision making. Here is a brief video of him summarizing the talk he gave at the conference. He reached out after the USPSTF published the new breast cancer guidelines.

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PulmCrit: Bilevel Sequence Intubation (BSI) – The new standard

EMCrit

introduction Bilevel Sequence Intubation (BSI) refers to initiation of noninvasive bilevel positive pressure ventilation with a backup rate prior to intubation (either using a BiPAP machine or a full-featured mechanical ventilator). BSI is distinct from traditional rapid sequence intubation (RSI), since BSI involves the delivery of machine-initiated, pressure-controlled breaths following administration of sedation and paralytics. […] EMCrit Project by Josh Farkas.

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How antivaxxers weaponize vaccine safety studies to falsely portray vaccines as dangerous, part 2: The children

Science Based Medicine

A few months ago, I wrote about how antivaxxers misrepresent vaccine safety studies to portray vaccines as dangerous, using a large study of outcomes in adults as an example. They're doing it again, but this time it's a large study of COVID-19 vaccines in children. The post How antivaxxers weaponize vaccine safety studies to falsely portray vaccines as dangerous, part 2: The children first appeared on Science-Based Medicine.

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How medical school fails students

Sensible Medicine

In prior posts, I was critical of the culture among trainees. One essay described the phenomenon of calling in fake sick. Another asked what the balance is between accommodation and the rigors of the job. These essays were about the effort, dedication and professionalism of trainees. Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.

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ECG Cases 50 – STEMI: A Failed Paradigm, Enter Occlusion MI

Emergency Medicine Cases

Dr. Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg. acute Q waves or loss of R waves, hyperacute T waves, or reciprocal STD/TWI) and if the ECG is nondiagnostic, consider other OMI signs including clinical (refractory isc

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Save the Whales, Blind the Children

Science Based Medicine

The Ancient Egyptian Book of the Dead depicts a scene in which a bowel of golden rice is weighed against the feather of truth. The post Save the Whales, Blind the Children first appeared on Science-Based Medicine.

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SGEM#443: Don’t Stop Me Now – REBOA for Hemorrhage Control in Trauma Patients?

The Skeptics' Guide to EM

Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program.

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Noninvasive Ventilation for Preoxygenation during Emergency Intubation

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Does the use of non invasive ventilation prior to intubation of critically ill patients improve outcomes? The post Noninvasive Ventilation for Preoxygenation during Emergency Intubation appeared first on St.Emlyn's.

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Extreme Heat in India: Climate Crisis Hits Hard

Emergency Live

A Critical Situation India has been struck by a wave of extreme heat, reaching record temperatures in several cities, including New Delhi, which recorded 52.3°C, surpassing the historic measurement of 50°C. This phenomenon is just one of the symptoms of the climate crisis gripping the subcontinent, influenced by the global phenomenon of El Niño. The […] The post Extreme Heat in India: Climate Crisis Hits Hard appeared first on Emergency Live.

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Will Your Tattoo Give You Cancer: Probably Not…but Maybe?

Science Based Medicine

Do tattoos cause lymphoma? A new study that says "maybe?" is making the rounds but I wouldn't worry too much. The post Will Your Tattoo Give You Cancer: Probably Not…but Maybe? first appeared on Science-Based Medicine.

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PulmCrit: PPIs are safe and effective for GI prophylaxis… the end.

EMCrit

REVISE is the latest multicenter RCT on the use of PPIs for GI prophylaxis in critical illness. I would view this as the triquel following SUP-ICU and PEPTIC. In order to understand REVISE in context, let's briefly review SUP-ICU and PEPTIC trials, before discussing REVISE. Part I: SUP-ICU (2018) This was a large multicenter RCT […] EMCrit Project by Josh Farkas.

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Podcast – Sudden Cardiac Death Syndrome

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Learn about Sudden Arrthymic Death Syndrome in children. Listen to the podcast recorded live at the Premier Conference 2024. The post Podcast – Sudden Cardiac Death Syndrome appeared first on St.Emlyn's.

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Safety at sea: how to protect yourself while on vacation

Emergency Live

Practical Tips for a Beach Vacation Without Risks Summer vacations are the perfect time to enjoy the sea and sun, but it’s important to prioritize water safety. Whether you’re an experienced swimmer or a beginner, following a few simple rules can make the difference between a carefree day and a potentially dangerous incident. In this […] The post Safety at sea: how to protect yourself while on vacation appeared first on Emergency Live.

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The Decaf Wars

Science Based Medicine

We can add decaffeinated (decaf) products to the list of things you probably shouldn’t worry about but someone wants to make you worry anyway. You may have read recently that some decaf coffee and tea brands have “chemicals” in them that may be a health risk. The real story, as you might imagine, is more complicated. The cause of the recent headlines […] The post The Decaf Wars first appeared on Science-Based Medicine.

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Apply Today: ACEP Now Is Recruiting Next Resident Fellow

ACEP Now

ACEP Now is looking for its next resident to join our editorial team. The position is open to any emergency medicine resident physician in an ACGME-accredited program who will be PGY2–4 during the July 2024–July 2025 Resident Fellow term. Responsibilities include: Regularly promote ACEP Now articles via social media, including Twitter and Facebook. Author or curate 4 Resident Voice columns during the 12-month position.

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A Rolling Stone Without a Home: Bouveret Syndrome on PoCUS

EM Ottawa

This case report demonstrates the utility of point-of-care ultrasound (POCUS) to identify complicated gallbladder disease. In this case, the patient presented with abdominal pain and a known history of cholelithiasis. POCUS demonstrated signs of small bowel obstruction and subsequently guided the decision to pursue radiology-performed imaging. Subsequently, the rare complication of Bouveret syndrome was identified. […] The post A Rolling Stone Without a Home: Bouveret Syndrome on PoCUS ap

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Rise of ticks in Europe: the risks and how to prevent them

Emergency Live

The increase of ticks in Europe Ticks pose a growing public health problem in Europe, with a significant rise in their prevalence in recent years. This phenomenon is mainly due to climate change, which is altering the habitats and habits of these parasites. Reports and health consequences Ticks are particularly active during the warm months, […] The post Rise of ticks in Europe: the risks and how to prevent them appeared first on Emergency Live.

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Amazon goes where the FDA does not

Science Based Medicine

Amazon has implemented new quality standards for some dietary supplements. The post Amazon goes where the FDA does not first appeared on Science-Based Medicine.

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Regular Wide Complex Tachycardia. What to do?

Dr. Smith's ECG Blog

A patient in the ICU with significant underlying cardiac disease [HFrEF 30%, non-ischemic cardiomyopathy, LBBB s/p CRT-D (biventricular pacer), AVNRT s/p ablation a few yrs ago, hx sinus tachycardia while on max tolerated BB therapy] went into a regular wide-complex tachycardia after intubation for severe COPD exacerbation. Here is the ECG: Regular Wide Complex Tachycardia at a rate of 166 bpm.

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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: PREOXI RCT – Preoxygenation with Noninvasive Ventilation vs. Non-rebreather Mask Spoon Feed Noninvasive ventilation (NIV) was superior to a standard non-rebreather (NRB) oxygen mask for preoxygenation of critically

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HYNAERO-ONERA collaboration for Fregate-F100 development

Emergency Live

Hynaero leverages ONERA’s expertise in developing the Fregate-F100, a Franco-European amphibious water bomber aircraft HYNAERO, the Bordeaux-based start-up, and ONERA (Office national d’études et de recherches aérospatiales) have signed a memorandum of understanding (MoU) to collaborate on the development of the new generation amphibious water bomber aircraft, the Fregate-F100.

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A discussion with interventional cardiologist Dr David Cohen on medical evidence, TAVR and stroke prevention

Sensible Medicine

David Cohen is one of the smartest docs on Twitter. I learned a bunch talking with him. The procedure called transcatheter aortic valve implantation or TAVR is a damn miracle. In days of old, a heart surgeon would have to saw open the chest and cut out the heavily calcified immobile aortic valve and sew in a new one. I watched a case as a young doctor and came away shocked that patients survive this surgery.

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Improving Productivity: Implementing the A.D.D. framework

First 10 EM

Maximizing your productivity and impact is hard. The A.D.D. framework: Automate, Deprecate, and Delegate, identifies strategies that can be implemented to scale your impact in research and beyond. This is a guest post by Dr. Ross Prager, which was also posted on his blog at resub.app, but that I should would be useful to readers […] The post Improving Productivity: Implementing the A.D.D. framework appeared first on First10EM.

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Incorporate HCAHPS changes into your patient experience strategy

NRC Health

NRC Health’s vast expertise in CAHPS and our innovative methods provide healthcare organizations with the necessary tools and insights to deliver exceptional care and craft long-term patient experience strategies. The post Incorporate HCAHPS changes into your patient experience strategy appeared first on NRC Health.

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Airbus presents first H160 delivered to Italy in Trento, Italy

Emergency Live

Airbus Helicopters Introduces the H160: Innovation and Versatility in the Aviation Landscape On June 14, 2024, Airbus Helicopters unveiled the first H160 helicopter delivered in Italy at its headquarters in Trento. The buyer, Air Corporate – the launch customer for the H160 in Italy – further bolsters its fleet with this delivery. This helicopter, the […] The post Airbus presents first H160 delivered to Italy in Trento, Italy appeared first on Emergency Live.

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EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments

Emergency Medicine Cases

In this month's EM Quick Hits podcast: Megan Landes on the importance of diagnosing HIV in the ED, Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion, Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient, Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis, Matt Pointer on the most lucrative side-gig, DIY investing.

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Fear and Opioids in Academic Medicine

Sensible Medicine

This is the fourth and final of our essays on power. The first three are here and here. I’ve been thrilled to feature some of our readers. We hope you have enjoyed these. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber. “I’m nervous. I don’t know what will happen.” I, then a 50-year-old associate professor of medicine, said those words over the phone to a friend late one night in

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EMCrit RACC-Lit Review for June 2024

EMCrit

All the literature goodness for June 2024 EMCrit Project by Scott Weingart, MD FCCM.

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Poisonous Animals in North America: Precautions and Answers

Emergency Live

Preventing and Responding to Snake and Spider Bites North America is home to many venomous animals, some of which can be deadly if not treated promptly. Among these, rattlesnakes and spiders are two of the most dangerous species. The rattlesnake, also known as Crotalus atrox, is one of the continent’s most aggressive species and can […] The post Poisonous Animals in North America: Precautions and Answers appeared first on Emergency Live.

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What would you do with acute chest pain and this ECG? You might see what the Queen thinks.

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. Case An 82 year old man with a history of hypertension presented to the ED with chest pain at 1211. He described his chest pain as pleuritic and reported that it started the day prior while swinging a golf club. An EKG for chest pain was obtained right away: For an 82 year old, this is a good looking EKG, with sinus rhythm at a rate of 70 BPM.

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Igniting Human Understanding: Jackie Stevens

NRC Health

“My passion for improving the patient experience was ignited almost two decades years ago,” Jackie said. With her career at NRC Health spanning nearly 20 years, Jackie is passionate when she talks about her role. As a mother, sister, daughter, friend, youth baseball fan, avid traveler, and volunteer she says she—like every person—is not just one role in life.

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Effective Communication with the Hearing-Impaired Training

American Medical Compliance

The following Effective Communication with the Hearing-Impaired Training is designed to educate healthcare providers (HCP) on the basis of hearing-impairment and how to effectively communicate with patients who are affected by hearing loss. Furthermore, it is crucial for healthcare providers to understand how to communication and care for the impaired.

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How Cruise Ships Handle Medical Emergencies

Emergency Live

Medical Facilities and Specialized Personnel On Board Cruise ships are like floating cities equipped with state-of-the-art medical facilities to handle any health emergency. Each ship has a medical center with hospital beds, diagnostic equipment such as ECG and X-ray machines, and a well-stocked pharmacy. On board, there is always a team of healthcare professionals, including […] The post How Cruise Ships Handle Medical Emergencies appeared first on Emergency Live.

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