Sat.Jul 13, 2024 - Fri.Jul 19, 2024

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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.

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ECG Blog #439 — How Many Possibilities?

Ken Grauer, MD

How would YOU interpret the rhythm in Figure-1 — if you were sent this tracing without the benefit of any history? Figure-1: How would YOU interpret this rhythm? The "Quick" Answer: My initial thoughts on the rhythm in Figure-1 : The rhythm in Figure-1 is not completely regular. That said — the R-R interval for the first 5 beats looks regular. The R-R interval for the last few beats is shorter than this — but also regular.

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How Often Should My Trauma Multidisciplinary Performance Improvement Committee Meet?

The Trauma Pro

Every trauma center is required to have two specific committees: a multidisciplinary trauma performance improvement committee (PI) and a trauma operations committee (ops). However, a common question is, “How often do my committees need to meet?” Let’s start with your PI committee. The answer, of course, is “it depends.” There is no cookie-cutter, one-size-fits-all answer.

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JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background – What do we already know about REBOA? In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.

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PREOXI Trial – Noninvasive Ventilation for Preoxygenation

The Bottom Line

In critically ill patients undergoing tracheal intubation does pre-oxygenation with non-invasive ventilation compared with pre-oxygenation with an oxygen mask reduce the incidence of hypoxemia during intubation?

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Ozempic May Cause Eye Problems - But I Doubt it

Sensible Medicine

The GLP1 agonists (glucagon-like-peptide-1-receptor agonist) may be the biggest medical development of this century. The success of Western society has resulted in widespread obesity—and obesity-related diseases, such as diabetes, high blood pressure, heart failure and vascular disease. Obesity is clearly not a good thing for human health. The statistics on obesity—especially in children—are staggering.

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How Often Should My Trauma Operations Committee Meet?

The Trauma Pro

In my last post, I discussed how often your multidisciplinary trauma performance improvement committee (PI) should meet. As you know, one other mandatory committee is required of all trauma centers, the Trauma Operations Committee (Ops). In this post, I will: describe how often your operations committee should meet help you determine whether your two committees should meet on the same day or separately How Often?

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Thinking in probabilities: eCPR edition

Critical Care Now

Reading Time: 3 minutes Extracorporeal cardiopulmonary resuscitation (eCPR) has been somewhat of a controversial topic in the intensive care community over the years, with observational and randomized controlled trials (RCTs) swinging the pendulum of scientific consensus back and forth from “hugely beneficial” to “expensive, without significant benefit”.

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Initial Resuscitation in ARDS

Northwestern EM Blog

Written by: Hart Edmonson, MD (NUEM ‘27) Edited by: David Adler, MD (NUEM ‘25) Expert Commentary by : Anthony J. Esposito, MD Expert Commentary Thank you to Drs. Edmonson and Adler for this infographic that concisely emphasizes key concepts for the recognition and initial management of acute respiratory distress syndrome (ARDS) in the Emergency Department.

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Providing Clarity Regarding the Regulation of Respirators Used in Health Care Settings

NIOSH Science Blog

A Discussion Paper, Streamlining Regulatory Oversight of Respirators Used in Health Care Settings will Improve Worker Protection, was recently published in the National Academy of Medicine’s NAM Perspectives journal by respiratory experts outside of the federal government. This paper highlights continued confusion amongst interested parties including health care organizations and manufacturers seeking approval regarding federal regulations and guidance on the use of air-purifying respirators (AP

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Vacation first aid kit: your personal pharmacy on the road

Emergency Live

In order to have the best vacation and a well-deserved rest, you need to be prepared for anything. A well-stocked first aid kit can make the difference After a long period of work, a nice trip and a well-deserved vacation are ideal for relaxing and recharging. But in order to fully enjoy your vacation, it […] The post Vacation first aid kit: your personal pharmacy on the road appeared first on Emergency Live.

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But the INR is 3.2! Markers of Coagulation Status in Cirrhotics

Taming the SRU

Rout G, Shalimar, Gunjan D, et al. Thromboelastography-guided Blood Product Transfusion in Cirrhosis Patients With Variceal Bleeding. J Clin Gastroenterol 2019;54(3):255–62. This study was a single-center, prospective, open-label, randomized controlled trial of patients with cirrhosis and acute variceal bleeding. Patients were randomized to blood product resuscitation guided by either TEG parameters or conventional coagulation tests (INR, platelet count, and fibrinogen).

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Conspiracy Medicine

Science Based Medicine

Was COVID cooked up in a lab? Do “they” have a cure for cancer and are hiding it from the public? Do pharmaceutical companies make up diseases to market otherwise failed drugs? Did insurance companies scheme with infectious disease professional organizations to suppress treatments for chronic Lyme disease? Did the supplement industry lobby congress to weaken regulations of their own products?

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Research Roundup (July 2024)

First 10 EM

Some big and potentially practice changing articles this month. (I tend to read ridiculous articles in my free time, which I have had very little of, and so there are no intubation in outer space or highly philosophical papers about the language this month. Don’t worry, there is still a very bad joke.) BiPAP for […] The post Research Roundup (July 2024) appeared first on First10EM.

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Killer heat hits Mecca: how to cope with high temperatures

Emergency Live

Nearly 1,000 pilgrims have died in Saudi Arabia due to extreme temperatures. Once again, high temperatures are having a dramatic impact on human health Mecca: The carnage of high temperatures During the annual Hajj pilgrimage to Mecca, a tragic heat wave hit Saudi Arabia killing nearly 1,000 people. The extreme temperatures, which exceeded 50 degrees, […] The post Killer heat hits Mecca: how to cope with high temperatures appeared first on Emergency Live.

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Invasive Group A Strep (iGAS). It’s Backkkkk (Part 2)

EM Ottawa

In case you missed it, in part 1 of this series, Dr. Zworth discussed the increasing prevalence of invasive Group A Strep (iGAS), the mounting public health concern, recognition, and diagnosis. In this post, we focus on management, the treatment of (strep) pharyngitis, and post-exposure prophylaxis. Take home #5: The four pillars of iGAS management […] The post Invasive Group A Strep (iGAS).

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Magnesium oil: Not so magical

Science Based Medicine

Despite the hype, there is no evidence to show magnesium oil is effective for any purpose. The post Magnesium oil: Not so magical first appeared on Science-Based Medicine.

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Which of these, if either, is OMI? Which of these underwent emergent angiography and PCI? Which should have?

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers Case 1: A man in his 50s presented with acute chest pain. Normal vital signs. Here is his ECG at triage: What do you think? Here's what Version 1 QOH thinks: It is diagnostic of acute LAD OMI, with the precordial swirl pattern. See this post if you dont know that pattern yet: Precordial Swirl -- 20 cases of Swirl or Look-Alikes Here was a repeat ECG done within 20 minutes (still with ongoing pain): It still looks like active OMI to me, but perhaps sli

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The Cardiology Seminal Trial's series is well underway

Stop and Think

With age, I have come to appreciate the value of reading and knowing the evidence underpinning what we do in cardiology. The thing is that cardiology requires a lot of technical learning. To read images or perform procedures, you have to master specific tasks. Forging these neural pathways takes a lot of effort and time, especially for new learners.

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"Toxic" quizzing: Is the attending mean or is the resident sensitive?

Sensible Medicine

Recently, I read an article on “toxic” quizzing. It’s was about attendings asking trainees questions in a mean way. Does it happen? Yes, of course. When I was a medical student, there was only one drug approved for HER-2 positive breast cancer. It was traztuzumab (this was before lapatinib). A breast surgeon, known for pimping, asked me about it in the OR.

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Aaron Siri vs. Stanley Plotkin on post-licensure safety monitoring of vaccines

Science Based Medicine

Vaccine scientist Stanley Plotkin coauthored a commentary on vaccine postlicensure studies. Antivax lawyer Aaron Siri tries to spin it as an "admission" that vaccines aren't safe. Predictable. The post Aaron Siri vs. Stanley Plotkin on post-licensure safety monitoring of vaccines first appeared on Science-Based Medicine.

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EMCrit ShadowBoxing – Casey Parker Rural Medicine Critical Care Case

EMCrit

A great rural medicine critical care cards case EMCrit Project by Scott Weingart, MD FCCM.

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Global healthcare leader and lifestyle expert Doctor Mike announced as HUB24 keynote

NRC Health

Seize the opportunity to be motivated by Doctor Mike’s insights and forward-thinking vision to revolutionize healthcare one viewer at a time. Join us on this journey toward improved health, powered by data-driven solutions and collaborative efforts. The post Global healthcare leader and lifestyle expert Doctor Mike announced as HUB24 keynote appeared first on NRC Health.

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EM@3AM: Endometritis

EMDocs

Authors: Haley Sinatro, MD (EM Resident Physician, UTSW EM); Alan John, MD (Assistant Professor, UTSW EM) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); 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 clinical basics.

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Drowning Deaths Continue Post-Pandemic Rise

Science Based Medicine

More people, mostly kids, are drowning these days, in no small part because of the pandemic. The post Drowning Deaths Continue Post-Pandemic Rise first appeared on Science-Based Medicine.

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Friday Reflection 42: Patient Approaches to a Doctor’s Visit

Sensible Medicine

PT is a 62-year-old man referred for an initial clinic visit by the medical center president. He is an executive at a Fortune 500 Company, a large donor to the University, and a member of the hospital board of directors. He is healthy, comes to the visit impeccably dressed, and knows exactly which tests are warranted – some which the doctor also recommends.

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ENRICH: Early Minimally Invasive Removal of ICH

The Bottom Line

In patients with spontaneous intracranial haemorrhage (ICH), does the use of early minimally invasive surgery + standard management compared to standard management alone, result in better functional outcomes at 180 days?

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Medics were criticized for not activating the cath lab

Dr. Smith's ECG Blog

This is the prehospital ECG from an 81 year old man with acute chest pain. You will need to click on it to enlarge it in order to see it well enough What do you think? The medics did NOT activate the cath lab. But the paramedic got "told off" by ER staff saying they should have called the Cath lab saying it’s an inferior MI". ECG: There is what appears to be STE in inferior leads with reciprocal STD in aVL.

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UCI Health communication strategy elevates patient experience

NRC Health

Patient income in med-surg units hinges on efficient communication between physicians and nurses. Any lapses can significantly sway patient outcomes. Recognizing the importance of clear communication across the care team, UCI Health set out to enhance these communication channels. The post UCI Health communication strategy elevates patient experience appeared first on NRC Health.

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Podcast – Hybrid Closed Loop Insulin Pumps in the ED

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Listen to a podcast about looking after patients with hybrid closed loop insulin pumps and what might go wrong The post Podcast – Hybrid Closed Loop Insulin Pumps in the ED appeared first on St.Emlyn's.

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Pulse Diagnostics

Science Based Medicine

Perhaps the EKG of my bulldog. TCPM wouldn't have a clue what was going on. The post Pulse Diagnostics first appeared on Science-Based Medicine.

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How Bad Road Maintenance Can Cause Bicycle Accidents

Medical Law

Santa Barbara is a haven for bicyclists, attracting both locals and tourists with its scenic routes and bike-friendly initiatives. The city’s mild climate and picturesque coastline make cycling an appealing mode of transportation and recreation year-round. On weekends, it is common to see families, fitness enthusiasts, and tourists exploring the city and its surroundings on two wheels.

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REAS 2024 unveils new aircraft, helicopters and seaplanes for forest firefighting

Emergency Live

From Oct. 4-6, the REAS 2024 international trade fair presents the latest technologies and new aircraft dedicated to fighting wildfire The twenty-third edition of the REAS 2024 International Emergency Exhibition will be held from October 4 to 6 at the Montichiari (Brescia) Exhibition Center. The fair presents itself as an opportunity to discover the latest […] The post REAS 2024 unveils new aircraft, helicopters and seaplanes for forest firefighting appeared first on Emergency Live.

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It’s Your Call – July 2024

Total Medical ComplianceHIPAA

HIPAA: Do surveillance cameras breach HIPAA regulations? Since HIPAA mandates the confidentiality of protected health information (PHI), installing video cameras can result in a violation if they are not placed correctly or used appropriately. Infection Control: What is the difference between universal, standard, and transmission-based precautions in preventing the spread of infection?

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Identifying Postpartum Depression: Signs, Causes, and Treatments

Ziqitza HealthCare Ltd

Postpartum depression, which is commonly referred to as baby blues, affects nearly 22% of urban mothers in India. Sure, these statistics don’t seem alarming, but other studies have found a lower volume of research on this topic. The reason is not that few suffer from postpartum depression, but rather a lack of awareness and seriousness surrounding this grave issue.

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The Silence Killer: Tinnitus and the Soundscape of Current Treatment

Clinical Correlations

By Carolyn Akers Peer Reviewed Roger Daltrey, co-founder and lead singer of The Who, had this to say of bandmate Pete Townshend’s famous penchant for bludgeoning Fender Stratocasters: “Pete wasn’t just smashing his guitar. He used to.

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Electric vehicles on fire: new training course dedicated to electric vehicle (EV) fires

Emergency Live

The International Fire Training Center (IFTC) has launched a revolutionary new course dedicated to electric vehicle (EV) fires In response to the exponential increase of electric vehicles (EVs), the International Fire Training Center (IFTC) has developed the first firefighting course dedicated specifically to EVs. This innovative course is the first of its kind in the […] The post Electric vehicles on fire: new training course dedicated to electric vehicle (EV) fires appeared first on Emer

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