The Trauma Pro

AUGUST 25, 2023

I am trying to figure out how I missed it! The Eastern Association for the Surgery of Trauma (EAST) snuck a new practice management guideline into the Injury journal last fall. And it desperately tries to answer a question that has been hanging around for several years. Do we vaccinate spleen injury patients who undergo angioembolization or not? I’ve been pondering this for some time and have reached my own conclusion based on some very old literature.

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Sepsis Research Outcomes Hospitals 243

Mount Sinai EM

AUGUST 23, 2023

Today is a 2 parter: 1) The Supraorbital (+supratrochlear) block for forehead lacs and 2) Comments on decision-making TNF at Ethyl’s 84th and 2nd again, 8 PM TLDR: The Supraorbital block will save you time and make your life easier/patient happier – WATCH THE 3 MIN VID ; We are DECISION MAKERS – make decisions, learn from them, READ THE ATTACHMENT, get amped THE SUPRAORBITAL/TROCHLEAR FOREHEAD BLOCK A must-have in your Elmhurst tool belt.

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EMS 187

Don't Forget the Bubbles

AUGUST 23, 2023

Siren and blue lights. Team allocated and primed. Voices command, ears listen, and hands swiftly execute. Monitors beep—loops of communication. As the second hand sweeps, loud voices grow quieter, and pulse checks fall into an unfortunate pattern. Realisation, its time, knowing looks, a shake of the head, a pain, heaviness. Winding down…. “Time of Death 10:43”.

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Emergency Department Resuscitation Documentation/Coding Best Practices 98

NRC Health

AUGUST 24, 2023

A team at Dayton Children’s, led by pediatric anesthesiologist Sean Antosh, MD, believed there was a better way to humanize care and environments for patients, particularly for children with Autism Spectrum Disorder or other special needs like ADHD or high anxiety. The post Dayton Children’s uses innovative sensory tools to humanize pediatric surgery appeared first on NRC Health.

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Pediatrics 98

The Trauma Pro

AUGUST 22, 2023

It’s more on the massive transfusion protocol (MTP). I’ll continue today with MTP activation triggers. What criteria should trigger your massive transfusion protocol? Sometimes, it’s obvious. The EMS report indicates that your incoming patient is in shock. Or there was notable blood loss at the scene. Or they have a mangled extremity and will need blood products in the OR, if not sooner.

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Shock Wellness EMS 100

ACEP Now

AUGUST 22, 2023

There is no shortage of guidelines, protocols, or quality measures across emergency medicine. Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. A common limitation to many of these guidelines, however, is the lack of recognition of available resources or the unique challenges of certain patient groups.

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Emergency Department Academics Critical Access Research 98

Science Based Medicine

AUGUST 21, 2023

The World Health Organization held the First WHO Traditional Medicine Global Summit this weekend. Unfortunately, its claims of being "evidence-based" aside, the conference followed the WHO's usual pattern of serving as propaganda, not science. The summit was one-sided, organized by believers with the only speakers being believers, to promote a predetermined policy goal of promoting traditional medicine and justify "integrating" it with science-based medicine.

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Medagadget

AUGUST 25, 2023

Researchers at the Mount Sinai Hospital have developed an mRNA-based treatment for cancer. The approach combines the delivery of mRNA therapy in lipid nanoparticles and also involves co-delivering dendritic cells that have also been primed through treatment with lipid-encased mRNA. The technology aims to overcome some of the immune evasive tricks that tumors use to circumvent the immune system, some of which can hamper more traditional immunotherapies.

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Research Hospitals 92

ACEP Now

AUGUST 25, 2023

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. She has a history of similar episodes. There are no other concerning aspects to her examination. Routine bloodwork was ordered in triage.

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Administration Pediatrics Outcomes Emergency Department 97

St. Emlyn

AUGUST 23, 2023

St.Emlyn's - Emergency Medicine #FOAMed Part 1 of an introduction to paediatric ultrasound in the emergency department from Dr Pete Hulme @Dr_Pete_EmMed @stemlyns #FOAMed The post Paediatric Point of care ultrasound: Big Kids playing with toys or the future of Paediatric emergency medicine? Part I appeared first on St.Emlyn's.

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Ultrasounds Emergency Department 89

Science Based Medicine

AUGUST 25, 2023

Why were misinformation doctors so eager to spread the easily-refutable myth that "no healthy child" had died of COVID? The post Vulnerable Children Really Count first appeared on Science-Based Medicine.

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Emergency Live

AUGUST 23, 2023

Extreme weather is becoming more and more frequent across Europe because of climate changes In recent years, as our world heats up, change has brought irregular weather patterns. Heatwaves, forest fires, droughts, heavy rain falls which lead to shocking destructive flooding and storms have rapidly becoming the new norm of our world. We witness, today, […] The post Changing World And How Project PEERS Can Help appeared first on Emergency Live.

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Shock 88

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. Please do listen. Bobby is one of the smartest people in cardiology today. After closely reviewing the cardiac literature for the past decade or so, I have become increasingly hopeless that we could glean any useful information from non-random retrospective comparisons.

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Administration Outcomes Research COPD 88

St. Emlyn

AUGUST 20, 2023

St.Emlyn's - Emergency Medicine #FOAMed Just a short post this week to highlight some of the most rewarding elements of my clinical life. For several years now I’ve been working as a BASICS doctor in … BASICS, NWPCCC and EPHC. St Emlyn’s Read More » The post BASICS, NWPCCC and EPHC. St Emlyn’s appeared first on St.Emlyn's.

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Medagadget

AUGUST 25, 2023

Scientists at New York University have developed a gene therapy for chronic pain. The technology works by targeting the NaV1.7 sodium ion channel present on neurons, which is an important component of the pain response. The researchers encoded a version of a peptide that allows a modulatory protein, called CRMP2, to bind to NaV1.7 sodium ion channels and modulate their activity.

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Research 85

Emergency Live

AUGUST 22, 2023

Heart murmurs are typical noises caused by turbulent blood flow The post Semeiotics of the heart: knowing and recognising systolic and diastolic heart murmurs appeared first on Emergency Live.

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Sensible Medicine

AUGUST 25, 2023

CT was an 83-year-old woman with temporal arteritis. She was diagnosed four years earlier. Multiple attempts at weaning prednisone were unsuccessful. Sensible Medicine is a reader-supported publication. If you appreciate our work, please become a free or paid subscriber. It is unoriginal to point out that doctors learn from their patients. Deliberate practice is learning from the daily, often mundane, tasks in medicine.

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Hospitals Urgent Care Wellness Fractures 85

Science Based Medicine

AUGUST 23, 2023

Studies have found large language model AIs to have impressive medical knowledge, but they are not quite there yet. The post Update on Dr. AI first appeared on Science-Based Medicine.

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Dr. Smith's ECG Blog

AUGUST 19, 2023

Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal disease was sent to the ED after dialysis for three days of nausea, vomiting, loose stool, lightheadedness and fatigue. RR18 sat 99% HR 90 BP 90/60, afebrile. Below is the 15 lead ECG. What do you think? There’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression and normal voltages.

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EKG/ECG Wellness Outcomes Hospitals 79

Emergency Live

AUGUST 24, 2023

The term amyloidosis refers to a group of rare, serious conditions caused by deposits of abnormal proteins, called amyloids, in tissues and organs throughout the body The post Diseases affecting the heart: cardiac amyloidosis appeared first on Emergency Live.

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RebelEM

AUGUST 21, 2023

Background Information: Cardiac arrest is a devastating event that imposes considerable human and financial burdens. While it is widely recognized that cardiac arrest leads to brain injury, what is often overlooked is the persistent cerebral hypoperfusion that continues even after circulation is restored. The sustained cerebral hypoperfusion can be attributed to impaired cerebrovascular auto-regulation, which renders normal arterial carbon dioxide tension (PaCO2) insufficient in achieving and ma

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Hospitals Resuscitation Outcomes CPR 77

Medagadget

AUGUST 22, 2023

Researchers at MIT have developed a wearable ultrasound system that is intended to allow women at high risk of breast cancer to perform an ultrasound scan on themselves at home, and may also let patients with early-stage malignancy or suspicious lesions to monitor how they are progressing. The technology can help patients to avoid having to attend a clinic, and may also help them to identify tumors that arise between routine breast checks at a clinic.

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Ultrasounds Research Radiology Radiology 76

EM Literature of Note

AUGUST 23, 2023

In a world of doors, truck beds, furniture, and other finger-crushing nuisances, emergency department visits for injuries involving the distal digits are common. Injuries range from tuft fractures, to degloving injuries, to all manner of nail and nailbed derangement. Perusing any textbook or online resource will typically advise some manner of repair, including, but not limited to, replacing an avulsed nail back into the proximal nail fold and securing it in place.

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Emergency Department Fractures Outcomes 75

Emergency Live

AUGUST 24, 2023

Revolutionizing Radiation Detection: The Advanced Features of the Teledyne FLIR device Teledyne FLIR Defense has taken a significant leap forward in radiation detection technology with the introduction of the identiFINDER R225, the latest addition to their spectroscopic personal radiation detector (SPRD) lineup. This groundbreaking device builds upon the success of its predecessor, the R200, while […] The post identiFINDER R225: The Cutting-Edge Personal Radiation Detector appeared first o

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First 10 EM

AUGUST 21, 2023

This is a guest post by Dr. Julia Dmytryshyn. Julia completed medical school at the University of Toronto and is now a 2nd year Family Medicine resident at the University of Toronto. She is the co-creator of the popular medical education podcast series The Vulva Diaries. Her areas of interest include emergency medicine and women’s […] The post Miscarriage (Mis)management part 2: Management and Counselling appeared first on First10EM.

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Medagadget

AUGUST 21, 2023

Researchers at the University of Leeds in the UK have developed a magnetic tentacle robot that is intended for use in minimally invasive medical procedures, such as the treatment of tumors in the lungs. The soft tentacles are made from silicone. They are unlikely to cause tissue damage, and contain a series of magnets that can be influenced by external magnetic robots.

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Research Wellness 70

RebelEM

AUGUST 24, 2023

Background: Sports-related concussions are among the most common injuries in children and adolescents, affecting millions of youth athletes annually. 1 Given their prevalence in this population, providers must be up to date on diagnosis and management. Historical practice recommends rest to prevent adverse outcomes; however, evidence suggests strict rest is harmful.

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Outcomes Pediatrics Research Hospitals 70

Emergency Live

AUGUST 25, 2023

Testing drones for aerial transport of biomedical material: Living Lab at San Raffaele Hospital Innovation in healthcare is taking giant steps forward thanks to the collaboration between the San Raffaele Hospital and EuroUSC Italy in the context of the H2020 European project Flying Forward 2020. This ambitious project aims to expand the boundaries of the […] The post The Future of Biomedical Transport: Drones at the Service of Health appeared first on Emergency Live.

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Hospitals 85

EM Ottawa

AUGUST 24, 2023

Dr. Barnes had previously provided a very thorough guide on burns management, which can be found here. The management of thermal injury has largely stayed the same but there have since been some important points that were highlighted by the ABA Pain management guidelines which were published in 2020 that require some update. In a […] The post Burnin’ Up: Thermal Burn Pain Management appeared first on EMOttawa Blog.

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Burns Resuscitation 75

Emergency Medicine Journal

AUGUST 23, 2023

Background High emergency department (ED) usage by older individuals for non-emergencies is a global concern. ED avoidance initiatives have proven effective in addressing this issue. To specifically cater to individuals aged 65 and above, the Southern Adelaide Local Health Network introduced an innovative ED avoidance service. This study assessed the acceptability of the service among its users.

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Emergency Department Urgent Care Hospitals 75

Medagadget

AUGUST 22, 2023

Researchers at the Harvard John A. Paulson School of Engineering and Applied Sciences have developed a technique that allows them to 3D print a heart ventricle, that can then go on to beat rhythmically. The technology could allow researchers to create heart models to test new cardiac drugs and may even pave the way for fully implantable cardiac components.

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Research 68

Emergency Live

AUGUST 25, 2023

Pityriasis rosea of Gibert is a benign, acute-onset dermatosis predominantly in children or young adults aged 10 to 35 years The post Pityriasis Rosea (Gibert's): Definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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Emergency Medicine Cases

AUGUST 22, 2023

In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer questions like: at what age is it safe to attempt reimplantation of an avulsed tooth in the ED? What are the 3 most time-sensitive dental trauma emergencies?

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Fractures EMS 68

EMDocs

AUGUST 24, 2023

Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles. Today we look at the FABLED trial. Authors: Brannon L Inman, MD (Critical Care Fellow, Orlando, FL) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis AKA the “FABLED” Trial Clinical question: In adults with severe manifestations of s

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Administration Sepsis Shock Outcomes 67

Taming the SRU

AUGUST 25, 2023

R1 CK: Pericarditis & myocarditis - r3 taming the sru - r4 case follow-up - ent emergencies - Ortho in a Resource-limited setting - pharmacy updates - pediatric seizures R1 Clinical knowledge: Pericarditis and Myocarditis WITH Dr. Knudsen-Robbins Overall, maintain a high index of suspicion, much of work-up is non-specific Pericarditis: EKG: diffuse ST elevations, Spodick's sign, also can be normal Dx need 2/4: typical pain, EKG, new/worsening effusion, friction rub If arrhythmias - consider

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Seizures Fractures EKG/ECG Resuscitation 66

Emergency Live

AUGUST 21, 2023

First discovered in 1866, Ebstein's anomaly presents as a downward displacement of the tricuspid valve, instead of the usual position between the right atrium and right ventricle The post Cyanosis, arrhythmias and heart failure: what causes Ebstein's anomaly appeared first on Emergency Live.

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The Skeptics' Guide to EM

AUGUST 19, 2023

Date: August 14, 2023 Reference: Ma et. al. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial. Lancet 2023 Guest Skeptic: Dr. Mike Pallaci is a Professor of Emergency Medicine (EM) for the Northeast Ohio Medical University, and an Adjunct Clinical Professor of […] The post SGEM#413: But Even You Cannot Avoid…Pressure – Intensive Care Bundle with Blood Pressure Reductio

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EMS Stroke Emergency Department 74