Ken Grauer, MD
JULY 9, 2023
The ECG in Figure-1 was obtained from a 60-year old woman — who presented to the ED ( E mergency D epartment ) for “palpitations”. Her vital signs were normal at the time this triage ECG was recorded. Blood was drawn , and the patient was promptly placed in a room to be seen — but on entering, the ED physician found her unresponsive in cardiac arrest.
The Trauma Pro
JULY 13, 2023
In my last post, I wrote about how the electronic trauma flow sheet (eTFS) practically assures a garbage in situation. Today, I’ll dig into what happens on the back end, and how it also creates a garbage out situation. There are two ways to view the eTFS on the back end (abstraction phase): read a paper report (timeline), or view it live in the electronic health record (EHR).
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Sensible Medicine
JULY 9, 2023
I always tell junior faculty that your contract means little, and, indeed, I found that to be the case, when a mid-career faculty departed and I inherited a third of his lung cancer patients. Yet, like most unexpected clinical changes in my career, I ended up learning unexpected truths. One man taught me about lung cancer screening. He was the most improbable 74 year old.
ECG Guru
JULY 14, 2023
ECG 1 is from a 57-year-old male with no prior cardiac disease. He reports acute shortness of breath for 2 days. We see a sinus rhythm with left anterior fascicular block (LAFB) and conspicuous T-wave inversions in the inferior leads and in V1-V6. These are typical ECG changes that may indicate a pulmonary embolism. ECG 2 was taken from the same patient 1 year earlier.
Don't Forget the Bubbles
JULY 12, 2023
4-year-old Mark presents with lethargy, jaundice, and abdominal pain after eating one portion (40g) of broad beans. Could he have G6PD deficiency? G6PD , short for glucose-6-phosphate dehydrogenase, is an enzyme active in all cell types and is key to protecting red blood cells from oxidative damage and early destruction. A child with reduced G6PD enzyme activity has increased red blood cell breakdown – haemolysis – when exposed to specific triggers.
PEMBlog
JULY 14, 2023
The case A self-proclaimed dance team superstar presents after injuring her foot at a regional competition. She tried to finish the routine after landing awkwardly. But was having difficulty bearing weight. She applied ice overnight and despite ibuprofen is still in pain, and presents to the ED the next day.On her exam the neruovascular exam is normal, and she has pain along the proximal edge of the 5th metatarsal.
ACEP Now
JULY 8, 2023
ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Science Based Medicine
JULY 10, 2023
Two decades ago, I cut my skeptical teeth countering advertising for whole body scans by companies making extravagant promises for their products. This particular medical fad faded for a while, but now it's back with a vengeance.with AI! Looking at these products, what I see is basically the quackery that is functional medicine on steroids and powered by AI.
Emergency Live
JULY 9, 2023
Health of our heart: magnetic resonance imaging is a diagnostic method based on the application of a high-intensity magnetic field directed at the area of interest The post Magnetic resonance imaging of the heart: the relevance in diagnosing heart disease appeared first on Emergency Live.
The Skeptics' Guide to EM
JULY 8, 2023
Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM.
Core Medical Group
JULY 14, 2023
Have you ever wondered what it takes to find the perfect match between healthcare candidates and their dream roles? In the world of healthcare recruitment, there are professionals who go above and beyond to find the perfect match between candidates and their respective roles.
Science Based Medicine
JULY 12, 2023
FDA upgrades Leqembi for AD from accelerated to traditional approval based on latest clinical data. The post FDA Approves Leqembi for Alzheimer’s first appeared on Science-Based Medicine.
Emergency Live
JULY 8, 2023
Molluscum contagiosum is a viral skin infection that causes lesions of the skin and, more rarely, the mucous membranes. Molluscum contagiosum presents itself with skin lesions with a typical dome shape called papule with a hollow in the centre, called umbilication The post Molluscum contagiosum: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.
Sensible Medicine
JULY 14, 2023
EJ was a 32-year-old man with risk factors for HIV infection who presented to the emergency room with two weeks of worsening shortness of breath. When he arrived, he was tachycardic, tachypneic, hypoxic, and his chest x-ray revealed diffuse parenchymal infiltrates consistent with pneumonia. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.
First 10 EM
JULY 12, 2023
I have spent a lot of time reading and talking about the TXA literature. The more literature I see, the less valuable TXA seems. However, trauma remains the one area of practice with a clearly positive trial, with the CRASH2 trial that started it all. Despite its size, the CRASH2 trial was imperfect, and replication […] The post PATCH-trauma: Another negative (but complicated) TXA trial appeared first on First10EM.
Dr. Smith's ECG Blog
JULY 14, 2023
A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated w
Emergency Live
JULY 12, 2023
Focaccia Group: a new chapter of growth Focaccia Group, a company specialising in the outfitting of vehicles, recently announced the acquisition of the historic NCT – Nuova Carrozzeria Torinese factory, marking a significant advance in its path of growth and consolidation. This plant, a former Lancia and Abarth factory, is at the centre of a […] The post Focaccia Group acquires NCT factory appeared first on Emergency Live.
Taming the SRU
JULY 13, 2023
HISTORY OF PRESENT ILLNESS A middle aged male presented with right eye pain. Patient stated that upon waking up from a nap his right eye spontaneously “popped out.” He was able to self-reduce the eye via relaxation and gentle pressure. He reported residual redness and soreness of the right eye. He denied any visual changes or difficulty with eye movements.
Science Based Medicine
JULY 13, 2023
This book — written by "Anonymous", edited by Children's Health Defense lawyer Mary Holland and Children's Health Defense Publisher Liaison and Thinking Moms’ Revolution co-founder Zoey O’Toole, and published by "The Turtles Team" — purports to use only mainstream references to prove its points. But the book employs all the standard tropes in a master class of science denial and antivax tactics and techniques.
EMCrit
JULY 8, 2023
Today I am joined by Mathieu Brunet, MD; a EM Doc and Trauma Team Leader. He recently wrote me with a case of Transcutaneous Pacing in which he thought he had mechanical capture due to a perfect matched pulse ox waveform. Well it turned out that was erroneous. Why??? Listen to this episode. EMCrit Project by Scott Weingart, MD FCCM.
Emergency Live
JULY 12, 2023
Mycosis of the foot: suspicious spots, flaking skin, nails that change colour and texture: if the feet begin to show these characteristics, it could be a fungal infection The post Skin fungi: mycosis of the foot appeared first on Emergency Live.
Taming the SRU
JULY 8, 2023
Admit/Transfer/Discharge - Breakng bad News - History of EM Admit-Transfer-Discharge WITH Dr. Paulsen There are many factors that influence disposition, including independence of the patient and family/friend support, access to follow up, resources at your hospital, and transfer environment Why Transfer? Regionalized certified care centers, specialty procedural interventions, higher level of care Why Consult?
University of Maryland Department of Emergency Med
JULY 8, 2023
Pelvic fractures can be a major source of life threatening hemorrhage. Suspect fracture with significant force/mechanism. Signs are pelvic tendern.
Medagadget
JULY 12, 2023
Moximed , a medtech company based in California, has developed the MISHA knee system, an implantable shock absorber for use in patients with knee osteoarthritis. The system is designed as an alternative to total knee replacement, and can help to reduce pain and discomfort for patients when performing daily activities, such as walking. The system is implanted on the outside of the knee, beneath the skin, and there is no need to remove bone, muscle, or ligament, resulting in a much faster patient
Emergency Live
JULY 11, 2023
Myocarditis is an inflammation that affects the heart muscle. The name comes from the myocardium, the muscular component of the heart that makes up its walls and enables it to perform its pumping function The post Inflammations of the heart muscle: myocarditis appeared first on Emergency Live.
Science Based Medicine
JULY 14, 2023
Ideally, leaders of American medicine would have had the courage to correct misinformation spread by their fellow doctors. At a bare minimum, they didn't have to lavish praise on a doctor who repeatedly polluted our COVID landscape with obvious misinformation and falsely pacified people the worst was over, when in fact the worst was yet to come. The post Praise for Dr.
Sensible Medicine
JULY 12, 2023
In our last podcast , Vinay and I discussed the problem with medical journals. This was in response to a column I wrote about four fatally flawed studies that appeared in the most prominent journals. The commenter is an established academic who will remain nameless because his success depends on journals publishing his work. Was disappointed that in the most recent sensible med podcast — you guys didn't mention what I think is the biggest conflict of all and reason we don't get fair judgin
Dr. Smith's ECG Blog
JULY 12, 2023
I come in early for every shift to read the ECGs on the system that have not yet been "confirmed". I came across this one: The computer calls is: "SINUS RHYTHM. NORMAL ECG" What do you think? Be VERY careful when the computer calls the ECG "Normal". I saw the inferior ST depression (which is reciprocal to subtle STE in aVL) and the subtle ST depression in precordial leads and thought: "If this patient came in with chest pain, then it is an acute OMI.
Emergency Live
JULY 14, 2023
The term maculopathy identifies a whole series of eye diseases that can affect the macula: the macula is a part of the eye, located in the center of the retina, responsible for clear and detailed vision It is an extremely delicate area which is therefore very vulnerable to pathological and degenerative phenomena. Maculopathies are varied […] The post Eye diseases: what is maculopathy?
St. Emlyn
JULY 11, 2023
St.Emlyn's - Emergency Medicine #FOAMed @LizCrowe2 explains how the term burnout is being inappropriately used and as a result may obscure and excuse some of the work related stressors we experience. @stemlyns #FOAMed The post Liz Crowe: Is burn out burning us out? St Emlyn’s appeared first on St.Emlyn's.
Medagadget
JULY 14, 2023
Researchers at the University of Washington have developed an app that converts common smartphones into clinical thermometers. Spotting the signs of fever early could make a difference in providing early treatment or beginning a period of isolation to reduce the chance of disease transmission. This is particularly important for viral diseases, such as COVID-19.
EMDocs
JULY 8, 2023
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: DEVICE RCT – VL vs DL for Critically Ill Adults Spoon Feed Video laryngoscopy (VL) was associated with higher rates of first attempt intubation success compared to direct laryngoscopy (DL) for critically ill patient
Emergency Live
JULY 14, 2023
The essential characteristic of individuals with Dependent Personality Disorder is dependent and submissive behavior aimed at seeking someone to protect and care for them The post Dependent Personality Disorder: Definition, Causes, Symptoms, Diagnosis, and Treatment appeared first on Emergency Live.
EMCrit
JULY 13, 2023
Massive Hemorrhage Protocol--The Trauma Anesthesiologist Perspective. EMCrit Project by Scott Weingart, MD FCCM.
Medagadget
JULY 10, 2023
Engineers at MIT have developed a microelectronic probe that can measure and influence the behavior of neurons involved in the brain-gut axis. Neural communication between the brain and GI tract has been implicated in a range of conditions as varied as autism and Parkinson’s disease. However, studying the interplay between these neurons was difficult, until now.
University of Maryland Department of Emergency Med
JULY 8, 2023
This study found that time to intraosseous was faster than time to peripheral IV. This lead to quicker resuscitation time. This was particularly tr.
Emergency Live
JULY 13, 2023
Mastitis is a very frequent inflammatory pathology after childbirth, during breastfeeding, and is usually due to an infection of bacterial origin The post Mastitis, the difference between puerperal and non-puerperal appeared first on Emergency Live.
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