Sat.Oct 28, 2023 - Fri.Nov 03, 2023

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Help! My Consultant Won’t Come In To See A Patient!

The Trauma Pro

Consultants provide very important services to trauma patients in the ED and inpatient settings. The trauma professionals managing those patients can’t know everything (although we sometimes think we do). But occasionally our patients present issues that require evaluation by other experts in order to guarantee excellent care. Sometimes our consultants want to do too much, or make recommendations that are not really in their area of expertise (e.g. a cardiologist evaluating a cardiac contu

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MEDALL Lecture Slides — Blog #351 — Posterior Leads.

Ken Grauer, MD

= NOTE: These are my "slides" for November 2, 2023 — for my M edALL p resentation. The talk will be recorded and posted on-line. Based on ECG Blog #351 ( www.tinyurl.com/KG-Blog-351 ) LINK to this Page — www. tinyurl.com/KG-MedAll-351 — = = ECG Blog #205 = The Systematic Approach I favor. The "formula" = [link] LINK for Blog #205 = [link] - = Figure: The Systematic Approach that I favor.

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Trending Sources

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Doctors and 'experts' who got it wrong during the COVID-19 pandemic

Sensible Medicine

Doctors and ‘experts’ who got COVID policy wrong are asking for forgiveness. Their errors hurt children— resulting in massive learning losses— and caused broader destabilization to the economy, work life, social communities and more. Do they deserve forgiveness? And, why did they err in the first place? Recently Scott Galloway, the NYU professor, appeared on Bill Maher.

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How To Read a Scientific Paper

Don't Forget the Bubbles

Read between the lines. No matter where we are or what type of medicine we practice, it is likely that we all were told at one point that we were expected to be lifelong learners. This is important as medical knowledge is constantly evolving. Dr. David Sackett, the father of evidence-based medicine, once said: I The traditional way to stay current is by reading the relevant scientific literature.

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The Deep Freeze: A Review of Frostbite Management

EM Ottawa

Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1) These injuries can be debilitating requiring surgical intervention, debridement or amputation in the most severe cases.

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Study laundering: IPAK, antivax “scientists,” and the return of living dead antivax studies

Science Based Medicine

Antivaxxers don't like it when one of their crappy studies that they somehow managed to sneak into a decent peer-reviewed journal is deservedly retracted, as happened to Mark Skidmore's paper that estimated that 278K people might have died from COVID-19 vaccines. Fortunately for Skidmore and others, there exist fake journals that will launder their study by republishing it so that antivaxxers can continue to claim the work has been published in a "peer-reviewed journal.

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CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

RebelEM

Background: Hemorrhage is the leading cause of trauma related mortality. The initial injury is often complicated by multifactorial coagulopathy that can exacerbate bleeding. Fibrinogen is the precursor to fibrin and a major component of stable clot formation. Fibrinogen and fibrin are often depleted during major trauma as a result of consumption, breakdown, and dilution.

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Haemorrhage Control

Life in the Fast Lane

Kane Guthrie Haemorrhage Control Haemorrhage Control: Principles and Cognitive Aid with Cliff Reid. Don't Let Your Patient Bleed to Death!

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Residency Spotlight: Cleveland Clinic Akron General

ACEP Now

What does your program offer that residents can’t get anywhere else? We are the first community emergency medicine program in the country. Residents train at an academic Level I trauma center and several freestanding emergency departments (EDs). We offer innovative ultrasound training, which includes nerve blocks in the ED, and annually participate in SAEM Sonograms.

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Implementation of a standardized pregnancy screening process to address gender disparities in radiology turn-around-time and ED length of stay

EM Ottawa

Methodology: 1.5/5 Usefulness: 1.5/5 Loke DE, et al. CJEM. 2022 Mar;24(2):206-213. Question and Methods: Trying to quantify gender disparities in CT turnaround time and ED LOS and determine if intervention in the form of protocolized point-of -care pregnancy testing would eliminate the disparity. Findings: Pre intervention women of childbearing age had 18 min longer CT […] The post Implementation of a standardized pregnancy screening process to address gender disparities in radiology turn-

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Part 2: Is an Abnormal Lab Value After Vaccination More Concerning Than Death From COVID?

Science Based Medicine

Part 1 is available here. “There is No COVID Heart” On May 14, 2021, three “medical conservatives,” Drs. John Mandrola, Andrew Foy and Vinay Prasad, published an article titled “Setting the Record Straight: There is No ‘Covid Heart’” In it, they argued that “The issue of Covid-19 induced cardiac problems was massively overblown.” Though the virus had existed for barely over year, they were very […] The post Part 2: Is an Abnormal Lab Val

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Lung Chip Mimics Radiation Injury

Medagadget

Researchers at the Wyss Institute at Harvard University have developed a microfluidic chip that can recreate some of the features of radiation-induced lung injury. The lungs are very sensitive to radiation, and this can limit the application of radiotherapy to treat cancer. Accurately modeling radiation-induced lung injury could assist in developing new methods to prevent and treat the phenomenon, but it has been difficult to study this before the advent of advanced organ-on-a-chip models.

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Pediatric DKA and HHS

EB Medicine

In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the November 2023 Pediatric Emergency Medicine Practice article, Pediatric Diabetes: Management of Acute Complications in the Emergency Department and some of the highlights from the other EB Medicine articles published in November. Epidemiology Differential diagnosis Prehospital care ED history and physical exam Diagnostic studies Point of care testing Labs Imaging Treatment IV fluids, the 2-bag system Mild DKA Moderate to severe DKA

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Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults

EM Ottawa

Methodology: 4/5 Usefulness: 3.5/5 Prekker ME et al. N Engl J Med. 2023 Aug 3;389(5):418-429. Question and Methods: Authors aimed to determine if video laryngoscopy improves rates of first pass success compared to direct laryngoscopy. They performed a pragmatic, multicenter, unblinded randomized parallel-group trial. Findings: 85.1% first pass success with video laryngoscopy and 70.8% with direct […] The post Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Ad

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Fluoride and IQ

Science Based Medicine

The evidence continues to support that low levels of fluoride in drinking water are safe. The post Fluoride and IQ first appeared on Science-Based Medicine.

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Ocular foreign body removal

Life in the Fast Lane

James Miers and John Mackenzie Ocular foreign body removal Emergency Procedure: Ocular foreign body removal.

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EQUAL: a Straightforward Approach To Caring for Disabled Patients

ACEP Now

A disability is any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them. 1 This includes impairments or difficulty with: vision; movement, processing, or thinking and remembering; verbal or non-verbal communication; mental health; hearing; or relationships.

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BRASH Part 2: A BRASH with Death

Kings County Downstate EM

Co-Authors: Esteban Davila, Hemil Chauhan This is part 2 of a 2-part series focusing on BRASH. Part 1 can be found here. Patient Presentation A 70-year-old male with a past medical history of diabetes, hypertension, and chronic kidney disease (baseline creatinine 2-3 mg/dL) is brought in by EMS after being […] The post BRASH Part 2: A BRASH with Death appeared first on County EM.

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Bacteria Tag Team Tumors with T Cells

Medagadget

A team at Columbia University School of Engineering and Applied Science has developed a technique to enhance chimeric antigen receptor (CAR) T cell therapy in solid tumors. The technique involves engineering E. coli bacteria, that naturally tend to accumulate in the immune privileged core of solid tumors. The bacteria have been engineered to interact with tumor cells and deposit a synthetic antigen on the cells that can then be targeted by CAR T cells.

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Air Force Rescue: Rescue of a Hiker on Mount Miletto (Italy)

Emergency Live

Hero of the Sky: How the 85th SAR Centre at Pratica di Mare (Italy) Performed a Complex Rescue At first light, the Italian Air Force completed an extraordinary rescue mission, once again demonstrating the value and effectiveness of its operations in critical situations. With an HH-139B helicopter from the 85th SAR (Search and Rescue) Centre […] The post Air Force Rescue: Rescue of a Hiker on Mount Miletto (Italy) appeared first on Emergency Live.

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Chelsea's Path: Balancing Healthcare Recruitment and Parenthood

Core Medical Group

In the world of healthcare recruitment, Chelsea's journey has been very influential. For the past six months, she's worked as a Recruiter within CoreMedical Group's Allied Healthcare Division, finding inspiration in her work and her team's collaborative spirit. Beyond her professional role, Chelsea is a culinary enthusiast, crafting new recipes in the kitchen.

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SGEM#419: Welcome Back – To Another Episode on Back Pain

The Skeptics' Guide to EM

Date: October 26, 2023 Reference: Jones et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial placebo-controlled trial. Lancet July 2023 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers […] The post SGEM#419: Welcome Back – To Another Episode on Back Pain first appeared on The Skeptics Guide

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Magnetoelectric Material Stimulates Neurons Minimally Invasively

Medagadget

Researchers at Rice University have developed a magnetoelectric material that converts a magnetic field into an electric field. The material can be formulated such that it can be injected into the body, near a neuron, and then an alternating magnetic field can be applied to the area from outside the body. Magnetic fields are very useful in this context, as they can easily penetrate tissue without causing any damage.

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India: Train Accident in Andhra Pradesh, Balance Sheet Very Severe

Emergency Live

Rescue Teams Intervene Massively After Collision Between Two Trains in Southeast India A serious train accident sowed death and destruction last night in southeastern India, specifically between the towns of Alamanda and Kantakapalle in the state of Andhra Pradesh. Two trains collided under circumstances yet to be clarified, leaving behind a devastating toll of 13 […] The post India: Train Accident in Andhra Pradesh, Balance Sheet Very Severe appeared first on Emergency Live.

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ALiEM AIR Series | Trauma 2023 Module

ALiEM

Welcome to the AIR Trauma Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to trauma in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board.

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Haemorrhage Control Part 2

Life in the Fast Lane

Kane Guthrie Haemorrhage Control Part 2 Haemorrhage Control: Principles and Cognitive Aid Part 2.

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Eko’s Newest CORE 500 Stethoscope: A Review

Medagadget

Arriving in two boxes reminiscent of Apple product packaging – one for the chest piece (the part that contacts the body), and another for the detachable earpiece (tubes + ear tips) – the CORE 500 is clearly an upgrade from the Eko DUO stethoscope. Similar to its predecessor, the CORE 500 can be used with your own headphones, smart phone, and just the chest piece, making it free of any hassle with the earpiece tubes.

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San Diego regulates lithium-ion batteries

Emergency Live

San Diego Introduces Regulations for the Safety and Disposal of Lithium Batteries: Pioneering Initiative for Responsible and Safe Use In a bid to address safety concerns and promote responsible disposal practices, San Diego is set to become the first city in the county to introduce comprehensive regulations governing the storage and disposal of lithium-ion batteries. […] The post San Diego regulates lithium-ion batteries appeared first on Emergency Live.

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See this "NSTEMI" go unrecognized for what it really is, how it progresses, and what happens

Dr. Smith's ECG Blog

Written by Nathanael Franks MD, reviewed by Meyers, Smith, Grauer, etc. A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest.

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Soren Diederichsen on Atrial Fibrillation Screening

Sensible Medicine

If you care about AF you will love this conversation. Soren has some interesting ideas about what AF is now vs what AF was in the past. Here are some links: The LOOP Study (which was non-significant). Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP Study Severity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke: A Post Hoc Analysis

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Guidelines Merge STEMI and non-STE ACS: ECS emphasizes that ACS is a spectrum of disease, not only a STEMI-NSTEMI dichotomy

Emergency Medicine News

An abstract is unavailable.

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CRI Conference: Celebrating the 160th Anniversary of the Red Cross Emblem

Emergency Live

160th Anniversary of the Red Cross Emblem: a conference to celebrate and learn more about the symbol of humanitarianism On 28 October, Italian Red Cross President Rosario Valastro kicked off the CRI Conference dedicated to the 160th Anniversary of the Red Cross Emblem. The event was a unique opportunity to celebrate the iconic symbol that […] The post CRI Conference: Celebrating the 160th Anniversary of the Red Cross Emblem appeared first on Emergency Live.

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Research Roundup (Perth live edition)

First 10 EM

As usual, a random smattering of articles. This group was presented as part of a live podcast recording at Sir Charles Gairdner Hospital in Perth, Australia, where I was honoured to be invited to be the WG Smith visiting lecturer. The guests helped select the papers, which means they are just as random as usual. […] The post Research Roundup (Perth live edition) appeared first on First10EM.

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First10EM LIVE podcast: October 2023

Broome Docs

This is a very special episode of the Broome Docs Podcast Journal Club with Dr Justin Morgenstern. Justin was invited to visit us in Western Australia as a guest lecturer for the W.G. Smith lecture series. So we decided to invite along a few of our favourite FOAMed friends to be a part of the festival of nerdiness and record a live version in front of the local crew.

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emDOCs Revamp: Esophageal Perforation

EMDocs

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

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Bari: Practical Emergency-Urgency Congress With Top National Experts

Emergency Live

Theoretical and practical emergency-urgency congress in Bari (Italy): a unique opportunity for professionals and practitioners A not-to-be-missed event is the one promoted and conceived by Dr. Fausto D’Agostino, medical director Anesthesiologist Resuscitation at the Campus Bio-Medico in Rome, which will be held in Bari at the Hi Hotel on Nov. 24-25 entitled “Theoretical-Practical EMERGENCY-URGENCY Congress“ […] The post Bari: Practical Emergency-Urgency Congress With Top

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ACMT Toxicology Visual Pearl: Who Doesn’t Like a Nice Rosé?

ALiEM

What clinical presentation and medication is associated with this urinary discoloration? Critical illness requiring intubation and propofol sedation Cyanide toxicity requiring sodium thiosulfate Iron toxicity treated with deferoxamine Refractory vasoplegic shock treated with methylene blue Septic shock treated with vancomycin and cefepime Reveal the Answer 3.

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