Pediatric EM Morsels

MARCH 15, 2024

We encounter seizures commonly in the Emergency Department. While they can be dramatic and devastating, we have learned to become comfortable with the wide variety that may present in children. From the simple febrile seizure to the complex seizure, we know how to stabilize and how to evaluate. While fortunately most seizure activity is short lived, we also know that status epilepticus can be difficult to manage, and persistent seizures should make us consider specific etiologies (ex.

Seizures 247

Seizures Pediatrics Psychiatric Emergency Department 247

Sensible Medicine

MARCH 13, 2024

Martin Kulldorff was a professor at Harvard Medical School who argued during the pandemic that school closure was misguided policy, lockdowns were inappropriate and draconian, vaccine mandates were unjust, natural immunity conferred protection against subsequent severe disease, kids did not need to be vaccinated, and that two year old children should not wear cloth masks in daycare.

Academics 145

Academics Hospitals 145

EM Ottawa

MARCH 14, 2024

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. The diagnosis can be extremely challenging as findings are often not typically focal. Posterior strokes are misdiagnosed more than 3x more often than anterior circulation strokes.1 Similar to anterior circulation strokes, posterior strokes are most commonly […] The post Posterior Circulation Strokes appeared first on EMOttawa Blog.

Stroke 139

Stroke Documentation/Coding Resuscitation 139

Science Based Medicine

MARCH 12, 2024

"Science cannot survive in a society that does not value truth and strive to discover it." The post Dr. Martin Kulldorff, Who Posted Pictures of Guillotines and Promised Herd Immunity Would Arrive 3-6 Months After Lockdowns Ended, Fired for “Clinging to the Truth”. first appeared on Science-Based Medicine.

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EM Literature of Note

MARCH 12, 2024

A few words regarding an article highlighted in one of my daily e-mails – a report regarding the Elders Risk Assessment tool (ERA) from the Mayo Clinic. The key to the highlight is the assertion this score can be easily calculated and presented in-context to clinicians during primary care visits, allowing patients with higher scores to be easily identified for preventive interventions.

Outcomes 120

Outcomes Hospitals 120

Sensible Medicine

MARCH 12, 2024

On February 8th, Lisa Rosenbaum published an excellent and thought-provoking piece in the New England Journal titled: On Being Well While Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training. This article, and the accompanying podcast , has stimulated more conversation than a “non-research” article has in years.

Wellness 118

Wellness Academics Research 118

ACEP Now

MARCH 11, 2024

ACEP Now wishes to congratulate the medical students who matched into emergency medicine today! This year, it is estimated that only about 137 of more than 3,000 spots remained unfilled as of Monday, March 11, 2024. This is in comparison to more than 550 unmatched positions last year. While the full explanation for the rebound in emergency medicine remains unknown, one potential reason is a large increase in international medical graduate applicants this year.

EMS 115

EMS 115

American Medical Compliance

MARCH 15, 2024

Among the various areas of compliance, Fraud, Waste, and Abuse (FWA) compliance stands out as a critical pillar. The Department of Justice recently revealed charges against 78 individuals involved in healthcare fraud schemes. Therefore, for healthcare providers to prevent these charges from happening, understanding FWA compliance is essential. Healthcare organizations need to fully understand FWA compliance to maintain integrity, protect patients, and uphold regulatory standards.

Best Practices 105

Best Practices Risk Management Documentation/Coding Operations 105

Dr. Smith's ECG Blog

MARCH 9, 2024

Written by Willy Frick A 67 year old man with a history of hypertension presented with three days of chest pain radiating to his back. He had associated nausea, vomiting, and dyspnea. What do you think? This ECG together with these symptoms is certainly concerning for OMI, but the ECG is not fully diagnostic, and another consideration could be acute pericarditis.

EKG/ECG 100

EKG/ECG 100

EMCrit

MARCH 13, 2024

People on twitter absolutely hate the concept of using a central line to resuscitate a GI bleeder. This comes up a couple times per year. I think the source of this hatred is largely two-fold: A central line alone is garbage (without a Level-1 or Belmont infuser). I'll admit that. So if you're working in […] EMCrit Project by Josh Farkas.

Resuscitation 92

Resuscitation 92

Science Based Medicine

MARCH 13, 2024

Tik Tok is a cesspool of wellness pseudoscience and misinformation. All of social media has the potential to spread misinformation without any filter, but for some reason Tik Tok has become the preferred platform for the most outrageous claims and nonsense. A recent trend on Tik Tok (and within the wellness community generally) is the parasite cleanse.

Wellness 103

Wellness 103

American Medical Compliance

MARCH 11, 2024

Amidst the busy dental appointments, treatments, and patient care, there are crucial aspects that often operate in the background but hold importance. These are recordkeeping and documentation. While the primary focus in dentistry is patient health and well-being, carefully keeping records is equally needed. In a survey , dental providers agree that careful and precise recordkeeping is indispensable, emphasizing the importance of documenting elements such as patient histories, examination result

Documentation/Coding 105

Documentation/Coding Best Practices Operations Outcomes 105

Taming the SRU

MARCH 10, 2024

Qi/KT: Hypoglycemia - R1 CK: Syncope rules - R3 TTS: Traumatic cardiac tamponade - ohio aceP Guest lectUre r2 quality improvement/knowledge translation: Hypoglycemia with drs. beyde and wolski Hypoglycemia: blood glucose of <70 mg/dL. Beware of relative hypoglycemia in patients who live at very high blood glucose levels - they may have symptomatic hypoglycemia with a blood glucose that is normal for the majority of the population.

EKG/ECG 86

EKG/ECG Shock Wellness EMS 86

Emergency Live

MARCH 13, 2024

A Future of Emergencies Managed by Artificial Intelligence The world of emergency medicine is undergoing a radical transformation thanks to the advent of autonomous ambulances. These innovative rescue vehicles, equipped with autonomous driving systems, promise to revolutionize the way emergencies are handled, improving service efficiency and patient safety.

Patient Safety 83

Patient Safety 83

Science Based Medicine

MARCH 15, 2024

The first post-rollout data for the RSV antibody shot looks pretty good, but far too many little ones missed out. The post Some Good, But Preliminary Real World Data on Those Baby RSV Shots first appeared on Science-Based Medicine.

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Dr. Smith's ECG Blog

MARCH 13, 2024

Written by Willy Frick A man in his early 40s with BMI 36, hypertension, and a 30 pack-year smoking history presented with three days of chest pain. It started while he was at rest after finishing a workout. He described it as a mild intensity, nagging pain on the right side of his chest with nausea and dyspnea. It woke him the next day and radiated into his back.

EKG/ECG 78

EKG/ECG Urgent Care Sepsis Wellness 78

EMDocs

MARCH 9, 2024

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: Epinephrine or Airway First in OHCA? Spoon Feed In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experien

Head Injuries 80

Head Injuries Airway Management Outcomes EMS 80

Emergency Live

MARCH 13, 2024

Exploring Paths of Excellence: The Future of Nursing in Europe In a rapidly evolving healthcare landscape, specializing with a Master’s in Nursing Science can make a difference in a professional’s career. Europe offers globally recognized, high-quality programs for those ready to embark on this journey of professional growth. Leading Universities Choosing the right institution is […] The post Best Master's Degrees in Nursing in Europe appeared first on Emergency Live.

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The Skeptics' Guide to EM

MARCH 9, 2024

Date: March 6, 2024 This is an SGEM Xtra created from a lecture I gave for the Rural Ontario Medical Program (ROMP) ICE Camp Retreat in Collingwood, Ontario last month. ROMP helps Ontario medical students & residents arrange core & elective rotations in rural Ontario. An old friend, Dr. Matt De Stefano invited me to […] The post SGEM Xtra: A Philosophy of Emergency Medicine first appeared on The Skeptics Guide to Emergency Medicine.

EMS 75

EMS 75

First 10 EM

MARCH 11, 2024

The time has come to learn from the pandemic; to learn from our mistakes (and hopefully a few successes). There are many topics to choose from. In future posts, I plan to be very positive about the tremendous work done by so many colleagues. I will probably also have to write about our incredible scientific […] The post Lessons from the pandemic: Lagging indicators appeared first on First10EM.

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St. Emlyn

MARCH 11, 2024

St.Emlyn's - Emergency Medicine #FOAMed Greg Yates (new to the St Emlyn's team) reviews for Journal Club a review of a JAMA paper on elderly deaths associated with long overnight waits on an ED trolley. #FOAMed @stemlyns The post JC: Are long waits in A&E lethal for elderly patients? appeared first on St.Emlyn's.

Administration 71

Administration 71

Emergency Live

MARCH 13, 2024

From Early Diagnosis to Advanced Treatments: How Science Opens New Avenues Against Ocular Melanoma Knowing the Enemy: Ocular Tumors Ocular tumors, while relatively rare, pose a significant threat to visual health. Among these, ocular melanoma emerges as the most common and dangerous, attacking the uvea, a crucial component for eye function. Unlike other tumors, ocular […] The post New Frontiers in the Fight Against Ocular Melanoma appeared first on Emergency Live.

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Intensive Blog

MARCH 11, 2024

Everything ECMO 047: ECMO Retrieval in Victoria Author: Dr Chris Parry Peer reviewers: Dr David Anderson , Dr Andy Paton You are doing a Locum ICU shift in Mildura. It’s 23:30 on a Friday and you have just intubated a 160 kg 50yo male for respiratory failure. Despite a PEEP of 18 cmH20 and an Fi02 100% you can’t adequately oxygenate the patient. His saturations are hovering in the high 80’s.

Hospitals 69

Hospitals Radiology Radiology Sepsis 69

ALiEM

MARCH 15, 2024

A 28-year-old male presented to the ED for evaluation of an injury to his right eye. While working out with an exercise band, it snapped back, hitting the patient in the right eye. He experienced blurry vision and excess eye tearing immediately after the incident occurred. The patient also developed gross blood over the front of the eye. Physical Exam Vitals : Temp 98°F, HR 73, BP (135/77), RR 16, SpO2 99% HEENT : Gross blood in the anterior portion of the right eye (grade I).

Academics 64

Academics Administration Wellness 64

NRC Health

MARCH 14, 2024

For Cami Mitelman, Customer Success Manager at NRC Health, a personal passion has had a profound impact on her approach to enhancing the patient experience. Yoga’s emphasis on mindfulness aligns perfectly with the principles of patient-centric care, she explains. The post Spring healthcare events to build connections in 2024 appeared first on NRC Health.

Leadership 59

Leadership Pediatrics 59

Emergency Live

MARCH 12, 2024

The Importance of Blood Donation and Its Health Benefits The Importance of Blood Donation Blood donation is an altruistic act that can make the difference between life and death for many people. Every day, thousands of individuals worldwide rely on blood donations to receive life-saving medical care. Blood transfusions are crucial for treating patients with […] The post Donating blood: an act of generosity that saves lives appeared first on Emergency Live.

Blood Transfusions 80

Blood Transfusions 80

Intensive Blog

MARCH 11, 2024

As prepared by Chris Nickson, here are the practice written questions from a recent CICM Second Part exam practice session at The Alfred ICU, with recommended reading from LITFL.com Critical Care Compendium and other FOAM sources: Q1. You are referred a critically ill patient who has methaemoglobinaemia. List 6 possible causes (20%) What are the clinical features of methaemoglobinaemia?

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ACEP Now

MARCH 13, 2024

I recently spoke with Ramon W. Johnson, MD, MBA, who is currently the president of the American Board of Emergency Medicine (ABEM). He joined me for our annual conversation between ACEP Now and ABEM to answer some questions from practicing emergency physicians. Our conversation has been edited for space and clarity. Dr. Dark: Our profession is composed of over 44,000 ABEM certified emergency physicians, about 96 percent of whom are EM residency trained.

Resuscitation 59

Resuscitation Wellness Academics Research 59

Don't Forget the Bubbles

MARCH 11, 2024

A 4-month-old boy presents to the paediatric ED. His parents are concerned about the appearance and shape of his head. They ask how this can be fixed. Before we get into the clinical case, let’s consider some anatomy and background. Sutures and skull development in infancy The skull is made up of five bones – two frontal bones , two parietal bones and an occipital bone.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Emergency Live

MARCH 12, 2024

Addressing Preoperative Anxiety: A Clinical Imperative Approximately 70% of patients experience states of stress and anxiety before, during, and after a surgical procedure. Typically, sedatives, opioids, and anxiolytics can alleviate this discomfort, but they expose the individual to a series of significant consequences. Therefore, reducing the consumption of these drugs limits associated side effects (nausea, […] The post Hypnosis in the operating room: a new study on its effectiveness ap

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Operations 79

NRC Health

MARCH 11, 2024

During February’s Becker’s Hospital Review podcast, Gregory Makoul, Ph.D., M.S., Chief Transformation Officer at NRC Health, joined host Erica Spicer-Mason to discuss the latest findings from the NRC Health 2024 Experience Perspective Report. The post Explore key takeaways from the 2024 Experience Perspective on the Becker’s Healthcare podcast appeared first on NRC Health.

Hospitals 59

Hospitals Leadership 59

Science Based Medicine

MARCH 9, 2024

I hopped the trolley to Kenton to spend the afternoon helping Susan with the quarantine. After I got off the trolley, I purchased thirty of the Extra Editions and handed them out to the families of the Cholera victims. Mostly because I wanted people to know about the seawater treatment, I figured that word about the pump water would spread quickly, and […] The post Skeptics in the Pub.

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RebelEM

MARCH 13, 2024

How sure are you? Think back to the last time someone asked you a difficult question regarding a patient on shift. How sure were you about your decision? Was there a clear-cut right or wrong answer? And after making your decision, how sure were you that the answer you made was the correct one? REBEL Reflections Episode 5: Thinking in Bets – Making Better Decisions When You Don’t Have All the Facts Click here for Direct Download of the Podcast Think back to the last time someone asked

Documentation/Coding 57

Documentation/Coding Outcomes EMS Stroke 57

Emergency Live

MARCH 12, 2024

Between Challenge and Innovation: The Ongoing Quest to Beat Leukemia A Comprehensive Overview Leukemia, an umbrella term encompassing various forms of blood cancer, occurs when white blood cells, vital components of the immune system, undergo uncontrolled genetic mutations. This disease, affecting both adults over 55 and children under 15, underscores the crucial importance of ongoing […] The post Leukemia: let's get to know it closely appeared first on Emergency Live.

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ALiEM

MARCH 11, 2024

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. His symptoms included malaise, body aches, subjective fevers, a sore throat, tender, swollen neck glands, body rash, and irritation of his left eye.

Documentation/Coding 56

Documentation/Coding Academics Emergency Department Hospitals 56

NRC Health

MARCH 15, 2024

This episode dives deep into healthcare marketing strategies. We explore how to balance performance marketing with building brand loyalty, the importance of including the patient voice, and the core metrics of brand equity in healthcare. Learn how NRC Health helps organizations navigate the evolving landscape and achieve success. The post The Patient’s Voice: Why Consumers Matter in Healthcare Marketing appeared first on NRC Health.

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RebelEM

MARCH 12, 2024

Bottom Line Up Top: Pretreatment is ineffective and unnecessary as it does not significantly reduce the risk of serious adverse reactions to contrast. Pretreatment should not delay imaging required for definitive diagnosis. Clinical Scenario: A 65 year-old woman presents with shortness of breath. Her vitals are notable for tachycardia and mild hypoxia, but she is otherwise hemodynamically stable.

Allergic Reactions 57

Allergic Reactions Administration EMS 57