Sat.Mar 09, 2024 - Fri.Mar 15, 2024

article thumbnail

Gelastic Seizures: No Laughing Matter

Pediatric EM Morsels

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 253
article thumbnail

How Big Should Your Trauma Bay Be?

The Trauma Pro

Trauma professionals are never satisfied with the size of their trauma bay. Today, I’ll write about optimal trauma bay size. Next week, I’ll describe my system for quantifying the space in your trauma bay and address the equipment layout in your resuscitation room. Trauma resuscitation rooms vary tremendously. They can range from very spacious… to very tight… Most trauma bays that I have visited were somewhere between 225 and 300 square feet (21-28 sq meters), although some were quit

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Martin Kulldorff was wrongly fired from Harvard Medical School

Sensible Medicine

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 144
article thumbnail

Posterior Circulation Strokes

EM Ottawa

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 138
article thumbnail

ECPR evidence – a historical journey

Intensive Blog

Everything ECMO 048: History of ECPR evidence and considerations for future research Author: Dr George Walker Peer reviewer: A/Prof Aidan Burrell Introduction The first recorded attempts to resuscitate patients were as early as 1530 where Swiss physician Paracelsus used fireplace bellows to reinflate the lungs of those who had stopped breathing. Several more centuries passed before techniques more akin to modern day cardio-pulmonary resuscitation were reported.

CPR 130
article thumbnail

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”.

Science Based Medicine

"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.

129
129
article thumbnail

Quick Hit: Elders Risk Assessment

EM Literature of Note

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

More Trending

article thumbnail

Being Comfortable Being Uncomfortable – A Medical Student’s Perspective

Sensible Medicine

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 112
article thumbnail

Prions. Why did it have to be prions? (Again.)

Science Based Medicine

Prions. Why did it have to be prions? (Again.) The antivax trope that vaccines cause prion disease is an old one, and antivaxxers are trying desperately to resurrect it to apply to COVID-19 vaccines. The post Prions. Why did it have to be prions? (Again.) first appeared on Science-Based Medicine.

109
109
article thumbnail

Understanding FWA Compliance in Healthcare

American Medical Compliance

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.

article thumbnail

Acute chest pain and ST Elevation. CT done to look for aortic dissection.

Dr. Smith's ECG Blog

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 102
article thumbnail

Consultant Corner: Acute Management of the Dislocated Knee

Taming the SRU

Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). Knee dislocations make up less than 0.5% of all orthopedic injuries and may be difficult to recognize if the dislocation spontaneously reduces prior to care in the Emergency Department, which may occur in upwards of 50% of cases (3).

article thumbnail

Parasite Cleanse

Science Based Medicine

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 104
article thumbnail

How to Ensure Dental Regulatory Compliance 

American Medical Compliance

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

article thumbnail

PulmCrit wee: Why I like central lines for GI bleed resuscitation

EMCrit

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.

article thumbnail

SQuID Protocol for DKA: Impact on ED Length-of-Stay

Taming the SRU

Griffey RT, Schneider RM, Girardi M, et al. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. Acad Emerg Med 2023;30(8):800–8. 10.1111/acem.14685 Clinical Question : What is the impact of a subcutaneous insulin protocol for mild-to-moderate DKA on ED length of stay and ICU admission rates? Background Diabetic ketoacidosis (DKA) is a common and resource-intensive condition contributing to significant morbidity and mortality among patients with

article thumbnail

Some Good, But Preliminary Real World Data on Those Baby RSV Shots

Science Based Medicine

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.

84
article thumbnail

Autonomous Ambulance Revolution: Between Innovation and Safety

Emergency Live

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.

article thumbnail

Cholera: ED presentation, evaluation, and management

EMDocs

Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy.

article thumbnail

Grand Rounds Recap 3.6.24

Taming the SRU

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
article thumbnail

A man in his 40s with 3 days of stuttering chest pain

Dr. Smith's ECG Blog

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 80
article thumbnail

Best Master's Degrees in Nursing in Europe

Emergency Live

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.

83
article thumbnail

Policy Playbook: Medicaid Expansion

EMDocs

Author: Nicholas Rizer, MD (Emergency Medicine PGY3, Johns Hopkins University) // Reviewed by: Phillip Groden, MD; Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) What’s the issue? The Mississippi House recently passed a bill expanding Medicaid coverage for its residents. It currently awaits a vote in the state Senate and, if successful, would result in Mississippi being the 42nd state (including the District of Columbia) to adopt ‘Medicaid expansion.’ 1 Medicaid expansion seeks to i

article thumbnail

SGEM Xtra: A Philosophy of Emergency Medicine

The Skeptics' Guide to EM

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 74
article thumbnail

JC: Are long waits in A&E lethal for elderly patients?

St. Emlyn

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.

article thumbnail

New Frontiers in the Fight Against Ocular Melanoma

Emergency Live

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.

83
article thumbnail

Journal Feed Weekly Wrap-Up

EMDocs

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

article thumbnail

Lessons from the pandemic: Lagging indicators

First 10 EM

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.

71
article thumbnail

A long way from the mothership

Intensive Blog

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.

article thumbnail

Donating blood: an act of generosity that saves lives

Emergency Live

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.

article thumbnail

SAEM Clinical Images Series: Workout Gone Wrong

ALiEM

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).

article thumbnail

Spring healthcare events to build connections in 2024

NRC Health

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.

article thumbnail

CICM Second Part Exam Practice SAQs 06032024

Intensive Blog

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?

64
article thumbnail

Hypnosis in the operating room: a new study on its effectiveness

Emergency Live

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

article thumbnail

Skeptics in the Pub. Cholera. 11b

Science Based Medicine

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.

60
article thumbnail

A Conversation with ABEM President Dr. Ramon W. Johnson

ACEP Now

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.

article thumbnail

An approach to the infant with plagiocephaly

Don't Forget the Bubbles

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.