Pediatric EM Morsels
FEBRUARY 2, 2024
There have been many times I have encountered a triage note which states “ patient recently returned from … (insert awesome foreign country) … ” Not only does this leave me daydreaming about my future travel adventures, but has often caused me to take pause. Thoughts of what endemic illnesses could this child potentially have been exposed to in their travels?
Dr. Smith's ECG Blog
FEBRUARY 2, 2024
Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. These are Osborn waves usually associated with hypothermia. There is also large T wave inversion and long QT.
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The Trauma Pro
JANUARY 29, 2024
You’re running a trauma activation, and everything is going great! Primary survey – passed. Resuscitation – lines in, fluid going. You are well into the exam in the secondary survey. Then it happens. The automated blood pressure cuff shows a pressure of 72/44. But the patient looks so good! You recycle the cuff. A minute passes and another low pressure is noted, 80/52.
Science Based Medicine
JANUARY 29, 2024
A couple of weeks ago, I discussed why antivax quacks' claimed biological mechanisms for COVID-19 vaccine "shedding" reminded me of homeopaths. Confabulation about fantastical scientific mechanisms continues, courtesy of "A Midwestern Doctor." The post Antivax quacks are continuing to make up fantastical biological mechanisms for COVID-19 vaccine “shedding” first appeared on Science-Based Medicine.
RebelEM
FEBRUARY 1, 2024
Background : Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. Tenecteplase, a modified version of alteplase, is being increasingly utilized for AIS due to its favorable pharmacological profile, ease of administration, and cost effectiveness.
Don't Forget the Bubbles
JANUARY 29, 2024
A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Of those patients admitted with RSE, a subset will go on to develop super-refractory status epilepticus (SRSE).
The Skeptics' Guide to EM
JANUARY 27, 2024
Reference: Wilkinson-Stokes M, Betson J, Sawyer S. Adverse events from nitrate administration during right ventricular myocardial infarction: a systematic review and meta-analysis. Emerg Med J. February 2023 Date: January 24, 2024 Guest Skeptic: Dr. Rupinder Sahsi is a fellow EBM enthusiast with academic appointments at McMaster University and Wright State University who works as an emergency physician […] The post SGEM#428: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in R
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Stop and Think
JANUARY 31, 2024
Randomized clinical trials are the best way to know what works in medicine. While medical interventions (drugs or devices) remain the same, situations often change. One of the cool things that our Cardiology Trials substack project (Andrew Foy and Mohammad Ruzieh and I are cataloging the seminal trials) is teaching me, is that medications/devices proven effective in trials decades ago, may no longer have benefit now.
PulmCCM
JANUARY 29, 2024
AHA Updates its Cardiac Arrest Guidelines In December 2023, the American Heart Association published a “focused update” to its landmark guidelines for the management of cardiac arrest. PulmCCM is not affiliated with the American Heart Association. Read the document for all the details (it’s not long). Here’s PulmCCM’s take on the new changes.
Dr. Smith's ECG Blog
JANUARY 27, 2024
Written by Jesse McLaren, comments by Smith A 55 year old with a history of NSTEMI presented with two hours of exertional chest pain, with normal vitals. Below is the triage ECG, with a computer interpretation (Marquette 12 SL) of “normal” which was confirmed by the over-reading cardiologist. What do you think? Should this patient continue to stay in the waiting room, without interruption of the physician to interpret the ECG, because the computer interpretation is normal?
Sensible Medicine
JANUARY 29, 2024
I got the idea of this story from our project over at Cardiology Trials , where we are cataloging the seminal trials in cardiology. Gosh, I am learning a ton about medical evidence. Please do head over there and join the learning. When I rounded in the coronary care units back at Indiana University in the early 1990s, there was momentum to use IV-magnesium (Mg) in patients after myocardial infarction.
EM Ottawa
JANUARY 29, 2024
Methodology: 4/5 Usefulness: 3.5/5 Thiele H, et al. N Engl J Med. 2023 Oct 5;389(14):1286-1297. Editorial: Routine Early ECLS in Infarct-Related Cardiogenic Shock? Question: Does early ECLS therapy confer a mortality benefit in patients with MI complicated by cardiogenic shock? Methods: Open label RCT with 417 patients comparing 30-day all-cause mortality between ECLS versus standard […] The post Extracorporeal Life Support in Infarct-Related Cardiogenic Shock appeared first on EMOttawa B
EM Literature of Note
JANUARY 27, 2024
A brief post collating a few bits of my various work published across the interwebs … The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Apple Podcasts Google Podcasts Soundcloud Naturally, there are continuing Journal Club features, covering the following articles: Zone 1 endovascular balloon occlusion of the aorta vs resuscitative thoracotomy for patient resuscitation after severe hemorrha
EB Medicine
FEBRUARY 1, 2024
In this episode, Sam Ashoo, MD, and T.R. Eckler MD interview Nick Harrison, MD and Daniel Brenner, MD, two of the authors of the February 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Right Heart Failure Pathophysiology Presenting Symptoms Differential Diagnosis Specific Acute Causes PE Sepsis RVMI PPV ARDS COVID-19 Specific Chronic Causes CTEPH Left Heart Failure Congenital Heart Disease LVAD Lung Disease Group 3 Pulmonary Hypertension Pulmonary A
Sensible Medicine
JANUARY 31, 2024
Recently, I came across a tweet that lavished praise on an unremarkable article. The article contained, as my friend Bapu Jena likes to say, no new ideas. It merely restated things that had been said before. Immediately, the tweet jumped out at me — there was a disconnect between the flattery and the content. I happen to know the doctor who tweeted this and consider him a straight shooter.
EMCrit
JANUARY 30, 2024
Polypharmacy is technically defined as taking five or more medications on a daily basis. Polypharmacy is increasingly becoming the norm among adults, due to several factors (an aging population, increasing numbers of medical problems, and increasingly complex regimens available to treat chronic disorders such as heart failure). Indeed, the term “polypharmacy” is arguably antiquated now […] EMCrit Project by Josh Farkas.
Emergency Live
FEBRUARY 1, 2024
A Leap Forward in the Air Rescue Sector Thanks to Innovative Technologies of Airbus H145 Helicopters Innovations and Versatility of the Airbus H145 The Airbus H145 helicopter stands out in the field of air rescue due to its unique features, making it a benchmark model in the industry. With its new Helionix avionics suite, this […] The post The new faces of helicopter rescue: the success of Airbus' H145s appeared first on Emergency Live.
NRC Health
JANUARY 31, 2024
In this episode, we explore consumer & caregiver perspectives on artificial intelligence, from in-room patient monitoring to AI-powered care searches. The post The Impacts of AI on Patient Experience and Patient Care appeared first on NRC Health.
Sensible Medicine
FEBRUARY 2, 2024
At a Thanksgiving gathering, a middle-aged doctor talks to an older relative. While enjoying a pre-feast cocktail, the relative asks, “Why is it that doctors don’t want to see patients?” The doctor bumbles through a reply. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a paid subscriber.
Life in the Fast Lane
JANUARY 29, 2024
Sheralyn Guilleminot and Mike Cadogan Using Artificial Intelligence in the Medical Field Full interview with critical care clinician and AI enthusiast, Dr Sameer Shaikh, on the many ways to use AI to save time and increase efficiency in healthcare
Emergency Live
JANUARY 31, 2024
Female Health Awareness at the Center of European Strategies The New Era of Women’s Healthcare Prevention in Europe Female healthcare prevention has taken on new importance in Europe, particularly through the EU4Health 2021-2027 program. This program, representing the largest ever undertaken by the EU in the healthcare sector, places a particular emphasis on promoting health […] The post Revolution in women's health: a modern and proactive vision appeared first on Emergency Live
Thinking Critical Care
JANUARY 31, 2024
In the last couple of years VExUS has seemingly sparked a number of clinicians to focus on right-sided or venous congestion and its deleterious consequences. Many of us feel there is sufficient associative evidence and physiological basis to use VExUS to manage patients on a daily basis and do so routinely. Currently, several studies we know of (and probably many we don’t!
Taming the SRU
JANUARY 29, 2024
HISTORY OF PRESENT ILLNESS The patient is a female in her late 60’s presenting with acute onset of left arm pain and swelling. She initially noticed pain in her left arm with movement while helping her family move earlier on the day of presentation. While changing, she noticed that her arm was swollen to the mid humerus. She feels that this swelling came on over several hours.
Life in the Fast Lane
JANUARY 30, 2024
Chris Nickson Critical Care Reviews… Down Under! Expressions of interest are open to attend the "Critical Care Reviews Down Under" meeting in Melbourne, December 10th & 11th 2024.
Emergency Live
JANUARY 31, 2024
An Integrated Approach to Addressing Alcohol Consumption and its Effects in Europe Informational-Educational Campaigns in Italy In Italy, various initiatives have been launched to raise awareness among young people about the dangers of alcohol. Campaigns such as “Io non sbando” and “Non perderti in un bicchiere” have reached students in schools to disseminate information about […] The post Alcoholism: new awareness strategies in Europe appeared first on Emergency Li
First 10 EM
JANUARY 29, 2024
REBOA (resuscitative endovascular balloon occlusion of the aorta) has been discussed in the emergency medicine world for quite some time now, but always with very limited data. There have been some observational studies that suggested REBOA was associated with worse outcomes, but the outcomes were largely assumed to be the result of confounders. (Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM.
EM Ottawa
FEBRUARY 1, 2024
In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we’ve learned. If you haven’t read part one – check it out here! […] The post Lung Protective Ventilation appeared first on EMOttawa Blog.
Science Based Medicine
FEBRUARY 2, 2024
Did a meeting of chiropractors from around the world come to a historic consensus on the true causes of the chiropractic subluxation? No, this is satire. Still read the post though. Please. The post Science-Based Satire: Historic Conference Clarifies Vertebral Subluxation Causes first appeared on Science-Based Medicine.
Emergency Live
JANUARY 30, 2024
Understanding the Symptoms, Causes, and Treatment Options for Rheumatoid Arthritis What is Rheumatoid Arthritis? Rheumatoid arthritis is a chronic autoimmune disease that primarily affects the joints, causing inflammation, pain, swelling, and, in some cases, loss of function. Contrary to what one might think, rheumatoid arthritis is not just a joint disease; it can also have […] The post Rheumatoid arthritis: what it is and how it manifests itself appeared first on Emergency Live.
Dr. Smith's ECG Blog
FEBRUARY 2, 2024
This case was sent by Dr. Jean-christophe Reiters, an interventionalist in Belgium. He has been following the blog for 4 years. He has now implemented the Queen of Hearts in his hospital. He wanted to share one of the first cases. A 55 year old with no previous cardiac history presented with 3 hours of chest pain. The pain was persistent and reportedly still present at the time of the ECG.
Core Medical Group
JANUARY 30, 2024
Laura Magner has been named the new Chief Operating Officer for CoreMedical Group, a national healthcare staffing agency based in Manchester, NH.
Science Based Medicine
FEBRUARY 1, 2024
The use of of complementary health approaches overall, and for pain management, is growing among US adults. The post More Americans turning to complementary approaches to pain control first appeared on Science-Based Medicine.
Emergency Live
JANUARY 30, 2024
Understanding the Functioning and Importance of Defibrillators in Managing Cardiac Emergencies What are Defibrillators Defibrillators are life-saving devices in the treatment of cardiac emergencies, providing an electrical shock to the heart to correct dangerous heart rhythms or cardiac arrests. These devices are particularly important in treating ventricular fibrillation and pulseless ventricular tachycardia, two forms of […] The post The defibrillator: a lifesaver in case of cardiac arre
First 10 EM
JANUARY 31, 2024
The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the focus is on content I have found, but I hope the community gets engaged […] The post The First10EM monthly wrap-up for January 2024 appeared first on First10EM.
EMDocs
JANUARY 29, 2024
Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. Louis); Marina Boushra, MD (EM-CCM Attending Physician, Cleveland Clinic Foundation); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case: A 39-year-old male is brought in by EMS with a sudden-onset severe headache
Science Based Medicine
JANUARY 28, 2024
Sensible Medicine doctors often utter the words "do an RCT". So why are their readers so ignorant about RCTs? The post Why Are Sensible Medicine Doctors Indifferent to the Nonsense Comments of Sensible Medicine Commentators? As Instructed, I Consider the Dualities of Interest and Motivating Biases. first appeared on Science-Based Medicine.
Emergency Live
JANUARY 30, 2024
Italy Witnesses Significant Progress in the Fight Against Cancer The mRNA Vaccine Revolution In a significant breakthrough in the battle against melanoma, Italy has witnessed the administration of the first dose of an innovative mRNA vaccine. This pioneering treatment, taking place at the Pascale Cancer Institute in Naples, opens a new frontier in cancer treatment. […] The post New era in melanoma therapy: vaccine enters the scene appeared first on Emergency Live.
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