Sensible Medicine

NOVEMBER 18, 2023

This week, a viewpoint appeared in JAMA Health forum. It argues that patients, particularly disabled and immunocompromised patients, should be able to request health care providers wear masks, and providers should not be permitted to decline that request. Doctors have a duty not to harm their patients, and ergo, should wear masks when requested. It then discusses ways state medical boards and other groups can police this policy.

Blood Transfusions 142

Blood Transfusions Hospitals Wellness 142

Ken Grauer, MD

NOVEMBER 18, 2023

== — CLICK HERE — for a V ideo presentation of this case! ( 15 minutes ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #344 — == How would YOU interpret the lead II rhythm strip shown in Figure-1 ? Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? Or — Is it “ something else ”? Figure-1: How would YOU interpret this lead II rhythm strip?

EKG/ECG 239

EKG/ECG 239

Science Based Medicine

NOVEMBER 20, 2023

The BMJ, once a bastion of evidence-based medicine, has become disturbingly susceptible to publishing biased "investigations" that feed antivax narratives. Its latest report on VAERS by Jennifer Block, who in the past has defended Gwyneth Paltrow and Goop and whose history is not one of supporting science, is just another example of this deterioration.

CDC 136

CDC 136

Don't Forget the Bubbles

NOVEMBER 22, 2023

One-liner… Although commonly used, Propofol can have severe adverse effects. Propofol Infusion Syndrome (PRIS) can lead to significant morbidity and mortality in children. What is Propofol? Commonly referred to as “the milk of amnesia”, propofol is a drug used for induction and maintenance of general anaesthesia and for procedural sedation. Propofol is prepared in a lipid emulsion, giving it a characteristic milky white appearance, and due to its ability to dissolve in fats, it is rapidly redist

Pediatrics 126

Pediatrics Research EKG/ECG Operations 126

Life in the Fast Lane

NOVEMBER 20, 2023

Sheralyn Guilleminot and Mike Cadogan What is AI and How Does it Work? We review two important aspects of AI, natural language processing and machine learning, that provide key insights into how AI works.

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Stop and Think

NOVEMBER 19, 2023

I had thoughts. Maybe you did too. There were just so many media reports of cardiac arrest in athletes. This is a column about two things—a medical problem (cardiac arrest) and the way our brains work. During the pandemic we learned that the vaccine against SARS-CoV-2 could cause myocarditis—or inflammation of the heart. Young males had the highest risk of this adverse effect.

Documentation/Coding 119

Documentation/Coding Wellness Resuscitation 119

ALiEM

NOVEMBER 22, 2023

The toxin from the golden poison dart frog most resembles which of the following in its mechanism of action? Botulinum toxin Bufotoxin Grayanotoxin Palytoxin Tetrodotoxin Photo adapted from Wilfried Berns (Wikimedia Commons) Reveal the Answer 3. Grayanotoxin – a sodium channel opener Background The golden poison dart frog ( Phyllobates terribilis ), often considered one of the most poisonous animals on the planet, secretes onto its skin the lipophilic alkaloid batrachotoxin , which irreversibly

Poisoning 113

Poisoning 113

Life in the Fast Lane

NOVEMBER 21, 2023

Chris Nickson Come join the 2024 Clinician Educator Incubator! If you want to develop as a Clinician Educator and help lead 21st century critical care education, join the 2024 Clinician Educator Incubator!

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Sensible Medicine

NOVEMBER 21, 2023

A few years ago, Dr. Richard T. Bosshardt waded into a minefield. He had been a Fellow of the American College of Surgeons (ACS) for over thirty years when he expressed his opinion that the ACS’s diversity, equity, and inclusion initiatives were threatening their dedication to excellence. Dr. Bosshardt has garnered support for his objections and has published his opinions in The Wall Street Journal, City Journal, and National Review.

Leadership 112

Leadership Fractures Wellness 112

Medagadget

NOVEMBER 20, 2023

A research team at the University of California San Diego have developed a smartphone attachment that can provide information on changes in pupil size, which can be used to assess neurological phenomena, such as traumatic brain injury and Alzheimer’s disease. Such changes in pupil size have been difficult to characterize in the past in those with a dark iris, which is more common in people with darker skin tones, because it can be challenging to distinguish between the iris and the pupil.

Research 111

Research Wellness 111

St. Emlyn

NOVEMBER 24, 2023

St.Emlyn's - Emergency Medicine #FOAMed Emergency care practitioners are known for creating order from chaos, being pragmatic amidst difficult circumstances and advocating for patients when others cannot. The post The Emergency Care Voice Rescued from a Sea of Politics appeared first on St.Emlyn's.

EMS 106

EMS 106

First 10 EM

NOVEMBER 20, 2023

When caring for pregnant women, I frequently find myself searching for information on radiation risks from diagnostic imaging, to help guide our shared decision making process, so I decided to create a summary in a spot I would always know where to find it. I have ranted in the past about the many problems with […] The post Diagnostic imaging during pregnancy and lactation appeared first on First10EM.

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Sensible Medicine

NOVEMBER 20, 2023

I received a text message from a colleague last night during dinner that a trial we were part of, called OCEANIC AF , was being terminated early by the data safety monitoring board. This morning, the makers of asundexian had a press release up on its site. This is huge news in cardiology. But it is also worthy of a column here because we at Sensible Medicine are interested in how new therapies are tested.

Stroke 106

Stroke Outcomes Wellness 106

Science Based Medicine

NOVEMBER 22, 2023

The first CRISPR-based therapy approval is a milestone worthy of noting. The post First CRISPR Treatment Approval first appeared on Science-Based Medicine.

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Emergency Live

NOVEMBER 20, 2023

Specialized Solutions for the Safety of Small Passengers During Emergency Transport Transporting children by ambulance requires special care and precautions. In emergency situations, ensuring the safety of young patients is a top priority. This article explores international regulations and technological innovations that help make pediatric ambulance transport safe and effective.

Pediatrics 96

Pediatrics 96

Medagadget

NOVEMBER 20, 2023

Engineers at the University of British Columbia have collaborated with the Japanese automotive company Honda to develop an e-skin for robotic prostheses that allows such devices to sense their environment in significant detail. The soft skin is highly sensitive, letting robotic hands to perform tasks that require a significant degree of dexterity and tactile feedback, such as grasping an egg or lifting a glass of water without breaking it.

Research 96

Research Stroke 96

Life in the Fast Lane

NOVEMBER 19, 2023

Casey Parker and James Rippey Ultrasound Case 111 A 45 year old woman with chronic alcoholic liver disease presents to the ED with exertional dyspnoea and is noted to have a SpO2 of 90% at rest despite having a normal chest examination and CXR.

Ultrasounds 85

Ultrasounds 85

Trigger Lab

NOVEMBER 23, 2023

Ventilare un neonato prematuro ricercando la migliore strategia di sincronizzazione rappresenta una sfida quotidiana in neonatologia.

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Emergency Live

NOVEMBER 20, 2023

Cervical Cancer Elimination Day of Action: A Renewed Commitment to Overcoming Global Health Inequalities Nov. 17 marks the third “Cervical Cancer Elimination Day of Action,” a pivotal moment for the international community as world leaders, cervical cancer survivors, advocates and civil society come together to celebrate progress and recognize persistent challenges.

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Taming the SRU

NOVEMBER 21, 2023

airway grand rounds - r1 clinical knowledge: heavy metals - consultant corner: acute leukemia - pediatric sim - pediatric cases airway grand rounds WITH dr. carleton Difficult airway algorithm: when should we RSI? When you are forced to act immediately When reoxygenation and intubation is likely to be successful and a patient is able to tolerate a period of apnea (is not likely to become profoundly hypoxic nor hypercarbic) How to perform a successful awake look intubation when RSI not indicated:

Pediatrics 80

Pediatrics EKG/ECG Resuscitation Dehydration 80

EMDocs

NOVEMBER 20, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American College of Gastroenterology recently released updated guidelines for managing patients with lower GI bleeding (LGIB). This post will provide the major takeaways for emergency clinicians. Background Acute LGIB results in over 100,000 admissions in the U.S. annually, and the incidence appears to be increasing based on current literature.

Resuscitation 78

Resuscitation Fluid Resuscitation Hospitals Research 78

Science Based Medicine

NOVEMBER 23, 2023

A new survey shows use of melatonin in children is widespread despite modest efficacy and an unknown long-term safety profile. The post Despite safety and quality questions, melatonin use growing in children first appeared on Science-Based Medicine.

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Emergency Live

NOVEMBER 23, 2023

Emotional Management During Resuscitation: A Crucial Aspect for Operators and Rescuers A Different Perspective on Cardiopulmonary Resuscitation Cardiopulmonary resuscitation (CPR) is a vital skill for emergency workers and lay rescuers. However, Marco Squicciarini, BLSD Training Coordinating Physician at the Ministry of Health and BLSD Instructor Trainer since 2004, highlights an aspect often overlooked in training […] The post Understanding Traumatic Dissociation in Cardiopulmonary Resusc

Resuscitation 89

Resuscitation CPR Operations 89

Core Medical Group

NOVEMBER 21, 2023

As the holiday season approaches, it's time to express gratitude and appreciation for the clinicians who have been on the frontlines of healthcare throughout the year. In the spirit of giving back, many retailers are offering exclusive Black Friday and Cyber Monday deals for healthcare workers. This is the perfect opportunity to indulge in some well-deserved self-care or find thoughtful gifts for loved ones.

Wellness 72

Wellness 72

EM Ottawa

NOVEMBER 23, 2023

As you’ve gleaned from the title of this blog post, today we are focusing our conversation on CHANGE; with a particular emphasis on its implications in healthcare. However, before we get deep in the weeds, it’s important that we acknowledge the elephant in the room; CHANGE is HARD. I suspect that most of you reading this […] The post Change: Why Healthcare Reform is More Important Than Ever appeared first on EMOttawa Blog.

Administration 66

Administration Wellness 66

EMDocs

NOVEMBER 18, 2023

Author: Jacob Kirkland, MD (EM Resident Physician, UTSW – Dallas, TX); Stephen Field, DO (Assistant Professor of EM/Attending Physician, UTSW – Dallas, TX) // Reviewed by: Sophia Görgens, MD (EM Resident Physician, Zucker-Northwell NS/LIJ, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited

EMS 67

EMS Ultrasounds Emergency Department Outcomes 67

Emergency Live

NOVEMBER 22, 2023

Advancing European CBRN-E Preparedness and Response through Standardisation The National Standards Authority of Ireland (NSAI) and the PracticE Ecosystem for StandaRdS (PEERS) project are collaboratively hosting a webinar on December 12, 2023, titled ‘Enhancing CBRN-E Preparedness and Response Capabilities through Standardisation.’ The webinar aims to showcase ongoing European CBRN-E research and standardisation efforts, specifically focusing […] The post PEERS and NSAI Webinar

Research 84

Research 84

Science Based Medicine

NOVEMBER 18, 2023

The novel serialization continues. Novel as in work of fiction, not unique or unusual. The post Skeptics in the Pub. Cholera. Chapter 3b. first appeared on Science-Based Medicine.

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University of Maryland Department of Emergency Med

NOVEMBER 19, 2023

Acute bronchiolitis (AB) is a common cause of respiratory tract infections in infants. A recent study looked at the application of Point-of-Car.

Ultrasounds 74

Ultrasounds Pediatrics 74

EMDocs

NOVEMBER 21, 2023

Today on the emDOCs cast with Jess Pelletier and Brit Long, we discuss a case of hypokalemic periodic paralysis. Episode 90: Hypokalemic Periodic Paralysis Case: 20-year-old Caucasian male presents with severe pain and weakness in both of his thighs with inability to walk independently that started when he woke up that morning. Normal state of health prior to this.

Administration 67

Administration 67

Emergency Live

NOVEMBER 21, 2023

From Buses to Tracked Vehicles: Fermignano Puts Civil Defense Vehicles on Sale A Rare Opportunity to Acquire Rescue Vehicles The City of Fermignano, in an unprecedented move, has put up for sale an entire fleet of vehicles, many previously used by the local civil defense. This sale offers a unique opportunity for rescue entities, organizations […] The post Unique Bargains for Rescue Vehicles: Special Sale in Fermignano (IT) appeared first on Emergency Live.

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Science Based Medicine

NOVEMBER 21, 2023

When a placebo is called 'powerful', what is meant? Nothing. The post Adjectives first appeared on Science-Based Medicine.

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University of Maryland Department of Emergency Med

NOVEMBER 22, 2023

This retrospective study looked at trauma patients over age 65 and divided them into age ranges 65-80 (geriatric) and 80 plus (super-geriatric). Th.

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EM Ottawa

NOVEMBER 22, 2023

Methodology: 3.5/5 Usefulness: 4/5 Davenport R, et al. JAMA. 2023 Oct 12:e2321019. Editorial: Contemporary Adjuncts to Hemorrhage Control. Question and Methods: In trauma patients with major hemorrhage, does early cryoprecipitate (6g fibrinogen) administration improve survival, compared to standard care? Findings: There was no difference in all-cause mortality at 28 days (25.35 vs. 26.1%); OR 0.96 […] The post Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic In

Administration 54

Administration 54

Emergency Live

NOVEMBER 24, 2023

Coping with Floods and Blackouts in Florida: Useful Safety Tips Torrential Rains and Flooding in Florida Florida is facing a wave of severe weather characterized by heavy rains and intense winds, which has already caused flooding and power outages in several areas of the state. The situation is particularly severe along the southeast coast, where […] The post Florida Floods: A Guide to Safety and Prevention appeared first on Emergency Live.

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Ziqitza HealthCare Ltd

NOVEMBER 24, 2023

As the winter season arrive­s, it brings a special beauty of snowy scene­s and warm nights by the fire. But amidst the fe­stivities, the cold weathe­r can also affect our health. This blog will share important tips for staying we­ll during winter, with a focus on the life-changing he­althcare offered by Ziqitza and its founde­r, Sweta Mangal. The Power of Hydration in Winter: Staying Moisturized Inside Out In winter, the­ air gets dry, which can affect our skin and hydration.

Wellness 52

Wellness Ambulance Services Dehydration 52

University of Maryland Department of Emergency Med

NOVEMBER 21, 2023

A recently published study of ED APPs, residents, attendings, and nurses attempted to assess clinician's perspectives on how ED boarding im.

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