Ken Grauer, MD

MAY 6, 2023

The ECG in Figure-1 — was obtained from an older woman with chest pain. How would YOU interpret this tracing? What kind of AV block is present? — OR — Is there no clear evidence of any AV block? Figure-1: The initial ECG in today’s case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Thoughts on the ECG in Figure-1: This tracing is challenging to interpret because of the changing QRS morphology — and because of the uncertainty regarding atrial activity.

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EKG/ECG 195

The Trauma Pro

MAY 12, 2023

Any trauma professional who has dealt with spleen injuries knows that the white blood cell (WBC) count rises afterwards. And unfortunately, this elevation can be confusing if the patient is at risk for developing inflammatory or infectious processes that might be monitored using the WBC count. Is there any rhyme or reason to how high WBCs will rise after injury?

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Pediatric EM Morsels

MAY 12, 2023

We all know that Gravity Works ! While this fact can adversely affect anyone, it offers the greatest challenge for those who cannot protect themselves , like children less than 3 months of age ! We last pondered this in 2011 Morsel , just a couple years after PECARN head injury data was published. Since that time there have been several studies externally validating the PECARN rule in all age groups and in multiple different countries.

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Don't Forget the Bubbles

MAY 10, 2023

In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. We’ve incorporated some of our favourite elements from their presentations in this blog post. You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. You’re just about aware of the tannoy in the background.

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Mind The Bleep

MAY 12, 2023

Introduction Patients with liver disease are common in the UK. Since 1970, mortality from liver disease has quadrupled. It has become the greatest cause of death in people aged between 35-49 years old 1. It is important you know how to manage these patients in the medical take or on general medical wards and are aware of the complexities of their management.

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The Trauma Pro

MAY 9, 2023

For years, I’ve taught my residents participating in trauma activations, “Your patient is bleeding to death until proven otherwise.” This concept served as the basis of the [poorly documented] “Golden Hour” and for decades has directed our efforts at getting patients to a center with an immediately available OR as quickly as possible.

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Science Based Medicine

MAY 12, 2023

A recent study found that young children are increasingly being harmed by accidental ingestion of cannabis in the form of edibles. The post More Marijuana More Problems for Young Children Part 2: Additional Problems for the Aforementioned Children first appeared on Science-Based Medicine.

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Mind The Bleep

MAY 12, 2023

As a foundation doctor, shortness of breath is one of the commonest symptoms you can encounter on the acute take. Causes of shortness of breath are very broad but in this session, we will discuss pleural effusion. The management will vary depending on the causes of pleural effusion, therefore the diagnostic approach is important. The first step is confirmation of pleural effusion clinically or radiologically (chest x-ray or ultrasound).

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Radiology Radiology Ultrasounds 52

Life in the Fast Lane

MAY 11, 2023

Kyle Cunningham MD and Michael Gibbs MD Abdominal Imaging Cases 025 April 2023 Adult Abdominal imaging cases and interpretation with Kylee Brooks, Parker Hambright, Alexis Holland, William Lorenz, Brent Mathews and Kyle Cunningham

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Radiology Radiology 52

NRC Health

MAY 12, 2023

Innovative approach and service-leading team set NRC Health apart in exhaustive selection process. The post UCHealth Partners with NRC Health to Improve Healthcare Experiences appeared first on NRC Health.

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EM Ottawa

MAY 11, 2023

Acute pancreatitis is one of the most common gastroenterology conditions we see in the emergency department with a prevalence of 110-140 cases per 100,000 population. (1) At The Ottawa Hospital alone, we saw over an average of 1 case per day over the last year. Unfortunately, a lot of what we do in the emergency […] The post Rethinking Acute Pancreatitis in the ED appeared first on EMOttawa Blog.

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Science Based Medicine

MAY 10, 2023

While the COVID health emergency is over, COVID itself is not, and we need to have an eye on the next potential pandemic. The post WHO Declares COVID Emergency Over first appeared on Science-Based Medicine.

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Stop and Think

MAY 10, 2023

First read my latest on why there are so many bad medical studies. Two of the three commenters nudged me to consider a more optimistic take. One of these came from Dan Matlock, a professor of medicine at the University of Colorado. You should first know Dan is one of the smartest and kindest academics I have met. He wrote, publicly , in the comments section, that incentives to publish—even bad studies—was part of the problem, but I should consider a more optimistic take: Namely, that

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Academics Research Administration Wellness 52

NRC Health

MAY 11, 2023

Our partners at Phoenix Children’s share how grassroots efforts helped to define and drive patient experience priorities and build alignment throughout the organization. The post Building infrastructure to support the patient experience along the way appeared first on NRC Health.

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Emergency Medicine Cases

MAY 10, 2023

In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life. The post ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes appeared first on Emergency Medicine Cases.

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EM Ottawa

MAY 10, 2023

Methodology: 2/5 Usefulness: 3/5 Market M, et al. CJEM. 2022 Jun;24(4):426-433. Question & methods: Whether quality improvement interventions could decrease the rate of repeat reductions in pediatric hand injuries by plastic surgeons. The study was conducted using two Plan-Do-Study-Act cycles that implemented informal feedback and formal educational workshops for ED physicians.

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Pediatrics 52

RebelEM

MAY 10, 2023

Take Home Points Many patients with renal colic require a CT scan. Diagnostic imaging should focus on eliminating concerning mimics; not on clinching the diagnosis of renal colic. POCUS and radiology department US are important modalities in evaluation of renal colic. REBEL Core Cast 101.0 – Imaging in Renal Colic Click here for Direct Download of the Podcast References Moore CL et al.

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Radiology Radiology EMS 52

Science Based Medicine

MAY 9, 2023

How would you have reacted on 1/1/2020 if a doctor claimed that a virus that killed zero children was "truly dangerous" compared to one that kill 2,000? The post An Absurd Thought Experiment first appeared on Science-Based Medicine.

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Emergency Medicine Cases

MAY 9, 2023

In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key.

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EMS 52

AED Leader

MAY 9, 2023

An accident on a construction site can be devastating if not deadly, so it’s important to have the right construction safety equipment on hand at all times. Some of these safety essentials are required by the Occupational Safety and Health Administration (OSHA) while others are just smart to have available. 1. Hard Hats Hard hats Read More "A Complete Construction Safety Equipment List" The post A Complete Construction Safety Equipment List appeared first on AEDs for Sale | Buy Defibrillators an

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Administration 52

EM SIM Cases

MAY 9, 2023

This case comes from Drs. Katie Maguire and Nicole Holm. Dr. Maguire is a PGY5 Emergency Medicine resident at the University of British Columbia. Her interests include medical education, disaster medicine and simulation. She is particularly interested in simulation as an educational technique to develop communication and crisis resource management skills.

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Pediatrics CPR Radiology Radiology 52

NRC Health

MAY 9, 2023

NRC Health is proud to recognize and thank the incredible nurses and hospital staff who work tirelessly to keep their communities healthy and safe. Your dedication and compassion are inspiring. Thanks for all you do! The post Celebrating nurses and hospital staff appeared first on NRC Health.

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Hospitals 52

Emergency Medicine Cases

MAY 9, 2023

In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key.

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EMS 52

Core Ultrasound

MAY 8, 2023

At long last, Core Ultrasound Image Review episode #20! In this episode, we discuss median nerve blocks, fibroids, pneumonia, pleural effusions, CRAO, AAA, abscesses, endocarditis, DVTs, CVC confirmation and gallstones. Check out the YT for the full video! CUIR #19 CUIR #18 CUIR #17 The post Core Ultrasound Image Review, Episode 20! first appeared on Core Ultrasound.

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Ultrasounds 52

Science Based Medicine

MAY 8, 2023

Back in the day, I used to refer to something I dubbed "misinformed refusal," a term that refers to how antivaxxers had weaponized "informed consent" by inverting it to frighten parents against vaccinated. In the age of the pandemic, ProtocolKills.com generalizes misinformed refusal to all COVID-19 treatments with the help of "hospital hostage negotiator" Laura Bartlett, who views COVID-19 treatments in hospitals as "holding patients hostage" and provides an "informed consent template" that refu

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Hospitals 52

First 10 EM

MAY 8, 2023

Syphilis is on the rise. Across North America, we are seeing syphilis rates unheard of since we abandoned the lambskin condom. (OK, I have no idea if that is factually accurate, but I always imagined syphilis and lambskin going hand in hand.) In Canada, there were 96 cases of congenital syphilis in 2021, as compared […] The post Syphilis: A rapid review appeared first on First10EM.

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Infectious Diseases 52

Dr. Smith's ECG Blog

MAY 8, 2023

Sent by Pete McKenna M.D. Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion. This is a huge anterolateral OMI. Deadly. I cannot be anything else.

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EKG/ECG Documentation/Coding Outcomes Shock 52

Don't Forget the Bubbles

MAY 8, 2023

1-year-old Ruby presents with pallor and faltering growth. She is of Asian origin and has a family history of thalassaemia. Her blood tests show a microcytic anaemia. What do you do next? Thalassaemias are inherited blood disorders that can cause anaemia. Usually, haemoglobin, comprised of four globin chains and a haem group, carry oxygen around the body.

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Blood Transfusions 52

Core Ultrasound

MAY 8, 2023

At long last, Core Ultrasound Image Review episode #20! In this episode, we discuss median nerve blocks, fibroids, pneumonia, pleural effusions, CRAO, AAA, abscesses, endocarditis, DVTs, CVC confirmation and gallstones. Check out the YT for the full video!

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Ultrasounds 52

Board Bombs

MAY 7, 2023

We tell you in a few easy steps how to make your urologist love you. You shouldn't be consulting them for the vast majority of your acute urinary retention complaints. Let’s talk about presentation, causes, diagnosis, and management. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com.

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American Medical Compliance

MAY 8, 2023

In March 2023, researchers from Rockefeller University made a significant breakthrough in the fight against HIV/AIDS. They cured a New York woman of HIV using a new treatment method. This method modified her immune cells to resist the virus through gene therapy. This development offers hope for millions of people living with HIV/AIDS worldwide. This is a major breakthrough in healthcare worldwide.

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Research Wellness 52

SheMD

MAY 7, 2023

,At SheMD, we strive to provide resources for women in all stages of their medical education. Recently, we realized that we needed to fill a void in resources for students currently in their clinical clerkships. We have reached out to students across the country to help us help you all. They will offer you the ins and outs to several different rotations that you are either currently in or are looking forward to starting some day.

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OB/GYN Operations Wellness 52

ACEP Now

MAY 6, 2023

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

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PHARM

MAY 9, 2023

This post is the written version of a presentation delivered at the Australian and New Zealand College of Anaesthetists Annual Scientific Meeting in … Utopia or Dystopia?

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Life in the Fast Lane

MAY 8, 2023

Hayden Richards Comms Lab: Advocacy Inquiry Comms Lab 47: Advocacy Inquiry: Advocacy Inquiry is a powerful means of addressing concerning behaviour in others.

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University of Maryland Department of Emergency Med

MAY 7, 2023

52 yo M with chest pain and shortness of breath, ECG as shown, do you activate cath lab? The posterior descending artery (PDA) s.

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EKG/ECG 52

EMergucate

MAY 9, 2023

The chest x-ray is from a patient with severe dyspnoea. Patient has a past history of chronic airway obstruction.

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EMS 52