Pediatric EM Morsels

JUNE 30, 2023

I’m sure you can recall at least several parents who bring their children into the ED for concern of recurrent pneumonias. Often the parents focus on a possible underlying immunodeficiency. Fortunately, most commonly these pneumonias are due to viral infections, and we can often offer reassurances to the parent. The differential could also include aspiration , asthma , and bronchiectasis depending on the patient’s history.

Ultrasounds 208

Ultrasounds Pediatrics Operations EMS 208

The Trauma Pro

JUNE 27, 2023

It’s been five years since I published my series on the use of the electronic trauma flow sheet (eTFS). Anyone who knows me is familiar with my skepticism about this tool. I’ve been writing about the significant problems it can create since 2008! With the progress in computing power and interfaces we have enjoyed, we would have this problem solved by now.

Hospitals 241

Hospitals 241

Don't Forget the Bubbles

JUNE 30, 2023

A PEM adventure It’s time for another PEM adventure. Join us on another journey (with an inbuilt time travel machine) in managing Elsa, a 2-year-old girl who is a HUGE fan of the Disney movie, Frozen. Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. Emergency Medical Services found her apneic and pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Science Based Medicine

JUNE 24, 2023

The amount of energy needed to refute b t is an order of magnitude bigger than that needed to produce it. The post Steve Kirsch and Brandolini’s law first appeared on Science-Based Medicine.

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Greater Sydney Area HEMS

JUNE 25, 2023

In this episode, Senior Staff Specialist Dr Geoff Healy reflects on a formative case with unexpected long term follow-up, and how this has shaped his clinical career as both a physician, and mentor.

Hospitals 124

Hospitals 124

The Trauma Pro

JUNE 30, 2023

Today, I’ll kick off my series on the use of the electronic trauma flow sheet (eTFS). The biggest question is, why does your hospital want you to use it? Typically, hospital administrators pressure trauma programs to adopt an eTFS at some point after implementing the hospital-wide use of an electronic health record (EHR). When I started this series nearly 15 years ago, many hospitals still used paper charting.

Hospitals 130

Hospitals Administration Resuscitation Best Practices 130

Don't Forget the Bubbles

JUNE 30, 2023

A PEM adventure Meet Polly, a 6-year-old girl with a penchant for shopping. Besides a few febrile convulsions when she was two, she’s a healthy 6-year-old. Having just bought the most gorgeous pair of red ballet pumps that would go delightfully with the red bow she bought in Harrods last week, she was skipping down Regent’s Street with her nanny. As they crossed the front of Liberty, a huge letter L came plummeting down, crashing in front of her.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

St. Emlyn

JUNE 28, 2023

St.Emlyn's - Emergency Medicine #FOAMed We love a jolly @StEmlyns and true to form we were off to the UK Intensive Care Society State of the Art conference this week in Birmingham. This is always … ICS #SOA23 – Day 1 Read More » The post ICS #SOA23 – Day 1 appeared first on St.Emlyn's.

Research 110

Research 110

Science Based Medicine

JUNE 30, 2023

Those of us who thought about vaccines before the pandemic know perfectly well that anti-vaxxers start with their conclusions and work backwards to retrofit the "evidence." Doctors who do the same shouldn't be regarded any differently. The post Kids Don’t Need the Vaccine Because They Are Less Likely to Acquire SARS-CoV-2 and Because Most Already Had COVID-19 first appeared on Science-Based Medicine.

Wellness 109

Wellness 109

Don't Forget the Bubbles

JUNE 26, 2023

In this case-based article, we’ll talk about single ventricle defects and their management (both medical and surgical), then look at the two main shunt options during Stage 1 reconstruction. Single ventricle defects Many complex congenital heart defects have single ventricle physiology. This means that one ventricle is too small, weak or obstructed to pump effectively, leaving the other ventricle to supply both systemic and pulmonary circulations in parallel via a shunt such as the ductus

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Emergency Live

JUNE 29, 2023

BLSD stands for Basic Life Support Defibrillator, i.e. first aid manoeuvres using a defibrillator The post BLSD: what is it? How should the manoeuvres be performed? appeared first on Emergency Live.

Basic Life Support 112

Basic Life Support 112

First 10 EM

JUNE 26, 2023

I think the conclusions of the paper are incredibly obvious, and therefore not practice changing, but I worry that a superficial read might lead to misinterpretation, and therefore the paper is probably worth covering. (This is the same research group that published the infamous PESIT study, and all the subsequent misinformation about PE risk in […] The post PE risk in severe exertional dyspnea appeared first on First10EM.

Research 108

Research EMS 108

St. Emlyn

JUNE 29, 2023

St.Emlyn's - Emergency Medicine #FOAMed We’re back for the second day of the Intensive Care Society Sate of the Art Congress here in Birmingham! Yesterday was great and we learnt a lot with loads of … ICS #SOA23 – Day 2 Read More » The post ICS #SOA23 – Day 2 appeared first on St.Emlyn's.

Teamwork 105

Teamwork 105

Science Based Medicine

JUNE 25, 2023

Joe Rogan conveyed a challenge by antivax crank turned Presidential candidate RFK Jr. to vaccine scientist Dr. Peter Hotez to "debate me, bro!" In the week since, wealthy right wingers have added money to the inducement, and through an awful op-ed by Ross Douthat this weekend, even the New York Times has amped up the pressure for a "debate" about vaccines with RFK Jr.

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Emergency Live

JUNE 28, 2023

The electrocardiogram, or ECG, is an instrumental diagnostic test that uses an electrocardiograph to record and graphically reproduce the heart's electrical activity through a series of electrodes The post Electrocardiogram, an overview appeared first on Emergency Live.

EKG/ECG 111

EKG/ECG 111

NRC Health

JUNE 30, 2023

In this episode Amy Feeder, Customer Experience Program Manager at M Health Fairview and Jon Tanner, Program Director of Human Understanding at NRC Health join us to discuss the importance of team recognition and how it strengthens patient care. The post Attracting and Retaining Talent using Team Recognition appeared first on NRC Health.

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EM Ottawa

JUNE 29, 2023

Patients with heart failure are often newly diagnosed in the Emergency Department, or are the presenting location for those with decompensated heart failure. This is why it is important for ER Physicians to remain updated on the latest AHA/ACC/HFSA guidelines for the management of heart failure. In this post, we are going to touch on: […] The post Don’t go Breaking my Heart: 2022 Heart Failure Guidelines appeared first on EMOttawa Blog.

Emergency Department 98

Emergency Department Resuscitation 98

PEMBlog

JUNE 27, 2023

It is summertime, so the bees and bugs are out! In this episode, Dr. Ben Grebber, a pediatric resident at Boston Children’s Hospital/Tufts Children’s Hospital, discusses Bee Stings and Spider Bites. A very common pediatric summer complaint in emergency departments, urgent cares, and primary care offices, this episode covers common signs and symptoms, some pathophysiology, and recommended treatments.

Urgent Care 98

Urgent Care Pediatrics Emergency Department Hospitals 98

Emergency Live

JUNE 30, 2023

The defibrillator is a device capable of generating a controlled electrical discharge to the heart in order to re-establish the rhythm of its beats in the event of cardiac arrest or rhythm alterations The post Cardiac arrest, let's talk about defibrillator voltage appeared first on Emergency Live.

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SCGH ED

JUNE 29, 2023

The Neurology Rapid Access Clinic (NRAC) will commence 3/7/23. This clinic has opened with the intent of diverting patient’s with symptoms consistent with a diagnosis of a Transient Ischaemic Attack from hospital admission for investigation and having them worked up in an expedited fashion as an outpatient. ED will now be able to clinically assess patients, organise appropriate initial investigations (including a CT/CTA) and then discharge them to be seen in the clinic, ideally within less

Hospitals 98

Hospitals 98

Intensive Blog

JUNE 26, 2023

Author: Dr Ken Hoffman Peer reviewer: A/Prof Chris Nickson These videos are aimed at ICU staff and trainees who are new to ECMO. Part 1 focusses on nomenclature and components of ECMO (extracorporeal membrane oxygenation). Part 2 focusses on V-V (veno-venous) ECMO. Part 3 tackles V-A (veno-arterial) ECMO and the final video, Part 4, addresses ECPR (ECMO-CPR during cardiac arrest).

CPR 98

CPR 98

PulmCCM

JUNE 26, 2023

An expert panel broadened the definition of acute respiratory distress syndrome (ARDS). They announced this at the American Thoracic Society meeting in May 2023. Thirty-two experts virtually to update the 2012 update (in Berlin) , and declared that ARDS shall henceforth include anyone with: PaO2/FiO2 ≤300 mmHg (on an arterial blood gas) or SpO2/FiO2 ≤315mmHg with SpO2 ≤97% (on pulse oximetry without an ABG) That’s while receiving either mechanical ventilation, or (this is

Outcomes 98

Outcomes Hospitals Ultrasounds Wellness 98

Emergency Live

JUNE 27, 2023

Subconjunctival hemorrhage: the bloodstains in the eye are the consequence of the rupture of some capillaries affecting the visual system, and more specifically the sclera and the conjunctiva The post Blood in the eye? Often everything is ok, but the subconjunctival hemorrhage can reveal more appeared first on Emergency Live.

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Sensible Medicine

JUNE 30, 2023

KW was a 58-year-old man with long standing type 1 diabetes mellitus and hypertension. He came to an appointment one Friday afternoon with chest pain. The pain had been present intermittently for 10 days. It was on the left side of his chest and beneath his sternum. It did not radiate anywhere, it was not related to exertion, nor was it associated with diaphoresis or shortness of breath.

Hospitals 91

Hospitals Hospice Resuscitation COPD 91

St. Emlyn

JUNE 25, 2023

St.Emlyn's - Emergency Medicine #FOAMed Critical appraisal of the DEVICE trial as published in 2023 NEJM. VL outperforms DL in this study of critically unwell patients. #FOAMed #airway @stemlyns The post JC – Video vs Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults appeared first on St.Emlyn's.

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Medagadget

JUNE 28, 2023

Researchers at the University of Connecticut have developed an ultrasound implant that can assist in opening the blood brain barrier to allow chemotherapy to enter and treat brain cancer. However, unlike cumbersome ultrasound systems, this technology can be implanted directly into the brain, and does not require a follow-up surgery to remove the device later as it degrades away to nothing in the brain over time.

Ultrasounds 86

Ultrasounds Research 86

Emergency Live

JUNE 27, 2023

What is a vasculitis? Vasculitis is a group of pathologies united by the presence of an inflammatory process affecting any blood vessel (arteries, arterioles, veins, venules or capillaries) The post Let's talk about vasculitis: what dangers does vasculitis cause? appeared first on Emergency Live.

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Sensible Medicine

JUNE 26, 2023

Dr. Mandrola and I are trading beats this week. I am posting the “Study of the Week” today and John will be publishing a “My Favorite Article” piece later in the week. Over time, I have realized the type of medicine I enjoy practicing. I love evaluating symptoms, making diagnoses, and curing (or more commonly managing) diseases.

Stroke 91

Stroke Wellness 91

Science Based Medicine

JUNE 28, 2023

New research, same old narrative. The post Does Intermittent Fasting Work? first appeared on Science-Based Medicine.

Research 98

Research 98

Medagadget

JUNE 26, 2023

BBy , a medtech company based in New York, has developed a spray drying method that hospitals can use to process human breast milk into a shelf-stable powder. Human breast milk is an incredibly important source of nutrition for neonates in intensive care units (NICUs). At present, human donor milk is frozen and must be defrosted prior to use in such facilities.

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CDC Hospitals Research Wellness 84

Emergency Live

JUNE 28, 2023

Even the trachea, like other organs, can become inflamed due to viruses and bacteria. In this case we speak of "tracheitis" The post Tracheitis: symptoms, causes, diagnosis and treatment appeared first on Emergency Live.

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Sensible Medicine

JUNE 28, 2023

Words that pop into my head when thinking about the academic literature: vast, insipid, repetitive, Sisyphus. Then I found this: Ultimately, our success as a profession will depend on our ability to engage in debate, acknowledge different opinions, and seek answers through science. This sentence came seven years before social media and a virus shredded our norms.

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Academics Outcomes 84

Dr. Smith's ECG Blog

JUNE 26, 2023

== MY Comment , by K EN G RAUER, MD ( 6/26 /2023 ): == The tracing in Figure-1 was sent to me — without the benefit of any history. How would YOU interpret this tracing? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Initial Thoughts: My attention was immediately drawn to the long lead rhythm strip in Figure-1.

EKG/ECG 75

EKG/ECG Seizures Sepsis Operations 75

Medagadget

JUNE 26, 2023

Scientists at Rice University have developed a highly flexible nanoelectrode that is designed for long-term implantation in the brain. The brain stimulation provided by the technology is incredibly fine-grained, thanks to the very low current it can deliver. This results in a very discrete area of neurostimulation, potentially allowing for much finer control of small groups of neurons.

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Research Shock 78

Emergency Live

JUNE 27, 2023

What is a retroverted uterus? It is a clinical condition that is much more frequent than one might assume: it affects between 20 and 30% of women The post Retroverted uterus: causes, symptoms, diagnosis, treatment and consequences appeared first on Emergency Live.

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EMDocs

JUNE 24, 2023

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: How to Improve STI Test Accuracy – Swab or Urine? Spoon Feed Vaginal swabs are more accurate than urine samples in diagnosing Chlamydia trachomatis , Neisseria gonorrhoeae , and Trichomonas vaginalis.

Dehydration 76

Dehydration Fractures CDC Pediatrics 76

Emergency Medicine Cases

JUNE 27, 2023

We miss potentially dangerous and even lethal drug interactions in EM more often than we realize. In this main episode EM Cases podcast with Dr. David Juurlink and Dr. Walter Himmel we review the common categories of drugs, the high risk patients and the key drug interactions that we need to know about in Emergency Medicine. The post Ep 184 Must Know Drug Interactions in Emergency Medicine appeared first on Emergency Medicine Cases.

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EMS 72