2022

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Lisfranc Injury

Mount Sinai EM

Summary Summary The Lisfranc joint is made of the first four metatarsals, cuneiforms and cuboid and associated ligaments A Lisfranc injury is any disruption of the joint The mechanism of injury (axial load on plantarflexed foot, rotational force, crush injury) should increase suspicion for this injury Familiarize yourself with the normal foot x-ray as findings for a Lisfranc injury can be subtle Management depends on the severity of injury and should involve a discussion with your orthopedic sur

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EMCrit 335 – APRV TCAV for Lung Rescue Made Simple with Rory Spiegel

EMCrit

Every Resus doc should be able to crash a patient on to APRV for lung rescue. EMCrit Project by Scott Weingart, MD FCCM.

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New CDC Guidelines on COVID-19

American Medical Compliance

The Centers for Disease Control and Prevention released a statement saying that people no longer need to quarantine if they are exposed to someone with COVID-19. This recommendation also holds for people not fully vaccinated. The CDC guidelines state that exposed people now only need to wear masks while indoors for up to 10 days. They also should test for COVID-19 on day 5.

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How Breast Centers are Improving Patient Experience

PDC Healthcare

Due to increasing scrutiny around patient satisfaction and what it may mean for reimbursement, patient volume, and quality standards, it’s no surprise that patient experience is at the forefront of breast centers’ priorities. We spoke with many of our top breast health professionals about the top priorities for their facilities. As expected, improving patient experience […].

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HIPAA AND BATTLING PARENTS

Total Medical ComplianceHIPAA

Dealing with a minor’s medical records can be a minefield when a child is from a blended family or the parents have a contentious divorce going. Things get especially sticky when you add in stepparents and grandparents, and when a minor controls all or a portion of their own records. It’s a good time to review the basics. Custody versus Parental Rights: Don’t confuse custody with parental rights.

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Drucker on How to Manage Change

33 Charts

Peter Drucker, the father of modern day management, inspired a generation of leaders with his quote, “ One cannot manage change. One can only be ahead of it.” This needs to be reconsidered. Because there’s the fantasy of staying ahead of change and then there’s the modern reality. Early in this century technological progress exceeded the system’s ability to keep up.

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Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis

EMergucate

Original paper Findings Intranasal topical TXA is associated with a lower rate of need for anterior nasal packing and a shortened stay in the ED Bottom line Topical TXA for epi…

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More Trending

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How to Land the Best Travel Nursing Job Ever

Core Medical Group

Editor's Note: This post was originally published in April 2017 and has been updated for accuracy and comprehensiveness. These 3 simple lessons will help you land the best travel nursing job ever – whether it’s your first time or fifteenth time!

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157. Alcohol Withdrawal: What are you doing New Year's Eve?

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Happy Holidays and New Year’s to our listeners! Thank you for what you do for your patients each day. We appreciate you listening. We decided to re-publish one of our most popular episodes from 2022 as a throw-back.

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30-something woman with a HEART score of zero, EDACS of 2, computer "Normal" ECG, and initial troponin < Limit of Detection

Dr. Smith's ECG Blog

I was working in triage very late when a 30 yo previously completely healthy woman walked in with 30 minutes of central chest pressure. This ECG was recorded: The computer called it "Normal" except for "Possible right ventricular conduction delay" What do you think? I immediately recognized an inferior-posterior-lateral OMI. There are hyperacute T-waves in II, III, and aVF.

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ECMO made EZ

Mount Sinai EM

Intro For this week’s teaching pearl, I wanted to go back and cover a medical pearl. We always hear the word “ECMO” thrown around but I want to today go into a very brief overview of what ECMO is and why it is being used more commonly. I am going to provide the pearl in a Q/A format to make it easier to process. Disclaimer : This is only a very brief overview of ECMO just so everyone at least has a basic understanding of what the technology is and what the circuit looks like.

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EMCrit RACC Lit Review for December 2022

EMCrit

All the resus/acute critical care literature goodness for December 2022. EMCrit Project by Scott Weingart, MD FCCM.

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Dental Waterlines Found to Contain Bacteria

American Medical Compliance

A number of dental waterlines have been found to contain waterborne bacteria, infecting children with nontuberculous Mycobacteria (NTM). This caused the Centers for Disease Control and Prevention (CDC) to issue a health advisory on bacteria in the pipes of dental facilities. Dental Waterlines and Infections. Biofilms containing bacteria can easily develop in dental waterlines.

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Five Best Practices for IV Medication Administration Safety 

PDC Healthcare

Healthcare professionals are faced with many obstacles while administering IV medication to patients, which can lead to medical errors and a risk for patient safety. Nearly 40% of medical errors take place during medication administration as it is one of the most intricate processes for healthcare staff. It is critical to ensure the 5 rights […].

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Website Privacy Policies and HIPAA’s Notice of Privacy Practices

Total Medical ComplianceHIPAA

If you have spent any time on the Internet, you have been asked what you would like a website to do with its cookies. A cookie is information saved by your web browser. Cookies are like flags that allow a website to recognize and remember your device if you return to that site in the future. Some cookies can also keep track of your device over time.

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WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do?

Emergency Medicine Cases

In this month's Waiting to Be Seen blog Dr. Howard Ovens outlines challenges, innovations and coping strategies in the EM Crisis. The post WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do? appeared first on Emergency Medicine Cases.

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ECG of the Week 21st December 2022

EMergucate

This ECG was obtained from a 22 year old man who had taken a polypharmacy overdose 24 hours ago. He had suffered a bradycardic / asystolic arrest and is currently in the intensive care unit.

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Ultrasound vs Landmark Subclavians

Ultrasound Gel

This episode has been a long time coming! We're talking ultrasound-guided subclavian central lines, and a lot of people have opinions. Are they better than landmark? What should we teach learners? The GEL team discusses through the lens of this fascinating RCT. [link] [link] This episode has been a long time coming! We're talking ultrasound-guided subclavian central lines, and a lot of people have opinions.

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Discover Interim Healthcare Management

Core Medical Group

The job market has been a whirlwind in recent years, so it’s likely affected you in one way or another if you’re in a management or director-level position within the healthcare industry.

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Pro-MEDIC

The Bottom Line

In adults with an expected ICU stay of > 72 hours, does the provision of enteral melatonin compared to placebo increase the number of delirium-free assessments within 14 days or before ICU discharge?

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See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

by Emre Aslanger Dr. Aslanger is our newest editorial member. He is an interventional cardiologist in Turkey. Dr. Aslanger is also the author of the DIFFOCULT study: Emre K. Aslanger , a, ⁎ Özlem Yıldırımtürk , b Barış Şimşek , c Emrah Bozbeyoğlu , c Mustafa Aytek Şimşek , a Can Yücel Karabay , b Stephen W. Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction.

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POCUS guided LP

Mount Sinai EM

Intro Raise your hand if you ever struggled obtaining a CSF sample from a Lumbar Puncture. I “virtually” see that most if not all of you at one point in your career struggled with this. This pearl is inspired by an overnight Elmhurst A-side shift I had several months ago with a patient requiring a Lumbar Puncture. I waved off my senior/attending and told them “No worries, I got this.

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PulmCrit Blogitorial – SIESTA syndrome:  Sedation Induced EEG Suppression with Transient Agitation

EMCrit

This is SIESTA syndrome. The patient is locked in a cycle of unconsciousness, punctuated with brief episodes of agitation. Most of the time the patient is sedated to the point of having minimal EEG activity, which may hinder their ability to regain consciousness. . EMCrit Project by Josh Farkas.

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Cybersecurity Threats to Health Systems

American Medical Compliance

Cybersecurity threats against healthcare systems have increased since the beginning of the COVID-19 pandemic due to the adoption of new health technologies. During 2020, cyberattacks against health systems increased by forty-seven percent. Adopting stronger security measures will be essential to protecting patient data moving forward. Causes of Increased Cybersecurity Threats.

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3 More Efficient Ways to Identify Patients at an ASC

PDC Healthcare

3 More Efficient Ways to Identify Patients at an ASC According to a recent survey with PDC customers, a majority of Ambulatory Surgery Centers are using a printed label adhered to a paper or plastic wristband as their method of identifying patients. While this method enables them to satisfy the Joint Commission’s Two Patient Identifiers […]. The post 3 More Efficient Ways to Identify Patients at an ASC appeared first on connectID - PDC Healthcare Blog.

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ADA Cybersecurity Attack

Total Medical ComplianceHIPAA

In the past week the American Dental Association has confirmed that they fell victim to a cybersecurity event. There is a banner posted on the home page of the website alerting their members of this continuing situation and asking for their patience as the issue is resolved. News outlets are consistently reporting the following information related to the incident: Web-based chat, email and telephone services were all impacted.

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ECG Cases 38 – ECG Interpretation in Cocaine Chest Pain

Emergency Medicine Cases

Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associated chest pain require benzodiazepines +/- nitroglycerine for symptom relief, aspirin and ECG to look for signs of occlusion and reperfusion. In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern.

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156. Aortic Dissection: On a Tear

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. It lives in our nightmares. On this special holiday episode, Blake and Iltifat share the pearls and pitfalls of aortic dissection presentation, diagnosis, and management. You won't want to miss this high yield year's end conclusion.

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Pediatric Collab preview: Support employees and deliver better care

NRC Health

The NRC Health 2023 Pediatric Collaborative is truly a can’t-miss experience, with exceptional presentations that will stir innovative ideas. The post Pediatric Collab preview: Support employees and deliver better care appeared first on NRC Health.

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Why You Shouldn’t Settle Until You’re 100% Medically Stable

Medical Law

When you’ve suffered serious injuries caused by somebody’s careless behavior, you’ll probably want to resolve the matter quickly. After all, you have other things to focus on — overcoming the trauma, getting back to work, and resuming your daily activities. There’s a natural desire to finalize the legal process and start putting your life back together.

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ECG of the Week 14th December 2022

EMergucate

The following ECG was obtained in a 38 year old Indigenous man with a history of ischaemic cardiomyopathy at a regional hospital. He did not have a history of left bundle branch block previously.

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Right Bundle Branch Block and Posterior OMI????

Dr. Smith's ECG Blog

This 39 year old patient presents with syncope. What do you think? There appears to be RBBB with excessively discordant ST depression (2-2.5 mm) in V2 and V3, suggestive of RBBB with posterior OMI Whenever you see abnormal ST-T (ST elevation, ST depression, hyperacute T-waves), you MUST look at the entire ECG (rhythm, rate, P-waves, intervals, and QRS) to see if there is some abnormality among these which can explain the ST-T.

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Does Spine Surgery Have a Role in Low Back Pain? - Clinical Correlations

Clinical Correlations

By: Michael Moore Peer Reviewed “Too many complex back surgeries are being performed and patients are suffering as a result” wrote National Public Radio health science journalist Joanne Silberner in her 2010 article “Surgery May Not.

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EMCrit 338 – End of Year Question & Answer Session

EMCrit

Rounding up the questions from the past few months. EMCrit Project by Scott Weingart, MD FCCM.

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REBEL Core Cast 92.0 – Perichondritis

RebelEM

Take Home Points Perichondritis is an infection of the cartilage and connective tissue of the ear Perichondritis can be recognized clinically by erythema, swelling and tenderness of the auricle. The most common organism in perichondritis is P. aeruginosa and antibiotics should be tailored to cover this organism REBEL Core Cast 92.0 – Perichondritis Click here for Direct Download of the Podcast Background Perichondritis may appear to be a simple cellulitis of the ear but, in fact, it repres

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Influenza

EB Medicine

In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2022 Evidence-Based Urgent Care article on Influenza in Urgent Care. Epidemiology Historical data Since COVID, tracking "influenza-like illness" has been complicated Influenza deaths and age Annual mortality  Outbreaks Transmission Classification Influenza A, B, and C Hemagglutinin and neuraminidase subgroups Antigenic drift and shift Pathophysiology Transmission Incubation Secondary infection H3N2 Vaccines Egg-based,

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Carrying Loss During The Holidays

Dr. Mike Sevilla

What a beautiful day here in northeastern Ohio. It was a crisp 39 degrees at Beaver Creek State Park today as we hiked close to sunset. This hike really reminded me of the time when my father was sick two years ago. In the past few weeks, I’ve seen on by feed that there are many of my Facebook friends have experienced loss with the passing of a family member recently.

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