The Trauma Pro
SEPTEMBER 6, 2024
Trauma professionals don’t always know everything. Sometimes we have to engage a specialist in the care of our patient. And unfortunately, we don’t always know which conditions demand immediate attention and which can wait. This can lead to overuse of our consultant colleagues and calls at inappropriate times. So what if we diagnose an injury in their area of expertise at 2 am?
Science Based Medicine
SEPTEMBER 14, 2024
Maybe this isn't a drill. The post We Want Them Infected Doctors Sanewashed Robert F. Kennedy Jr. Will He Reward Them With Appointments at the CDC, FDA, and NIH? first appeared on Science-Based Medicine.
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Sensible Medicine
SEPTEMBER 5, 2024
The lay media is abuzz with stories about Elle Macpherson, who admits in a new memoir to declining chemotherapy seven years ago. Although precise details are not provided, it sounds like Ms. Macpherson had localized or regional breast cancer and underwent surgery. We learned something about the risks of commenting on the health of celebrities over a decade ago when an OpEd we published in Washington Post about former president George W.
Dr. Smith's ECG Blog
SEPTEMBER 7, 2024
A 70-something y.o. male presents to triage with shortness of breath. He reports significant chest pain at the base of his scapula on the right side along with new shortness of breath. ECG 1 at time zero EARLY REPOLARIZATION ABNORMAL ECG ED final official overread: "early repol vs hyperacute T, minimal changes from previous (previous shown below)" What do YOU think?
Broome Docs
SEPTEMBER 3, 2024
Welcome to another month of nerdy journal jam goodness. This month Justin has served up an eclectic collection of evidence, ethics and educational excellence. As always – we have the full PDFs liked below and you can read more deep thoughts over at First10EM where Justin likes to inconvenience a lot of electrons in his pursuit of educational elegance.
American Medical Compliance
SEPTEMBER 9, 2024
In assisted living, one of the most critical aspects of resident care is the prevention and management of skin issues. For instance, one of the most common risk factors associated with the development of pressure ulcers is being 70 years of age or older. Skin health is not only a matter of comfort and well-being but also a key indicator of a resident’s overall health status.
The Trauma Pro
SEPTEMBER 10, 2024
Field amputation is not thought of very often, and for good reason. It is unpleasant, uncommon, and not very safe for trauma professionals due to the austere environment. I will dedicate the next several posts to the topic, starting with some of the facts. First, let’s start with definitions. Two distinct procedures are discussed here. The first and most commonly described is field amputation.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Sensible Medicine
SEPTEMBER 2, 2024
First a review of the main trial then to the new paper in the Journal of the American College of Cardiology. SELECT Trial The SELECT trial was the first to show that the glucagon-like-peptide-1 receptor agonist (GLP1) semaglutide could actually modify cardiovascular disease. The discovery of another disease-modifying agent for heart disease is a breakthrough.
Dr. Smith's ECG Blog
SEPTEMBER 11, 2024
A former resident texted me this case: "Hey Dr. Smith. Hope you’re doing well! How excited would you have been about this case?" Here is the case: Report from EMS was witnessed syncope, his son did CPR, but the patient had pulses when EMS arrived. When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. No Chest Pain, but somnolent.
Don't Forget the Bubbles
SEPTEMBER 2, 2024
Can’t get enough of Bubble Wrap? This year, four wonderful speakers shared their thoughts on what was important. Here are their recommendations for a little light reading. 1.Neonatal Bubble Wrap from Brian Dunn Seidler AL, Aberoumand M, Hunter KE, Barba A, Libesman S, Williams JG, Shrestha N, Aagerup J, Sotiropoulos JX, Montgomery AA, Gyte GM. Deferred cord clamping, cord milking, and immediate cord clamping at preterm birth: a systematic review and individual participant data meta-analysis.
Emergency Medicine Cases
SEPTEMBER 10, 2024
On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG.
The Trauma Pro
SEPTEMBER 13, 2024
There are basically four indications, two absolute and two relative : Absolute #1 : entrapped extremity with a lengthy extrication and a physiologically impaired patient who does not respond to fluids. In this case, there is occult blood loss in other areas that is killing your patient, and they need to get out quickly for definitive management. Absolute #2 : entrapped extremity with a lengthy extrication and an unstable physical environment.
Science Based Medicine
SEPTEMBER 8, 2024
Bhattacharya, Atlas, and Makary are also set to speak at Stanford next month The post Hopkins Business School to Platform COVID-19 Contrarians at Health Policy Symposium first appeared on Science-Based Medicine.
Sensible Medicine
SEPTEMBER 1, 2024
As seems to be the norm on Sensible Medicine these days, whenever John, Vinay, or I publicly disagree with one another, one of our readers chimes in to explain how all of us are off the mark. Today I am happy to post the latest comeuppance, this one by Dr. Thomas Huddle. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.
Dr. Smith's ECG Blog
SEPTEMBER 5, 2024
Written by Magnus Nossen - Edits by Grauer and Smith The patient in today’s case is a woman in her 70s with a previous medical history of HTN and hyperlipidemia. She presented to an outside hospital after several days of malaise and feeling unwell. At the time of admission, her vital signs were normal. Heart rate was in the 80s. She had a very elevated troponin T at 12,335 ng/L at the time of presentation. ( This is a value typical for a large subacute MI, n ormal value 48 hours after myocardial
St. Emlyn
SEPTEMBER 3, 2024
St.Emlyn's - Emergency Medicine #FOAMed @LizCrowe2 gives us a fantastic critical appraisal of an EMJ paper discussing the patient experience in the emergency department. A qualitative study gives real insight into the patient experience. #FOAMed @stemlyns The post JC: The patient experience in the Emergency Department. appeared first on St.Emlyn's.
Core Medical Group
SEPTEMBER 12, 2024
At CoreMedical Group , our QA team is the backbone of your job placement journey. From finding travel nursing and therapy opportunities to getting you started in new locations, our QA experts, alongside your recruiter, ensure everything is top-notch. Whether it’s your first or fifteenth assignment , we’ve got your back with personalized service, helping with applications, licensing, housing, and even some local tips for your new destination.
Taming the SRU
SEPTEMBER 12, 2024
Weakness is a common, though sometimes vague, presenting symptom in the ED. Neuromuscular (NM) weakness can have various causes, ranging from common and relatively easy to diagnose conditions (such as strokes and trauma) to less common and more difficult to diagnose ones (such as vascular pathologies, infections, autoimmune diseases, and neoplasms).
Science Based Medicine
SEPTEMBER 3, 2024
Myrna Mattaring, a retired scientist who worked in diagnostic labs, claims that COVID-19 vaccines caused a 1432% increase in cancer cases, a clearly impossible claim. Here I make a plea for examining such claims, including a much more famous and accepted one, with basic math. The post Quoth Myrna Mantaring: “US government data” confirms a “143,233% increase in cancer cases due to COVID vaccination”?
Sensible Medicine
SEPTEMBER 9, 2024
In his post yesterday, Adam discussed the STRONG-HF trial. I will expand on it because it is a great example of a positive trial that does not add knowledge to the treatment of patients with heart failure. The larger question is: what are trials for? When I think about science classes in high school, I remember experiments as a way to explain nature.
Dr. Smith's ECG Blog
SEPTEMBER 12, 2024
Written by Pendell Meyers A man in his 40s called EMS for acute chest pain that awoke him from sleep, along with nausea and shortness of breath. His history included known heart failure with prior EF 18%, insulin dependent diabetes, and polysubstance abuse. Vitals were within normal limits except for tachypnea. Here are his EMS ECGs along with the Queen of Hearts interpretations below each one: EMS1 0650 EMS2 0707 Click here to sign up for Queen of Hearts Access The ECGs show RBBB and LAFB, with
PulmCCM
SEPTEMBER 4, 2024
Jon-Emile S. Kenny MD [ @heart_lung ] Since its first description [1], the Venous Excess Ultrasound Score [VExUS] has received much research attention. Very simply, VExUS combines the size of the inferior cava [IVC] with Doppler patterns from the hepatic, portal and intrarenal veins. From these measures a score from 0 to 3 is given as a marker of increasing ‘venous congestion [VC].’ But what exactly does VC mean?
EMDocs
SEPTEMBER 8, 2024
Welcome to the emDOCs Videocast – please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today we focus on IV blood pressure medications in patients with neurovascular emergencies. EBM Update: IV BP Meds in NV Emergencies Background: There is no one agent that is recommended over others for reducing elevated BP in those with neurovascular emergencies.
EMCrit
SEPTEMBER 6, 2024
Learn about how to use ultrasound during cardiac arrest EMCrit Project by Scott Weingart, MD FCCM.
Science Based Medicine
SEPTEMBER 13, 2024
As RSV approaches, some "real world" data out of France provides even more support for the RSV antibody shot for babies. The post More Evidence Supports Infant RSV Shot Safety and Effectiveness first appeared on Science-Based Medicine.
Sensible Medicine
SEPTEMBER 15, 2024
Recently John Mandrola, once again, stepped out of his lane. About a recent, cancer trial, which was celebrated by oncologists, he said this: In fact, John’s observation is broadly true for this revolutionary class of medications. Although these drugs— checkpoint inhibitors— are great for melanoma and cutaneous squamous cell cancer, they aren’t wonder drugs and many uses are marginal.
First 10 EM
SEPTEMBER 9, 2024
Welcome back to another research roundup. This edition doesn’t have any immediate practice changers, but I think there are some very important topics. Enjoy. The BroomeDocs podcast: [link] The BroomeDocs podcast on YouTube: (I am on vacation, so this will probably be inserted later.) In a surprise to no one who reads First10EM, clinical judgment […] The post The September 2024 Research Roundup appeared first on First10EM.
Dr. Smith's ECG Blog
SEPTEMBER 9, 2024
Written by Willy Frick A 40 year old woman was at home cooking when she developed chest pain. She took an oxycodone and called EMS. Her presenting ECG is shown below: ECG 1 What do you think? I sent this to Drs. Meyers and Smith and the response was: "I’m quite confident that this is OMI." Here is the Queen's verdict with explainability: She sees OMI with low confidence.
EMDocs
SEPTEMBER 4, 2024
The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. This podcast on health equity and the impact of standardized clinical care pathways and decision support tools embedded in the electronic health record (EHR).
EMCrit
SEPTEMBER 3, 2024
All the Resuscitation and Acute Critical Care goodness in the literature for September 2024 EMCrit Project by Scott Weingart, MD FCCM.
Science Based Medicine
SEPTEMBER 4, 2024
In our increasingly technological we are constantly exposed to radio frequency electromagnetic waves (RF-EMF). It would certainly be inconvenient, to say the least, if this ubiquitous and essential technology had negative health effects. But of course we would need to know if this were the case so that steps could be taken to fix it. Fortunately, a recent systematic review conducted by […] The post WHO Systematic Review of RF and Cancer first appeared on Science-Based Medicine.
ALiEM
SEPTEMBER 13, 2024
A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. The patient presented to an outside “eye doctor” and was told to go to the nearest hospital for evaluation.
First 10 EM
SEPTEMBER 2, 2024
The First10EM monthly (or I guess seasonal this time) 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 format means the focus is mostly on content […] The post The First10EM monthly wrap-up for summer 2024 appeared first on First10EM.
Sensible Medicine
SEPTEMBER 10, 2024
I am a proud American and an avowed capitalist. I am sure that Adam Smith’s “invisible hand of the free market” maximizes social benefits. Capitalism has its flaws – the concentration of wealth and environmental degradation among others -- but no other system is as good at organizing societies and improving standards of living.
EMDocs
SEPTEMBER 14, 2024
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: Sedation, Aspiration, and the Risk of GLP-1 Agonists Spoon Feed Patients on GLP-1 agonists might be at risk of delayed gastric emptying, which has significant implications for procedural sedation and endotracheal in
EB Medicine
SEPTEMBER 13, 2024
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department Introduction and Announcements Elder Abuse and Neglect: An Overview Risk Factors and Reporting Pre-Hospital and Emergency Department Considerations Screening Tools and Physical Examination Documentation and Disposition Cultural Considerations and Future Directions Conclusion an
Science Based Medicine
SEPTEMBER 11, 2024
It seems there is an endless stream of artificial intelligence (AI) news coming out, and this includes the field of medicine. There also continues to be a debate about the true impact of AI – how much is hype, and how much is a genuine advance that can transform our technology? As with many technological advances, it’s both. New tech, perhaps especially […] The post Update on AI in the Clinic first appeared on Science-Based Medicine.
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