Emergency Care Today

December, 2024

The Implications Of A High Pediatric Readiness Score

The Trauma Pro

DECEMBER 3, 2024

In my last post, I described the Pediatric Readiness Score and its components. Today, I’ll explain why maintaining a high score may benefit your trauma center and what it costs to do so. Research groups at the Oregon Health Sciences University and the University of Utah combined multiple data sources to estimate current levels of ED pediatric readiness, the cost to achieve it, the number of pediatric deaths in emergency departments, and the number of potential lives saved if readiness is m

Pediatrics

Pediatrics Emergency Department Research Hospitals

What can you find with continuous ST monitoring in the ED?

Dr. Smith's ECG Blog

DECEMBER 3, 2024

This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He had recently returned from overseas travel where these symptoms had been intermittently bothersome over the preceding weeks and had been attributed to heartburn.

EKG/ECG

EKG/ECG Burns Wellness Shock

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Trending Sources

EMCrit 389 – Massive Transfusion Update and Hemostatic Resuscitation

EMCrit

DECEMBER 1, 2024

John Holcomb, author of the PROPPR trial, on massive transfusion in 2024 EMCrit Project by Scott Weingart, MD FCCM.

Resuscitation

Questions For Senators to Ask Drs. Marty Makary and Jay Bhattacharya

Science Based Medicine

DECEMBER 3, 2024

Yesterday, Dr. David Gorksi invited us to come up with questions for Senators to ask our future public health leaders. Here are mine. The post Questions For Senators to Ask Drs. Marty Makary and Jay Bhattacharya first appeared on Science-Based Medicine.

Podcast – ECMO in Trauma with Chris Bishop at Tactical Trauma 24

St. Emlyn

DECEMBER 3, 2024

St.Emlyn's - Emergency Medicine #FOAMed In this podcast, Liz Crowe discusses the effect bad behaviour has on teams and ultimately patient safety. The post Podcast – ECMO in Trauma with Chris Bishop at Tactical Trauma 24 appeared first on St.Emlyn's.

Patient Safety

Patient Safety Shock Resuscitation

A Story about Surrogate Outcomes

Sensible Medicine

DECEMBER 2, 2024

JAMA Network Open published our paper —which is open access. You can read the whole thing. What follows is a preliminary report. Senior author Andrew Foy and I are writing more on our findings. We believe the question of how to measure outcomes in heart failure is a huge issue in this era of cardiology. Also, kudos to first author Ahmed Sayed, MBBS, who has strong skills in data analytics and maybe even a stronger work ethic.

Outcomes

Outcomes Hospitals

EM@3AM: Murine Typhus

EMDocs

DECEMBER 1, 2024

Authors: Grant Gerstner, DO (EM Resident Physician, San Antonio, TX); Kyle Smiley, MD (EM Resident Physician, San Antonio, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

EMS

EMS Infectious Diseases Shock Resuscitation

EM Quick Hits 61 TEE in Cardiac Arrest, Nebulized Ketamine, Cellulitis Update, SQ Insulin for DKA, Medicolegal DDx Documentation Tips

Emergency Medicine Cases

DECEMBER 3, 2024

On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips.

Documentation/Coding

Documentation/Coding EMS Resuscitation

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EM Quick Hits 61 TEE in Cardiac Arrest, Nebulized Ketamine, Cellulitis Update, SQ Insulin for DKA, Medicolegal DDx Documentation Tips

Emergency Medicine Cases

DECEMBER 3, 2024

Documentation/Coding

Documentation/Coding EMS Resuscitation

Getting Triggered By Errors in the Emergency Department

EM Literature of Note

DECEMBER 4, 2024

The emergency department is a place of risk and errors. Those who work in the ED are acutely aware of this, and it conjures up tremendous cognitive pressures on staff every shift. Every ED clinician knows the most benign-appearing triage complaint may obfuscate lurking catastrophe. The vision changes that are actually an acute aortic dissection. A sore shoulder that is necrotizing fasciitis.

Emergency Department

Emergency Department Stroke Patient Safety Research

REBEL Core Cast 132.0 – Recent-Onset AFib

RebelEM

DECEMBER 4, 2024

Take Home points : If the patient is low risk with CHA 2 DS 2 -VASc (men < 2, women < 3), cardioversion is safe up to 48 hours from onset. In higher risk patients, we should reserve cardioversion unless there is clear onset less than 12 hours or the patient has been anticoagulated for 3 weeks. Consider anticoagulation in every patient with atrial fibrillation whether they are cardioverted or referred.

Emergency Department

Emergency Department Stroke EMS Shock

Toxic alcohol poisoning: What do we know about fomepizole, methanol and ethylene glycol?

St. Emlyn

DECEMBER 2, 2024

St.Emlyn's - Emergency Medicine #FOAMed Uncover the truth about alcohol poisoning. Find out how toxic alcohols can be ingested accidentally or intentionally and the serious consequences they can have with a focus on Emergency medicine management. #FOAMed @stemlyns The post Toxic alcohol poisoning: What do we know about fomepizole, methanol and ethylene glycol?

Poisoning

SAEM Clinical Images Series: This Rash Came Out of No Where

ALiEM

DECEMBER 3, 2024

A 26-year-old male with a past medical history of eczema presented to the Emergency Department with a rash for two days. The patient stated he first noticed a rash on his right arm that rapidly spread to his face, chest, and left arm. He reported having similar rashes before but never to this extent. The patient stated he was given Bactrim and amoxicillin about one month ago for another rash, though he was unsure of the diagnosis.

Academics

Academics Emergency Department Infectious Diseases

emDOCs Podcast – Episode 111: Guillain-Barré Syndrome Part 1

EMDocs

DECEMBER 2, 2024

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover Guillain-Barré syndrome focusing on the history, examination, and ED evaluation. Part 2 will cover management. Episode 111: Guillain-Barré Syndrome Part 1 Background: GBS is an immune-mediated disease affecting peripheral nerves. An inciting event creates antigens that look like normal host cells or proteins, which confuses the immune system and results in antibodies that attack the myelin sheath of peripheral nerves.

Burns

Bubble Wrap PLUS – December 2024

Don't Forget the Bubbles

DECEMBER 3, 2024

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

Pediatrics

Pediatrics Telemedicine Research Hospitals

WOMAN-2: TXA has no role in postpartum hemorrhage

First 10 EM

DECEMBER 2, 2024

Despite being widely talked about in glowing terms, the original WOMAN trial was clearly negative, with no benefit in their primary outcome, and no change in all cause mortality, and therefore no hint of benefit. (There is a lot of confusion about what disease specific mortality means when this paper is discussed, but it only […] The post WOMAN-2: TXA has no role in postpartum hemorrhage appeared first on First10EM.

Outcomes

Outcomes EMS

Whoop! There It Is: A Pertinent Pediatric Pertussis Podcast

PEMBlog

DECEMBER 4, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , we explore pertussis, also known as whooping cough – a disease that remains a public health challenge despite widespread vaccination efforts. We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates.

Pediatrics

Pediatrics PPE Wellness Infectious Diseases

Empowering Your Workplace: New Courses for Safety, Compliance, and Cybersecurity

Total Medical ComplianceHIPAA

DECEMBER 3, 2024

In today’s rapidly evolving professional landscape, staying informed and prepared is more crucial than ever. To meet the diverse needs of organizations and their staff, we are excited to introduce a selection of new courses designed to enhance safety, compliance, and overall workplace effectiveness. From cybersecurity awareness to infection control in dental settings, these courses provide comprehensive training to help you build a safer, more secure, and compliant work environment.

CDC

CDC Best Practices Wellness

ICM Clinical Refresher Course

Life in the Fast Lane

DECEMBER 2, 2024

Chris Nickson ICM Clinical Refresher Course Returning to the clinical coalface after a prolonged absence is inherently challenging. The good thing is there are courses that can help you get back in the swing of things.

Imaging Case of the Week 611

EMergucate

DECEMBER 3, 2024

The x-ray is from a toddler with fever and abdominal pain. What can be seen? Answer will be posted later.

EMS

The Word “Mental” in Project 2025. (vi + vii)

Maria Yang, MD

DECEMBER 1, 2024

The sixth instance of the word “mental” is on page 509 in the section about “First-Day and First-Year Administrative Reforms” for The Department of Housing and Urban Development (emphasis mine): The Office of the Secretary should execute regulatory and subregulatory guidance actions, across HUD programs and applicable to all relevant stakeholders, that would restrict program eligibility when admission would threaten the protection of the life and health of individuals and fail to encourage upwar

Psychiatric

Psychiatric Domestic Violence Administration Research

What Causes Delayed Passage of Meconium?

Pediatric Education

DECEMBER 1, 2024

Patient Presentation A 2-day-old female was in the newborn nursery. She was a term infant, born to a G2P2 mother without complications. It was noted before rounds that she was almost 48 hours old and had not passed any meconium. She was acting normally and breastfeeding well every 2-3 hours. Her routine labs had been sent at 24 hours of age including her newborn screening test and its results were pending.

Pediatrics

Pediatrics Wellness Sepsis Operations

Medical Music Mondays: Constipation Nation

PEMBlog

DECEMBER 2, 2024

The Rome IV criteria are how you diagnose constipation. Also X-Rays don’t help. And “The Red Hot Chili Poopers” would be a great name for a tribute band. Lyrics Can’t poop, no stool in about three weeks Walk slow cause now I think my butt leaks I strain and try but I can’t go – no My bowel transit rate is so slow Bristol One is all that I can do I hurts so much when I try to go poo [chorus] Constipation!

Enhance Safety, Security, and Compliance with Our Latest Online Training Courses

Total Medical ComplianceHIPAA

DECEMBER 3, 2024

In today’s rapidly evolving professional landscape, staying informed and prepared is more crucial than ever. To meet the diverse needs of organizations and their staff, we are excited to introduce a selection of new online training courses designed to enhance safety, compliance, and overall workplace effectiveness. From cybersecurity awareness to infection control in dental settings, these courses provide comprehensive training to help you build a safer, more secure, and compliant work env

CDC

CDC Best Practices Wellness

Filling an Empty Nest—Not with Work!

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

Should My Patient Get a 7th Covid Shot?

Sensible Medicine

DECEMBER 3, 2024

Evidence, trust, and clear-thinking are core beliefs here at Sensible Medicine. What struck me most when I read this essay from electrophysiologist, Dr. Joseph Marine, was his change in attitude regarding the SARS-CoV-2 vaccine. There is much to learn from the public health handling of the pandemic. How the current leaders lost the confidence of respected doctors is surely one of the most important lessons for the new health team.

CDC

CDC Outcomes Hospitals Wellness

Are usual vasopressor doses causing unrecognized harm?

PulmCCM

DECEMBER 3, 2024

Maintaining a mean arterial pressure (MAP) of 65 mm Hg has been advised for patients with sepsis and other forms of vasodilatory shock. In practice, treating teams often exceed this target by a significant margin, such as in patients with more severe organ failure or pre-existing hypertension. This strategy is likely pursued out of concern that lower MAP targets would produce suboptimal perfusion in some (or most) patients.

Sepsis

Sepsis Shock Outcomes Hospitals

ECG Cases 52 – The Art of Occlusion MI, part 1: Mirror Image

Emergency Medicine Cases

DECEMBER 3, 2024

In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more.

EKG/ECG

EKG/ECG EMS