Ken Grauer, MD
DECEMBER 1, 2023
== CLICK HERE — for a V ideo presentation of this case! ( 19:40 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #351 — == The ECG in Figure-1 — was obtained from a previously healthy older man who contacted EMS ( E mergency M edical S ervices ) because of "chest tightness" that began ~1 hour earlier.
The Trauma Pro
DECEMBER 5, 2023
Blunt cardiac injury can be an enigma. Significant injuries are uncommon, and the literature on it consists of case reports and small series. The group at Scripps La Jolla has an excellent review article on the topic that is currently in press. This post will relate some of the key points in this nicely prepared article. Use the correct nomenclature.
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Science Based Medicine
DECEMBER 4, 2023
On Thursday, Steve Kirsch gave his long-hyped talk about "record-level data" from New Zealand that supposedly demonstrates that COVID-19 vaccines have killed more than 10 million people worldwide. His "analysis" of illegally obtained data from a "whistleblower" was so ridden with false assumptions and rookie errors that even some antivaxxers couldn't accept it.
Emergency Live
DECEMBER 5, 2023
A Resilient and Technological Approach for the Cities of the Future Urban crisis management requires an innovative approach, combining resilience with new technologies to improve security in large cities. Urban Resilience Urban resilience is critical for adapting to crisis situations, such as pandemics, climate change, droughts, heat waves, and floods.
The Skeptics' Guide to EM
DECEMBER 2, 2023
Reference: Shaikh N, et al. Identifying children likely to benefit from antibiotics for acute sinusitis: a randomized clinical trial. JAMA July 2023 Date: October 17, 2023 Guest Skeptic: Dr. Alasdair Munro is a clinical research fellow specializing in pediatric infectious disease at the University of Southampton. He is currently involved with clinical trials of vaccines […] The post SGEM#422: And It was all Yellow-Nasal Discharge and Antibiotics in Pediatric Sinusitis first appeared on The Skep
Kings County Downstate EM
DECEMBER 5, 2023
Co-authors: Taylor Murtaugh MD, Esteban Davila MD The Case A 59-year-old male with a past medical history of hypertension, hyperlipidemia, and gastroesophageal reflux disease was brought in by EMS to the ED with severe chest pain. EMS administered 324 mg of aspirin. The patient endorsed left-sided chest pain while ambulating […] The post Hypertrophic Cardiomyopathy Part 1: Chest Pain appeared first on County EM.
Dr. Smith's ECG Blog
DECEMBER 5, 2023
Acute coronary syndrome in a pediatric patient? Written by Kirsten Morrissey, MD with edits by Bracey, Grauer, Meyers, and Smith An older teen was transferred from an outside hospital with elevated serum troponin and and ECG demonstrating ST elevations. The patient was obese and had a medical history of only recurrent tonsillitis status post tonsillectomy and adenoidectomy but was otherwise healthy and fully vaccinated.
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Science Based Medicine
DECEMBER 1, 2023
"I used to think medicine could be separated from politics. Gosh. That was super dumb." The post Medical Conservatives: Mixing Politics and Medicine is a Bad Idea, If I Disagree with Your Politics first appeared on Science-Based Medicine.
Emergency Live
DECEMBER 5, 2023
The benefits and challenges in the digital age: the telemedicine revolution in emergency care Telemedicine is playing an increasingly significant role in emergency care, revolutionizing the way care is delivered. The ability to conduct remote medical consultations has opened up new opportunities for faster and more efficient response to medical emergencies.
University of Maryland Department of Emergency Med
DECEMBER 2, 2023
A retrospective study of 2 years of data from 24 trauma centers looking at end tidal CO2 as a predictor of mortality in trauma patients found: Click to view the rest
EMCrit
DECEMBER 2, 2023
Retrograde, in 2023 is basically a backwards way of doing things. EMCrit Project by Scott Weingart, MD FCCM.
Dr. Smith's ECG Blog
DECEMBER 5, 2023
Beyond STEMI: Diagnosing Acute Coronary Occlusion on the ECG. The Queen of Hearts AI app can do it for you. With explainability too.
First 10 EM
DECEMBER 6, 2023
If you haven’t yet discovered the Foohey’s Figures section of First10EM, now is the time. Foohey’s Figures is run by the brilliant educator Dr. Sarah Foohey, and is dedicated to graphics that distill emergency medicine topics down to their basics. They are amazing for quick reference on shift and are easy to save to your […] The post Foohey’s Figures Updates appeared first on First10EM.
Science Based Medicine
DECEMBER 3, 2023
Doctors who prioritized politics over being a "neutral judge" failed to provide the best information. The post The People Can Decide the Best Policy, Only If They Have the Best Information first appeared on Science-Based Medicine.
Emergency Live
DECEMBER 6, 2023
New Strategies and Technologies for the Effective Management of Diabetes in Critical Situations Diabetes is a chronic disease that requires careful and constant management. However, in emergency situations, such as accidents or natural disasters, diabetes management can become extremely complex. Fortunately, in recent years, new strategies and technologies have emerged that are revolutionizing the management […] The post Diabetes: from telemedicine to new drugs appeared first on Emergency
EMDocs
DECEMBER 2, 2023
Author: Haley Sinatro, MD (EM Resident, UTSW); Colin Danko, MD (Assistant Professor, UTSW EM) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.
Sensible Medicine
DECEMBER 1, 2023
PP is a 67-year-old woman who comes to clinic with six weeks of progressive weakness. She feels aching in her buttocks, thighs, and shoulders. She is unable to rise from a chair unassisted and can walk only if supported by a companion. PP has a long history of hypertension and type II diabetes, both well controlled. She has coronary artery disease and had stable angina until she started an appropriate medical regimen.
RebelEM
DECEMBER 5, 2023
How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis? Bottom Line Up Top: After prompt recognition and appropriate treatment with IM epinephrine, the risk of biphasic reactions are exceedingly low. There is no set observation time to monitor patients as long as their symptoms have resolved. At the time of discharge, appropriate patient education and prescriptions for IM epinephrine are essential.
First 10 EM
DECEMBER 4, 2023
First10EM is wrapping up its 9th year in existence. There have been 453 blog posts to date, and I am getting very close to having written 1 million words in total, or the equivalent of 20 average length nonfiction books. (Actually, the stats don’t include static pages like the catalog of research bias, so I […] The post First10EM updates and audience survey appeared first on First10EM.
Science Based Medicine
DECEMBER 6, 2023
The claims of Neurocytonix are extraordinary and dubious. The post Cytotron – Magical Device Pseudoscience first appeared on Science-Based Medicine.
Emergency Live
DECEMBER 5, 2023
Coping with the stress and trauma of frontline work Stress and trauma in the emergency room setting Emergency room workers face not only the physical challenges of medical emergencies, but also a significant burden of emotional stress and trauma. Daily exposure to intense and traumatic situations can have a lasting impact on the mental health […] The post Mental health in emergency rooms appeared first on Emergency Live.
EMDocs
DECEMBER 5, 2023
Author: Phillip Groden, MD (PGY-3, Mount Sinai Emergency Medicine) // Reviewed by: Summer Chavez, DO, MPH, MPM (Attending Physician, University of Houston); Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK) Policy Playbook returns to emDOCs with a concise summary of the latest developments in emergency medicine-related health policy over the summer months.
PulmCCM
DECEMBER 3, 2023
Induced sighs in mechanically ventilated patients (SiVent trial) In the 1960s, anesthesiologists noticed that if they gave a large breath (a “sigh”) to anesthetized patients every so often, their oxygenation improved. More seemed better, and soon all ventilated patients were getting lung-straining tidal volumes of 10-15 ml/kg. Those with persistent hypoxemia could be further topped off with recruitment maneuvers: delivering sustained PEEP of >50 cm H2O (60-70 cm H2O in obese pati
Sensible Medicine
DECEMBER 4, 2023
Today I will tell you about a trial that delivered a positive result but will add little benefit to patients. The teaching lesson surrounds the choice of endpoint to measure. First some brief background. When I started cardiology, much research focused on improving the care of people who had myocardial infarction (MI). Post-MI care was a target because injury to the heart from an occluded coronary led to bad things—like heart failure and arrhythmias.
ALiEM
DECEMBER 4, 2023
A 49-year-old male presented to the emergency department of an academic hospital with the chief concern of penile pain. Prior medical history is notable for end-stage renal disease on hemodialysis three times per week, but the patient has not been dialyzed in the past four days, hypertension, insulin-dependent diabetes mellitus, heart failure with reduced ejection fraction (59% two months prior), seizure disorder, prior pulmonary embolism (eight months prior), a left nephrectomy seven months ago
Thinking Critical Care
DECEMBER 7, 2023
The H&R Advanced Airway Workshop Santa Cabrini Hospital, Feb 9th, 2024, 1200pm-4pm Airway/Intubation Advanced airway skills are a key element of the resuscitationist’s arsenal. In this workshop, participants will be able to tailor their experience and spend as much or as little time as they want in each station to maximize their learning. We will cover basic direct and video laryngoscopy and intubation with and without the use of the bougie as well as bronchoscopic assistance.
Emergency Live
DECEMBER 6, 2023
Dedication and expertise serving the community at critical times The indispensability of Volunteers Volunteers play a crucial role in emergency and disaster situations. Taking on responsibilities without expectation of material reward, more than 13 million volunteers work with the Red Cross and Red Crescent Movement, demonstrating the growing importance of volunteerism in modern society.
EMDocs
DECEMBER 4, 2023
Author: Braeden D. Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.
AED Leader
DECEMBER 6, 2023
Omaha resident Greg Schraeder suffered a cardiac arrest on a social bike ride on June 20, 2023. He was fortunate to be surrounded by a “dream team” including a retired pediatrician, a retired law enforcement officer, and a retired respiratory therapist. The group performed cardiopulmonary resuscitation on Schraeder for around 11 to 13 minutes before an ambulance arrived and shocked him with an AED before taking him away.
Don't Forget the Bubbles
DECEMBER 6, 2023
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.
ALiEM
DECEMBER 1, 2023
A 23-year-old female with a past medical history of asthma presented with a rash that began five days ago on her face and spread to her chest. The lesions are painful and pruritic, spreading slightly to her extremities. She noted a slight sore throat and nasal congestion. She denied any known fever and had no known vaginal or oral lesions. She has a 5-year-old daughter at home with no known symptoms.
American Medical Compliance
DECEMBER 6, 2023
Elopement is defined by the VA National Center for Patient Safety (NCPS) as when a patient knows they are not allowed to leave but yet chooses to do so consciously. Finding out that a patient has “gone missing” is a terrifying experience for both clinicians and patients’ families. Furthermore, patients who elope frequently have decreased cognitive abilities as a result of dementia, brief delirium, or sporadic changes in mental status brought on by medicine, illness, or traumati
Emergency Live
DECEMBER 5, 2023
From artificial intelligence to 3D printing, a revolutionary landscape Artificial intelligence in the service of diagnosis Advanced medical technologies are redefining the way we address health challenges. Artificial Intelligence (AI) stands out for its ability to analyze medical records, formulate treatment plans, and even develop new drugs. Companies such as Atomwise and DeepMind are already […] The post The future of medicine: innovative technologies in the service of health care appear
Mind The Bleep
DECEMBER 6, 2023
Introduction Randomised Control Trials (RCTs) play a vital role in evidence-based medicine, providing valuable insights into the effectiveness of medical interventions. As medical students, it is crucial to develop the skills to critically appraise RCTs. What is a Randomised Control Trial? An RCT is a type of study used to assess the effectiveness of medical interventions, such as new drugs, treatments, or procedures.
AED Leader
DECEMBER 6, 2023
Before the arrival of Thanksgiving, Chad Martinez went into cardiac arrest multiple times and was given a total of over 100 AED shocks to try to restart his heart. When he first lost consciousness at 2 a.m., his wife, Deidre, started chest compressions immediately and called 9-1-1. Later on, after transfer to AdventHealth Porter, surgeons located the damaged heart tissue that was causing electrical problems and performed a cardiac ablation.
EMDocs
DECEMBER 6, 2023
Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA); Alec Pawlukiewicz, MD (EM Attending Physician; Killeen, TX) // Reviewed by: Brit Long, MD (EM Attending Physician, San Antonio, TX) Even prior to COVID-19’s strain on emergency departments (ED), boarding has been a longstanding issue. Especially for clinicians working in EDs with limited resources and consultants, the ED workup may not provide comprehensive care, and thoughtful evaluation can improve inpatient care and aid consul
Ziqitza HealthCare Ltd
DECEMBER 5, 2023
The holiday season is upon us, a time of joy, celebration, and togetherness. As we immerse ourselves in the festivities, it’s essential to prioritize our health and well-being. In this blog post, we will discuss strategies for maintaining a healthy balance during the holidays. We will also share insights from Sweta Mangal , the founder of Ziqitza Healthcare Ltd .
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