The Trauma Pro
JULY 23, 2024
Although very few things in medicine are new, I love it when I learn about something I’ve never heard of before. Recently, while reading an autopsy report, I ran across the term “hinge fracture of the skull.” What? Maybe if I were a neurosurgeon, I would have recognized the term. This was the perfect excuse to hit the books (or, more accurately, the internet).
Pediatric EM Morsels
JULY 26, 2024
We have discussed many causes of encephalitis and encephalopathy previously (ex, Eastern Equine Encephalitis , Posterior Reversible Encephalopathy , FIRES , Reye’s Syndrome ) and have highlighted the fact that they can be challenging to diagnose early. An irritated brain can lead to such a wide array of symptoms. It is even more challenging when the initial symptoms seem to align with what we perceive as psychiatric concerns.
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Science Based Medicine
JULY 21, 2024
Actual death is worse than theoretical death. This didn't used to be controversial in medicine. The post Dr. John Ioannidis: Yet Another Doctor Who Treats Theoretical Death From The Vaccine With More Gravity Than Actual Death From COVID first appeared on Science-Based Medicine.
Dr. Smith's ECG Blog
JULY 21, 2024
Written By Magnus Nossen — with edits by Ken Grauer and Smith. The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The pain was 10/10 in intensity radiating bilaterally to the shoulders and also to the left arm and neck. The below ECG was recorded. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion.
ECG Guru
JULY 26, 2024
In order to differentiate supraventricular extrasystoles/tachycardias with aberrant conduction from ventricular extrasystoles/tachycardias, the search for P waves is often very important. Here are some examples of how the P waves can be positioned around the ventricular extrasystoles.
Sensible Medicine
JULY 22, 2024
I call it therapeutic fashion. Practice patterns. Beliefs. Ways of doing things. Examples: patients with new heart failure get coronary angiography; patients with chest pain without evidence of heart attack get stress tests; certain drugs and devices become favored over generics. The curious thing about many therapeutic fashions is their lack of evidentiary support.
Science Based Medicine
JULY 26, 2024
Doctors who claimed that only enormous RCTs for every variant could demonstrate the COVID vaccine's benefits, were fine just casually inventing reasons not to use it. The post Making Up Reasons to Let Unvaccinated Kids Get COVID: Pediatricians Will Run Out of Time and Measles Will Return first appeared on Science-Based Medicine.
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Taming the SRU
JULY 25, 2024
Femoral nerve block case review - morbidity & mortality - community practice - r2 Clinical pathologic case - visual diagnosis - when time matters - operational aspects of stroke care Femoral nerve Block Case Review WITH dr. stolz Why do we care about regional anesthesia, specifically femoral nerve blocks? More efficacious than parenteral opioids alone Safer than opioids Decreased delirium Patients have been shown to have improved functional outcomes at 30 days Early pain control matters!
Core Medical Group
JULY 26, 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.
Emergency Medicine Journal
JULY 22, 2024
Background The outcomes of patients who call an ambulance but are discharged at scene reflect the safety and quality of emergency medical service (EMS) care. While previous studies have examined the outcomes of patients discharged at scene, none have specifically focused on paramedic-initiated discharge. This study aims to describe the outcomes of adult patients discharged at scene by paramedics and identify factors associated with 72-hour outcomes.
Dr. Smith's ECG Blog
JULY 25, 2024
This patient was witnessed by bystanders to collapse. They started CPR. EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% sodium bicarbonate.
RebelEM
JULY 24, 2024
Do you know what the latest evidence in critical care/resuscitation? If this question makes you uncomfortable or you just don’t have time to keep up with the literature, you should sign up for the REBEL Lit Distillery at the ResusX Conference in Philly. Let us help you keep up to date. -Workshop: Sept 17 th , 2024 -Location: Philadelphia, PA -20 to 25 Critical Care/Resuscitation Papers Reviewed -Direct Link: [link] The post The REBEL Lit Distillery at ResusX appeared first on REBEL EM - Emergen
The Skeptics' Guide to EM
JULY 20, 2024
Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of clinical practice has been largely devoted to health care policy.
Taming the SRU
JULY 24, 2024
Knack SKS, Scott N, Driver BE, et al. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world.
EMDocs
JULY 25, 2024
Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.
Northwestern EM Blog
JULY 22, 2024
Written by : Jilan Shimberg, MD (NUEM ‘26) Edited by : Michael Tandlich, MD (NUEM ‘24) Expert Commentary by : Matthew B Maas, MD MS Expert Commentary Posterior Reversible Encephalopathy Syndrome (PRES) is a potentially catastrophic but frequently overlooked diagnosis. It often coexists in a pathophysiological spectrum with Reversible Cerebral Vasoconstriction Syndrome (RCVS).
St. Emlyn
JULY 23, 2024
St.Emlyn's - Emergency Medicine #FOAMed Welcome back to another instalment of our Critical Appraisal Nugget series with Rick Body and Greg Yates here at St Emlyn’s. In our previous podcast, we delved into the concepts […] The post Podcast – Positive and Negative Predictive Values: Critical Appraisal Nugget appeared first on St.Emlyn's.
Critical Care Now
JULY 21, 2024
Reading Time: 3 minutes Article Herman R, Meyers HP, Smith SW, et al. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. Eur Heart J Digit Health. 2023;5(2):123-133. Published 2023 Nov 28. PMID: 38505483 Cath lab activation based on ST-elevation myocardial infarction (STEMI) criteria relies on outdated data and needs modernization.
EMDocs
JULY 20, 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: Does Stress Ulcer Prophylaxis with a PPI Work? Spoon Feed An international, multi-center RCT found that administering pantoprazole to intubated ICU patients lowered the rate of upper GI bleeding compared to placebo.
Science Based Medicine
JULY 24, 2024
Rehabilitation robots, first introduced in the 1990s, are just what they sound like – robotics used to aid in regaining function through rehabilitation following an injury. The idea sounds compelling, and the technology has been advancing steadily. But still we have to ask ourselves the question – do they actually help, and what is the evidence?
St. Emlyn
JULY 22, 2024
St.Emlyn's - Emergency Medicine #FOAMed Background As I think I have mentioned before, I spend some of my time as a major trauma consultant on the major trauma ward (MTW). You may be shocked to […] The post JC: Evaluation of Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study appeared first on St.Emlyn's.
Taming the SRU
JULY 22, 2024
INDICATIONS Arthrocentesis is a common procedure performed in the Emergency Department, in which a needle is inserted into a joint to withdraw fluid from the joint capsule. This procedure may be performed for diagnostic and/or therapeutic purposes [1]. Diagnostic arthrocentesis is often performed to distinguish between septic arthritis and other common causes of acute monoarthritis including hemarthrosis, crystal arthropathies (gout, psedogout), and autoimmune arthropathies (SLE, RA, etc.) [2].
Sensible Medicine
JULY 26, 2024
I once had a section chief who was fond of telling me to “make it count twice.” If I was doing work for one part of my job, she suggested that I try to use it for something else. If I worked hard on a lecture for our students, maybe I could turn it into a paper or a workshop to give at a meeting. If research into a patient’s problem raised some interesting questions, maybe I could try to answer these questions as part of a research project.
ECG Guru
JULY 26, 2024
This is the ECG of a 50-year-old man with a congenital heart defect (we do not have exact details). To interpret an ECG with several different abnormalities, you have to proceed systematically. You can see my comments in the second picture. Perhaps Dawn would like to add something?
Ziqitza HealthCare Ltd
JULY 26, 2024
A key component of modern healthcare, telemedicine utilizes technology to make medical services accessible despite many barriers and challenges. Telemedicine services make it easier for people to access medical services and treatment and get essential and timely healthcare. Telemedicine is making different medical services available to people virtually.
NRC Health
JULY 23, 2024
Patients, families, and even healthcare team members often walk into medical settings filled with fear—and when they’re scared, they can’t fully grasp the critical information providers are trying to convey. Mindy G. Spigel, RN, MSN, CPXP, will delve into her research on patient and family fear, offering key strategies to alleviate this anxiety at Human Understanding Beyond | HUB 24 in San Diego, August 21–23.
ACEP Now
JULY 25, 2024
ACEP Now has received an APEX Award of Excellence for writing for “Space Medicine: Emergency Physicians Voyage Into the Final Frontier ” (July 2023). You can read the award-winning article. The annual APEX Awards are given by Communication Concepts to recognize excellence in writing, digital content, graphic design, social media, public relations, and marketing.
St. Emlyn
JULY 22, 2024
St.Emlyn's - Emergency Medicine #FOAMed Background I spend some of my time as a major trauma consultant on the major trauma ward (MTW). You may be shocked to hear that an Emergency Medicine doctor such […] The post Lidocaine Patches for Elderly Patients with Rib Fractures: A Feasibility Study appeared first on St.Emlyn's.
Total Medical ComplianceHIPAA
JULY 22, 2024
Health and Human Services (HHS) has finalized disincentives for Information Blocking and healthcare providers. Here is a summary: The HHS rule impacts the Merit-based Incentive Payment System (MIPS) by penalizing clinicians who engage in information blocking. MIPS eligible clinicians found to be information blockers by the HHS Office of Inspector General will receive a zero score in the Promoting Interoperability performance category for the year in which the violation occurs.
Don't Forget the Bubbles
JULY 22, 2024
Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. Unfortunately, the number of acute wheeze exacerbations coming through the doors is still rising , but are we equipped to manage these children? In the UK, national guidance advises giving oral prednisolone early when treating paediatric asthma attacks.
PEMBlog
JULY 22, 2024
Bogus man! Kids can get kidney stones too. This alt-rock homage discusses imaging, pain control, and more. Lyrics Everyone knows that kidney stones cause so much pain colicky anguish radiation to the flank and symptoms all the same toradol is the first choice along with fluids if you’re a nice doc an ultrasound can show hydronephrosis if a stone’s blocked [chorus] kidney stones can happen in children think about the pain, the pee, the ultrasound if you feel me don’t forget to c
Emergency Medicine Journal
JULY 22, 2024
Naloxone is a potent opioid receptor antagonist that reliably reverses life-threatening respiratory depression in opioid overdose but can precipitate severe withdrawal in opioid-dependent individuals. 1 Guidelines recommend naloxone specifically for respiratory depression and not for reduced level of consciousness alone, with lower doses recommended in patients who may be opioid-dependent. 2 3 The extent to which such guidelines are applied in practice has received little attention.
Emergency Live
JULY 22, 2024
Women with Endometriosis have a higher risk of developing ovarian cancer, according to a study What is Endometriosis? Endometriosis is a chronic gynecological disease that affects women, most frequently of childbearing age. It is caused by the abnormal presence of endometrial cells (the tissue lining the inner wall of the uterus) in organs other than […] The post Endometriosis: new study reveals fourfold increased risk of ovarian cancer appeared first on Emergency Live.
Board Bombs
JULY 22, 2024
PE workup? Sure. Oh by the way they're pregnant.yep. Let's discuss how this is workup needs to be simplified and not feared. Also, say goodbye to VQ scans. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 230. PE and Pregnancy.
PulmCCM
JULY 21, 2024
Do we perform chest compressions in the wrong spot on half our patients during CPR? How would we even know? Resuscitative transesophageal echocardiography means using point-of-care TEE in emergency or critical care settings to guide treatments of crashing patients based on observed cardiovascular physiology in real-time.
Emergency Medicine Journal
JULY 22, 2024
As the attending physician in the ED, I have already heard the case presentation from the resident. "Doctor," the patient says, "there’s something wrong with my blood." I notice the patient’s gestures, his hand movements. His filler words are ‘eh ’ and ‘esto ’ rather than ‘um’ or ‘well’, the melody of his speech not unlike the sounds of my own childhood.
Emergency Live
JULY 22, 2024
Trias i Pujol Hospital presents an innovative technique that is simpler and more effective than traditional surgeries Trias i Pujol German University Hospital in Barcelona takes a decisive step forward in the fight against atrial fibrillation, the world’s most common cardiac arrhythmia. For the first time in Catalonia, Can Ruti cardiologists have adopted an innovative […] The post Atrial fibrillation: Trias i Pujol presents a new technique with high-energy pulses appeared first on Em
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