Sat.May 18, 2024 - Fri.May 24, 2024

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An EPiC mental model. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed The practice of coordinating, consulting and managing an entire acute clinical service in real-time is fairly unique to emergency medicine. Central to this is the EPiC (or emergency physician in charge) role #FOAMed @stemlyns with @codingbrown The post An EPiC mental model. St Emlyn’s appeared first on St.Emlyn's.

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When a Medicine Works but Overall Benefit is Minimal to None

Sensible Medicine

The story of reversal agents for anticoagulants exposes many of the complexities of treating human beings. I like the story and I think you will too. Some background, then to the ANNEXA-I study. The new anticoagulants are called direct acting oral anticoagulants or DOACs. Rivaroxaban (Xarelto) and apixaban (Eliquis) are the two most popular. These drugs surpassed the old one, warfarin, because of convenience, efficacy and safety.

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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

This was sent by an undergraduate (not yet in medical school, but applying now) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly. Edited by Smith He also sent me this great case. A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon.

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FitScript™: Functional health quackery and a misleading alternative cancer cure testimonial

Science Based Medicine

Perusing the hellscape that is what Twitter has degenerated into as X, I found an alternative cancer cure testimonial, which led me into "functional health" nonsense that I hadn't encountered before. Introducing FitScript. The post FitScript™: Functional health quackery and a misleading alternative cancer cure testimonial first appeared on Science-Based Medicine.

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Cardiac Arrest – the 5 C’s

Life in the Fast Lane

Kane Guthrie Cardiac Arrest – the 5 C’s Cardiac Arrest - the 5 C's with Cliff Reid. Causes Of Cardiac Arrest You NEVER Thought Of?! Meet The Hs & Ts & Cs!

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Rosh Review My EMCert Monthly Question

RebelEM

A 67-year-old woman with a history of atrial fibrillation on apixaban presents to the ED for epistaxis that began 30 minutes ago. Her bleeding is difficult to control with direct nasal pressure and topical agents but resolves with silver nitrate cauterization. Her vital signs are within normal limits. How should this patient’s apixaban be managed? Administer a one-time dose of intravenous vitamin K Administer andexanet alfa Bolus 1 unit of prothrombin complex concentrate Give intravenous tranexa

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Early versus Later Anticoagulation for Stroke with Atrial Fibrillation

EM Ottawa

Methodology: 3/5 Usefulness: 2/5 Fischer U, et al. N Engl J Med. 2023 Jun 29;388(26):2411-2421. Question and Methods: RCT at 103 sites to compare outcomes at 30 days for early versus late DOAC initiation among patients with ischemic stroke and atrial fibrillation. Findings: Primary outcome (ischemic stroke, systemic embolism, major bleeding, vascular death) occurred in […] The post Early versus Later Anticoagulation for Stroke with Atrial Fibrillation appeared first on EMOttawa Blog.

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223. Hernias: incarcerated or strangled- would you rather?

Board Bombs

This episode we chat about common hernias and the 3 major scenarios you will encounter with them in the ED. We also offer you a game of would you rather. As usual, lots of highbrow conversation. 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; Wosiski-Kuhn, Marlena. 223.

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Network Five: LGBTQIA+ Identity & Healthcare.

Life in the Fast Lane

Pramod Chandru Network Five: LGBTQIA+ Identity & Healthcare. Network Five Emergency Medicine Journal Club Episode 29 reviewing papers on LGBTQIA+ identity and healthcare!

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Andexanet vs prothrombin concentrate complex for intracranial hemorrhage (ANNEXA-I trial)

PulmCCM

A randomized trial shows that andexanet can stem the progression of intracranial hemorrhage better than 4-factor prothrombin complex concentrate in patients taking factor Xa inhibitors. The clinical relevance is unclear, though, as patient-centered outcomes were not improved, and andexanet resulted in more serious thrombotic events than PCC. Factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban in the U.S.) are anticoagulants that have largely displaced warfarin for the prevention of stroke

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Still using opioids for back pain?

Critical Care Now

Reading Time: 3 minutes Following a short break, this week we return to the always interesting topic of pain management and we are tackling a major issue in acute and chronic pain management – back pain. The study, titled “Opioid analgesia for acute low back pain and neck pain ( the OPAL trial ): a randomised placebo-controlled trial” by Jones et al, is a multicentric triple-blinded randomised controlled trial conducted in Sydney, Australia, across 157 research sites.

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CCN VLOG 1 – May 2024

Critical Care North Hampton

Here it is folks… the long-awaited first VLOG / Podcast from us here at CCN! Crunching all things critical care into one byte-sized session… added humour mandated!

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Thankful For Vaccine Fevers | Home remedies for Button Ingestions

JournalFeed

The JournalFeed podcast for the week of May 13-17, 2024. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Wednesday Spoon Feed: Serious bacterial infections were exceedingly rare in this study of recently immunized infants 6-12 weeks presenting to the emergency department with a fever.

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Journal Feed Weekly Wrap-Up

EMDocs

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: Honey…or Jam for Button Battery Ingestion? Spoon Feed This pig cadaver study argues that jam is a reasonable alternative (if honey and sucralfate are unavailable) to give patients while awaiting definitive endoscopi

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SGEM Xtra: Yeah, Might Be All that You Get – How Ted Lasso Made Us Better

The Skeptics' Guide to EM

Date: May 13, 2024 Guest Skeptics: Dr. Rebecca Szabo is an obstetrician/gynecologist and medical educator specializing in simulation from Melbourne, Australia working at The Royal Women’s Hospital and The University of Melbourne. This is her first time as a guest skeptic on the SGEM, she has created FOAMed content through various media, including the MedEd Stuff N Nonsense Podcast.

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How Common Are Subconjunctival Hemorrhages in Newborns and Infants?

Pediatric Education

Patient Presentation A 5-day-old male came to clinic for his well-examination. He was breastfeeding, stooling, and urinating well, and had no concerns for jaundice. The parents were worried about a red spot on his lateral right eye. The past medical history showed a term male born by spontaneous vaginal delivery to a G1P1 26 year old female. The family history and review of systems were non-contributory.

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Explore the Frontiers of Pre-Hospital Care Research

RCEM Learning

The post Explore the Frontiers of Pre-Hospital Care Research appeared first on RCEMLearning.