Sat.Dec 02, 2023 - Fri.Dec 08, 2023

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What You Need To Know About Blunt Cardiac Injury

The Trauma Pro

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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Steve Kirsch’s “mother of all revelations” about the “deadliness” of COVID-19 vaccines goes poof

Science Based Medicine

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.

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Urban crisis management: innovative strategies for security in big cities

Emergency Live

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.

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SGEM#422: And It was all Yellow-Nasal Discharge and Antibiotics in Pediatric Sinusitis

The Skeptics' Guide to EM

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

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OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.

Dr. Smith's ECG Blog

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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Hypertrophic Cardiomyopathy Part 1: Chest Pain

Kings County Downstate EM

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.

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Diabetes: from telemedicine to new drugs

Emergency Live

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

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The People Can Decide the Best Policy, Only If They Have the Best Information

Science Based Medicine

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.

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Red Leg in the Heartland of America: A Rural Physician’s Approach to the Patient with a Potential DVT

EMDocs

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.

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Telemedicine in emergency care

Emergency Live

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.

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Webinar: Beyond STEMI: Diagnosing Acute Coronary Occlusion on the ECG. The Queen of Hearts can do it for you!!

Dr. Smith's ECG Blog

Beyond STEMI: Diagnosing Acute Coronary Occlusion on the ECG. The Queen of Hearts AI app can do it for you. With explainability too.

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JC: Prehospital transfusion decision making. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Here at St Emlyn’s we have often talked about decisions and decision complexity. Our belief is that one of the key attributes of the clinician who works in emergency care … JC: Prehospital transfusion decision making. St Emlyn’s Read More » The post JC: Prehospital transfusion decision making.

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Initial Hematology Work Up for Cytopenias

EMDocs

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

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The role of volunteers in disasters: an irreplaceable pillar of disaster relief

Emergency Live

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.

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Briefs: Heralding the rosy pits

PEMBlog

The Case A middle-school aged boy presents with a slightly pruritic rash that started along the side of his chest, but then soon spread to encompass several dozen similar lesions across his torso, especially his back. he has had no other symptoms, including fever or upper respiratory complaints. There are no new food, personal care product, or animal exposures.

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"A patient just arrived as a transfer for NSTEMI."

Dr. Smith's ECG Blog

Written by Willy Frick The OMI paradigm has taught me that any diagnosis of NSTEMI is cause for immediate evaluation. "A patient just arrived as a transfer for NSTEMI." I quickly reviewed the patient’s records and saw that she was a 53 year old woman with a history of BMI 40, but no other identifiable risk factors for coronary artery disease. Her first hsTnI at the referring facility was undetectable.

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Foohey’s Figures Updates

First 10 EM

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.

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Mental health in emergency rooms

Emergency Live

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.

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The Way is Shut: Aortic Stenosis

EM Ottawa

Aortic Stenosis is the most common valvular heart disease in Canada. In fact, after hypertension and coronary artery disease, it is the third most common cardiovascular condition. The prevalence of valvular heart disease increases sharply with age. Approximately 1 in 10 of your patients over the age of 75 has aortic stenosis. The most common […] The post The Way is Shut: Aortic Stenosis appeared first on EMOttawa Blog.

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How a “Positive” Trial Can Add Little to Clinical Care

Sensible Medicine

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.

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Pre-Hospital End Tidal CO2 as a Predictor of Trauma Mortality

University of Maryland Department of Emergency Med

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

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The future of medicine: innovative technologies in the service of health care

Emergency Live

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

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Cytotron – Magical Device Pseudoscience

Science Based Medicine

The claims of Neurocytonix are extraordinary and dubious. The post Cytotron – Magical Device Pseudoscience first appeared on Science-Based Medicine.

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First10EM updates and audience survey

First 10 EM

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.

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Policy Playbook: Executive Order on Artificial Intelligence (AI)

EMDocs

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.

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Women in the Fire Service: From Early Pioneers to Distinguished Leaders

Emergency Live

Increasing the Female Presence in the Technical and Operational Roles of the Italian Fire Service The Pioneering Entry of Women into the Fire Service In 1989, the National Fire Service in Italy saw a historic moment: the entry of the first women into the operational sector, ushering in an era of change and inclusion. Initially, […] The post Women in the Fire Service: From Early Pioneers to Distinguished Leaders appeared first on Emergency Live.

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Misinformation is pervasive, and AI will turbocharge it

Science Based Medicine

Is it possible to refute an infinite amount of AI-generated health misinformation? The post Misinformation is pervasive, and AI will turbocharge it first appeared on Science-Based Medicine.

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EMCrit 363 – Retrograde Intubation

EMCrit

Retrograde, in 2023 is basically a backwards way of doing things. EMCrit Project by Scott Weingart, MD FCCM.

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Clinical Conundrums: How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis?

RebelEM

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.

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Global triage: a comprehensive assessment for timely response

Emergency Live

Effective organization and priority criteria in medical rescue The organizational model of global triage Global triage is a professional patient assessment methodology based on a holistic approach. This organizational model involves a series of steps aimed at comprehensive patient management, beginning with the assessment at the door. This initial phase aims to immediately identify emergency […] The post Global triage: a comprehensive assessment for timely response appeared first on Emerge

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EM@3AM: Oculomotor Nerve Palsy

EMDocs

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.

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The Latest in Critical Care, 12/4/23 (Issue #21)

PulmCCM

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

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HIPAA Compliance Tips During the Holiday Season

Total Medical ComplianceHIPAA

The holiday season is a time for celebration, joy, and spreading goodwill. However, for those working in healthcare, it’s also necessary to remain cautious about protecting sensitive patient information. As festivities begin and work environments shift, here are some key tips to uphold HIPAA compliance during this joyous time. Enhance Staff Training: Offer refresher courses or workshops specifically tailored for the holiday season.

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Planning for mass evacuation strategies

Emergency Live

A crucial approach to managing the unpredictable Mass evacuation management is an essential component of preparedness for emergency situations. Planning an effective response to natural disasters, major accidents or other crises is critical to public safety. This article will examine some key strategies for planning for mass evacuations. Risk identification and preparation The first step […] The post Planning for mass evacuation strategies appeared first on Emergency Live.

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A Comprehensive Training on the Foundations of Restorative Nursing

American Medical Compliance

Restorative nursing entails several nursing interventions that support the resident’s ability to perform at their highest level. Furthermore, the purpose of a Restorative Nursing Program (RNP) is to restore as much independence as feasible while still preventing functional loss. RNPs assist people in doing things for themselves rather than personnel conducting duties on their behalf.

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SAEM Clinical Images Series: Penile Lesion with a Poor Prognosis

ALiEM

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

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It’s Your Call – December 2023

Total Medical ComplianceHIPAA

HIPAA: What are prevalent healthcare scams during the holiday season? Email Phishing: Perpetrators adopt the personas of festive figures or reputable entities (e.g., charities) to entice recipients into clicking malicious links in emails. This tactic compromises personal data, including login credentials and credit card details. It is advised to verify authenticity by contacting the sender or IT support before interacting with any links.

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