EM Ottawa

JANUARY 9, 2025

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED). However, their use is far from straightforwardbalancing […] The post These are the ‘Roids you are looking for – Steroids in the ED appeared first on EMOttawa

Shock 111

Shock Emergency Department Infectious Diseases Sepsis 111

Science Based Medicine

JANUARY 3, 2025

Once again, sheltered laptop-class doctors are treating children's health as a parlor game to advance their political objectives. The post To Spread Mistrust, Dr. Martin Kulldorff Asks RFK Jr. to do an Unethical, Impossible RCT of Vaccines He Knows Are Safe & Effective first appeared on Science-Based Medicine.

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Dr. Smith's ECG Blog

JANUARY 7, 2025

(This was created by Arron Pearce ( [link] ) Online QT calculator for wide QRS (LBBB, RBBB, etc.

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Sensible Medicine

JANUARY 3, 2025

Doctors of a certain age tend to fetishize the physical exam. I think this is because learning the physical exam is an important part of the socialization of the doctor. It is also a skill that doesn’t really wither with time. Though with every passing day I feel more and more like part of the old guard, I can only give the exam a tepid defense.

Urgent Care 105

Urgent Care Ultrasounds Wellness 105

St. Emlyn

JANUARY 2, 2025

St.Emlyn's - Emergency Medicine #FOAMed This feasibility study described the delivery of ECMO CPR (ECPR) for the first time in the UK The post Pre Hospital Extracorporeal CPR (ECPR) in the UK: The Sub30 study appeared first on St.Emlyn's.

CPR 121

CPR Hospitals Resuscitation 121

PulmCCM

JANUARY 2, 2025

Many randomized trials have tested the biomarker procalcitonin as a guide to de-escalate or stop antibiotic therapy in patients with known or suspected infection. A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. But most such trials have been small, often single-center, and vulnerable to bias due to the unblinded nature of the intervention.

Sepsis 98

Sepsis Outcomes Stroke Shock 98

ACEP Now

JANUARY 5, 2025

Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.

Airway Management 81

Airway Management Operations Resuscitation Pediatrics 81

EB Medicine

JANUARY 7, 2025

In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1. Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. Growth of EMIC - Expansion from three members to over 500 - Focus areas: Education, mentorship, opportunity 3.

EMS 80

EMS 80

EMDocs

JANUARY 8, 2025

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.

EKG/ECG 73

EKG/ECG EMS Academics Emergency Department 73

ECG Guru

JANUARY 3, 2025

Here we see a 30 s long strip of a 1-leadECG, recorded with a modern Smartwatch (Apple watch). The ECG has been graphically processed for better visualization. The paper speed is 25 mm/s as usual. The lead shown corresponds to ECG lead I of the limb leads.

EKG/ECG 83

EKG/ECG 83

EMCrit

JANUARY 10, 2025

Nitty Gritty of All Things Defibrillation EMCrit Project by Scott Weingart, MD FCCM.

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80

Science Based Medicine

JANUARY 10, 2025

Defenders of the GBD won't tell you what it actually said. I will. The post Defenders of the Great Barrington Declaration Neither Know Nor Care What it Proposed. The Deliberate Erasure of the We Want Them Infected Movement Has Succeeded. first appeared on Science-Based Medicine.

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Dr. Smith's ECG Blog

JANUARY 2, 2025

By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.

EKG/ECG 86

EKG/ECG Sepsis Wellness Documentation/Coding 86

ALiEM

JANUARY 13, 2025

A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.

Academics 67

Academics Emergency Department 67

St. Emlyn

JANUARY 13, 2025

St.Emlyn's - Emergency Medicine #FOAMed Explore the variability in maintaining prehospital anaesthesia for trauma patients in this comprehensive summary of a multinational survey. With insights into drug protocols, administration methods, and governance, the article highlights challenges and opportunities for standardisation in prehospital care.

Administration 70

Administration Research Outcomes 70

EM Ottawa

JANUARY 13, 2025

Methodology: 4/5 Usefulness: 4/5 Vallentin MF, et al. N Engl J Med. 2024 Oct 31. doi: 10.1056/NEJMoa2407616. Editorial: The Way to a Patient’s Heart – Vascular Access in Cardiac Arrest Question and Methods: This RCT compared IO vs. IV vascular access in adults with OHCA, using ROSC as a primary outcome. Findings: No significant difference […] The post Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest appeared first on EMOttawa Blog.

Hospitals 75

Hospitals Outcomes Resuscitation 75

Life in the Fast Lane

JANUARY 8, 2025

Chris Nickson Come join the 2025 Clinician Educator Incubator! Expressions of interest are now open for the sixth Clinician Educator Incubator - EOIs close Feb 10th 2025.

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Emergency Medicine Cases

JANUARY 7, 2025

In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine? How can we best streamline thorough data gathering for each case so that we don't miss key data points?

Documentation/Coding 90

Documentation/Coding EMS 90

Sensible Medicine

JANUARY 6, 2025

When I was at Indiana back in the 1990s, we called an ICD by a company’s brand name. At IU, all ICDs were “PCDs” PCD was Medtronic’s brand name. I didn’t realize it at the time, but this was pro-level marketing. A similar thing has happened with coronary stents—at least in my neighborhood. Now it is Xience, a brand of drug-eluting stent (DES) from Abbott.

Outcomes 79

Outcomes Academics 79

EMDocs

JANUARY 11, 2025

Author: Christopher Blanton, MD, MBA (EM Resident, UTSW / Dallas, TX); Joslin Gilley-Avramis, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); 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.

EMS 72

EMS Sepsis Shock Fluid Resuscitation 72

ECG Guru

JANUARY 3, 2025

This ECG is from a 65-year-old woman who had previously had no cardiac abnormalities but has now suffered several syncopes within 2 weeks. During the last syncope she suffered a fracture of the left femur.

Fractures 81

Fractures EKG/ECG 81

ACEP Now

JANUARY 4, 2025

In recent years, emergency medicine, once the bastion of quick decision making, clinical acumen, and patient-centered care, has been quietly succumbing to a different forcethe slow but steady erosion of critical thinking. The culprit is the increasing reliance on protocolization and the diminishing autonomy of emergency physicians. This shift, intended to standardize care and mitigate error, is paradoxically undermining the very heart of medicinethe doctors ability to think critically, adapt to

Administration 52

Administration Sepsis Emergency Department 52

Science Based Medicine

JANUARY 6, 2025

A proponent of the Great Barrington Declaration is comparing rejection of its "natural herd immunity" approach to the pandemic to the rejection of Ignaz Semmelweis and his findings. It's a deceptive comparison beloved of all manner of scientific cranks. The post The Semmelweis gambit: A red flag for defending bad science and quackery first appeared on Science-Based Medicine.

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111

Dr. Smith's ECG Blog

JANUARY 13, 2025

A 50-something male presented to triage with chest pain for one day. An ECG was recorded quickly before any further history or physical exam: What do you think? When I saw this (presented at a conference), I immediately thought it looked like Thype 1 Brugada phenocopy (in other words, Type 1 Brugada ECG pattern ). There is an rSR' in lead V1 without any spike of the R'-wave.

Hyperthermia / Hypothermia 74

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 74

ALiEM

JANUARY 10, 2025

A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. The infant appeared to be asymptomatic per parents, without any behavior changes or associated symptoms noted. The patients mother noticed her sons left pupil was dilated and unresponsive to light the morning of presentation.

Pediatrics 64

Pediatrics Documentation/Coding Academics Administration 64

St. Emlyn

JANUARY 6, 2025

St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). This retrospective study explores time efficiency, injury severity, and patient outcomes, highlighting the role of HEMS in delivering critical care to severely injured patients in remote locations.

Emergency Department 89

Emergency Department Outcomes Hospitals 89

American Medical Compliance

JANUARY 1, 2025

Restorative nursing is an essential pillar of healthcare, dedicated to helping patients regain and maintain their physical and psychological well-being. With approximately 12.2% of adults in the United States facing mobility challenges, according to the CDC, the demand for effective restorative care has never been greater. For healthcare providers, these programs go beyond improving patient outcomesthey create a holistic and supportive care environment.

CDC 81

CDC Wellness Best Practices Stroke 81

PulmCCM

JANUARY 13, 2025

A restrictive approach to red blood cell transfusion (e.g., transfusion to Hb ≥7-8 g/dL) is recommended in most critically ill patients after a mortality benefit was noted in the 1999 TRIC trial. Should patients with acute myocardial infarction, or cardiac disease generally, be transfused to the same hemoglobin targets as other critically ill patients?

Blood Transfusions 52

Blood Transfusions Outcomes 52

Northwestern EM Blog

JANUARY 7, 2025

Written by: Ashley Segobiano, MD (NUEM 28). Edited by: Nicholas Maurer, MD, MPH (NUEM 26). Expert Review by : Molly Estes, MD Molly Estes, MD Emergency Medicine Physician, Assistant Professor at Feinberg School of Medicine Northwestern Memorial Hospital, Feinberg School of Medicine How To Cite This Post: [Peer-Reviewed, Web Publication] Segobiano, A.

Hospitals 59

Hospitals 59

EMergucate

JANUARY 14, 2025

The following ECG is from a 60-year-old male who has presented with 5 days of central chest pain and epigastric pain which radiates between his shoulder blades.

EKG/ECG 52

EKG/ECG 52

EMDocs

JANUARY 1, 2025

Authors:Brit Long, MD ( @long_brit EM Attending Physician, San Antonio, TX);Manpreet Singh, MD ( @MPrizzleER Assistant Professor of Emergency Medicine / Department of Emergency Medicine Harbor-UCLA Medical Center); andAlex Koyfman, MD ( @EMHighAK EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) Happy New Year, and thank you for everything you do!

Sepsis 62

Sepsis EMS EKG/ECG Hospitals 62

ECG Guru

JANUARY 13, 2025

This ECG was sent to me by a friend, I don't know if he did it himself. The question was whether a heart attack can be recognized here. The patient is a 55-year-old man who has typical angina pectoris lasting more than 1 hour. What can you answer?

EKG/ECG 73

EKG/ECG 73

ACEP Now

JANUARY 4, 2025

Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr.

Forensics 52

Forensics Urgent Care Hospitals Emergency Department 52

Science Based Medicine

JANUARY 1, 2025

In 2020, the GBD was all about herd immunity via natural immunity. Today, its defenders censor that. The post A Challenge For Dr. Edward Livingston: Defend the Great Barrington Declaration Without Censoring the Great Barrington Declaration first appeared on Science-Based Medicine.

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89

NRC Health

JANUARY 14, 2025

In healthcare, the pursuit of exceptional patient care is paramount. However, a fundamental yet often overlooked component in delivering the highest-quality care is the experience of healthcare employees. The post Prioritizing the employee experience to transform healthcare appeared first on NRC Health.

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52

Life in the Fast Lane

JANUARY 11, 2025

Michael Gibbs MD Adult Ortho Cases 004 Shoulder Dislocations. Adult Orthopedic case interpretation.

Dislocations 52

Dislocations Ultrasounds Radiology Radiology 52

St. Emlyn

JANUARY 7, 2025

St.Emlyn's - Emergency Medicine #FOAMed Mastering likelihood ratios can transform your diagnostic skills. In this podcast with Rick and Greg, discover how likelihood ratios can enhance decision-making and improve patient care. The post Podcast – Likelihood Ratios: Critical Appraisal Nugget 12 appeared first on St.Emlyn's.

Research 102

Research 102