Sensible Medicine

FEBRUARY 17, 2025

John is sick, so I have big shoes to fill. Today’s study of the week is a cancer trial. I know many of you aren’t cancer doctors, and you are thinking about skipping this essay. Let me assure you: you will learn something. The trial has issues with control arm, skewed randomization (2:1), drop out and endpoints. It is a rollercoaster ride of critical appraisal.

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Hospice Wellness Research 103

NRC Health

FEBRUARY 20, 2025

Discover the latest updates from NRC Health's CAHPS Insider Live webcast, including new HCAHPS 2025 survey dimensions, care coordination, hospital environment restfulness, and symptom information. Learn best practices for data goal-setting and increasing CAHPS participation. The post Webcast Recap: Key updates on 2025 HCAHPS and patient experience strategies appeared first on NRC Health.

Best Practices 52

Best Practices Hospitals 52

The Trauma Pro

FEBRUARY 14, 2025

The Advanced Trauma Life Support course lists “classes of hemorrhage”, and various other sources list a similar classification for shock. I’ve not been able to pinpoint where these concepts came from, exactly. But I am sure of one thing: you will be tested on it at some point in your lifetime. Here’s the table used by the ATLS course: The question you will always be asked is: What class of hemorrhage (or what % of blood volume loss) is the first to demonstrate systolic hy

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Shock Resuscitation 147

Science Based Medicine

FEBRUARY 14, 2025

$160 million is a lot of money, especially when you consider its not just money. It's lost dreams, careers, and discoveries. The post Open Letter II: President Levin, There Are Now 160 Million Reasons Why You Shouldnt Have Censored We Want Them Infected Doctors first appeared on Science-Based Medicine.

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ACEP Now

FEBRUARY 18, 2025

Emergency medical services (EMS) were called to the home of a 22-year-old woman after a syncopal episode and seizure-like activity. The patient reported consuming plant needles obtained online in a suicide attempt several hours prior. On EMS arrival, the patient was alert, pulse was fluctuating between 40 and 130 beats/min, and manual systolic blood pressure was 60 mmHg.

EKG/ECG 52

EKG/ECG Seizures Emergency Department EMS 52

Emergency Medicine Cases

FEBRUARY 18, 2025

Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Only one in 246 patients who screen positive for an eating disorder at triage have a chief complaint suggesting it. These patients dont always fit the stereotypemany appear healthy, have normal BMI, or present with vague GI, cardiac, or neurological symptoms.

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Psychiatric Emergency Department EMS Outcomes 54

Sensible Medicine

FEBRUARY 18, 2025

For decades, the treatment of acute appendicitis was appendectomy. Nobody even questioned this treatment approach. The appendix was acutely inflamed, at risk of perforation, it needed to be removed. The idea that there could be a simple, non-surgical management could not have been imagined. But, eventually evidence would accumulate casting doubt on this paradigm.

Outcomes 84

Outcomes Research Emergency Department Pediatrics 84

NRC Health

FEBRUARY 19, 2025

This years lineup includes many great presentations, including a session focused on reclaiming the practices of resilience by focusing on the power to find the I within resiliency. The post Pediatric Collaborative Preview | How caregiver wellness shapes experiences appeared first on NRC Health.

Wellness 52

Wellness Pediatrics 52

Life in the Fast Lane

FEBRUARY 18, 2025

Michael Gibbs MD Neuroimaging Cases 008 Intraventricular rupture of brain abscess (IVROBA). Second in our Neuroimaging case study series with Teresa Crow, Troy Carnwath, Scott DiMeo, L.

Radiology 52

Radiology Radiology 52

The Evolution & Medicine Review

FEBRUARY 17, 2025

By Joe Alcock Many advances in the care of critically ill patients over time have involved intervening less aggressively. A recent perspective by DAmico and colleagues (1) builds on that tradition of less is more. In Protective Hemodynamics: C.L.E.A.R.! the authors urge caution in treating low blood pressure with fluids or vasopressor medications. DAmico, F.

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Sensible Medicine

FEBRUARY 20, 2025

As always, we are happy to feature articles that expand on ideas discussed on Sensible Medicine – even when the author agrees more with Dr. Prasad than with me. Today, we welcome back Dr. Raudasoja, who last published with us about a year ago. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.

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Research Outcomes Wellness 62

Science Based Medicine

FEBRUARY 13, 2025

Electrolyte drinks are very popular - but are they necessary? The post Do you need to drink electrolytes? first appeared on Science-Based Medicine.

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NRC Health

FEBRUARY 19, 2025

This years lineup includes many great presentations, including a session focused on reclaiming the practices of resilience by focusing on the power to find the I within resiliency. The post Peds Collab Preview | How caregiver wellness shapes experiences appeared first on NRC Health.

Wellness 52

Wellness Pediatrics 52

Life in the Fast Lane

FEBRUARY 15, 2025

Chris Nickson Fusariosis CCC entry for fusariosis / Fusarium infections (infectious disease)

Infectious Diseases 52

Infectious Diseases 52

Clinical Correlations

FEBRUARY 14, 2025

By Daniel Martinez-Krams Peer Reviewed You are rounding on your patients, and your team is discussing a 52-year-old man with HIV who came in with shortness of breath and fever and was found to have pneumonia.

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First 10 EM

FEBRUARY 17, 2025

The decision between mechanical thrombectomy and catheter directed thrombolysis for pulmonary embolism is not one that most emergency physicians are making. Most (like me) probably dont even have access to such therapies, which might be a good thing, as both therapies remain completely unproven. However, I thought I would share the PEERLESS trial as a […] The post PEERLESS: Interventional therapies for pulmonary embolism appeared first on First10EM.

EMS 52

EMS 52

Science Based Medicine

FEBRUARY 18, 2025

Pondering the future of a few infections. As to the image, consider it a metaphor of before and after where Jesus is a stand in for science or public health or whatever you want him to be. Except a promoter of peace and helping the poor. Not in 2025 anyway. See [link] for more. The post Its the end of the world as I know it. And I feel fine. first appeared on Science-Based Medicine.

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Intensive Blog

FEBRUARY 14, 2025

As prepared by Chris Nickson, here are the practice written questions from a recent CICM Second Part exam practice session at The Alfred ICU, with recommended reading from LITFL.com Critical Care Compendium and other FOAM sources: Q1. A 34-year-old patient presents to the emergency department with a suspected recreational drug overdose and is intubated for a low Glasgow Coma Scale (GCS).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Psychiatric Forensics PPE 52

PulmCCM

FEBRUARY 20, 2025

After liberation from mechanical ventilation, obese patients may be at increased risk for recurrent respiratory failure and reintubation. Obesity reduces lung volumes, especially functional residual capacity, producing atelectasis and propensity to hypoxemia and hypoventilation. Noninvasive ventilation (NIV) may help recruit posterior alveoli and improve ventilation and oxygenation.

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EM Ottawa

FEBRUARY 20, 2025

Ever feel like your PoCUS image lacks clarity? Like. you’re over the right area of interest but the lines aren’t crisp enough? In this post, our PoCUS pearl is all about using focus mode to optimize your images. Why Does Focus Matter? Ultrasound machines use tiny piezoelectric crystals to send and receive information. However, […] The post FOCUS your PoCUS!

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Ultrasounds 40

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

This is what the providers in the ED understood on patient arrival: Patient called 911 for syncope, then had witnessed PEA arrest after medics arrived. Not a shockable rhythm. Resuscitated with chest compressions, epinephrine. Here is the written paramedic report available after all the events were over: Patient was seen by witnesses to become unresponsive.

EKG/ECG 61

EKG/ECG Resuscitation EMS Seizures 61

American Medical Compliance

FEBRUARY 19, 2025

Hypoxia can lead to severe complications if not addressed promptly and effectively. As healthcare professionals, understanding the complexities of managing hypoxia is crucial to providing high-quality care. This training course is designed to equip healthcare personnel with the knowledge and practical skills needed to recognize, assess, and manage hypoxic patients.

Outcomes 52

Outcomes 52

Ken Grauer, MD

FEBRUARY 15, 2025

The ECG in Figure-1 was obtained from a middle-aged woman who presented to the ED ( E mergency D epartment ) for epigastric pain that had begun ~1 hour earlier. The epigastric pain began during dinner. She was diagnosed in the ED as having gastritis. The 1st Troponin was not elevated. QUESTIONS: How would you interpret the initial ECG in Figure-1? Does the negative initial Troponin rule out an acute event?

EKG/ECG 355

EKG/ECG 355

PulmCCM

FEBRUARY 17, 2025

Cardiopulmonary resuscitation (CPR) is performed on more than 250,000 people in U.S. hospitals each year. When a patient is failing to recover spontaneous circulation, the clinician in charge must decide whether and when to cease resuscitation efforts. Moments after he or she says “stop,” the person will be declared legally dead. It’s an awesome and humbling responsibility, the ultimate life-and-death decision.

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CPR Hospitals Resuscitation Documentation/Coding 71

The Trauma Pro

FEBRUARY 18, 2025

It’s been five years since I published my Laws of Trauma, and it’s time to dust them off again. In the meantime, I’ve added a couple of new ones. But before I start publishing them I’d like to take a moment to share “McSwain’s Rules of Patient Care.” I met Norm McSwain when I was junior faculty at the University of Pennsylvania.

EMS 165

EMS Hospitals Wellness 165

Sensible Medicine

FEBRUARY 15, 2025

In a NYTimes op-ed by former NCI and NIH director, and Nobel Laureate, Harold Varmus, Varmus argues that future NIH director Jay Bhattacharya is wrong to tie NIH funding to academic freedom. He calls the plan “outlandish” Varmus’ claim begs the questions: What is academic freedom? Is there a public interest to incentivize universities that honor it?

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Academics Administration Wellness 144

St. Emlyn

FEBRUARY 16, 2025

St.Emlyn's - Emergency Medicine #FOAMed Background Resuscitative hysterotomy, also known as perimortem caesarean section, is a high-stakes, time-critical intervention performed in pregnant women who experience cardiac arrest. It’s also one of the most daunting HALO […] The post Maternal and Neonatal Outcomes Following Resuscitative Hysterotomy for OHCA.

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Resuscitation Outcomes 100

American Medical Compliance

FEBRUARY 14, 2025

image source: [link] Workplace harassment is a widespread issue, and healthcare is no exception. In healthcare settings, harassment not only impacts employees but also affects patient care and safety. A global survey by ILO-Lloyds Register Foundation-Gallup found that 17.9% of workers have experienced psychological harassment, 8.5% have faced physical harassment, and 6.3% reported experiencing sexual harassment, with women being particularly vulnerable.

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Teamwork Leadership Patient Safety Wellness 85

Science Based Medicine

FEBRUARY 19, 2025

I just watched the new Netflix series, Apple Cider Vinegar, which tells the story of Belle Gibson, an Australian woman who launched a wellness business based largely on the false claim that she had survived “terminal brain cancer” It is worth a watch, and overall I feel the writers (this is a fictionalized version, not a documentary) captured the industry of fake […] The post Apple Cider Vinegar first appeared on Science-Based Medicine.

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Wellness 78

Dr. Smith's ECG Blog

FEBRUARY 16, 2025

The answer is at the bottom, and illustrated by this case. Written by Willy Frick A man in his mid 30s with type 1 diabetes presented with two days of midsternal and epigastric pain, described as both "sharp" and squeezing." There was associated nausea, vomiting, and dyspnea. He said the pain was worse with supination and improved with upright posture.

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EKG/ECG Documentation/Coding 76

Emergency Medicine Cases

FEBRUARY 17, 2025

On this month's ECG Cases, Dr. Jesse McLaren explains how STEMI criteria can be false positive with large scale QRS and proportional ST elevation, or false negative with low/normal scale QRS and disproportionate ST elevation and hyperacute T waves, and that rules for subtle occlusion using proportionality can help differentiate LBBB with or without Occlusion MI, or LV aneurysm vs anterior STEMI with Q waves.

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EKG/ECG EMS 76

St. Emlyn

FEBRUARY 15, 2025

St.Emlyn's - Emergency Medicine #FOAMed This week I read a great article in the EMJ by Dan Horner and Rich Carden on new resuscitation targets. notably the use of diastolic blood pressure. DBP is the […] The post Is Diastolic Blood Pressure the New Resuscitation Target appeared first on St.Emlyn's.

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Resuscitation 94

Sensible Medicine

FEBRUARY 14, 2025

Pitchers and catchers. George Vecsey probably said it best. Just say it out loud, the mantra that gets some of us through the winter. Pitchers and catchers, pitchers and catchers. Like NPR republishing Susan Stamberg's cranberry relish recipe or every dance school putting on The Nutcracker each December, I think Sensible Medicine needs a tradition. So here, in honor of the start of spring training, when pitchers and catchers report for duty, a Friday Reflection that I first posted on Feb 17, 202

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Outcomes Hospitals 72

EB Medicine

FEBRUARY 18, 2025

In this episode, Sam Ashoo, MD interviews Ashley Weisman, MD about her career in rural emergency medicine, and the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department Interview with Dr. Ashley Wiseman Introduction of Dr. Wiseman: Emergency physician specializing in rural ER. Dr.

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EMS Academics Critical Access Emergency Department 59

Dr. Smith's ECG Blog

FEBRUARY 14, 2025

Written by Pendell Meyers A man in his 30s presented with acute upper midline abdominal pain and nausea. He described it as radiating into his chest, like "pressure", and "burning". Vitals were within normal limits except bradycardia. Here is his triage ECG: What do you think? Sinus bradycardia, normal QRS. There is STE in several leads including I, aVL, and V2, with STD in II and aVF.

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EKG/ECG Burns 64

EM Literature of Note

FEBRUARY 17, 2025

Ive taken the opportunity of reboot to try and make smaller, more digestible chunks to highlight what Im reading and to post more often. So, check out: The Journavx Hype Predicting Heart Failure from ECGs Whats the Best Fluid for Pancreatitis? A Nice Win for Radiology AI Where Endovascular Treatment Fails Even the Best Make Terrible Alerts The Future of AI is FUTURE-AI?

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Anaphylaxis Radiology Radiology Stroke 57

St. Emlyn

FEBRUARY 18, 2025

St.Emlyn's - Emergency Medicine #FOAMed The St Emlyns podcast delves into moral injury in healthcare with Dr. Caroline Leech. Learn how repeated exposure to ethical dilemmas leads to distress and explore strategies to mitigate its impact on clinicians. The post Podcast – Moral Injury with Caroline Leech at Tactical Trauma 24 appeared first on St.Emlyn's.

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