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Glasgow Coma Scale in Children

Pediatric EM Morsels

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! 2019 Jul;20(7):660-666. 2019 Sep;241:112-118. Epub 2019 Apr 22. 2019 Jul;20(7):682-683. 2019): 478–483. Fun fact for animal lovers!- Pediatr Crit Care Med. doi: 10.1097/PCC.0000000000001938.

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What I Read Last Week

Sensible Medicine

The authors obtained incidence data for 34 types of cancer and mortality data for 25 types of cancer for individuals aged 25–84 years for the period Jan 1, 2000, to Dec 31, 2019 from the North American Association of Central Cancer Registries and the US National Center for Health Statistics, respectively.

Academics 103
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Video beats direct laryngoscopy for intubation--even for experts

PulmCCM

Anesthesiology residents literally stop counting, generally performing well over a thousand intubations in a four-year residency (compared to pulmonary-critical care fellows’ mere nine months total in the ICU on a traditional research/clinical split), including extensive experience on difficult airways and advanced airway management.

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Peter Attia, Outlive, Cardiology 3.0 and primordial prevention of heart attacks

Sensible Medicine

Peter Attia - From Surgeon to Longevity Guru I first encountered Peter Attia online while researching ketosis , the Atkins diet and low carb diets in 2012 and found his writing to be incredibly well-researched and helpful. Attia calls the era exemplified by Hippocrates and lasting for 2000 years after his death Medicine 1.0.

Research 111
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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

This could have influenced care the patients received as well as reporting of adverse events (i.e. Clinical judgement is still alive and well…one protocol will not work for a heterogenous disease process. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4 Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

Sepsis 104
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SGEM#323: Mama I’m Comin’ Home – For Outpatient Treatment of a Pulmonary Embolism

The Skeptics' Guide to EM

She is low risk by Wells Criteria but PERC Rule positive because of an appendectomy last month. This is in contrast to Canada where papers in the early 2000 demonstrated the safety of out-patient management of PEs ( Kovacs ). Outpatient Management of Patients Following Diagnosis of Acute Pulmonary Embolism.

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Electrical injuries

Don't Forget the Bubbles

The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. 2000 Aug;46(1–3). Mechanisms of Injury Industrial electrical injuries are typically high-voltage injuries, resulting in deep tissue damage, burns, and significant systemic effects. Electrical Injuries. Chen P, Bukhman AK.

Burns 80