The Skeptics' Guide to EM

FEBRUARY 22, 2020

Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency […] The post SGEM Xtra: Right, You’re Bloody Well Right, You’ve got the Bloody Right to Care first appeared on The Skeptics Guide to Emergency Medicine. Reference: Dorsett et al. How is it different from the Choosing Wisely Campaign?

Wellness 52

Wellness Emergency Department EMS 52

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

He did well and was discharged. Rituparna et al — as well as Chauhan and Brahma ( Int. Sci 5[4] 268-270, 2015 ) both highlight a likely association between acute development of ischemic J waves — and high risk of developing malignant ventricular arrhythmias ( My Comment in the September 23, 2020 post ). Smith’s ECG Blog ).

Hyperthermia / Hypothermia 132

Hyperthermia / Hypothermia EKG/ECG Wellness 132

ALiEM

FEBRUARY 26, 2024

Otherwise, he was well-appearing, acting normally, and eating/voiding/stooling normally. Additional Images Physical Exam General : Well appearing, acting appropriately for age HEENT : Scalp normal. 2015 Mar-Apr;60(2):211. The patient presented with a vesicular rash on his face including around his eyes. Pediatr Dermatol.

Academics 78

Academics Pediatrics Wellness 78

The Trauma Pro

OCTOBER 6, 2023

At the time, there was a debate about whether the procedure should be done immediately versus waiting until the patient was well-resuscitated. This was a big procedure, with the possibility of several major complications, with postop paraplegia being one of them. The concern was that death was nearly certain if the aortic lesion progressed.

Head Injuries 147

Head Injuries Research Hospitals Resuscitation 147

American Medical Compliance

JANUARY 9, 2024

trillion in 2015. More than 3,900 cases of medical identity theft involving patients and providers were recorded in 2015, according to the most recent FTC data, with over 10,000 cases reported between 2013 and 2015. As a result of their large size, these healthcare systems are easy targets for fraud. Learn more below.

Wellness 52

Wellness 52

EMDocs

JULY 9, 2024

Addressing social determinants of health at well child care visits: a cluster RCT. 2015 Feb;135(2):e296-304. Epub 2015 Jan 5. Epub 2015 Jul 14. Epub 2016 Nov 7. PMID: 27599265. Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Pediatrics. doi: 10.1542/peds.2014-2888. PMID: 25560448; PMCID: PMC4306802. Acad Pediatr.

Pediatrics 71

Pediatrics Emergency Department Research Burns 71

Emergency Medicine Journal

NOVEMBER 28, 2023

Journals reviewed were Archives of Disease in Childhood, BMJ Emergency Medicine, and the Lancet Adolescent and Child Health; as well as published studies by the Paediatric Emergency Research in the UK and Ireland (PERUKI) Network. Practice resource summary: September 2015 [Internet]. 2015 [cited 2022 Nov 17]. J Gen Intern Med.

Research 40

Research Burns Wellness 40

EMDocs

AUGUST 22, 2024

have limited English proficiency according to the 2015 U.S. Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter. Lion KC, et al.

Documentation/Coding 81

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 81

EMDocs

FEBRUARY 7, 2024

Unionization of healthcare providers can create opportunities to improve staff’s financial and general well-being, but may also facilitate future strikes. Trainees and attending providers should be informed about both the opportunities that come with unionization, as well as the challenges that come with managing strikes.

Hospitals 76

Hospitals Research Wellness Patient Safety 76

Maria Yang, MD

MARCH 18, 2024

To try to answer the perennial question I ask myself (“what am I doing?”), I recently read this 2015 article, What is mental health? Maybe “well” versus “unwell”? It is more common to hear “I’m physically doing well,” rather than “My physical health is high.”) As a psychiatrist 1 , do I treat mental illness?

Psychiatric 52

Psychiatric Hospitals Wellness 52

Ken Grauer, MD

FEBRUARY 3, 2024

I’ve taken th e l ead V 3 examples in Figure-3 from previous cases posted on Dr. Smith’s ECG Blog : T OP in Figure-3 — Despite the marked ST elevation in this lead V3 — this is not T-QRS-D, because there is well-defined J-point notching ( BLUE arrow ). This patient had a repolarization variant as the reason for ST elevation. What is M INOCA?

EKG/ECG 390

EKG/ECG Resuscitation Hospitals Wellness 390

RebelEM

APRIL 29, 2024

In these situations, the American Heart Association (AHA) and the European Resuscitation Council (ERC) of 2015 recommend the intraosseous (IO) route after the peripheral route and before the central venous route ( 1). 2015 PMID: 25768683 8 Leidel BA. This can often lead to significant delays in proper resuscitation. Trauma 1996.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

ALiEM

APRIL 12, 2023

The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. The adhesive cover itself serves as a sterile barrier and a slick surface to improve probe maneuverability. Accessed April 5, 2023.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

ALiEM

SEPTEMBER 27, 2023

What well-known adverse reaction results from ingestion of the pictured mushroom? Disulfiram-like reaction with ethanol consumption Coprinus atramentarius or Ink Cap mushroom is well known to cause a disulfiram-like reaction when it is consumed prior to ethanol. Encyclopedia of Toxicology (Third Edition), Academic Press. Goldfrank L.

Seizures 67

Seizures Academics Wellness 67

Don't Forget the Bubbles

FEBRUARY 19, 2024

The Role of Gaming in Emotional Well-being Stress Relief: Gaming can be a form of relaxation and stress relief, providing an escape from the pressures of daily life. There is a complex interplay between gaming, psychological needs, and adolescent well-being. It can offer a safe environment to unwind and engage in enjoyable activities.

Academics 59

Academics Leadership Research Teamwork 59

American Medical Compliance

APRIL 10, 2023

Rise in Cases of Sexual Harassment There were 4,738 cases of improper sexual conduct reported from 2005-2015. This empowers victims to step forward with these allegations as well as show others that they are not alone. Individuals are making connections and empowering change throughout the industry.

Hospitals 52

Hospitals Wellness 52

EMDocs

DECEMBER 14, 2023

If a physician is allowed to be on call for more than one hospital – or to be in the OR when on call – define the procedure for simultaneous calls as well as when a surgeon is operating. Reference : See similar case in “ Where ’ s all that blood coming from” in the November 2015 issue of MMI-LFL. Patient dies in ED.

Hospitals 72

Hospitals Patient Safety Operations Wellness 72

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. 2015 May;28(7):793-8. A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. She had a precipitous delivery while the ambulance was pulling in. Triage vital signs (VS) include BP 88/45, HR 121, T 97.1,

EMS 96

EMS Resuscitation Seizures Blood Transfusions 96

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. Epub 2015 Nov 10. The rim may be echogenic or blend in with surrounding tissue.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Taming the SRU

MAY 23, 2023

BACKGROUND Foot injuries are common and can have significant implications for a patient’s well-being, functional capacity, and finances. Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. 2015 Apr 28]. 2015 Dec;8(1):76. Epub 2015 Jul 25. Calcaneus fractures.

Fractures 55

Fractures Dislocations Operations EMS 55

Taming the SRU

JUNE 24, 2024

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart. MedEdPORTAL Publications; 2015. Circulation , vol. 1103–1104, [link] Cousar J, Bohanske M, Hill J. Transvenous Cardiac Pacemaker Educational Resource.

Advances Cardiac Life Support (ACLS) 83

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 83

EMDocs

DECEMBER 4, 2023

The Wells’ Criteria for DVT can help risk stratify [2,3]. If the patient’s Wells score is ≤ 0, DVT is nearly clinically excluded and no further immediate lab or ultrasound is necessary. In patients with a Wells’ score of 1-2 (moderate risk), DVT can be ruled out with a negative d-dimer rather than an US. Published 2020 Feb 11.

Ultrasounds 70

Ultrasounds Wellness Documentation/Coding EMS 70

Emergency Medicine Ireland

MAY 27, 2024

This is a somewhat philosophical approach that reminds us that the PA pressures themselves don’t prognosticate especially well but a failure of flow from right to left will result in cardiogenic shock and death. Well, take a step back to start with. Indeed diuresing the hypotensive patient may well be the way to go. Souza, R. &

Poisoning 52

Poisoning Wellness Shock 52

Don't Forget the Bubbles

JANUARY 17, 2024

2015 But we all know that what happens in the lab does not always mirror what happens in real life. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. ” ( Ed. After Darracq et al., Darracq, M.A.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Taming the SRU

JULY 24, 2023

Risk factors associated with increased risk of acute perforated cholecystitis include age greater than 65 years old, as well as diabetes mellitus, atherosclerosis, or organ failure (1, 2). The most well-accepted classification of acute perforated cholecystitis is the Niemeier classification which is outlined as below (3,6).

Ultrasounds 72

Ultrasounds Sepsis Radiology Radiology 72

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). 12 March 2015. NMS is hard to diagnose because it's rare. A tricky cause of NMS is the removal of a dopamine agonist. References 1. Institute for Safe Medication Practices.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 52

RebelEM

FEBRUARY 22, 2023

Bagheri 2015 ). Giant Cell Arteritis (arteritic anterior ischemic neuropathy) ( Bagheri 2015 , Hayreh 2009 ) Pathophysiology Giant cell arteritis(GCA) affects that medium-sized and large arteries. Persistent vision loss defined as loss of vision >24 hours. Causes: There are multitude of causes of vision loss.

Emergency Department 52

Emergency Department EMS Wellness 52

American Medical Compliance

AUGUST 15, 2023

Medication Management Patients may be taking medications for dementia as well as for other comorbid conditions. Beer’s Updated Criteria (2015) includes a list of potentially inappropriate medications for elderly patients. Therefore, there are several medication management considerations.

Wellness 52

Wellness 52

Dr. No

DECEMBER 1, 2021

The way to get round this slippery data problem, as regular readers of this blog will know only too well, is to look at all cause mortality. Well, Dr No did try a bit of figuring, by looking at all cause deaths by age band in recent years, downloaded from this page. Just as it seems a strand is emerging, it slithers away again.

Forensics 52

Forensics Wellness Operations 52

ACEP Now

SEPTEMBER 11, 2023

While summitting Carstensz in Indonesia in October 2015, he and his wife led a Wild Med Kilimanjaro Expedition and summited Kili in March 2016. He also became close friends with Chris Imray, a vascular surgeon and leading frostbite expert, on that 2015 Indonesia climb, and they reconnected to summit Mt.

Wellness 126

Wellness 126

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged. 2015, March 1). RV: Cavity size normal. 1900: RBBB and LAFB are almost fully resolved. 2300: QRS now within normal limits. No other significant injuries were found. Cramer, M.

EKG/ECG 106

EKG/ECG Wellness Fractures Hospitals 106

The Skeptics' Guide to EM

APRIL 6, 2019

This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran. We covered the interim analysis of 90 patients included in a prospective cohort study by Pollack et al NEJM 2015 on SGEM#139. Dabigatran is a direct thrombin inhibitor.

Stroke 52

Stroke Administration EMS Wellness 52

Pediatric EM Morsels

OCTOBER 6, 2023

(Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective. Clin Infect Dis.

Pediatrics 161

Pediatrics CDC Seizures Infectious Diseases 161

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

I have discussed burnout and wellness a number […] The post SGEM Xtra: The Water is Wide first appeared on The Skeptics Guide to Emergency Medicine. Mayo Clin Proc 2015 * Shanafelt et al. I was invited by the College of Physicians and Surgeons of Ontario (CPSO) to give a talk at their council meeting on burnout. Shanafelt et al.

Emergency Department 52

Emergency Department Wellness 52

Sensible Medicine

AUGUST 14, 2024

In popular (lay) understanding, SIDS represents a common danger that a well-cared for and apparently healthy baby will suddenly and terrifyingly be found dead in the morning. The sudden death of an apparently healthy child is a devastating tragedy, and if it’s preventable, the costs of supine sleep may be worthwhile.

CDC 77

CDC Sepsis Research Pediatrics 77

SheMD

OCTOBER 22, 2023

I had to sign a contract at the start promising that I wouldn’t work during medical school so that I could focus on becoming a well-trained physician. An average first-year resident salary is $55,400 annually, as of 2015. I ultimately chose the life of a physician and it did not come cheap. I know others are not in the same situation.

Wellness 52

Wellness Academics 52

EM Guide Wire

JULY 21, 2019

” [ Belanger, 2015 ] Difficult Airway – unable to provide adequate gas exchange despite BVM, airway adjuncts, or combination of the two. Belanger, 2015 ] There are patient factors that are associated with difficult intubation. Belanger, 2015 ] There are patient factors that are associated with difficult intubation.

Pediatrics 40

Pediatrics Wellness 40