Science Based Medicine

JUNE 19, 2023

It turns out, however, that that Dr. Buttar had not been a well man since 2016 and was as much a victim of quackery as his patients had been. Because he hadn't been vaccinated, antivaxxers struggled mightily to reconcile his death with their conspiracy theory about COVID-19 vaccines killing thousands "suddenly."

Wellness 73

Wellness 73

Pediatric EM Morsels

JUNE 21, 2024

Antibacterial ointments , like bacitracin, tend to be well tolerated and promote faster wound healing than silver sulfadiazine and other creams in partial thickness wounds. Ointment has shorter half-life, so should be cleansed and changed every 12 hours. Get the Goop! Halt the Hurt!

Burns 169

Burns Pediatrics Hospitals Wellness 169

Sensible Medicine

NOVEMBER 28, 2023

Being perfectly honest, not all the articles have aged well. One of these was an article that Vinay Prasad and I wrote back in 2016: Wearables, Smartphones and Novel Anticoagulants: We Will Treat More Atrial Fibrillation, but Will Patients Be Better Off? I am actually embarrassed by a few of them and many are forgettable.

Stroke 80

Stroke Academics Outcomes Administration 80

Sensible Medicine

MARCH 28, 2024

In 2016, Jonathan Reiner said this about Carrie Fisher’s mother, who died very shortly after her daughter. Just 3 examples: #1 #2 #3 Here is the problem: Adjuvant chemotherapy is a well described medical term, but preventive chemotherapy is a colloquialism.

Hospitals 88

Hospitals Outcomes Wellness 88

Dr. Smith's ECG Blog

OCTOBER 12, 2024

The providers documented concern for ST elevation in the precordial and lateral leads as well as a concern for hyperkalemic T waves in the setting of succinylcholine administration. 2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. Potassium resulted as 4.9, initial troponin I 0.05 Lee DH, Walsh B, Smith SW. Am J Emerg Med.

EKG/ECG 113

EKG/ECG Documentation/Coding Emergency Department COPD 113

Sensible Medicine

NOVEMBER 14, 2023

He also co-led the team whose work led the CDC to issue a major clarification of its 2016 opioid prescribing guideline and is currently a principal investigator of the only national study to examine individual suicides that occur after the reduction of prescribed opioids. . Criticism of these programs is both well-deserved and unfair.

Psychiatric 112

Psychiatric Research CDC Best Practices 112

Mind The Bleep

FEBRUARY 2, 2025

Here we assume you know the basics , and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Further reading For more information on potential biases, read Thinking Fast and Slow by Daniel Kahneman For more information on clinical decision making, see: Trimble M & Hamilton P (2016).

Dehydration 97

Dehydration Documentation/Coding Wellness 97

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. C., & ESCMID Study Group for Infections of the Brain (ESGIB) (2016). WHO - Who Needs an LP in the ED?

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

Taming the SRU

JANUARY 1, 2024

For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Additional Resources Please see a previous Taming the SRU post for extra tips and trouble-shooting tricks, as well as a video demonstration for IO access. 2016 Dec 14;20(1):102.

Emergency Department 91

Emergency Department Ultrasounds Administration Burns 91

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. 2016 Nov;23(11):1298-1306. Epub 2016 Nov 1. 2016 Feb;169:122-7.e1.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

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. Elbrus, the highest peak in Europe, through contacts on his Indonesia expedition and summited in August of 2016. On that same trip, they put together a trip to Russia climbing Mt.

Wellness 112

Wellness 112

Dr. Smith's ECG Blog

APRIL 30, 2024

I fully acknowledge some speculation — given that we lack precise timing of these serial tracings, as well as not knowing the corresponding serum K+ level at the time each tracing was recorded. I focus my comments on: i ) The initial rhythm; and , ii ) Reasons for the dramatic changes in ST-T wave appearance between ECG #1 and ECG #2.

EKG/ECG 102

EKG/ECG CPR EMS Resuscitation 102

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. 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, RR 28, SpO2 89% on 6L NC.

EMS 95

EMS Resuscitation Blood Transfusions Seizures 95

EMDocs

DECEMBER 18, 2024

2016; 83(1): 67-79. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold Management of drug and alcohol withdrawal. N Engl JMed. 2003; 348:1786-1795. Cleve Clin J Med.

Seizures 87

Seizures Hyperthermia / Hypothermia Emergency Department EMS 87

Total Medical ComplianceHIPAA

NOVEMBER 7, 2022

Website owners are required to tell visitors what kind of cookies they use, as well as how they use and disclose the visitor’s information collected by their website. Cookies are like flags that allow a website to recognize and remember your device if you return to that site in the future.

Documentation/Coding 72

Documentation/Coding Wellness 72

ALiEM

SEPTEMBER 9, 2024

Past surgical history was significant for laparoscopic ventral hernia repair with mesh and lysis of adhesions (three years ago), as well as prior appendectomy, cholecystectomy, c-section, and right nephrectomy. C); BP 110/56; HR 64; RR 16; SpO2 100% General : No acute distress, well appearing. 2016 Dec 28;7(Suppl 44):S1150-S1153.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

EMDocs

JANUARY 23, 2024

Published February 15, 2016. Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. J Emerg Med. 2020 Aug;59(2):216-223. doi: 10.1016/j.jemermed.2020.05.001. 2020.05.001. BRASH syndrome: Bradycardia, Renal failure, Av blocker, Shock, and Hyperkalemia.

Shock 86

Shock Dehydration Sepsis EKG/ECG 86

Don't Forget the Bubbles

AUGUST 23, 2023

Definitive emotional support is critical to our emotional and psychological well-being. 2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”. This gives rise to feelings of failure alongside the feelings of grief. Psychological harm occurs. Be kind and care for yourself and those around you.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

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. Bektas, Firat, and Secgin Soyuncu. The efficacy of transcutaneous cardiac pacing in ED.” The American Journal of Emergency Medicine , vol. Circulation , vol.

Advances Cardiac Life Support (ACLS) 89

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 89

The Skeptics' Guide to EM

JUNE 4, 2017

Lancet August 2016. Lancet August 2016. A systematic review by the authors of the present study confirmed a possible benefit of the pan scan, but it showed a need for a well-designed, large, prospective randomized clinical trial with patient oriented outcomes ( Sierink et al 2012 ). Lancet August 2016.

Radiology 52

Radiology Radiology CPR Hospitals 52

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. Published May 4, 2016. He looks really bad, stating that he has been vomiting blood. He is hypotensive. He then vomits a copious amount of blood right in front of you. EM:RAP HD Videos.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

Don't Forget the Bubbles

AUGUST 7, 2023

However, that guidance needs to take into account the influence of emotion, environment, body temperature, as well as the underlying disease process, on vital signs, especially in younger infants. NICE; 2016 [cited 2023 Mar 28]. cited 2023 Mar 28]. Available from: [link] Nijman RG, Jorgensen R, Levin M, Herberg J, Maconochie IK.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Advanced Medical Reviews

SEPTEMBER 15, 2017

Especially since millennial satisfaction with the healthcare system is lower – only 32 percent report being treated well , according to an Accenture survey – than it is for preceding generations. Access to personalized recommendations, as well as public reviews, is a defining feature of the current media landscape.

Operations 56

Operations Research Wellness Hospitals 56

Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Instead, IR performed pulmonary thrombectomy and the patient did well. It is not generally appreciated that that anterior lead ST elevation can sometimes be seen with acute PE ( Zhan et al — Ann Noninvasive Electrocardiol 19(6):543-551, 2014 — and — Omar HR — Eur Heart J: Acute Cardiovascu Care (5(8): 579-586, 2016 ).

EKG/ECG 127

EKG/ECG Ultrasounds Shock EMS 127

Don't Forget the Bubbles

JULY 22, 2024

The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. 2016 Aug;51(8):868–76. 2016 May;67(5):593-601.e3. So, an up-to-date, high-quality meta-analysis iss much needed. Pediatr Pulmonol.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

Taming the SRU

FEBRUARY 24, 2024

Early recognition and prompt treatment is key. non-invasive positive pressure ventilation and IV nitroglycerin infusion have been shown to reduce morbidity (intubation rates, ICU admission) & mortality.

Leadership 93

Leadership EMS Pediatrics Stroke 93

Sensible Medicine

JUNE 21, 2024

“Well,” my friend advised, “if you’re feeling nervous right now, that is because the thing you are about to do might upset people, and that takes courage.” It was the night before a health ethics conference at a university. ” It felt like I was hearing this for the very first time. .”

Academics 71

Academics Research Burns Outcomes 71

CasesBlog

JUNE 27, 2021

It's a poignant moment in the life of a singer whose career spans 56 years and more than 100 million records sold; the passing of his wife, Linda, in 2016 after 59 years of marriage was devastating and resulted in the longest break between recordings of his career. His performance here brought me to tears and is well worth the wait."

Wellness 52

Wellness 52

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. 2016 PMID:27075364 13 Astasio-Picado Á et al. Resuscitation. 2021 PMID: 34273470 12 Petitpas F et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. This data was collected over a five-year period (2016-2020) had true papilloedema. She went to the optician today to get a new pair of glasses. The Ophthalmology SHO agreed and referred Olivia to you.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

Don't Forget the Bubbles

DECEMBER 13, 2023

Susan had issues initially with ensuring the correct latch, but after a review with a lactation consultant, feeding is going well. Though it has been hard, they have been coping well and enjoying parenthood. First and foremost, do they look well or unwell? 2016 Apr;175(4):573-9. At the 6-week check, Luke is 3.54

Dehydration 98

Dehydration CDC Hospitals Wellness 98

The Skeptics' Guide to EM

DECEMBER 7, 2019

The change in name took place in 2016. The subcommittee on ALTEs in the AAP published a practice guideline renaming ALTEs to brief resolved unexplained events ( BRUEs ) in 2016. It is a diagnosis of exclusion that applies to infants under the age of 12 months. Most of the definition is in the name itself. *

Pediatrics 52

Pediatrics Seizures CPR Hospitals 52

Mount Sinai EM

OCTOBER 11, 2024

2016 performed a Cochrane systematic review and meta-analysis of 11 studies (614 patients) that compared needle aspiration with incision and drainage. And well before the depth at which it would reach the carotid). Intraoral: Transcervical: Image Credit: Long et al., Then place the cut sheath back on your spinal needle.

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

EM SIM Cases

MAY 9, 2023

However, if you find yourself treating a drowning patient in the ED, this case will have you well prepared. WHY IT MATTERS Every year as the weather warms and more people take advantage of water sports and outdoor activities there is increased risk of drowning. When it comes to pediatric drowning, prevention is the best medicine.

Pediatrics 52

Pediatrics CPR Radiology Radiology 52

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

In 2016, the American Academy of Pediatrics (AAP) reaffirmed their clinical practice guidelines for the diagnosis and management of UTIs. However, if the child is looks well, but the clinician determines that the febrile infant is not in the low risk group for a UTI, the AAP recommends two options.

Pediatrics 52

Pediatrics Emergency Department Sepsis Wellness 52

PHEM Cast

FEBRUARY 25, 2021

In the UK sea water is very unlikely to be icy or cold enough – however, small areas of water may well be, particularly in the winter months. Golden & Hervey, 1981 Oakley & Pethybridge, 1997 Tipton 2016 Bierens 2014. This is a regular point of discussion and concern. Water temperature is a key determinant: icy versus not.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

SheMD

NOVEMBER 9, 2023

Step 2: Know your values Some of the biggest contributors to burnout are feeling ineffective and conflicts between action and personal values (Maslach and Leiter, 2016). Being well-rested is a value. What do I want to call my mom and tell her about when it’s going well? Getting paid is a value. Resources Maslach, C.

Leadership 52

Leadership Wellness Research 52