Pediatric EM Morsels

JANUARY 19, 2024

Unfortunately, the possibility of congenital infections always looms large as well, including congenital syphilis. CDC 2023] In 2021, there were over 2800 cases of congenital syphilis, tripled from 2017. Hussain 2023] With proper treatment, bone lesions and periostitis resolve within 6 weeks or so and full recovery can be made.

Infectious Diseases 269

Infectious Diseases CDC Pediatrics Fractures 269

Medical Law

JUNE 14, 2023

The essays we received were informative, well-written, and deeply moving. NordstrandBlack PC is pleased to announce the finalists for our 2023 college scholarship: Cynthia A. We’ll be announcing our winner on June 28, 2023. It was a privilege to read your essays, and we learned so much. – Santa Barbara, CA Camille B.

Wellness 52

Wellness 52

Stop and Think

DECEMBER 29, 2023

For an older patient with stroke risk factors and 3 hours of AF on a cardiac device, pre-2023 thinking would have us leaning toward anticoagulation. In this case, the industry incentives (to hopefully gain a larger market share) aligned well with patients’ incentives. These were well-conducted trials that taught us a lot.

Stroke 90

Stroke Research EKG/ECG Wellness 90

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) Female to male predominance with a ratio of 3:2. Oka, 2023) It has various other names but one is Cast Syndrome due to a slight increased risk with patients in hip spica casts. Oka, 2023) Always consider SMA syndrome in patients with eating disorders who present with nausea and bilious vomiting. Record, 2015).

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Broome Docs

APRIL 6, 2023

2023 Jan 21. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. PMID: 35780790 [ open access here ] Stiell IG, Clement CM, Grimshaw JM, Brison RJ, Rowe BH, Lee JS, Shah A, Brehaut J, Holroyd BR, Schull MJ, McKnight RD, Eisenhauer MA, Dreyer J, Letovsky E, Rutledge T, Macphail I, Ross S, Perry JJ, Ip U, Lesiuk H, Bennett C, Wells GA.

Sepsis 52

Sepsis Ultrasounds Hospitals Outcomes 52

Medical Law

JULY 5, 2023

The decision to award two scholarships was not initially planned, but the exceptional quality of this year’s applications and the inspiring stories we encountered compelled us to extend our support to an additional student, who will be announced on July 6 th , 2023. The second winner will be announced on July 6 th , 2023.

Academics 52

Academics Wellness 52

Total Medical ComplianceHIPAA

APRIL 14, 2023

On April 11, 2023, the HHS published a notice on upcoming new rules to add greater protection to reproductive health care because of new state laws passed due to the outcome of the Supreme Court ruling on Roe v. You should always keep the “minimum necessary” rule in mind whenever you are giving out information.

Documentation/Coding 83

Documentation/Coding Outcomes Wellness 83

PHARM

NOVEMBER 25, 2023

news/2023-11-25/well-known-tasmanian-gpdennis-pashen-dies-in-swimming-accident/103150726 Long-time Tasmanian GP Dennis Pashen is being remembered as a fierce advocate for rural health and “just a fantastic fella” after his death in a swimming accident on Bruny Island on Thursday. Read on www.abc.net.au/news/2023-11-25/well-known-tasmanian-gpdennis-pashen-dies-in-swimming-accident/103150726

Wellness 40

Wellness 40

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. 2023; 40( 2): 349- 351.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

ACEP Now

MARCH 6, 2024

The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. Many clinicians staffing emergency departments intubate infrequently, as well, and these results are likely applicable to a wide scope of practice. How Best to Stop the Bleeding in Trauma?

Research 52

Research Airway Management Stroke Outcomes 52

Pediatric EM Morsels

NOVEMBER 3, 2023

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). falciparum parasitemia , and no other defined cause of AMS (WHO 2023). falciparum parasitemia , and no other defined cause of AMS (WHO 2023).

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

ALiEM

JULY 17, 2023

sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. as well as an analysis of the 2023 Match by Pupazan and Cook in Emergency Medicine News [3,4]. The Study In an Annals of Emergency Medicine paper , Preiksaitis et al.

EMS 52

EMS Burns Emergency Department Shock 52

Pediatric EM Morsels

JULY 19, 2024

DON’T forget to put on your Personal Protective Equipment as well! Have traditional, direct laryngoscopes available as well. This is worth a shot in a well appearing child that is old enough to gargle and spit. Well… sometimes it starts again. 2023 Aug;171:111644. Epub 2023 Jul 6. Get IV access!

Pediatrics 286

Pediatrics Airway Management Wellness Administration 286

Pediatric EM Morsels

OCTOBER 27, 2023

Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Broselow does not.

Pediatrics 269

Pediatrics Resuscitation Documentation/Coding Wellness 269

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Emergency Department (ED) crowding has dominated discourse around Emergency Medicine (EM) in recent years and is now well recognised as contributing towards patient harm. Recent EM research priorities have advocated identifying means to optimise trainee well-being, retention and recruitment.

Emergency Department 40

Emergency Department Wellness EMS Patient Safety 40

Pediatric EM Morsels

NOVEMBER 15, 2024

There are associated co-morbiditiested [Lee 2017, Steinrueke 2023] BECTS Seizures / Benign Rolandic Epilepsy- Moral of the Morsel It’s not a stroke, it’s a seizure. Updated 2023 Aug 7]. Symptoms can be unilateral and involve the face and tongue, but it’s not a stroke! References : Hernandez, A., Holmes, G.L. and Fisher, R. Edited by E.

Seizures 152

Seizures Stroke Pediatrics Wellness 152

PEMBlog

OCTOBER 19, 2023

Tyrosinemia The patient’s CT scan revealed liver replaced and distorted by innumerable, variably-enhancing nodules, as well as nephromegaly. Seattle (WA): University of Washington, Seattle; 1993-2023. Tyrosinemia Click here to reveal the correct answer E. Tyrosinemia Type I. 2006 Jul 24 [Updated 2017 May 25]. GeneReviews® [Internet].

Urgent Care 52

Urgent Care Pediatrics Poisoning Wellness 52

Total Medical ComplianceHIPAA

SEPTEMBER 7, 2023

While they share similarities, each term refers to a specific method used by cybercriminals: Phishing is the most well-known term among the three. It involves fraudulent attempts to obtain sensitive information, typically through email or instant messaging platforms.

Wellness 52

Wellness 52

Total Medical ComplianceHIPAA

AUGUST 11, 2023

Educate Your Staff One of the critical steps in maintaining HIPAA compliance is ensuring that all healthcare staff members are well-informed about the regulations pertaining to patient privacy and social media usage.

CDC 52

CDC Wellness 52

EMDocs

NOVEMBER 6, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. COR 2b, LOE C-EO.

Poisoning 94

Poisoning Hyperthermia / Hypothermia Seizures Administration 94

Ken Grauer, MD

SEPTEMBER 22, 2023

Note also that the P wave is negative in standard lead II in Figure-1 ( as well as in leads III and aVF, which are the other 2 inferior leads ). It is well to remember that IF the P wave in lead II is negative — then by definition — You do not have sinus rhythm ( unless there is lead misplacement or dextrocardia ).

EKG/ECG 446

EKG/ECG Wellness 446

Ken Grauer, MD

AUGUST 16, 2024

See ECG Blog #435 — ECG Blog #313 — as well as My Comment at the bottom of the page in the June 17, 2024 post in Dr. Smith's ECG Blog ). Acute PE remains one of the most commonly overlooked diagnoses. As per links that I provide below — IF the diagnosis of acute PE is not thought of, this entity will be missed! (

EKG/ECG 394

EKG/ECG Wellness Shock 394

RebelEM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Resus 2023. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Available at: HERE Branch KHR et al.

CPR 145

CPR EMS Documentation/Coding Outcomes 145

ALiEM

OCTOBER 28, 2024

She was well during the interval until more recently, the patient began to complain of persistent abdominal pain and would point to the epigastric area. The patient had been tolerating oral intake well, passing adequate urine, having normal bowel movements, and behaving at baseline. 2023 May 30. No scleral icterus. Wilms Tumor.

Pediatrics 64

Pediatrics Ultrasounds Academics Wellness 64

Pediatric EM Morsels

SEPTEMBER 22, 2023

” Children compensate for blood and volume loss very well… until they don’t. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Physical exam findings of occult shock in children can be subtle. Fortunately, there are screening tools for occult shock.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

Ken Grauer, MD

DECEMBER 29, 2023

The "good news" — is that after an extended hospitalization, the patient was finally discharged home, and doing well. = The ECG in Figure-1 — was obtained following successful resuscitation. A C loser L ook at Today's ECG: The rhythm in Figure-1 is sinus — with regular upright P waves with a constant and normal PR interval in lead II.

EKG/ECG 438

EKG/ECG Resuscitation Hospitals Wellness 438

PulmCCM

DECEMBER 18, 2023

Patients on mechanical ventilation and high-dose vasopressors restricted to ~420 kcal/day for the first 7 days did as well as those provided ~1750 kcal/day. Rather, the study suggested an even more permissive approach to hyperglycemia (glucose of 215 mg/dL rather than the common target of 180 mg/dL) might be reasonable. (

Outcomes 52

Outcomes Academics Wellness 52

Pediatric EM Morsels

MARCH 31, 2023

They like to pretend to be well when they are truly sick ( remember to check that Cap Refill and to never trust a Neonate! ) 2023 Feb 4;38:102122. Children love to trick us! Sometimes it is all in good fun and other times it is quite serious! They like to keep us on our toes so much, that even their cervical bones can deceive us.

Fractures 130

Fractures Dislocations Pediatrics Radiology 130

RebelEM

FEBRUARY 15, 2024

Additionally, intubation can risk hemodynamic instability as well as hypoxemia from the procedure itself. It is unclear, though, if the risks of intubation (including ventilator associated pneumonia) outweighs the benefits. Paper: Freund Y et al. References: Freund Y et al.

Poisoning 141

Poisoning Airway Management Seizures Shock 141

Ken Grauer, MD

JUNE 14, 2024

The above said, when for whatever reason sinus P waves are not well seen in lead II — the 2nd -best lead when looking to determine if sinus rhythm is present, is lead V1. ECG Blog #193 — Reviews the basics for predicting the "culprit" artery ( as well as reviewing why the term "STEMI" should be replaced by "OMI" = O cclusion-based MI ).

EKG/ECG 407

EKG/ECG Wellness Hospitals 407

Broome Docs

FEBRUARY 22, 2024

2023 Mar 30;110(4):432-438. PMID: 36946338 Bottom line: This is a well done RCT that demonstrates pretty convincingly that you should not bother trying to but fingernails back on after nail bed repair (and my guess is you definitely shouldn’t be removing them either). 2023 Nov 11. 2023 Oct 1;80(10):1047-1054. 2023 Oct 12.

Emergency Department 103

Emergency Department Psychiatric Resuscitation Wellness 103

ALiEM

OCTOBER 21, 2024

F; RR 22; O2 Sat 100% RA General : Alert, interactive, well-appearing HEENT : Left ear with moderate redness, swelling, warmth, and tenderness of the auricle sparing the lobule. The patient was on amoxicillin for strep throat, which was diagnosed a week before the onset of his symptoms and was improving. Eur Arch Otorhinolaryngol.

Academics 67

Academics Wellness 67

Don't Forget the Bubbles

OCTOBER 12, 2024

doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Much of the evidence in this blog is a translation of a recent 2023 Cochrane review of 45 randomised control trials involving 5888 children. Published 2023 Jan 10.

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

Sensible Medicine

APRIL 30, 2024

For her research, in 2023, she was awarded a Gairdner Early Career Investigator Award. Dr. Zeraatkar is well-spoken, clear and she explains a complicated topic in simple terms. She often works in areas in which the evidence is complex or conflicting, examples of which include nutrition and COVID-19 therapeutics.

Research 111

Research Wellness 111

Pediatric EM Morsels

JULY 26, 2024

These females should have imaging with either MRI or CT as well as abdominal or transvaginal ultrasound to assess for ovarian teratoma. 2023 Jul 17. UpToDate , June 2023, www.uptodate.com/contents/autoimmune-including-paraneoplastic-encephalitis-clinical-features-and-diagnosis?search=anti+nmda+receptor+encephalitis&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H2973236366.

Psychiatric 269

Psychiatric Seizures Outcomes Pediatrics 269

EM Literature of Note

SEPTEMBER 13, 2024

since August 2023. These authors compare the burden of lower respiratory tract infections and bronchiolitis admissions at 15 pediatric emergency departments across 2018 to 2024, with 2023-24 being the first season where nirsevimab was in wide usage.

Emergency Department 85

Emergency Department Pediatrics Administration Wellness 85

The Skeptics' Guide to EM

JULY 2, 2023

Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. His Glasgow Coma Scale (GCS) score is 13 with obvious head trauma as well. Prehospital Tranexamic Acid for Severe Trauma.

EMS 121

EMS Outcomes Hospitals Research 121