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Communic8: Eight Universal Leadership Lessons from the Children’s Emergency Department

Don't Forget the Bubbles

The Childrens Emergency Department is a busy, challenging, and dynamic environment. The skills needed to deliver the best possible outcomes for children and young people are multifaceted and constantly evolving. They involve a mixture of clinical, communication, and leadership traits. Having recently moved from a leadership position within the Childrens Emergency Department to a more system-based role involving children of all ages, its apparent to me how transferable my experiences on the shop

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To Spread Mistrust, Dr. Martin Kulldorff Asks RFK Jr. to do an Unethical, Impossible RCT of Vaccines He Knows Are Safe & Effective

Science Based Medicine

Once again, sheltered laptop-class doctors are treating children's health as a parlor game to advance their political objectives. The post To Spread Mistrust, Dr. Martin Kulldorff Asks RFK Jr. to do an Unethical, Impossible RCT of Vaccines He Knows Are Safe & Effective first appeared on Science-Based Medicine.

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ECG Blog #462 — Why so Slow. ?

Ken Grauer, MD

I was sent the ECG in Figure-1 told only that the patient was an older adult who reported dizziness with activity. QUESTIONS: What is the rhythm? ( HINT: There are at least 4 important findings that should be noted ). Is there AV block? Figure-1: The initial ECG in today's case. ( To improve visualization I've digitized the original ECG using PMcardio ).

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Nirsevimab (Beyfortus): is universal prophylaxis for RSV warranted?

Sensible Medicine

Dharini Bhammar, PhD, MBBS, is a respiratory physiologist and evidence enthusiast. As a new mum, her pediatrician recommended the RSV monoclonal antibody for her baby. After reviewing the evidence, she declined it. We are excited to share her clearly written argument as an excellent example of evidence translation. Core concepts discussed include effect size, net benefit and the external validity of clinical trials.

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Is procalcitonin "safe" to guide antibiotic use in patients with sepsis?

PulmCCM

Many randomized trials have tested the biomarker procalcitonin as a guide to de-escalate or stop antibiotic therapy in patients with known or suspected infection. A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. But most such trials have been small, often single-center, and vulnerable to bias due to the unblinded nature of the intervention.

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Torsade in a patient with left bundle branch block: is there a long QT? (And: Left Bundle Pacing).

Dr. Smith's ECG Blog

By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.

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Pre Hospital Extracorporeal CPR (ECPR) in the UK: The Sub30 study

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed This feasibility study described the delivery of ECMO CPR (ECPR) for the first time in the UK The post Pre Hospital Extracorporeal CPR (ECPR) in the UK: The Sub30 study appeared first on St.Emlyn's.

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A Challenge For Dr. Edward Livingston: Defend the Great Barrington Declaration Without Censoring the Great Barrington Declaration

Science Based Medicine

In 2020, the GBD was all about herd immunity via natural immunity. Today, its defenders censor that. The post A Challenge For Dr. Edward Livingston: Defend the Great Barrington Declaration Without Censoring the Great Barrington Declaration first appeared on Science-Based Medicine.

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Smartwatch-ECG

ECG Guru

Here we see a 30 s long strip of a 1-leadECG, recorded with a modern Smartwatch (Apple watch). The ECG has been graphically processed for better visualization. The paper speed is 25 mm/s as usual. The lead shown corresponds to ECG lead I of the limb leads.

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SGEM#464: I Can Do It with A Broken Heart – Compassion for Patients with OUD

The Skeptics' Guide to EM

Date: December 26, 2024 Reference: Steinhauser S et al. Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder. AEM December 2024 Guest Skeptic:Dr. Suchismita Datta. She is anAssistant Professor and Director of Research in theDepartment of Emergency Medicine at the NYU Grossman Long Island Hospital Campus.

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Top emDOCs Posts of 2024

EMDocs

Authors:Brit Long, MD ( @long_brit EM Attending Physician, San Antonio, TX);Manpreet Singh, MD ( @MPrizzleER Assistant Professor of Emergency Medicine / Department of Emergency Medicine Harbor-UCLA Medical Center); andAlex Koyfman, MD ( @EMHighAK EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) Happy New Year, and thank you for everything you do!

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The Impact of Restorative Nursing on Patient Mobility and Independence

American Medical Compliance

Restorative nursing is an essential pillar of healthcare, dedicated to helping patients regain and maintain their physical and psychological well-being. With approximately 12.2% of adults in the United States facing mobility challenges, according to the CDC, the demand for effective restorative care has never been greater. For healthcare providers, these programs go beyond improving patient outcomesthey create a holistic and supportive care environment.

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UCSF hematology oncology interest group

Sensible Medicine

An introduction to oncology for medical students

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SICK-SINUS-SYNDROME

ECG Guru

This ECG is from a 65-year-old woman who had previously had no cardiac abnormalities but has now suffered several syncopes within 2 weeks. During the last syncope she suffered a fracture of the left femur.

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Search and rescue in the Central Mediterranean: the view from here

Emergency Medicine Journal

The authors are an Emergency Physician and a Midwife on board the Geo Barents, Médecins Sans Frontières’ search and rescue ship in the Central Mediterranean Sea. Médecins Sans Frontières depends on private donations to support its work— www.msf.org.uk We are handed a little girl, maybe 3-year old and wrapped tight in winter clothes.

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EM Cases Top 10 Best of 2024

Emergency Medicine Cases

Based on a blend of number of listens, views, feedback from listeners, website traffic and personal faves, EM Cases Top 10 Best of 2024 podcasts, videos and blog posts. The post EM Cases Top 10 Best of 2024 appeared first on Emergency Medicine Cases.

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Critical Care 2024 Year in Review (Part 5)

PulmCCM

PEERLESS, ABC-SEPSIS, IV vs IO, BALANCE, FAST, SAHARA, TESLA/LASTE, Epic sued, ChatGPT vs MDs, more

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Lab case 454 interpretation

EMergucate

PH = 7.39, that is within the normal range. pCO2 = 30 mmHg, that is slightly low. This patient might have respiratory alkalosis. Next, we should look at the compensation for respiratory acidosis.

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Don’t Forget to Bubble Wrap

Don't Forget the Bubbles

We love learning and sharing what we learn. In this post, we will discuss Bubble Wraps , one of the many ways to get further involved in the Dont Forget The Bubbles (DFTB) community. What is a Bubble Wrap? The DFTB team releases Bubble Wraps each month. They are a roundup of interesting and useful articles that our Bubble Wrappers have found during the month.

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Emerging technology solutions to support national emergency workforce capacity-building initiatives: lessons from Ugandan policy and practice

Emergency Medicine Journal

Trauma and emergency care is a national priority in Uganda due to the high burden of injury, impacting a primarily young and rural population. With a significant gap in qualified emergency medicine professionals, a need exists to rapidly upskill the current health workforce and to strengthen access to learning for non-specialist emergency care providers nationally.

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Work Place Violence | JournalFeed Top 10!

JournalFeed

The JournalFeed podcast for the week of Dec 30 Jan 3, 2024. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Tuesday Spoon Feed : Workplace violence (WPV) occurs in one out of every 3.7 shifts among healthcare workers (HCWs) in emergency departments, with nurses and younger HCWs being at higher risk.

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Dizziness in a 40-something with recent stent for inferior OMI

Dr. Smith's ECG Blog

Dizziness is so unlikely to be OMI without an obvious ECG, that I am going to pretend that this patient presented with chest pain. The PMCardio Queen of Hearts app asks you, before giving an interpretation of OMI ("STEMI-Equivalent"), whether the patient's clinical presentation is high risk for OMI. If no, then she will tell you that the case is outside of the intended use group.

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Cardiac Arrest Update 2024 (Part 2)

Core Ultrasound

In part two of this series on using ultrasound during cardiac arrest, we dive into advanced strategies to further optimize your resuscitation care. Building on the foundation from part one, this video focuses on actionable tips to take your ultrasound skills to the next level during cardiac arrest scenarios. Cardiac Arrest Part 1 RUSH exam Courses The post Cardiac Arrest Update 2024 (Part 2) first appeared on Core Ultrasound.

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Medical Music Mondays: Anaphylax Attack

PEMBlog

Guess who’s back? Back again. Epi Pen. Jab a friend. Give that EpiPen even if you think it might possibly be anaphylaxis! Lyrics His palms are sweaty, knees weak, arms are heavy, He’s allergic, it’s anaphylaxis already. He’s chokin’, his throat’s closin’, hives all over, IgE mediated, peanut exposure Mucosa swollen, he’s gaspin’ for breath, Heart poundin’ like a drum, he’s scared to death. multi system reaction, puking and wheezin

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What influences ambulance clinician decisions to pre-alert emergency departments: a qualitative exploration of pre-alert practice in UK ambulance services and emergency departments

Emergency Medicine Journal

Background Ambulance clinicians use pre-alerts to inform receiving hospitals of the imminent arrival of a time-critical patient considered to require immediate attention, enabling the receiving emergency department (ED) or other clinical area to prepare. Pre-alerts are key to ensuring immediate access to appropriate care, but unnecessary pre-alerts can divert resources from other patients and fuel ‘pre-alert fatigue’ among ED staff.

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Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. Its time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: PARAMEDIC-3 and IVIO RCTs IO vs IV Epinephrine for OHCA Spoon Feed Two large studies randomizing patients with out-of-hospital-cardiac arrest (OHCA) to either an intraosseous (IO) or intravenous (IV) first approach

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2ND DEGREE SA BLOCK TYPE MOBITZ 2

ECG Guru

This 3-lead ECG comes from an 80-year-old gentleman who went for a cardiological examination after a syncope. The ECG shows a sinus rhythm with wide QRS complexes, the QRS morphology in lead I suggests an LBBB, heart rate here just under 60 bpm. After 3 sinus node beats there is a pause of just under 2 seconds. There are no P waves during this pause.

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Gaslighting RFK Jr.’s role in the deadly Samoan measles outbreak

Science Based Medicine

One of many shameful incidents in the life of antivax activist Robert F. Kennedy Jr. was his promotion of anti-MMR fear mongering during a measles epidemic in Samoa. Now that he could become HHS Secretary, his apologists are frantically trying to gaslight you. Here's how. The post Gaslighting RFK Jr.s role in the deadly Samoan measles outbreak first appeared on Science-Based Medicine.

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ECG Blog #463 — Lots to Explain.

Ken Grauer, MD

I was sent the ECG shown in Figure-1 told only that this tracing was obtained prior to elective electric cardioversion of a patient who had long been in persistent AFlutter ( A trial F lutter ). Serum electrolytes were normal at the time of cardioversion. The patient tolerated cardioversion well and later that day was discharged from the hospital. ( The post-cardioversion tracing will be shown momentarily in Figure-3 ).

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Primary survey: highlights from this issue

Emergency Medicine Journal

Happy New Year and welcome to the first primary survey for the Emergency Medicine Journal of 2025. I hope there was an opportunity to rest over the holiday period and for those that were working, thank you. A new year brings us straight into another exciting edition of the journal. This month, the journal brings a prehospital extravaganza of papers, along with global health and staff well-being.

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The Semmelweis Effect and The Great Barrington Declaration

Sensible Medicine

The story is often told in medical school about Ignaz Semmelweis, the Hungarian obstetrician who discovered that hand washing with chlorine reduced maternal mortality from puerperal fever. An intervention seemingly so simple and obvious but when first proposed in the 1840s, the experts of the day not only rejected it, but condemned Semmelweis as a heretic.

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PAROXYSMAL ATRIAL FIBRILLATION

ECG Guru

Atrial fibrillation is a very common arrhythmia, affecting hundreds of millions of people worldwide. The diagnosis of atrial fibrillation is of great importance, as the timely initiation of oral anticoagulation can in many cases significantly reduce the risk of embolism (which is associated with this arrhythmia). The risk of cardiac embolism is particularly high in the presence of paroxysmal atrial fibrillation, in which there is frequent alternation between sinus rhythm and atrial fibrillation.

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OMI? Subendocardial ischemia? Does it matter in this clinical context?

Dr. Smith's ECG Blog

Written by Pendell Meyers A woman in her 70s with known prior coronary artery disease experienced acute chest pain and shortness of breath. The chest pain was described as severe pressure radiating to both shoulders. Vital signs were within normal limits. She presented to the Emergency Department at around 3.5 hours since onset. She had taken aspirin at home.

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The AI Will Literally See You Now

EM Literature of Note

This AI study is a fun experiment claiming to replicate the clinical gestalt generated by a physician’s initial synthesis of visual information. The ability to rapidly assess the stability and acuity of a patient is part of every experienced clinician’s refined skills and used as a pre-test anchor for application of further diagnostic and management reasoning.

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How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments

Emergency Medicine Journal

Background Calls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response (‘pre-alerts’) have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke). However, little is known about their usefulness for other patients and the processes involved in ED responses to them.

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In Search of Motives

Sensible Medicine

This post really needs no introduction. Dr. Miller disagreed with a lot in my introduction and Dr. Ostacher’s recent piece about seeking motives for senseless acts of violence. Obviously, we at Sensible Medicine love to post well-reasoned responses to our articles. This is a great one. Adam Cifu Sensible Medicine is a reader-supported publication.

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2ND DEGREE SA BLOCK TYPE MOBITZ

ECG Guru

This 3-lead ECG comes from an 80-year-old gentleman who went for a cardiological examination after a syncope. The ECG shows a sinus rhythm with wide QRS complexes, the QRS morphology in lead I suggests an LBBB, heart rate here just under 60 bpm. After 3 sinus node beats there is a pause of just under 2 seconds. There are no P waves during this pause.

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