PulmCCM

JANUARY 8, 2025

Trauma patients are routinely provided with high doses of supplemental oxygen—even when they are relatively young, relatively healthy patients without lung disease with normal oxygen saturations and PaO2. The origins of this practice are unknown, and no good evidence supports it; the theory seems to be that a larger oxygen reservoir could somehow provide reserves to regions of localized tissue hypoxemia, or to a normoxemic patient who abruptly deteriorates.

Outcomes 93

Outcomes CDC Hospitals 93

Science Based Medicine

JANUARY 3, 2025

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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113

Sensible Medicine

JANUARY 3, 2025

Doctors of a certain age tend to fetishize the physical exam. I think this is because learning the physical exam is an important part of the socialization of the doctor. It is also a skill that doesn’t really wither with time. Though with every passing day I feel more and more like part of the old guard, I can only give the exam a tepid defense.

Urgent Care 107

Urgent Care Ultrasounds Wellness 107

St. Emlyn

JANUARY 2, 2025

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.

CPR 120

CPR Hospitals Resuscitation 120

PulmCCM

JANUARY 2, 2025

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.

Sepsis 98

Sepsis Outcomes Stroke Shock 98

Dr. Smith's ECG Blog

JANUARY 2, 2025

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.

EKG/ECG 87

EKG/ECG Sepsis Wellness Documentation/Coding 87

Science Based Medicine

JANUARY 6, 2025

A proponent of the Great Barrington Declaration is comparing rejection of its "natural herd immunity" approach to the pandemic to the rejection of Ignaz Semmelweis and his findings. It's a deceptive comparison beloved of all manner of scientific cranks. The post The Semmelweis gambit: A red flag for defending bad science and quackery first appeared on Science-Based Medicine.

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St. Emlyn

JANUARY 6, 2025

St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). This retrospective study explores time efficiency, injury severity, and patient outcomes, highlighting the role of HEMS in delivering critical care to severely injured patients in remote locations.

Emergency Department 74

Emergency Department Outcomes Hospitals 74

Dr. Smith's ECG Blog

JANUARY 7, 2025

(This was created by Arron Pearce ( [link] ) Online QT calculator for wide QRS (LBBB, RBBB, etc.

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Science Based Medicine

JANUARY 1, 2025

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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ECG Guru

JANUARY 3, 2025

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.

Fractures 84

Fractures EKG/ECG 84

EB Medicine

JANUARY 7, 2025

In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1. Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. Growth of EMIC - Expansion from three members to over 500 - Focus areas: Education, mentorship, opportunity 3.

EMS 69

EMS 69

Emergency Medicine Cases

JANUARY 7, 2025

In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine? How can we best streamline thorough data gathering for each case so that we don't miss key data points?

Documentation/Coding 92

Documentation/Coding EMS 92

Sensible Medicine

JANUARY 8, 2025

I have long followed the work of Dr. Margaret McCartney. She is a general practitioner in Glasgow, Scotland, writer, public speaker, and now PhD. She is a fierce advocate for evidence-based medicine. She holds highly skeptical views of screening for disease—which, to my surprise is quite common in the UK. Her recently finished PhD sought empirical evidence regarding declaration of conflicts of interest in the UK.

Documentation/Coding 66

Documentation/Coding 66

EMDocs

JANUARY 1, 2025

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!

Sepsis 62

Sepsis EMS EKG/ECG Hospitals 62

ACEP Now

JANUARY 4, 2025

In recent years, emergency medicine, once the bastion of quick decision making, clinical acumen, and patient-centered care, has been quietly succumbing to a different forcethe slow but steady erosion of critical thinking. The culprit is the increasing reliance on protocolization and the diminishing autonomy of emergency physicians. This shift, intended to standardize care and mitigate error, is paradoxically undermining the very heart of medicinethe doctors ability to think critically, adapt to

Administration 52

Administration Sepsis Emergency Department 52

ECG Guru

JANUARY 8, 2025

Sometimes in a simple 1-lead ECG strip, various interesting ECG phenomena can be recognized, such as here. One could briefly look over the ECG, make the diagnosis of ventricular bigeminus and then be satisfied. On closer inspection, however, 3 questions arise: 1. Is the P wave behind the PVC a sinus node P or an atrial extrasystole? 2. + 3. after one comes to the conclusion that it is a sinus node P: why is it not conducted and why is the PP distance smaller when there is a QRS complex in betwee

EKG/ECG 59

EKG/ECG 59

Emergency Medicine Cases

JANUARY 7, 2025

Dr. Patricia Lee is an EM physician in Calgary, Alberta and an Assistant Professor at the University of Calgary in the Department of Emergency Medicine. She reached out to me after listening to Episode 200 How EM Experts Think Part 1 as a longtime supporter of EM Cases, to highlight the importance of recognizing challenges that female-identifying EM physicians may face before, during and after ED shifts.

EMS 75

EMS Leadership Resuscitation 75

Sensible Medicine

JANUARY 6, 2025

When I was at Indiana back in the 1990s, we called an ICD by a company’s brand name. At IU, all ICDs were “PCDs” PCD was Medtronic’s brand name. I didn’t realize it at the time, but this was pro-level marketing. A similar thing has happened with coronary stents—at least in my neighborhood. Now it is Xience, a brand of drug-eluting stent (DES) from Abbott.

Outcomes 83

Outcomes Academics 83

American Medical Compliance

JANUARY 1, 2025

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.

CDC 80

CDC Wellness Best Practices Stroke 80

ACEP Now

JANUARY 5, 2025

Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.

Airway Management 52

Airway Management Operations Resuscitation Pediatrics 52

EMDocs

JANUARY 8, 2025

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.

EKG/ECG 57

EKG/ECG EMS Academics Emergency Department 57

Science Based Medicine

JANUARY 8, 2025

In 1964 the US Surgeon General released its first report on the health risks of smoking and tobacco use. This turned out to be a landmark move, paving the way for the following decades of progressively more restrictive regulation of public tobacco use and marketing. In 1964 smoking was at its peak in the US, when 42% of Americans smoked. Today the […] The post Surgeon General Alcohol Warning first appeared on Science-Based Medicine.

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52

NRC Health

JANUARY 8, 2025

The NRC Health 2025 Pediatric Collaborative is truly a cant-miss experience, with exceptional presentations that will stir innovative ideas. Check out a preview of one of the sessions! The post Peds Collab Preview | Join NRC Health experts for an interactive workshop appeared first on NRC Health.

Pediatrics 52

Pediatrics 52

PulmCCM

JANUARY 6, 2025

In the past decade, so-called “sepsis alerts” came out of nowhere to become a ubiquitous and resource-intensive component of inpatient medical care. The trouble is, no one checked first to see if they work. “Sepsis alerts” are automated notifications that flag patients who meet certain criteria compatible with severe infection discernible from the electronic medical record.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

ACEP Now

JANUARY 4, 2025

Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr.

Forensics 52

Forensics Urgent Care Hospitals Emergency Department 52

EMDocs

JANUARY 4, 2025

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

Shock 80

Shock Ultrasounds Pediatrics Administration 80

St. Emlyn

JANUARY 7, 2025

St.Emlyn's - Emergency Medicine #FOAMed Mastering likelihood ratios can transform your diagnostic skills. In this podcast with Rick and Greg, discover how likelihood ratios can enhance decision-making and improve patient care. The post Podcast – Likelihood Ratios: Critical Appraisal Nugget 12 appeared first on St.Emlyn's.

Research 62

Research 62

ALiEM

JANUARY 6, 2025

A 32 year-old male with PMH significant for opioid use disorder, a prior admission in 2021 for left-sided empyema s/p thoracotomy and decortication, gas bacteremia, and tricuspid endocarditis presented for a left leg wound. The patient reported a wound to his left leg that had become larger over the past 5 months. The pain worsened today, prompting him to come to the emergency department for evaluation.

Academics 56

Academics Emergency Department Hospitals 56

EMergucate

JANUARY 7, 2025

80 year old man presented with shortness of breath. This patient had history of CHF and COPD. His venous blood gases showed the following PH = 7.

COPD 52

COPD 52

ACEP Now

JANUARY 2, 2025

Thanks to Drs. Harrell and Bower for their excellent case discussion in the October issue of ACEP Now. They made a final diagnosis of hypertrophic obstructive cardiomyopathy and discussed how that diagnosis was made despite the initial anchoring on the wrong diagnosis. They continued to work the patient when they noted that the main presenting signtachycardiapersisted after the treatment for the initially anchored diagnosis, anxiety and panic disorder, and, possibly, hypovolemia.

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52

ECG Guru

JANUARY 3, 2025

Here we see a 30 s long strip of a 1-lead ECG rhythm strip, 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.

EKG/ECG 52

EKG/ECG 52

Northwestern EM Blog

JANUARY 7, 2025

Written by: Ashley Segobiano, MD (NUEM 28). Edited by: Nicholas Maurer, MD, MPH (NUEM 26). Expert Review by : Molly Estes, MD Molly Estes, MD Emergency Medicine Physician, Assistant Professor at Feinberg School of Medicine Northwestern Memorial Hospital, Feinberg School of Medicine How To Cite This Post: [Peer-Reviewed, Web Publication] Segobiano, A.

Hospitals 52

Hospitals 52

St. Emlyn

JANUARY 6, 2025

St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). The post Prehospital Emergency Anaesthesia (PHEA) vs. Emergency Department RSI: A Comparative Study on Trauma Care Timelines and Outcomes appeared first on St.Emlyn's.

Emergency Department 52

Emergency Department Outcomes Hospitals 52

JournalFeed

JANUARY 4, 2025

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.

Emergency Department 52

Emergency Department 52

ACEP Now

JANUARY 5, 2025

Every year, the hopeless task of keeping up with the medical literature grows even more unattainable. Will our Sisyphean burden be replaced with AI? ( Read this months Skeptics Guide to Emergency Medicine for that answer.) Will we be microchipped with peripheral PubMed brains? Will we finally wake up from the Matrix and be freed? Not yet! So, in the meantime, heres a host of articles of more than just passing interest from the past year, not already covered in ACEP Now.

Sepsis 40

Sepsis Research Airway Management Outcomes 40

Pediatric Education

JANUARY 5, 2025

Patient Presentation An 8-year-old male came to clinic with his parents because of uncontrolled asthma symptoms. They had moved into a rented home that was about 50 years old in August, when they moved to the area from another country. Since that time he had increased runny nose and coughing and used his albuterol only intermittently. He was coughing several times per day and his parents said he “coughed all night” but it didn’t wake up the patient.

Wellness 40

Wellness Pediatrics Hospitals 40