Don't Forget the Bubbles

DECEMBER 31, 2024

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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Leadership Emergency Department Outcomes Operations 140

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.

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Ken Grauer, MD

DECEMBER 28, 2024

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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EKG/ECG 428

Sensible Medicine

DECEMBER 28, 2024

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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Hospitals CDC Documentation/Coding Outcomes 139

Science Based Medicine

DECEMBER 27, 2024

The time to start speaking out to defend vaccines from RFK Jr. is now. The post Dr. Marty Makary, What Are You Going To Do If RFK Jr. Demands That Revoke Approval For Vaccines? first appeared on Science-Based Medicine.

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EMCrit

DECEMBER 27, 2024

All things stabilizing tamponade and performing pericardiocentesis EMCrit Project by Scott Weingart, MD FCCM.

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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.

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CDC Wellness Best Practices Stroke 80

St. Emlyn

DECEMBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed Does early exercise after blunt chest trauma make a difference? Find out when we review the ELECT trial. #FOAMed @stemlyns The post EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial) appeared first on St.Emlyn's.

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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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Sensible Medicine

JANUARY 2, 2025

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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Psychiatric Wellness Hospitals 57

The Skeptics' Guide to EM

DECEMBER 28, 2024

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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Emergency Department Academics Research Outcomes 63

Emergency Medicine Journal

DECEMBER 30, 2024

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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Operations 52

St. Emlyn

DECEMBER 27, 2024

St.Emlyn's - Emergency Medicine #FOAMed Intraosseous (IO) access is essential in prehospital emergency care when intravenous access is challenging. A Danish retrospective cohort study of over 5,000 patients found fewer than five cases of osteomyelitis, no osteonecrosis or compartment syndrome, and no complications in children. Despite a high mortality rate (60% at 180 days) potentially underestimating long-term risks, the study's robust design supports IO access as a generally safe and effe

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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!

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Sepsis EMS EKG/ECG Hospitals 55

Sensible Medicine

DECEMBER 29, 2024

An introduction to oncology for medical students

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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.

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Emergency Medicine Journal

DECEMBER 30, 2024

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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St. Emlyn

DECEMBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed Does early exercise after blunt chest trauma make a difference? Find out when we review the ELECT trial. #FOAMed @stemlyns The post EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial) appeared first on St.Emlyn's.

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Emergency Medicine Cases

DECEMBER 31, 2024

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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EMS 56

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.

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Sepsis Outcomes Stroke Shock 52

Stop and Think

JANUARY 2, 2025

Take a look at this post from Dr. Ed Livingston, a UCLA professor and former deputy editor of JAMA. “The legacy journals are dying…” “Blogs like Sensible Medicine are the future.” I hope he is right; but I am not so sure. Here is a screenshot of an editorial from Dr. Harlan Krumholz, an academic cardiologist at Yale. He wrote this in 2017 when he finished his tenure as editor-in-chief of Circulation: CV Quality and Outcomes.

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Academics Outcomes 52

Emergency Medicine Journal

DECEMBER 30, 2024

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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Ambulance Services Emergency Department Research Hospitals 52

EMergucate

DECEMBER 29, 2024

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 the Bubbles

DECEMBER 31, 2024

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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Emergency Department Pediatrics Research 59

PulmCCM

DECEMBER 30, 2024

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

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Sepsis 52

Dr. Smith's ECG Blog

DECEMBER 29, 2024

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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EKG/ECG Research Outcomes Hospitals 70

Emergency Medicine Journal

DECEMBER 30, 2024

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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Emergency Department Wellness 52

Core Ultrasound

DECEMBER 30, 2024

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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Ultrasounds Resuscitation 40

PEMBlog

DECEMBER 30, 2024

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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Anaphylaxis 52

PulmCCM

DECEMBER 27, 2024

"Covert consciousness," hyperglycemia guideline update, reviews on midodrine, antipsychotics, steroids, delirium, more

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St. Emlyn

DECEMBER 27, 2024

St.Emlyn's - Emergency Medicine #FOAMed Intraosseous (IO) access is essential in prehospital emergency care when intravenous access is challenging. This Danish retrospective cohort study supports IO access as a generally safe and effective procedure in critical care situations. The post What’s the long term complication rate of intraosseous access?

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Emergency Medicine Journal

DECEMBER 30, 2024

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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Emergency Department Stroke Documentation/Coding Outcomes 52

Science Based Medicine

DECEMBER 30, 2024

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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Sensible Medicine

DECEMBER 31, 2024

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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Sepsis CDC Burns Academics 134

Dr. Smith's ECG Blog

DECEMBER 27, 2024

Submitted anonymously, written by Willy Frick A man in his 70s with a history of remote MI (details unavailable) and prior stent placement presented to cardiology clinic for routine follow up. He complained of days to weeks of palpitations and dyspnea. His clinic ECG is shown. What do you think? In an elderly patient complaining of palpitations, we have an ECG with heart rate 140 bpm.

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EKG/ECG Hospitals Sepsis Documentation/Coding 121

EM Updates

DECEMBER 29, 2024

Depending on how you count, I’ve now been doing emergency medicine for 20 years. This is how I see patients. The protocol below does not apply to resuscitation patients. For resuscitation patients, see The First Five Minutes of Resuscitation. I apply this protocol to just about every patient. When you are systematic, you don’t miss stuff.

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Emergency Department Documentation/Coding Resuscitation Wellness 52

Emergency Medicine Journal

DECEMBER 30, 2024

Does your emergency department (ED) feel like a constant battle? Has the function of your ED been destroyed by external forces? It might strike the reader as extreme to use words related to battle regarding current working conditions in EDs but for most of us this is probably not far from the truth. When you think about battles, you think about frontline casualties (an irony given the origins of emergency medicine (EM)) and how there must be sacrifice for the majority to succeed.

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EMS Emergency Department Hospitals 52