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.
Northwestern EM Blog
DECEMBER 23, 2024
Written by: Chezlyn Patton, MD, (NUEM 27) Edited by: David Adler, MD (NUEM 25) Expert Commentary by : Melissa Marinelli, MD Expert Commentary Doctors in the ER are under intense time pressure to see many patients quickly and make hundreds of decisions over the course of a single shift. This actually fosters a natural honing of communication skills, because rapport must be developed quickly with anyone who walks through the door.
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Ken Grauer, MD
DECEMBER 12, 2024
I was sent the ECG in Figure-1 initially told only that it was obtained from an older man with palpitations. The cardiology team thought the rhythm was an SVT ( S upra V entricular T achycardia ) with QRS widening as a result of aberrant conduction. QUESTION: Do YOU agree that the rhythm is consistent with an SVT , in which there is QRS widening because of aberrancy?
The Trauma Pro
DECEMBER 17, 2024
Anyone who takes care of blunt trauma has seen the Morel-Lavallee lesion (M-L). Heres an obvious one because its acute: The M-L lesion is essentially a closed degloving injury in which the skin remains intact. The subcutaneous tissue is sheared off of the underlying fascia, and typically blood accumulates in the potential space that is created. This picture shows a less acute lesion; the bruising and ecchymosis on the surface have resolved.
Pediatric EM Morsels
DECEMBER 20, 2024
Its been a BIG year for Mycoplasma! If your EDs have been anything like ours, youve been seeing more patients with Mycoplasma Pneumonia than you expected. Many kids are presenting to the ED for failure of outpatient antibiotic therapy of community acquired pneumonia, only to find out thats because they werent on the right meds! Let’s debrief on this atypical bug.
Science Based Medicine
DECEMBER 6, 2024
Doctors who gushed over RFK Jr. made their bed, and they'll lie in it. The post Dr. Vinay Prasad Sabotaging RFK Jrs Confirmation Will Increase Vaccine Hesitancy & Doctors Criticizing RFK Jr. Paved the Way for His Ascendancy first appeared on Science-Based Medicine.
St. Emlyn
DECEMBER 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed Explore key takeaways from the DAS 2024 meeting, including airway management in obstetrics, ethics of training, challenges in critical care, and international practices. Insights tailored for emergency and anaesthesia professionals. The post Difficult Airway Society Meeting 2024 appeared first on St.Emlyn's.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
The Trauma Pro
DECEMBER 6, 2024
The debate over incidental appendectomy has waxed and waned over the years. And for the most part, it has nearly permanently waned in general surgical cases for now. But every once in a while, I am asked about incidental appendectomy during trauma laparotomy. Is it a good idea? What reasons could there possibly be for doing it? In the old days, we would frequently do an incidental appendectomy because… well, just because we were there.
Dr. Smith's ECG Blog
DECEMBER 6, 2024
A 50-something man presented with worsening severe exertional chest pain which was just resolving as he had an ECG recorded in triage. Time zero. Are the T-waves in leads I and II hyperacute? Hard to tell. How can we know? By the evolution of the ECG! Watch what happends as the heart recovers from its episode of ischemia. The T-waves deflate, demonstrating that the first one was indeed hyperacute. 2 hours T-waves in lead II are significant smaller In lead I not much difference Troponins returned
Thinking Critical Care
DECEMBER 8, 2024
Every resus doc needs to have a holistic approach to shock – MAP and forward flow simply isn’t enough. Here, Matt and I chat a bit about recent things we’ve heard in the world around us, as well as how we use and see the use of the interface concept. Don’t forget to come up your game at #HR25!!!
EMDocs
DECEMBER 6, 2024
Authors: Haley Dusek, MD (Emergency Medicine Resident, Carolinas Medical Center ); Erik Fisher, MD (Emergency Medicine Attending/Medical Toxicologist, Carolinas Medical Center) // Reviewed by: Anthony Spadaro, MD (@TSpadaro91, Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK); and Brit Long, MD (@long_brit) Case: A 27-
The Bottom Line
DECEMBER 11, 2024
Whats new in the Critical Care literature monthly updates
The Trauma Pro
DECEMBER 20, 2024
A new class of anticoagulants, the direct oral anticoagulants (DOACs), were introduced in 2010. I started writing about them more than five years ago and was initially pessimistic about their safety profile in patients with head injuries. However, reversal agents and/or protocols were introduced, and the literature has borne out the fact that they appear to be safer than the old stand-by warfarin.
St. Emlyn
DECEMBER 10, 2024
St.Emlyn's - Emergency Medicine #FOAMed A podcast with some of the highlights from the London Trauma Conference 2024 The post Podcast – Reflections from the London Trauma Conference 2024: Insights and Inspiration appeared first on St.Emlyn's.
Science Based Medicine
DECEMBER 20, 2024
If RFK Jr. "researches" vaccines, he will certainly "discover" they cause autism. It's possible that this "research" will be used as justification to revoke authorization for vaccines. That's always been the endgame. The post Trusting RFK Jr. to Research Vaccines is Like Trusting a Hungry Python to Babysit a Kitten first appeared on Science-Based Medicine.
EMDocs
DECEMBER 18, 2024
Authors: Kyler Osborne (EM-3 Resident Physician; Tacoma, WA); Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA); Rachel Bridwell, MD (EM Attending Physician; Charlotte, NC) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician) Welcome to emDOCs revamp!
Taming the SRU
DECEMBER 17, 2024
Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none. Considering the nationwide IV fluid shortage, judicious use of fluids is imperative.
ACEP Now
DECEMBER 17, 2024
Medical training is a difficult task. As residents and fellows, we move wherever the Match sends us, endure grueling hours, and sacrifice time with loved onesall in pursuit of becoming the best doctors we can be and delivering excellent patient care. But we should not have to sacrifice our own well-being in the process. In Washington, D.C., more than 450 residents and fellows employed by George Washington University (GW) spent the past 15 months fighting for our first contract.
St. Emlyn
DECEMBER 23, 2024
St.Emlyn's - Emergency Medicine #FOAMed David Purkarthofer reviews the highlights from the fantastic EuSEM conference held in Copenhagen earlier this year. #FOAMed @stemlyns The post EuSEM 2024 in review appeared first on St.Emlyn's.
Dr. Smith's ECG Blog
DECEMBER 16, 2024
Which patient needs a CT Scan? Case 1: 20-something woman with chest pain Case 2: 50-something man with chest pain Case 1 A 20-something yo woman presented in the middle of the night with severe crushing chest pain. It had begun 4 hours before arrival and was initially dull, but became severe and "unbearable" 2 hours prior to arrival. She was a walk-in at triage.
EMDocs
DECEMBER 11, 2024
Heres another case from Medical Malpractice Insights Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.
Don't Forget the Bubbles
DECEMBER 16, 2024
Over the last decade, there has been a concerning decline in childhood vaccination rates in the UK. This has been mirrored in many parts of the world. This trend, exacerbated by the COVID-19 pandemic, has led to a resurgence of vaccine-preventable diseases such as measles and pertussis. Once on the brink of eradication, these diseases now pose significant public health risks, especially to vulnerable groups like infants, young children, and the immunocompromised.
ALiEM
DECEMBER 9, 2024
A 25-year-old female with no pertinent past medical history presented to an emergency department in Massachusetts with four days of generalized malaise, myalgias, congestion, low-grade fever, and a rash behind her left knee. The patient denied cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, and diarrhea. She lives with three roommates, none of whom were sick, and she denied any other known sick contacts.
St. Emlyn
DECEMBER 16, 2024
St.Emlyn's - Emergency Medicine #FOAMed The blog highlights the updated 2024 guidelines from the Royal College of Radiologists (RCR) on imaging in pediatric trauma. It emphasizes critical changes from the previous 2014 guidelines, focusing on the judicious use of imaging to minimize ionizing radiation exposure in children. Key updates include algorithms for blunt trauma, penetrating trauma, and blast injuries.
First 10 EM
DECEMBER 16, 2024
Antibiotic resistance is an existential problem. Optimizing sepsis care, including the appropriate length of antibiotic therapy, is an important goal. So should we be willing to allow an increase in mortality to reduce total antibiotic use, as the ADAPT-Sepsis non-inferiority design seems to imply? The paper Dark P, Hossain A, McAuley DF, Brealey D, Carlson […] The post Killer antibiotic stewardship strategy?
Dr. Smith's ECG Blog
DECEMBER 13, 2024
Written by Magnus Nossen and Ken Grauer ( with Comment by Smith ) The ECG in Figure-1 was electronically transmitted by the ambulance service for evaluation. The patient is a young adult male with acute onset of palpitations. He was hemodynamically stable at the time ECG #1 was recorded. QUESTIONS: How would you interpret this ECG? What entities to consider in your differential diagnosis?
RebelEM
DECEMBER 17, 2024
Bottom Line Up Top: There doesnt appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. Only treat fever if it causes the patient distress. Clinical Scenario: A 45-year-old woman presents with cough and shortness of breath. Vitals are BP 114/42, HR 138, T 102.1, Sat 93% on RA. The patient is alert and oriented and has no other complaints.
The Skeptics' Guide to EM
DECEMBER 21, 2024
Date: December 15, 2024 Guest Skeptics: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Today, were sleighing through the holiday season with a special episode filled with statistical cheer, a dash of skepticism, and a hint of eggnog-flavoured nerdiness. This is an SGEM Xtra like the one we did on What I Learned from Top Gun. Its fun to mix it up and not do a structured critical appraisal of a recent publication and have a more philosophical chat.
Core Medical Group
DECEMBER 13, 2024
The holidays are upon us, the end of the year is inching closer and closer, and one question remains top of mind for travelers: how can I set myself up for success in 2025?
EMCrit
DECEMBER 13, 2024
I think ICU docs may have developed a bit of an RCT problem; not an addiction, but perhaps a dependency. It all started off fine at first. RCTs are the apex trial design, the only trial capable of proving causality. But we've taken it too far. Currently, a cluster-randomized trial is underway to study whether […] EMCrit Project by Josh Farkas.
ACEP Now
DECEMBER 8, 2024
The Centers for Disease Control and Prevention (CDC) estimates of emergency department (ED) visits for 2022 were recently released. 1 It was the highest volume ever reported by the CDC, at 155.4 million visits, with an all-time high utilization rate of 473 visits per 1,000 populations. This visit rate puts American EDs back on the data line it has followed since World War II.
Science Based Medicine
DECEMBER 22, 2024
If pro-RFK Jr. propaganda wins the day, I am confident we will soon find out a tough truth- MAHA is all about RFK and has everything to do with vaccines. The post Dr. Joseph Marine: MAHA is More Than RFK and Has Little to do With Vaccines first appeared on Science-Based Medicine.
St. Emlyn
DECEMBER 13, 2024
St.Emlyn's - Emergency Medicine #FOAMed In October, I had the opportunity to give a talk on the ethics of Artificial Intelligence at the EUSEM Congress in Copenhagen. My focus was on the ethical implications of […] The post The Promise and Perils of Artificial Intelligence in Emergency Care: Reflections from EUSEM 2024 appeared first on St.Emlyn's.
EMCrit
DECEMBER 14, 2024
All thing for HyperAngulated Blade Mastery EMCrit Project by Scott Weingart, MD FCCM.
ACEP Now
DECEMBER 7, 2024
Approximately 60,000 to 100,000 patients die from pulmonary embolism (PE) each year in the United States, and PE is the third leading cause of cardiovascular mortality. 1 A wide spectrum of severity exists in PE presentations, ranging from mild shortness of breath to cardiac arrest. A PE is classified into one of three categories: low risk, submassive, and massive.
American Medical Compliance
DECEMBER 13, 2024
By 2050, an alarming 61% of adults in the United States are projected to have some form of cardiovascular disease, according to a report published in the American Heart Association Journals. This statistic shows the urgency of early detection and proactive management to reduce the devastating impact of these conditions. Electrocardiograms (EKGs) are at the top of modern healthcare as indispensable diagnostic tools for identifying arrhythmias, heart attacks, and other cardiac disorders.
The Bottom Line
DECEMBER 15, 2024
Early Restrictive vs Liberal Oxygen for Trauma Patients Arleth. JAMA 2024. doi: 10.1001/jama.2024.25786 Clinical Question In adult patients experiencing blunt or penetrating trauma does an early restrictive oxygen strategy compared to a liberal oxygen strategy reduce death and/or major respiratory complications within 30 days?
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