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 271

Pediatrics Resuscitation Documentation/Coding Wellness 271

Sensible Medicine

MAY 25, 2024

Each year, cancer doctors — particularly academic doctors — take tens of millions in pharma payments while simultaneously writing guidelines that mandate the use of these drugs, and simultaneously prescribing them to desperate sick patients who want an objective opinion, but get a biased one instead. million, or 6 to 7.5.

Academics 145

Academics Poisoning Research Wellness 145

Stop and Think

MAY 10, 2023

You should first know Dan is one of the smartest and kindest academics I have met. ” Dan also noted that before we invest millions of dollars in well-designed RCTs, it might be wise to do some less costly observational studies first. It’s quite an honor to have legit academics comment on my Substack.

Academics 52

Academics Research Administration Wellness 52

SheMD

JULY 30, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. We typically recommend medical school applicants to get letters of recommendation from: 2 professors who taught you in science courses, 1 professor who taught you in a non-science course, and 1 non-academic mentor who knows you well.

Academics 104

Academics Leadership Research Wellness 104

Sensible Medicine

SEPTEMBER 19, 2023

This week, I talk with Andrew Foy, who is an academic cardiologist at Penn State University in Hershey, PA. FRAIL AF is in Andrew’s wheelhouse as one of his primary academic areas of study is the role of multi-morbidity in translating medical evidence. Andrew explains it well. Ablation vs Meds.

Academics 98

Academics Wellness 98

Ken Grauer, MD

AUGUST 4, 2023

L addergram I llustration : Academically — I was fascinated by today's rhythm. A DDENDUM ( 8/5/2023 ) : I received a comment today on this tracing from D avid R ichley , who is well known to most ECG enthusiasts who frequent any of the many ECG internet forums. N OTE : What follows below goes way beyond -the-core!

EKG/ECG 370

EKG/ECG Academics Resuscitation Wellness 370

Sensible Medicine

JUNE 28, 2024

If I had it all to do again, there is no doubt that I would choose medicine in general and academic general internal medicine in particular, but occasionally we all have a bad week. She follows up at a “highly ranked” west coast academic medical center, near where she lives half the year. I love my job.

Stroke 105

Stroke Academics EKG/ECG Hospitals 105

Sensible Medicine

DECEMBER 18, 2023

The American Academic of Pediatrics (AAP) proudly told parents to avoid peanuts in kids at high risk of allergy. That is my conclusion as well, and I favor large, pragmatic randomized trials in adults and kids with staggered starting times (adults first — to protect kids from harms we may not yet know). Better food?

Pediatrics 145

Pediatrics Documentation/Coding Burns Academics 145

Sensible Medicine

JANUARY 17, 2024

The episode details examples of academic papers with fraud — the data were fabricated, and there were many tell tale signatures of fraud along the way. Well first consider that most biomedical science is about two things: describing the world and improving it. Most academics create causal conclusions that aren’t true.

Academics 111

Academics Outcomes Wellness 111

RebelEM

MARCH 31, 2025

Wells’ , Revised Geneva ) or clinical gestalt. A recent publication in Academic Emergency Medicine attempts to shed light on this area. D-Dimer testing is commonly used to rule out PE in low- and moderate-risk patients due to its high sensitivity and negative predictive value. Historically PE rate in high-risk ~ 60%).

EMS 40

EMS Academics Fractures Wellness 40

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

The ST elevation in V2-V6 as well as in I and aVL becomes easily recognizable. The patient ultimately did well. Of academic interest — are the arrhythmias that developed. Shark fin ST elevation ( well seen in lead I of ECG #1 ) gave the false appearance of QRS widening. An ICD was placed. Is there OMI?

EKG/ECG 133

EKG/ECG Resuscitation Academics EMS 133

ALiEM

OCTOBER 30, 2023

Those who take the academic route face unclear promotion expectations, uncertainty about their niche, and a double-whammy of high clinical burden and a tacit expectation that you “prove” your worth as a teacher by taking on more tasks before being rewarded with salary support. But what can Dr. Garcia – or you – do?

Academics 64

Academics Leadership Wellness Research 64

Sensible Medicine

JUNE 15, 2024

These essays will be about how institutions, particularly academic medical leaders, fail doctors in training. Being well versed in domains of history and sports may even have a greater impact in the clinic, as it allows you to bond with many patients. A greater focus on wellness or work-life balance will solve none of these concerns.

Research 144

Research Wellness Academics Administration 144

Sensible Medicine

NOVEMBER 28, 2023

For many doctors in academic medicine, publishing in peer reviewed journal is an important part of their careers. People can rise through the academic ranks as gifted clinicians, creative and effective educators, and talented administrators. [i] Being perfectly honest, not all the articles have aged well.

Stroke 97

Stroke Academics Outcomes Administration 97

Ken Grauer, MD

MARCH 29, 2023

For the EP cardiologist — localization of the AP before EP study is more than academic, as it facilitates and expedites localization of the AP during EP study. That said — my algorithm nevertheless did well for predicting AP localization in today's case. ECG Blog #284 — Reviews a case similar to today's Very Fast AFib.

EKG/ECG 195

EKG/ECG Wellness Academics 195

Sensible Medicine

MARCH 12, 2024

On February 8th, Lisa Rosenbaum published an excellent and thought-provoking piece in the New England Journal titled: On Being Well While Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training. Yet, it seems that there is a palpable, unique shift in mindset amongst young medical trainees.

Wellness 134

Wellness Academics Research 134

Sensible Medicine

APRIL 14, 2024

Including: The academic speakers— who often consult for the drug companies and receive sizable personal payments. A few companies will get rich doing this, and many well-intentioned people will be cheering us over the cliff. Let’s be clear: that is not sustainable. Yet, most present at the meeting cheered on the changes.

Patient Safety 145

Patient Safety Academics Outcomes Wellness 145

Stop and Think

JANUARY 14, 2024

Since Andrew Foy and I wrote our Case Against Coronary Artery Scans in an academic journal, the test has only increased in popularity. The academic proponents of CAC scans strongly recommend CAC scans only to guide decision-making about using primary prevention therapies, such as statin drugs, in medium risk people. Exercise regularly.

Academics 125

Academics Outcomes Wellness 125

Northwestern EM Blog

MARCH 27, 2025

Attach a flush to ensure the vein and catheter is functioning well. For the clinician really looking to take their difficult IV access POCUS skills from good to great, I always recommend pre-scanning in both the short axis as well as the long axis to fully understand the anatomy and identify the best site for insertion.

Ultrasounds 52

Ultrasounds Dehydration Academics Hospitals 52

ALiEM

OCTOBER 23, 2023

There was a well-healed scar on the bottom eyelid. The hyperdense foreign body is again seen on CT, as well as a small focus of air within the anterior chamber. Additional Images Physical Exam General : Nontoxic appearing but seemed quite uncomfortable. The lateral canthus appeared inferiorly displaced. 2022;74(Suppl 2):1334-1343.

Academics 111

Academics Emergency Department Ultrasounds Wellness 111

Taming the SRU

JULY 24, 2024

Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world. They then tested the LASSO model using the remaining 20% of data to see how well it could detect sepsis at the same time points.

Sepsis 89

Sepsis Resuscitation Emergency Department Wellness 89

ACEP Now

AUGUST 22, 2023

This real-world pragmatism is the guiding principle embodied by the Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE) project, published by the Society for Academic Emergency Medicine. References Society for Academic Emergency Medicine. Academic Emergency Medicine. Academic Emergency Medicine.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

Pediatric EM Morsels

JULY 21, 2023

Academic emergency medicine 12.9 Acad Emerg Med. 2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PMID: 27197686. Holmes, James F et al. Performance of the Pediatric Glasgow Coma Scale in Children with Blunt Head Trauma.” 2005): 814–819. Chung CY, Chen CL, Cheng PT, See LC, Tang SF, Wong AM.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Ken Grauer, MD

SEPTEMBER 15, 2023

IF there are easier elements of the rhythm to interpret, as well as more difficult elements — Start with the EASIER elements ( and save the more difficult elements for last ). L addergram I llustration : Academically — I was fascinated by today's rhythm. Figure-4: I've labeled each of the P waves in today's rhythm.

EKG/ECG 248

EKG/ECG Academics Wellness 248

Sensible Medicine

OCTOBER 2, 2024

During the pandemic, some schools decided that they couldn’t be expected to offer grades on clinical clerkships or admit students to academic honor societies. But I can’t help feeling that it’s less than they deserve.

Academics 131

Academics Wellness 131

ALiEM

APRIL 10, 2023

Additional Images Physical Exam General: Well appearing, no distress. Skin: Large, serpiginous rash on the left forehead and scalp with central clearing and peripheral erythema as well as areas of erythematous plaques. Denies fever, cough, rhinorrhea, congestion, decreased appetite, diarrhea, and decreased urination. doi: 10.1111/j.1087-0024.2004.00827.x.

Pediatrics 98

Pediatrics EKG/ECG Academics Wellness 98

Sensible Medicine

AUGUST 25, 2024

Years ago, I was the target of a twitter mob when I posted my side of an academic debate organized to consider the question: Is it a physician’s professional duty to advocate politically? He describes them well in his post. 1 Though well after the fact since my day job tends to get in the way sometimes.

Academics 62

Academics Leadership Wellness Research 62

Dr. Smith's ECG Blog

SEPTEMBER 29, 2024

Of course the Queen of Hearts also sees OMI: Click here to sign up for Queen of Hearts Access Another ECG was recorded 13 minutes later, well after ROSC and with more stable vital signs: The heart rate is down to 114 beats per minutes What do you think? This is diagnostic of posterior OMI.

EKG/ECG 110

EKG/ECG Wellness Academics Resuscitation 110

The Injectable Orange

JUNE 18, 2017

It was a privilege to be able to share a little of my personal philosophy and also be the first nurse to post in the How I Stay Healthy in EM series on Academic Life in Emergency Medicine. For my offering head here.

EMS 52

EMS Academics Wellness 52

Sensible Medicine

MAY 30, 2023

Inter alia, if it wasn’t for his research, plenty of the work of academic journal editors and science publishers would go unnoticed, through thick and thin. Thank goodness John Ioannidis exists. Instead, his meta-research prompts us to question about these professions and about the future of science communication.

Research 95

Research Academics Wellness 95

ALiEM

FEBRUARY 26, 2024

Otherwise, he was well-appearing, acting normally, and eating/voiding/stooling normally. Additional Images Physical Exam General : Well appearing, acting appropriately for age HEENT : Scalp normal. The patient presented with a vesicular rash on his face including around his eyes. He had conjunctival discharge noted by mom.

Academics 78

Academics Pediatrics Wellness 78

Sensible Medicine

SEPTEMBER 1, 2024

Finally, Adam Cifu weighs in in favor of physician political involvement but cautions that academic medical centers should not take political stances and that physicians should be careful not to allow politics to interfere with the doctor patient relationship. Such platitudes about politics indicate a contrast of politics to medicine.

Academics 120

Academics Operations Hospitals Wellness 120

ALiEM

NOVEMBER 17, 2023

kg General : Well-appearing 4-year-old female acting appropriately with grandmother and mother at the bedside. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. C; Wt 18.2 Uptodate.com.

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

Sensible Medicine

APRIL 18, 2024

David Rind sent me this article, a thoughtful, well-argued, reply. This behavior was medically harmful and unnecessary, as well as being discriminatory. Wearing gloves for IV placement meant that you couldn’t feel veins as well. This sort of exchange has been our goal on Sensible Medicine since the beginning.

Academics 85

Academics Wellness Hospitals 85

ACEP Now

JULY 7, 2024

My current practice is a hybrid of academic and community sites, and I have worked in myriad community hospitals from busy ones to single coverage critical access hospitals. You are well prepared for this. Lead your room well. If the resuscitation does not go as well as you wanted, learn from it and move on.

Resuscitation 98

Resuscitation Risk Management Hospitals Critical Access 98

PHARM

JUNE 1, 2023

This cross-sectional study analyzes social media content from academic emergency medicine physicians and resident physicians to investigate changes in content a — Read on jamanetwork.com/journals/jamanetworkopen/fullarticle/2804673

Academics 40

Academics Wellness 40

Sensible Medicine

JULY 26, 2024

Although I found this advice a bit off-putting, I have to say that it has served me well in a career in academic medicine. A few weeks ago, I was asked to speak on the occasion of Dr. Mark Siegler ’s retirement. Mark was truly a giant in the field.

Academics 52

Academics Research Wellness 52