Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. He presented tachycardic and hypotensive with a capillary refill time of 5 seconds. After 40ml/kg of IV 0.9% NaCl, his HR came down a little, but the effect was short-lived. He has an HR of 190/min, and his BP is 85/35 mmHg. The CRT is unchanged.

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Shock Sepsis Fluid Resuscitation Resuscitation 143

Science Based Medicine

NOVEMBER 27, 2023

Recent evidence shows that public trust in science and vaccines has declined markedly since the pandemic. Why is this, and is there anything we can do about it? The post Trust in science and vaccines continues to decline. Why? first appeared on Science-Based Medicine.

Research 137

Research 137

First 10 EM

NOVEMBER 27, 2023

Evidentiary amnesia is a term I use to describe the phenomenon I frequently encounter in which evidence seems to be forgotten over time. When I hear people lecture about the management of intracranial hemorrhage, and even when I invite incredibly smart people to write about neurologic emergencies, blood pressure management is always recommended. But why?

EMS 128

EMS 128

Life in the Fast Lane

NOVEMBER 27, 2023

Sheralyn Guilleminot and Mike Cadogan Innovative Applications of AI in Healthcare 4 Innovative Applications of AI in Healthcare (and 2 Important Precautions!) AI is a tool to complement your expertise, but that it shouldn’t be used as a substitute for your own good judgement.

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Sensible Medicine

NOVEMBER 27, 2023

Don’t get hung up on the specific medical problem. The point of this Study of the Week is how to think about trial results. The medical question comes up pretty often: What to do with moderate anemia (low red blood cell counts) in a patient recovering from a heart attack (myocardial infarction = MI)? (We measure something called the hemoglobin level or Hgb to quantify the anemia.

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Blood Transfusions Outcomes Hospitals 98

SheMD

NOVEMBER 27, 2023

Wondering if you can be a doctor and have a family? Or how you can manage being a parent AND a physician? We are bringing you stories of female physicians that prove you CAN do it! Dr. Sriraman joins us on the blog to discuss "mommy guilt" and how our children REALLY see us, as incredible Moms in Medicine. Flashback, 2004. I introduce myself to a female neighbor who I had never met and we started chatting.

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Pediatrics Research Operations 98

Dr. Smith's ECG Blog

NOVEMBER 27, 2023

Written by Jesse McLaren A 45 year old presented with two weeks of recurring non-exertional chest pain, now constant for an hour. Below is old and then new ECG (old on top; new below). What do you think? Both ECGs have normal sinus rhythm, normal conduction and normal voltages. There’s a change in axis that may interfere with direct lead-to-lead comparison, but there appear to be larger T waves in I/aVL and new TWI in III/aVF.

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EKG/ECG Documentation/Coding Wellness 96

EMDocs

NOVEMBER 27, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

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EMS Sepsis Burns EKG/ECG 71

ALiEM

NOVEMBER 27, 2023

A 24-year-old G1P0010 female with a PMHx of ovarian cyst (unknown laterality) and emergency contraceptive use 3 months prior presented with sudden onset abdominal pain (upper > lower) that awoke her from sleep four hours prior to presentation with associated nausea and mild lower back pain. The pain is 10/10, sharp, stabbing, and diffuse. Additionally, she reported trace white vaginal discharge at baseline.

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Ultrasounds Academics Operations OB/GYN 64

EM Ottawa

NOVEMBER 27, 2023

Methodology: 2/5 Usefulness: 2/5 Jansen JO, et al. JAMA. 2023 Oct 12:e2320850. Editorial: Contemporary Adjuncts to Hemorrhage Control. Question and Methods: Multi-center pragmatic Bayesian RCT comparing 90d all-cause mortality and 10 secondary outcomes in trauma patients with hemorrhage receiving REBOA + standard of care vs. standard of care alone Findings: At 90d, 54% of patients in the […] The post Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma

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Emergency Department Resuscitation Outcomes 56

University of Maryland Department of Emergency Med

NOVEMBER 27, 2023

Background: -Initial lactate clearance over 2 hours has been used to measure pt response to resuscitation in sepsis. However, data.

Sepsis 54

Sepsis Resuscitation 54

SheMD

NOVEMBER 27, 2023

As a first-year medical student, eager to start your journey as a future physician, you are filled with a range of emotions: fear, excitement, nervousness, happiness. I can recall distinctly just how anxiety provoking the unknowns of medical school were. I did not know what to expect, nor what I could do to prepare prior to starting the first year of medical school.

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Wellness Academics Research 52

EMergucate

NOVEMBER 27, 2023

Answers: PH = 7.479, that is mild acidaemia. HCO3 = 30 mmol/L (that is high). So, we have metabolic alkalosis. Next we check the respiratory compensation for metabolic alkalosis.

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Life in the Fast Lane

NOVEMBER 27, 2023

John Mackenzie and Yuigi Yuminaga Procedure: Male Seldinger catheter Emergency Procedure: Male Seldinger catheter.

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ACEP Now

NOVEMBER 27, 2023

The third annual Stanford Emergency Medicine Innovation Symposium (STEMI X) was held on June 22nd, 2023.This year’s Symposium featured a keynote presentation on digital transformation in emergency medicine from Dr. Jared Conley, multiple expert panels and round table discussions, and innovation workshops. Topics covered included doctor-driven disruption, innovation through entrepreneurship, and the revolutionary power of AI in the ED.

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Ziqitza HealthCare Ltd

NOVEMBER 27, 2023

As the winte­r season settles in and daylight be­comes scarce, it’s normal for our enthusiasm to diminish. However, it’s esse­ntial to prioritize physical activity during the cold months as it greatly contribute­s to our overall well-being. In this blog post, we­ will delve into the significance­ of staying active during winter, prese­nt various exercise options suitable­ for this time of year, explore­ indoor workout ideas, and highlight the role of Ziqitza He­althcare in promoting

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Wellness Ambulance Services 52

PulmCCM

NOVEMBER 27, 2023

Beta-blockers for septic shock (STRESS-L trial) Septic shock deranges multiple complex signaling systems in the body. Complement pathways, the “inflammasome” (cytokines, et al), the coagulation cascade, and many, many more systems have been implicated, carefully mapped, with potential molecular targets identified for intervention. After more than 100 randomized trials, no effective therapy has yet resulted ( drotecogin-alfa was withdrawn from the market after postmarketing testing sh

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Sepsis Shock Administration Leadership 52

Mind The Bleep

NOVEMBER 27, 2023

Introduction: This exploration of peri-orbital cellulitis and orbital cellulitis is designed to aid in the diagnosis and management of two distinct but closely related ophthalmological conditions that are commonly managed by both ENT and Ophthalmology services. It aims to provide medical professionals and students with a working understanding of these conditions, including aetiology, presentation, diagnosis, management, and complications.

Best Practices 52

Best Practices Outcomes Hospitals 52

Core Ultrasound

NOVEMBER 27, 2023

Fetal Heart Rate Estimating Gestational Age Ectopic Pregnancy The post 5 Minute Sono – Basic OB/GYN Scanning Technique first appeared on Core Ultrasound.

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OB/GYN Ultrasounds 40