Dr. Smith's ECG Blog
SEPTEMBER 25, 2024
This is another case sent by the undergraduate (who is applying to med school) who works as an EKG tech. The undergraduate is now willing to identify himself: Hans Helseth. A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion.
St. Emlyn
SEPTEMBER 25, 2024
St.Emlyn's - Emergency Medicine #FOAMed This is the first of a series of blog posts on new research in emergency toxicology. We deal with all sorts of poisons here in Virchester, so be prepared for […] The post When is emergency endoscopy required for caustic ingestions? appeared first on St.Emlyn's.
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Emergency Medicine Journal
SEPTEMBER 25, 2024
Background Emergency Medical Services (EMS) studies have shown that prehospital risk stratification and triage decisions in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) can be improved using clinical risk scores with point-of-care (POC) troponin. In current EMS studies, three different clinical risk scores are used in patients suspected of NSTE-ACS: the prehospital History, ECG, Age, Risk and Troponin (preHEART) score, History, ECG, Age, Risk and Troponin (HEART) s
Science Based Medicine
SEPTEMBER 25, 2024
Myopia, or near-sightedness, has been steadily on the rise over the last half-century. A recent systematic review updates the literature on the extent and nature of this epidemic. Let’s get straight to the findings and then discuss what this means. The reviews includes: “276 studies, involving a total of 5,410,945 participants from 50 countries across all six continents.” The researchers find a […] The post Myopia Epidemic first appeared on Science-Based Medicine.
Dr. Smith's ECG Blog
SEPTEMBER 25, 2024
Submitted by Dr. George Mastoras (Twitter @georgemastoras), written by Jesse McLaren It’s a busy day in the ED when you’re sent another ECG to sign off from a patient at triage. A healthy 45-year-old female presented with chest pain, with normal vitals. The computer interpretation was “ST elevation, consider early repolarization, pericarditis or injury.
NRC Health
SEPTEMBER 25, 2024
A recent NRC Health webcast discussed the intersection of artificial intelligence (AI) and empathy in healthcare. Check out the key takeaways and watch the webcast on demand today. The post AI and the future of Human Understanding in healthcare appeared first on NRC Health.
ALiEM
SEPTEMBER 25, 2024
A 24-year-old male with a history of microscopic hematuria presented to the emergency department (ED) with left lower quadrant abdominal pain. His pain started about two weeks ago and has been intermittent. He describes the pain as stabbing. He decided to come to the ED today because of the persistent nature of the pain. He denies chest pain, cough, shortness of breath, fevers, nausea, vomiting, diarrhea, constipation, rectal bleeding, dysuria, and increased urinary frequency.
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Emergency Live
SEPTEMBER 25, 2024
The BioNTech laboratory has developed a new anti-tumour treatment based on a new mRNA vaccine The medical world is witnessing an unprecedented evolution in cancer treatment. At the heart of this revolution is a new protagonist: the vaccine. No longer limited to the prevention of infectious diseases, the vaccine is proving to be a promising […] The post A new era in the fight against lung cancer: mRNA vaccine appeared first on Emergency Live.
PEMBlog
SEPTEMBER 25, 2024
PEMPix is the American Academy of Pediatrics Section on Emergency Medicine’s annual visual diagnosis competition. This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. This is the third of the four cases. This case was submitted by Dr.
Emergency Live
SEPTEMBER 25, 2024
Estrogen-based TOS could offer strong long term protection against heart disease A new study on hormone replacement therapy (HRT) has yielded groundbreaking results. The results, presented to the Chicago Menopause Society, indicate that estrogen-based OT could offer strong long-term protection against heart disease. TOS: a lively safety debate For over twenty years, the TOS has […] The post Hormone therapy and heart: new hope for menopausal women appeared first on Emergency Live.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Leadership in emergency medicine is a routine part of day-to-day practice. Being a trauma team leader, emergency physician in charge or clinical lead all look very different and require a range of skills, but are all certainly forms of leadership that have a significant impact on the running of an emergency department, patient outcomes and, as is increasingly being recognised, staff well-being. 1 The EMLeaders programme was launched in 2018 as a collaboration between the Royal College of Emergen
Sensible Medicine
SEPTEMBER 25, 2024
“To see what is in front of one's nose needs a constant struggle." -- George Orwell Last week, #VarmaGate broke out. Jay Varma, NYC Public Health official, admitted on hidden camera that he, his pediatrician wife, and 8 to 10 others, gathered in a hotel room, took Molly, striped naked, and engaged in a sex party, while NYC schools were closed, shops were locked-down, dying patients were denied hospital visitors, and outdoor funerals were banned under his decree.
Emergency Medicine Journal
SEPTEMBER 25, 2024
This month’s update is by the Liverpool Emergency Department Research Unit Strategy Team. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.
Emergency Medicine Journal
SEPTEMBER 25, 2024
A shortcut review of the literature was conducted to examine whether administering a sphenopalatine ganglion (SPG) block provides symptomatic relief in adult patients with acute migraine. 381 papers were found of which 4 included data on patients relevant to the specific clinical question, these are discussed in the paper. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated.
Emergency Medicine Journal
SEPTEMBER 25, 2024
There are approximately 180 000 deaths per year from thermal burn injury worldwide. Most burn injuries can be treated in local hospitals but 6.5% require specialist burn care. The initial ED assessment, resuscitation and critical care of the severely burned patient present significant challenges and require a multidisciplinary approach. The management of these patients in the resuscitation room impacts on the effectiveness of continuing care in the intensive care unit.
Emergency Medicine Journal
SEPTEMBER 25, 2024
People experiencing the highest levels of social deprivation are more likely to present to emergency care across the spectrum of disease severity, and to have worse outcomes following acute illness. Emergency medicine in the UK and Europe has lagged behind other regions in incorporating social emergency medicine into practice. There is evidence that emergency clinicians have the potential to mitigate health inequalities, through advocacy and intervention supported by high-quality research, while
Emergency Medicine Journal
SEPTEMBER 25, 2024
Severe disability due to large vessel occlusion (LVO) stroke can be avoided by emergency mechanical thrombectomy (MT) 1 but provision varies nationally and internationally according to the availability of specialist facilities. Across England, Wales and Northern Ireland, only 26 hospitals can offer treatment, 2 and the majority of stroke patients are instead admitted to local non-MT hospitals.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Ambulance crew’s main focus during stroke care is symptom recognition and rapid transport to specialist units to maximise access to and effectiveness of time-critical treatments. However, in England, ambulance on-scene times (OSTs) (from when the ambulance arrives at the patients’ location to when it leaves for the hospital) have increased in recent years 1 and appear extended compared with international services. 2 3 Increased OSTs contribute to deteriorating symptom onset to arriva
Emergency Medicine Journal
SEPTEMBER 25, 2024
Clinical introduction A woman in her 60s with a history of hypertension and diabetes arrived at the emergency department reporting chest pain persisting for the past 4 hours. Describing it as retrosternal and crushing, she noted radiation to her right arm, accompanied by sweating and palpitations. She had a resting pulse of 70 bpm and blood pressure of 130/80 mm Hg.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Background Forearm fractures are a common ED presentation. This study aimed to compare the resource utilisation of three anaesthetic techniques used for closed forearm fracture reduction in the ED: haematoma block (HB), Bier’s block (BB) and procedural sedation (PS). Methods A retrospective multicentre cohort study was conducted of adult patients presenting to either Port Macquarie Base Hospital ED or Kempsey District Hospital ED in New South Wales, Australia, from January 2018 to June 202
Emergency Medicine Journal
SEPTEMBER 25, 2024
Procedural sedation (PS) is a frequently performed clinical practice in the ED 1 aiming to facilitate a state that allows patients to tolerate uncomfortable procedures. 2 The ideal agent for PS in the ED should provide anxiolysis, analgesia and amnesia in a rapid and predictable manner, with minimal adverse events and a rapid recovery phase. 3 Remimazolam (RMZ) is a novel benzodiazepine with rapid conversion into an inactive metabolite, making it ultra-short acting.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Currently, various sedative agents are widely used and researched for procedural sedation in EDs. Ensuring safe and effective sedation during painful procedures necessitates appropriate patient selection, a thorough understanding of drug safety profiles and awareness of potential patient–drug interactions. Remimazolam, a sedative previously evaluated in intensive care and anaesthesiology units, has seen more extensive exploration in ambulatory procedural sedation, particularly for endoscop
Emergency Medicine Journal
SEPTEMBER 25, 2024
Clinical introduction A 50-year-old man presented to the ED with a 3-week history of weakness and malaise. Upon examination, he was found to have a distinctive fetor and a fine whitish powdery deposit covering his body, especially prominent on his face ( figure 1 ). The skin findings are shown. Question What is the most likely diagnosis for this patient?
Emergency Medicine Journal
SEPTEMBER 25, 2024
The experience of forced migration is recognised as a key determinant of health and well-being. Asylum seekers and refugees (ASRs) are among the most vulnerable and marginalised members of many societies. Since 2022, the United Nations High Commissioner for Refugees has reported severe humanitarian disasters in Afghanistan, Africa and the Middle East—all of which have resulted in mass movement of people towards European shores.
Emergency Medicine Journal
SEPTEMBER 25, 2024
As ED clinicians, I think it is fair to say that we all want to do our best for anyone who presents to us for care. To paraphrase an interviewee in the Editor’s choice article ‘if you come (to ED) for help, you get help.’ Recently, in the UK and Europe in particular, the narrative around asylum seekers and refugees has become even more emotionally and politically charged.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Background The number of asylum seekers awaiting decisions on their claims in the UK has more than tripled since 2014. How we meet international obligations to provide appropriate healthcare to asylum seekers and refugees (ASRs) is therefore an increasingly important issue. The views of frontline healthcare workers are vital to ensure the development of sustainable and effective health policy when it comes to caring for this group.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Background Ultrasound-guided (USG) erector-spinae plane block (ESPB) may be better than intravenous opioids in treating acute hepatopancreaticobiliary (HPB) pain in the ED. Methods This open-label randomised controlled trial was conducted in the ED of a tertiary-care hospital between March and August 2023. All adult patients with severe HPB pain were recruited during times that a primary investigator was present.
Emergency Medicine Journal
SEPTEMBER 25, 2024
Background There is compelling evidence that AXRs have limited clinical value in the acute setting. Despite this, they are frequently used in many EDs. This quality improvement project (QIP) aimed to reduce unnecessary AXR use in a single-centre ED. Method All consecutive AXRs conducted on patients aged 16 years and above in a District General Hospital ED in England between 2 August 2021 and 5 June 2022 were included.
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