Mon.Jan 13, 2025

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Maintenance of Prehospital Anaesthesia in Trauma Patients: Variability in Practice

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Explore the variability in maintaining prehospital anaesthesia for trauma patients in this comprehensive summary of a multinational survey. With insights into drug protocols, administration methods, and governance, the article highlights challenges and opportunities for standardisation in prehospital care.

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SAEM Clinical Images Series: Spontaneous Eye Luxation

ALiEM

A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.

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SGARBOSSA CRITERIA

ECG Guru

This ECG was sent to me by a friend, I don't know if he did it himself. The question was whether a heart attack can be recognized here. The patient is a 55-year-old man who has typical angina pectoris lasting more than 1 hour. What can you answer?

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Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest

EM Ottawa

Methodology: 4/5 Usefulness: 4/5 Vallentin MF, et al. N Engl J Med. 2024 Oct 31. doi: 10.1056/NEJMoa2407616. Editorial: The Way to a Patient’s Heart – Vascular Access in Cardiac Arrest Question and Methods: This RCT compared IO vs. IV vascular access in adults with OHCA, using ROSC as a primary outcome. Findings: No significant difference […] The post Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest appeared first on EMOttawa Blog.

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A 50-something man with Chest pain at triage

Dr. Smith's ECG Blog

A 50-something male presented to triage with chest pain for one day. An ECG was recorded quickly before any further history or physical exam: What do you think? When I saw this (presented at a conference), I immediately thought it looked like Thype 1 Brugada phenocopy (in other words, Type 1 Brugada ECG pattern ). There is an rSR' in lead V1 without any spike of the R'-wave.

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Transfusion in acute MI: what's the right hemoglobin target?

PulmCCM

A restrictive approach to red blood cell transfusion (e.g., transfusion to Hb ≥7-8 g/dL) is recommended in most critically ill patients after a mortality benefit was noted in the 1999 TRIC trial. Should patients with acute myocardial infarction, or cardiac disease generally, be transfused to the same hemoglobin targets as other critically ill patients?

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Medical Music Mondays: So Appy to See You

PEMBlog

Appendicitis! Rock Opera! McBurney’s point! Epic! Lyrics [Chorus] So Appy to see you Said the Surgeon to the doc Take out that appendix while I’m on the clock [Verse] Pain was vague then moved last night In the quadrant lower right Vomit and some hopping pain A fever now, can you explain? McBurney’s point and rebound Next step is an ultrasound Call the surgeon, call them quick Appendicitis made him sick [Chorus} So Appy to see you Said the Surgeon to the doc Take out that appen

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Total Anomalous Pulmonary Venous Drainage

Don't Forget the Bubbles

One-liner Neonate with persistent cyanosis? Think TAPVD. A 6-hour-old baby is brought to A+E with respiratory distress. On arrival, his oxygen saturations are 78% in the air. The baby was born at home at term. Mum had normal antenatal scans. Following birth the baby cried immediately, however has had increasing work of breathing and poor colour. The A+E team has started the baby on 15 L face mask oxygen, and his saturations are now 85%.

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Is watchful waiting for ductal carcinoma in situ (DCIS) safe? Preliminary results of the COMET trial

Science Based Medicine

Ductal carcinoma in situ is a precursor of breast cancer that is usually treated with surgery, radiation therapy, and estrogen blockade. A new study suggests that watchful waiting might be safe for some women with DCIS. The post Is watchful waiting for ductal carcinoma in situ (DCIS) safe? Preliminary results of the COMET trial first appeared on Science-Based Medicine.

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How to pass the FRCOphth part 1 as a Foundation Doctor

Mind The Bleep

The FRCOphth (Fellowship of the Royal College of Ophthalmologists) Part 1 exam is a significant milestone for those pursuing a career in ophthalmology. The incentive of doing the exam early is it is worth 3 points if you pass and 1 point for attempting it as per the 2025 ST1 recruitment portfolio. As an FY1/FY2, it might feel daunting to attempt a membership exam, especially in a specialty that generally had limited exposure at medical school.

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