The Trauma Pro
AUGUST 21, 2024
All trauma professionals need to keep up with the current thinking in their field. There are a variety of ways to do this, including lectures, courses, online curricula, meetings, and reading journal articles. The last method requires a bit of skill and patience. Many research papers are dry, long, and hard to read. Quite a few people do not have the patience to wade through them, and get lost in all the details.
Science Based Medicine
AUGUST 21, 2024
It’s interesting to follow the scientific exploration of a new clinical entity in real time. It reveals a lot about how medical science works, and how scientists nibble away at complex problems. This is partly why I have been closely following the story of long COVID as it has unfolded over the last few years. I also see patients with long COVID […] The post More on Long COVID first appeared on Science-Based Medicine.
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St. Emlyn
AUGUST 21, 2024
St.Emlyn's - Emergency Medicine #FOAMed Listen to the podcast recorded live at the Premier Conference 2024 about neuroprotection in the prehospital phase of care. The post Podcast – Prehospital Neuroprotection appeared first on St.Emlyn's.
Emergency Medicine Journal
AUGUST 21, 2024
Background and introduction The ED is often perceived as noisy. Excessive noise has deleterious effects on health and productivity. This study evaluated if a package of noise-reducing interventions altered workload, physical complaints, productivity and room acoustics. Methods This was an observational pre-post implementation study. It was performed in our non-academic ED in the Netherlands from July 2021 to April 2022.
Intensive Blog
AUGUST 21, 2024
As prepared by Chris Nickson, here are the practice written questions from a recent CICM Second Part exam practice session at The Alfred ICU, with recommended reading from LITFL.com Critical Care Compendium and other FOAM sources: Q1. Discuss the advantages and disadvantages of using pulse oximetry to target oxygen therapy (50%) What SpO2 targets do you use in ICU patients and why?
Emergency Medicine Journal
AUGUST 21, 2024
Aim Junior doctors joining EDs are required to rapidly acquire new knowledge and skills, but there is little research describing how this process can be facilitated. We aimed to understand what would make ED formal induction and early socialisation more effective. Methods Qualitative study; informal interviews of junior doctors, consultants and nursing staff and direct observation of clinical interactions, induction and training in a single ED in an English Emergency Department between August an
EMergucate
AUGUST 21, 2024
Question 1: PH = 7.23, that is moderate acidaemia.
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EMergucate
AUGUST 21, 2024
Febrile convulsions This quick hits covers febrile seizures, what to do about them and what their prognosis is.
Emergency Medicine Journal
AUGUST 21, 2024
There is evidence that the actual shelf lives of some drug products are greater than their labelled expiration dates. When transported and stored correctly, many products have been found to remain stable for several months or in specific cases even years after reaching their labelled expiration date. In the USA, a shelf-life extension programme has been developed to generate stability data beyond labelled expiration dates. 1 In their EMJ paper, Soopairin et al systematically review existing prec
EMergucate
AUGUST 21, 2024
Urticaria This quick hits shows lots of examples of different forms of urticaria, what can cause it and how to … Continue reading →
Emergency Live
AUGUST 21, 2024
The nurses and the driver had to rely on a doctor who was accidentally on the beach An episode that has exposed the fragility of the territorial emergency system has upset the quiet Sunday of many Pesaro and tourists. A couple of men in their 50s, venturing past buoys into an unguarded area of the […] The post Emergency at the beach in Marotta: couple may drown, doctors are missing appeared first on Emergency Live.
EMergucate
AUGUST 21, 2024
Gastroenteritis One of the most common paediatric presentations. But do you feel confident assessing levels of dehydration?
Emergency Live
AUGUST 21, 2024
Research team has found that during breastfeeding, the female brain produces a hormone which protects the bones For centuries, breastfeeding was considered an act of love and nurturing for infants. But only recently, science has begun to unravel its deepest secrets and the benefits it brings not only to children, but also to mothers. A […] The post Breastfeeding: the key to stronger bones appeared first on Emergency Live.
EMergucate
AUGUST 21, 2024
Limping Child This presentation covers the various differentials for a limping child, the investigations required and what (if any) urgent … Continue reading →
Emergency Live
AUGUST 21, 2024
Brain magnetic stimulation can be used to slow ALS progression, according to a recent report A recent Italian study has brought a breath of optimism in the fight against Amyotrophic Lateral Sclerosis (ALS). A study conducted by the University Polyclinic Foundation Campus Bio-Medico and the Italian Auxological Institute IRCCS Foundation showed promising results in the […] The post Magnetic stimulation brings new hope to ALS patients appeared first on Emergency Live.
EMergucate
AUGUST 21, 2024
Pulled elbow This presentation above covers why a pulled elbow occurs, what investigations are required and tips for when reducing … Continue reading →
Emergency Live
AUGUST 21, 2024
Over 125 firefighters involved. Long and complex quenching operations, avoided the worst A thick smoke has risen over the beating heart of London, enveloping the historic Somerset House in a grey blanket. A fire, the causes of which are still to be determined, has shaken the city, mobilizing more than 125 firefighters who have fought […] The post London: Somerset House on fire appeared first on Emergency Live.
Ziqitza HealthCare Ltd
AUGUST 21, 2024
A severe form of pneumonia, legionnaires disease is caused by a bacteria called legionella. These bacteria surround corners and water systems and cause severe lung infections. Exposure to legionella happens by breathing in droplets that are contaminated with it. This exposure can lead to various symptoms like cough, intense fever, vomiting, runny stool, severe headache, shortness of breath, muscle aches and excessive sweating.
Emergency Live
AUGUST 21, 2024
The city has been tested by heavy rains, wind gusts and lightning, which have caused numerous damages A violent storm has hit Pesaro, transforming in a few minutes an apparently quiet day into a chaos of water, wind and thunder. The city has been severely tested by heavy rains, wind gusts and lightning, which have […] The post Pesaro: city paralyzed by fallen trees and flooding appeared first on Emergency Live.
Emergency Medicine Journal
AUGUST 21, 2024
We would like to express our congratulations to Sharifi et al for their recently published randomised, double-blinded clinical trial comparing methocarbamol to diazepam in the treatment of acute back pain in the ED. 1 Although skeletal muscle relaxants (SMR) are frequently (and controversially) used in the treatment of low back pain (LBP), there has been a paucity of data to suggest their clinical benefit. 2 To our knowledge, this is one of the first investigations that demonstrates the efficacy
Emergency Live
AUGUST 21, 2024
The rape and murder of a young female doctor trainee has triggered outrage beyond the medical community A heinous crime shook India and led doctors from all over the country to call for a national strike. The rape and murder of a young female doctor trainee at the prestigious R G Kar Medical College in […] The post India: doctors on strike after a colleague’s rape appeared first on Emergency Live.
Emergency Medicine Journal
AUGUST 21, 2024
A short systematic review was undertaken to assess whether adult patients presenting to the ED with a first seizure require a CT head scan to rule out emergent intracranial pathology. MEDLINE, EMBASE, Cochrane and Google Scholar databases were searched. Seven relevant papers were identified. Study information, patient characteristics, key results and methodological weaknesses were tabulated.
Emergency Live
AUGUST 21, 2024
The flood caused flooding of the stream. Several houses damaged and the center of the village was flooded The flood event in Tyrol, especially the district of Landeck and the area of St. Anton am Arberg, is a significant case study for emergency workers. The flood, which caused landslides and flooding, caused the flood of […] The post Flood in Tyrol: a stream has flowed to St.
Emergency Medicine Journal
AUGUST 21, 2024
Introduction This month’s update is by the Emergency Department Collaborative Research Group, St George’s University Hospitals NHS Foundation Trust 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.
PulmCCM
AUGUST 21, 2024
All nutritional strategies in critical care are based on hypothesis and conjecture. No strategy for delivery of caloric content (e.g., higher or lower) or mix of macronutrients has been shown to be beneficial over any other.
Emergency Medicine Journal
AUGUST 21, 2024
Case presentation A 61-year-old man presented to the ED with left eye pain and blurred vision, after being hit by tree branches while riding his motorbike. His only medical history was hypertension. The ophthalmological evaluation revealed a laceration on the left upper eyelid and conjunctiva with inferior rectus muscle dehiscence. His visual acuity based on a Snellen chart was 0.2 in the left eye.
Sensible Medicine
AUGUST 21, 2024
In Post #1 , Ms. Fama introduced and summarized her critical appraisal of the “Back to Sleep” campaign. In Post #2 she explored the possible downsides of supine sleep for infants. In Post #3 she gave us numbers on SIDS. This week, Ms. Fama reviews the evidence linking sleep position and SIDS. It’s a tour de force. Readers of Sensible Medicine may notice many common lessons in this evidence review.
Emergency Medicine Journal
AUGUST 21, 2024
The stability of antivenoms has been the subject of numerous studies. A recent review of the literature highlights the convergence of these studies demonstrating the efficacy and safety of expired antivenoms. 1 However, as the authors point out, the results do not come from randomised clinical trials, which alone could validate the use of expired antivenoms without loss of opportunity for the patient.
Emergency Medicine Journal
AUGUST 21, 2024
Introduction Limited access to antivenoms is a global challenge in treating snakebite envenoming. In emergency situations where non-expired antivenoms are not readily available, expired antivenoms may be used to save lives with the risk of deteriorating quality, efficacy and safety. Therefore, we aimed to systematically review and summarise the sparse preclinical evidence of neutralising efficacy of expired antivenoms and real-world experience of using expired antivenoms in humans.
Emergency Medicine Journal
AUGUST 21, 2024
Background Emergency medicine (EM) consultants are expected to provide leadership to facilitate optimal clinical results, effective teamwork and learning. To foster leadership skills, the Emergency Medicine Leadership Programme (EMLeaders) was launched in 2018 by the Royal College of Emergency Medicine (RCEM), Health Education England and National Health Service England.
Emergency Medicine Journal
AUGUST 21, 2024
A recent study based on Royal College of Emergency Medicine (RCEM) audit data concluded that it was not possible to identify an ED in the UK that performed consistently well in the assessment and management of pain. 1 Acute pain following rib fractures leads to a number of potential pulmonary complications, as a result of reduced inspiratory effort, weak cough and immobility. 2 Without prompt and effective analgesia, first-line interventions to reduce the risk of pulmonary complications such as
Emergency Medicine Journal
AUGUST 21, 2024
Background Older patients living with frailty have an increased risk for adverse events. The Clinical Frailty Scale (CFS) is a 9-point frailty assessment instrument that has shown promise to identify frail emergency department (ED) patients at increased risk of adverse outcomes. The aim of this study was to investigate the association between CFS scores and 30-day mortality in an ED setting when assessments are made by regular ED staff.
Emergency Medicine Journal
AUGUST 21, 2024
Clinical Introduction A 22-year-old woman presented to the emergency department with a painless lesion on the thenar eminence of her left hand ( figure 1 ). This originally started as a small wound from a cut 2 weeks prior. Of note, she was working with sheep before the lesion developed. She had no previous medical history, and she was not on any medications.
Emergency Medicine Journal
AUGUST 21, 2024
The Clinical Frailty Scale (CFS) uses clinician judgement to quantify the functional impacts of multidimensional health deficits. 1 The CFS has become widely adopted in research and clinical settings and has been recommended in the UK for routine administration with adults aged 65+ years with unscheduled hospital attendances. Frailty screening at ED triage has been recommended for its potential to alter downstream processes and attune care to the individual.
Emergency Medicine Journal
AUGUST 21, 2024
September is upon us. Summer is not quite gone, and yet, we have already welcomed our newest junior doctors on their first rota in the ED. Our junior doctors change work environments frequently, but perhaps no change is as dramatic as moving from medical school—or a relatively predictable ward—to work in the ED. The first few days (or weeks) in an ED can be, frankly, scary.
Emergency Medicine Journal
AUGUST 21, 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
AUGUST 21, 2024
Electronic patient records (EPRs) are potentially valuable sources of data for service development or research but often contain large amounts of missing data. Using complete case analysis or imputation of missing data seem like simple solutions, and are increasingly easy to perform in software packages, but can easily distort data and give misleading results if used without an understanding of missingness.
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