Science Based Medicine

DECEMBER 11, 2023

A new study is making the rounds in the antivax crankosphere. The study found that the modified mRNA used in the Pfizer vaccine can cause a frame shift (to be explained) that results in the production of proteins besides the intended spike protein. The findings are, as you probably guessed, a big nothingburger compared to how they are being spun. The post Do mRNA vaccines produce harmful “junk proteins” that “gunk up” the cell and cause unintended “off-target” immune responses?

Documentation/Coding 144

Documentation/Coding 144

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Occlusion myocardial infarction is a clinical diagnosis Written by Willy Frick (@Willyhfrick). Willy is a cardiology fellow with a keen interest in the ECG in OMI. A woman in her late 70s presented with left arm pain. The arm pain started the day prior when she was at the dentist's office for a root canal. Her systolic blood pressure at the dentist was over 200 mm Hg.

EKG/ECG 121

EKG/ECG Outcomes Academics Documentation/Coding 121

EMDocs

DECEMBER 11, 2023

Authors: Genevieve Pentecost, MD (@genpentecost, Emergency Medicine Resident, Washington University School of Medicine in St Louis) and Aaron Lacy, MD (@AaronLacyMD, Assistant Professor of Emergency Medicine, Washington University School of Medicine in St Louis) // Reviewed by: Jamie Santistevan, MD (EM Physician, Presbyterian Hospital, Albuquerque, NM); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Introduction Welcome back to ECG Pointers from emDOCS.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

Emergency Live

DECEMBER 11, 2023

Exploring emerging technologies in civil protection The evolution of technology in civil protection Emerging technologies are revolutionizing the field of civil protection, offering new tools and methods to improve response and emergency management. These innovations, including artificial intelligence, drones, IoT sensors and augmented reality, are radically changing the way civil protection agencies prepare for and […] The post Cutting-edge technology in civil protection: innovations to e

105

105

Sensible Medicine

DECEMBER 11, 2023

This one hits at the heart of my field—the ablation of atrial fibrillation. Current thinking holds that the way to ablate AF is to electrically isolate the muscle bundles going in and out of the pulmonary veins. Think of it as building an electric fence around the pulmonary veins. We use different energy sources to ablate the tissue. This is a picture I made in 2012.

Operations 105

Operations Hospitals 105

Emergency Live

DECEMBER 11, 2023

Cutting-edge strategies for diabetic patient care in emergency situations Diabetes, a chronic disease affecting millions worldwide, poses a significant challenge for emergency services. Managing diabetes in emergency situations requires specific knowledge and effective strategies to ensure timely and adequate treatment for diabetic patients, who may face acute complications like hypoglycemia or hyperglycemia under critical conditions. […] The post Battling Diabetes on the Frontline: Innova

105

105

First 10 EM

DECEMBER 11, 2023

Welcome back to another edition of the research roundup, where we discuss an eclectic collection of articles selected through the rigorous process of whatever I happened to find most interesting in my recent reading (with a couple suggestions from Dr. Casey Parker). The BroomeDocs podcast version can be found here: [link] Our poorly managed hospitals […] The post Research Roundup (December 2023) appeared first on First10EM.

Research 103

Research Hospitals Pediatrics EMS 103

ACEP Now

DECEMBER 11, 2023

The wave of increasing hospital closures and service line cutbacks continues to sweep the U.S. A recent article documents 56 additional U.S. hospitals that are closing clinical departments or ending or reducing services. Cited are issues of “shoring up finances,” “staffing shortages,” or “focusing on more in-demand services” as driving forces. 1 This adds to the over 640 (mostly rural) hospitals that recently failed financial stress tests and are adjudged to be at imminent risk of closing. 2 Of

Hospitals 98

Hospitals Administration Documentation/Coding Research 98

Emergency Live

DECEMBER 11, 2023

Reflections on the importance of compassionate and accessible healthcare for all The lost vocation of medicine Medicine, historically seen as a vocation and service to humanity, is gradually losing this essence. The profession now faces a paradigm where technical skills overshadow the sense of service and solidarity toward patients. This shift profoundly impacts the doctor-patient […] The post Medicine between vocation and competence: a path towards more equitable care appeared first on Em

105

105

Taming the SRU

DECEMBER 11, 2023

PATIENT PRESENTATION A young woman with a past medical history of major depressive disorder presented to the emergency room via EMS for a report of intentional ingestion of an unknown substance. EMS reported that she was vomiting profusely on their arrival to the scene but during transport became increasingly lethargic. She was given intranasal Narcan with no improvement in clinical condition.

EMS 96

EMS Psychiatric Emergency Department Poisoning 96

Emergency Live

DECEMBER 11, 2023

Innovation and challenges in the care of oncological patients in emergency situations Urgent Oncology: A New Frontier Emergency oncology has become a key field in cancer patient care. Emergency services are often the first contact point for oncological patients presenting with acute complications, making effective and timely management crucial. Complications Related to Oncological Treatments Complications […] The post Frontiers of Oncology in Emergency Care: Prehospital Cancer Management a

105

105

PulmCCM

DECEMBER 11, 2023

Thank you all for supporting PulmCCM by reading, sharing, and commenting since its relaunch in May. To those who have been able to contribute financially, I’m especially grateful. I hope you continue to find it valuable. Wishing you all a safe and happy holiday season! -Matt Read Dr. Jon-Emile Kenny’s other posts in this series here. Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid

Sepsis 83

Sepsis Stroke Shock Infectious Diseases 83

Board Bombs

DECEMBER 11, 2023

This may come as a surprise to you, but whole body MRIs don't help in this condition. What's more surprising is that ESR is more helpful than MRI here. What? Listen and let's talk temporal arteritis- an uncommon, scary cause of headaches. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here.

52

52

Emergency Live

DECEMBER 11, 2023

An in-depth analysis of rescue operations and their effects on the affected community The devastating impact of Hurricane Otis Hurricane Otis, a Category 5 storm, violently struck the Pacific coast of Mexico, leaving behind a trail of destruction and death. With winds reaching 165 mph, it particularly devastated the city of Acapulco, causing extensive damage […] The post Hurricane Otis in Mexico: Response to Devastation and Loss of Life appeared first on Emergency Live.

Operations 52

Operations 52

ACEP Now

DECEMBER 11, 2023

Many conditions outside of acute coronary syndrome (ACS) mimic ST-elevation myocardial infarction (STEMI), but only a handful of cases have reported ST-elevations (STE) in the setting of pancreatic inflammation where underlying ACS was excluded. 1,2 While acute pancreatitis can involve electrocardiographic changes in up to 50 percent of cases, the exact mechanism causing STE remains unknown. 3,4 Patients with ST segment elevation in the absence of classic ACS symptoms presents a dilemma for emer

EKG/ECG 52

EKG/ECG Hospitals Stroke Emergency Department 52

Emergency Live

DECEMBER 11, 2023

From physical preparation to prevention of major accidents Intensive Preparation for the Ski Season With the arrival of the 2023 ski season, the italian National Alpine and Speleological Rescue Corps (CNSAS) is engaged in intensive preparation. Recently, in Solda (Bolzano province, Italy), a crucial course dedicated to alpine rescue was held in preparation for safety […] The post 2023 Ski Season: Alpine Rescue and Accident Prevention appeared first on Emergency Live.

52

52

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. The preliminary 2022 report contained performance measures for 938 EDs that managed more than 46 million patient visits, plus 222 additional freestanding EDs that served more than 4 million patients.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

Don't Forget the Bubbles

DECEMBER 11, 2023

Adverse Childhood Experiences (or ACEs, for short) are no new thing, but only in recent decades have we come to realise the scope of their impact on children and the adults they become. ACEs can broadly be defined as traumatic events occurring before age eighteen. What counts as an ACE is open for interpretation, with the official domains liable to change.

Wellness 104

Wellness Research Outcomes Shock 104

ACEP Now

DECEMBER 11, 2023

Patients with severe agitation are frequently encountered in the emergency department (ED) setting. The first steps in the management of agitation are de-escalation and calming techniques, situational modifications, and, if needed, oral medications. Unfortunately, these techniques may be insufficient. Emergency departments can be crowded and chaotic, further exacerbating mental health issues.

Emergency Department 52

Emergency Department Pediatrics Research Hospitals 52

ACEP Now

DECEMBER 11, 2023

In September, a surprising publication by the U.S. Food and Drug Administration regarding the efficacy of oral phenylephrine as a nasal decongestant, caused a ruckus. 1 This publication would not come as a surprise to those following the past 15 years of efforts by the research teams examining phenylephrine. While they conclude that phenylephrine lacks efficacy, there remain important limitations to the scope of this action.

Administration 64

Administration Outcomes Research Stroke 64