Tue.Jul 30, 2024

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Vascular And Nerve Injury After Knee Dislocation

The Trauma Pro

There’s a lot of dogma in trauma care, as well as in the field of medicine generally. The knee dislocation dogma is that the incidence of vascular injury is high (around 50%) with posterior dislocation and somewhat lower with non-posterior dislocation. At least, that’s what I learned way back when. After recently finding myself spouting off those numbers, I wondered if it was really true.

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Podcast – Button Battery Ingestion

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Listen to the podcast recorded live at the Premier Conference 2024. The post Podcast – Button Battery Ingestion appeared first on St.Emlyn's.

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EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma

Emergency Medicine Cases

In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity.

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Long-Term Outcomes in Patients Using Protocol-Directed Active Surveillance for Prostate Cancer

Sensible Medicine

A pretty good portion of what we post on Sensible Medicine could be considered critical appraisal of the medical literature. Whether it is John Mandrola’s Study of the Week column, my “Improving Your Critical Appraisal Skills” articles, or Vinay Prasad calling out articles that contend something other than what they actually show, this is clearly an interest of ours.

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SSS

ECG Guru

The ECG shows an example of a patient with bradycardia/tachycardia syndrome. Initially, a sinus rhythm with a heart rate of approx. 70 bpm is seen. This is followed by my sinus arrest of just under 3000 ms, followed by a junctional escape beat (no preceding P wave, QRS remains narrow). After a further pause of just under 2000 ms, 2 sinus node beats follow, which merge into a sinus tachycardia or atrial tachycardia (heart rate approx. 120 bpm here).

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AV Dissociation and Complete AV Block: What’s the Difference?

Kings County Downstate EM

Author: Dante Robinson, MDEditor: Esteban Davila, MDCase:A 77-year-old male with a history of hypertension and diabetes is brought into the ED by EMS after being found unresponsive. According to the patient’s daughter, the patient had been growing weak and complaining of pain on urination along with urinary frequency. While en […] The post AV Dissociation and Complete AV Block: What’s the Difference?

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Uncover innovative solutions to enhance the healthcare experience

NRC Health

Imagine navigating the complexities of modern healthcare, constantly adapting to new challenges while striving to provide an exceptional patient experience. This is the journey of Katie Arnett and Janet Hall from UK King’s Daughters. They will share their inspiring story and valuable lessons learned at Human Understanding Beyond | HUB 24 in San Diego, August 21–23.

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Wegovy: from slimming to fighting smoking

Emergency Live

According to recent research, the weight loss drug Wegovy could be a powerful ally in the fight against smoking A surprising discovery could revolutionize the way we deal with tobacco addiction. According to recent research, the drug Wegovy, heretofore known primarily for its efficacy in treating obesity, may harbor a powerful ally in the fight […] The post Wegovy: from slimming to fighting smoking appeared first on Emergency Live.

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AV Nodal Reentry Tachycardia on a Holter Monitor Strip

ECG Guru

The first 3 beats are sinus node beats, all have the same morphology of the P wave. This is followed by a PAC, which is conducted via the fast pathway in the AV node. The next PAC is conducted via the slow pathway, then the AV nodal reentry tachycardia (slow/fast) starts. The retrograde P waves are visible at the end of the QRS complex in the lower lead K3.

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Breakthrough in the fight against lung cancer: new treatment offers hope

Emergency Live

Lorlatinib, a new lung cancer drug. Recorded an 81% reduction in the risk of progression and death A breakthrough drug, lorlatinib, is proving to be a powerful weapon against lung cancer. In particular, it is revolutionizing the treatment of a particularly aggressive form of this cancer characterized by a specific genetic mutation, ALK. This mainly […] The post Breakthrough in the fight against lung cancer: new treatment offers hope appeared first on Emergency Live.

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Sick Sinus Syndrome

ECG Guru

The ECG shows an example of a patient with bradycardia/tachycardia syndrome (also called sick sinus syndrome). Initially, a sinus rhythm with a heart rate of approx. 70 bpm is seen. This is followed by sinus arrest of just under 3000 ms, followed by a junctional escape beat (no preceding P wave, QRS remains narrow). After a further pause of just under 2000 ms, 2 sinus node beats follow, which merge into a sinus tachycardia or atrial tachycardia (heart rate approx. 120 bpm here).

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Coconut: merits and demerits of the ultimate beach fruit

Emergency Live

From beach star to real media phenomenon. But what are the real properties of this exotic fruit? Coconut: superfood or mere fad? A real debate has been created around this tropical fruit, between those who extol its beneficial properties and those who emphasize its potential health risks. But what are the facts? Let’s look in […] The post Coconut: merits and demerits of the ultimate beach fruit appeared first on Emergency Live.

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Compassionate Care to Improve Patient Outcomes and Your Career from EMU 2024

Emergency Medicine Cases

As a profession, we suck at compassion as it is trained out of us through medical school and beyond. Compassion in not simply innate; like any behaviour, it can be learned through deliberate practice. There is evidence that compassion may improve morbidity and/or mortality in patients after trauma, cardiac events, cancer, diabetes, back pain, migraine headache and other conditions, prevent physician burnout and reduces rates of medical error, reduce the rates of patient complaints and litigation

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HIV prevention: the new injection every six months is enough

Emergency Live

The six-month injection of the new drug Lenacapavir has proven incredibly effective in preventing HIV infection A new chapter in the fight against HIV has opened with the results of the Purpose 1 study, presented at the 25th International AIDS Conference in Munich. The six-month injection of the new drug Lenacapavir proved incredibly effective in […] The post HIV prevention: the new injection every six months is enough appeared first on Emergency Live.

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Dyshopia mathematica

Life in the Fast Lane

Michelle Johnston Dyshopia mathematica The Crumbling Fabric of Society Gets a Scorecard. Emergency departments are collapsing, buckling over like weary gravity into an event horizon.

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AVNRT ON A HOLTER-STRIP

ECG Guru

The first 3 beats are sinus node beats, all have the same morphology of the P-wave. This is followed by a PAC, which is conducted via the fast pathway in the AV node. The next PAC is conducted via the slow pathway, then the AV nodal reentry cardia (slow/fast) starts. The retrograde P waves are visible at the end of the QRS complex in the lower lead K3.

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ECG of the Week 31st July

EMergucate

The following ECG is from a 67-year-old man who presents with dizziness and fatigue. He has a past history of ischaemic heart disease, hypertension and hypercholesterolaemia.

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ToxCard: PNU (Vacor)

EMDocs

Authors: Rosa Malloy Post (@postponemyloanz, Emergency Medicine Resident, Atrium Health’s Carolinas Medical Center); Christine Murphy, MD (Emergency Medicine Attending, Medical Toxicologist, Atrium Health’s Carolinas Medical Center) // Reviewed by: Christopher Counts, MD (Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); Cynthia Santos, MD (Emergency Medicine Attending, Medical Toxicologist, Rutgers New Jersey Medical School); James Dazhe Cao, MD (@JamesCaoMD, Associate

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Imaging Case of the Week 599

EMergucate

The following chest x-ray is from a 13-year-old with chest pain & dyspnoea. What can be seen?

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