Ken Grauer, MD
MARCH 11, 2024
I was asked to interpret the 2-lead rhythm strip shown in Figure-1 — without the benefit of any history. What are YOUR thoughts? Is there AV block? If so — Is it complete AV block? Figure-1: You are asked to interpret this 2-lead rhythm strip without the benefit of any history. = NOTE: Today's rhythm is challenging — especially if you have not seen this type of rhythm before.
ACEP Now
MARCH 11, 2024
ACEP Now wishes to congratulate the medical students who matched into emergency medicine today! This year, it is estimated that only about 137 of more than 3,000 spots remained unfilled as of Monday, March 11, 2024. This is in comparison to more than 550 unmatched positions last year. While the full explanation for the rebound in emergency medicine remains unknown, one potential reason is a large increase in international medical graduate applicants this year.
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Science Based Medicine
MARCH 11, 2024
Prions. Why did it have to be prions? (Again.) The antivax trope that vaccines cause prion disease is an old one, and antivaxxers are trying desperately to resurrect it to apply to COVID-19 vaccines. The post Prions. Why did it have to be prions? (Again.) first appeared on Science-Based Medicine.
Sensible Medicine
MARCH 11, 2024
Dear readers. the Study of the Week will need to take two weeks off. I am traveling and lecturing in Denmark. Today I post this amazing explainer on statistics. I have read a lot on the p-value and confidence interval, and this may be the best explainer I have read. It may also be the best post we have ever had on Sensible Medicine. We are grateful to the authors and to our readers.
Taming the SRU
MARCH 11, 2024
Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). Knee dislocations make up less than 0.5% of all orthopedic injuries and may be difficult to recognize if the dislocation spontaneously reduces prior to care in the Emergency Department, which may occur in upwards of 50% of cases (3).
American Medical Compliance
MARCH 11, 2024
Amidst the busy dental appointments, treatments, and patient care, there are crucial aspects that often operate in the background but hold importance. These are recordkeeping and documentation. While the primary focus in dentistry is patient health and well-being, carefully keeping records is equally needed. In a survey , dental providers agree that careful and precise recordkeeping is indispensable, emphasizing the importance of documenting elements such as patient histories, examination result
First 10 EM
MARCH 11, 2024
The time has come to learn from the pandemic; to learn from our mistakes (and hopefully a few successes). There are many topics to choose from. In future posts, I plan to be very positive about the tremendous work done by so many colleagues. I will probably also have to write about our incredible scientific […] The post Lessons from the pandemic: Lagging indicators appeared first on First10EM.
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Intensive Blog
MARCH 11, 2024
Everything ECMO 047: ECMO Retrieval in Victoria Author: Dr Chris Parry Peer reviewers: Dr David Anderson , Dr Andy Paton You are doing a Locum ICU shift in Mildura. It’s 23:30 on a Friday and you have just intubated a 160 kg 50yo male for respiratory failure. Despite a PEEP of 18 cmH20 and an Fi02 100% you can’t adequately oxygenate the patient. His saturations are hovering in the high 80’s.
Don't Forget the Bubbles
MARCH 11, 2024
A 4-month-old boy presents to the paediatric ED. His parents are concerned about the appearance and shape of his head. They ask how this can be fixed. Before we get into the clinical case, let’s consider some anatomy and background. Sutures and skull development in infancy The skull is made up of five bones – two frontal bones , two parietal bones and an occipital bone.
Intensive Blog
MARCH 11, 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. You are referred a critically ill patient who has methaemoglobinaemia. List 6 possible causes (20%) What are the clinical features of methaemoglobinaemia?
NRC Health
MARCH 11, 2024
During February’s Becker’s Hospital Review podcast, Gregory Makoul, Ph.D., M.S., Chief Transformation Officer at NRC Health, joined host Erica Spicer-Mason to discuss the latest findings from the NRC Health 2024 Experience Perspective Report. The post Explore key takeaways from the 2024 Experience Perspective on the Becker’s Healthcare podcast appeared first on NRC Health.
RebelEM
MARCH 11, 2024
A 42-year-old man presents to the emergency department after a motor vehicle collision. He has no medical problems. He sustained a crush injury to his left leg and a prolonged extraction time. He is agitated and reporting significant pain. His left leg is mottled with significant ecchymoses and gross deformity below the left knee. Pulses are intact.
ALiEM
MARCH 11, 2024
In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. His symptoms included malaise, body aches, subjective fevers, a sore throat, tender, swollen neck glands, body rash, and irritation of his left eye.
PulmCCM
MARCH 11, 2024
Palliative care programs are sometimes pitched to administrators on the basis of their potential to reduce costs, by shortening length-of-stay or intensity of expensive and unhelpful therapies at the end of life. Observational data suggests palliative care consultation might reduce length of stay and costs , but the question had never been put to a serious randomized trial.
Northwestern EM Blog
MARCH 11, 2024
Written by: Jilan Shimberg, MD (NUEM ‘26) Edited by: Rafael Lima, MD (NUEM ‘23) Expert Commentary by : Matthew R Levine, MD Expert Commentary Unlike many of the treatments and interventions we use in the Emergency Department and the trauma bay, tranexamic acid (TXA) has rather robust studies to guide usage. Like many interventions, however, even when there are studies with large numbers of patients and positive results, there are still barriers towards implementation.
Ziqitza HealthCare Ltd
MARCH 11, 2024
As our population ages, the demand for specialized healthcare services for senior citizens continues to rise. Among these essential services, emergency medical assistance stands out as a critical need, particularly for the elderly population who may face unique medical challenges. In addressing these needs, companies like Ziqitza Health Care Limited emerge as pioneers, offering tailored ambulance services specifically designed to cater to the distinctive requirements of our elderly citizens.
Mind The Bleep
MARCH 11, 2024
The following article has been written by David Birch. David is a paramedic aiming to increase awareness of managing Autism amongst healthcare professionals, particularly paramedics and first responders. As healthcare professionals, there may be times when we encounter patients with Autism Spectrum Disorder (ASD). In these cases, healthcare professionals may have to adapt their approach to ensure that the patient is provided with the most effective and patient-centred care.
PulmCCM
MARCH 11, 2024
But first: A German “vaccine hoarder” got injected with 217 Covid vaccines, and is reportedly doing great. Societies push back on CMS’s cuts to critical care billing In 2022, the U.S. Centers for Medicare and Medicaid Services (CMS) made a change in reimbursement policy that devalued critical care time. (BORING CODING EXPLANATION AHEAD) Instead of the longstanding arrangement of allowing additional 30 minutes time (code 99292) to be billed after the first 30-74 minutes (code 99
Pediatric Education
MARCH 11, 2024
It has been an amazing journey that started with just one weekly case and now we have come to this newest milestone. Since 2004, we have offered a breadth of cases that continues to be unstructured pediatric curriculum and educational resource. Remember that the To Learn More Section of each case is continuously updated even if the case is a little older.
EMDocs
MARCH 11, 2024
Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy.
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