RebelEM

JANUARY 29, 2024

Background: Massive pulmonary embolism defined as sustained hypotension (SBP <90mmHg) has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) [1]. However, full-dose thrombolytic therapy (Alteplase 100mg (IV) is associated with an increase in bleeding [2]. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety

Stroke 136

Stroke Outcomes Hospitals Administration 136

Science Based Medicine

JANUARY 29, 2024

A couple of weeks ago, I discussed why antivax quacks' claimed biological mechanisms for COVID-19 vaccine "shedding" reminded me of homeopaths. Confabulation about fantastical scientific mechanisms continues, courtesy of "A Midwestern Doctor." The post Antivax quacks are continuing to make up fantastical biological mechanisms for COVID-19 vaccine “shedding” first appeared on Science-Based Medicine.

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122

Don't Forget the Bubbles

JANUARY 29, 2024

A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Of those patients admitted with RSE, a subset will go on to develop super-refractory status epilepticus (SRSE).

Seizures 122

Seizures Pediatrics Research Wellness 122

PulmCCM

JANUARY 29, 2024

AHA Updates its Cardiac Arrest Guidelines In December 2023, the American Heart Association published a “focused update” to its landmark guidelines for the management of cardiac arrest. PulmCCM is not affiliated with the American Heart Association. Read the document for all the details (it’s not long). Here’s PulmCCM’s take on the new changes.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Sensible Medicine

JANUARY 29, 2024

I got the idea of this story from our project over at Cardiology Trials , where we are cataloging the seminal trials in cardiology. Gosh, I am learning a ton about medical evidence. Please do head over there and join the learning. When I rounded in the coronary care units back at Indiana University in the early 1990s, there was momentum to use IV-magnesium (Mg) in patients after myocardial infarction.

Stroke 113

Stroke Outcomes 113

The Trauma Pro

JANUARY 29, 2024

You’re running a trauma activation, and everything is going great! Primary survey – passed. Resuscitation – lines in, fluid going. You are well into the exam in the secondary survey. Then it happens. The automated blood pressure cuff shows a pressure of 72/44. But the patient looks so good! You recycle the cuff. A minute passes and another low pressure is noted, 80/52.

Resuscitation 113

Resuscitation Wellness 113

EM Ottawa

JANUARY 29, 2024

Methodology: 4/5 Usefulness: 3.5/5 Thiele H, et al. N Engl J Med. 2023 Oct 5;389(14):1286-1297. Editorial: Routine Early ECLS in Infarct-Related Cardiogenic Shock? Question: Does early ECLS therapy confer a mortality benefit in patients with MI complicated by cardiogenic shock? Methods: Open label RCT with 417 patients comparing 30-day all-cause mortality between ECLS versus standard […] The post Extracorporeal Life Support in Infarct-Related Cardiogenic Shock appeared first on EMOttawa B

Shock 103

Shock 103

Life in the Fast Lane

JANUARY 29, 2024

Sheralyn Guilleminot and Mike Cadogan Using Artificial Intelligence in the Medical Field Full interview with critical care clinician and AI enthusiast, Dr Sameer Shaikh, on the many ways to use AI to save time and increase efficiency in healthcare

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Emergency Live

JANUARY 29, 2024

The Advent of Driverless Ambulances and Their Implications for the Healthcare System Innovation and Development in Driverless Ambulances Driverless ambulances represent a groundbreaking innovation in the field of healthcare. Autonomous driving technology is already finding applications in the transportation of medications and supplies within hospital complexes.

Hospitals 98

Hospitals 98

First 10 EM

JANUARY 29, 2024

REBOA (resuscitative endovascular balloon occlusion of the aorta) has been discussed in the emergency medicine world for quite some time now, but always with very limited data. There have been some observational studies that suggested REBOA was associated with worse outcomes, but the outcomes were largely assumed to be the result of confounders. (Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM.

Resuscitation 94

Resuscitation Outcomes EMS 94

Emergency Live

JANUARY 29, 2024

Understanding and Addressing the Inevitable Challenge of Stress in Everyday Life The Impact of Stress on the Body and Mind Stress, a natural response of the body to life’s challenges, can have profound and varied effects on physical and mental health. Common symptoms include headaches, muscle tension or pain, fatigue, stomach problems, sleep disturbances, and […] The post Stress in modern society: impacts and solutions appeared first on Emergency Live.

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Taming the SRU

JANUARY 29, 2024

HISTORY OF PRESENT ILLNESS The patient is a female in her late 60’s presenting with acute onset of left arm pain and swelling. She initially noticed pain in her left arm with movement while helping her family move earlier on the day of presentation. While changing, she noticed that her arm was swollen to the mid humerus. She feels that this swelling came on over several hours.

Emergency Department 93

Emergency Department Fractures Hospitals Operations 93

Emergency Live

JANUARY 29, 2024

Advanced Technology for Medical Material Transport: The Future of Hospital Rescues Modern technology continues to redefine the healthcare sector, and a shining example of this progress is the recent medical delivery drone project at Livorno Hospital. This initiative represents a significant innovation in medical materials distribution, leveraging the agility of drones and the efficiency of […] The post AI-Supervised Medical Delivery Drones in Livorno appeared first on Emergency Live.

Hospitals 98

Hospitals 98

Dr. Smith's ECG Blog

JANUARY 29, 2024

This was sent by Sam Ghali @EM_RESUS A 44 year old man presented with chest pain The tech came running with the ECG as the computer called "STEMI!" What do you think? Sam sent this to me and asked: "What do you think, Steve?" My answer: --Tough one! --But I'm going to stick my neck out and say "Not OMI" --STE in V2 has a near "saddleback" configuration, and that is a sign of false positive STE.

EKG/ECG 85

EKG/ECG Outcomes 85

Emergency Live

JANUARY 29, 2024

From Climate Change to Immigration: Factors Bringing Neglected Tropical Diseases to Europe Neglected Tropical Diseases (NTDs) Neglected Tropical Diseases (NTDs) are becoming increasingly common in Europe, largely due to immigration from endemic areas. These diseases, often overlooked by research and healthcare systems, encompass a variety of bacterial, parasitic, and viral infections.

Research 98

Research 98

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. Louis); Marina Boushra, MD (EM-CCM Attending Physician, Cleveland Clinic Foundation); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case: A 39-year-old male is brought in by EMS with a sudden-onset severe headache

Stroke 73

Stroke Outcomes EMS Seizures 73

Emergency Live

JANUARY 29, 2024

French Ministry of Interior Enhances Fleet with 42 Airbus H145 Helicopters for Emergency Response and Security In a significant move to enhance its capabilities in emergency response and law enforcement, the French Ministry of Interior has placed an order for 42 H145 helicopters from Airbus. The contract, facilitated by the French Armament General Directorate (DGA), […] The post 42 H145 helicopters, the significant agreement between the French Ministry of Interior and Airbus appeared first

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PDC Healthcare

JANUARY 29, 2024

Caregivers know that preserving patient safety is instrumental in every hospital. As we enter 2024, new challenges and events in the constantly changing world of healthcare mean that hospital staff must stay up to date with patient safety standards. To start off the new year, the Joint Commission has updated its National Patient Safety Goals®. […] The post Simple Ways to Align with the 2024 Joint Commission National Patient Safety Goals appeared first on connectID - PDC Healthcare Blog.

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Patient Safety Hospitals 70

Emergency Live

JANUARY 29, 2024

Exploring the Latest Innovations in Women’s Health Care Technological Advancements and Personalized Care In recent years, women’s health has benefited from significant advancements, especially in the realm of personalized medicine. Genetic testing, in particular, has revolutionized the approach to diseases such as breast and ovarian cancer.

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ALiEM

JANUARY 29, 2024

A 59-year-old male with no known past medical history other than an incidental abdominal aortic aneurysm presented with sudden onset, painless vision loss in his left eye. The patient was watching TV two days prior when he saw a “brightness” in his left eye and then progressive blurriness until his vision faded away, all occurring within the span of a minute.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

NRC Health

JANUARY 29, 2024

The transition of adolescents from pediatric to adult healthcare services is fraught with anxiety. What are you doing to support their journey and engage them in their future health systems? Nemours Children’s Health’s Chief Experience Officer Peggy Greco, Ph.D., Chief Patient Experience Officer, and Customer Success Manager Cami Mitelman of NRC Health discussed this quandary during a recent webcast.

Pediatrics 59

Pediatrics 59

Ultrasound Gel

JANUARY 29, 2024

In September 2023, the GEL crew traveled to Portland, Maine to do some on-the-street reporting at the annual conference for the Society of Clinical Ultrasound Fellowships (SCUF). What evolved was a series of incredible mini-interviews focusing on the different paths to ultrasound and the exciting new frontiers of ultrasound technology. This is Part 1 of 2.

Ultrasounds 52

Ultrasounds 52

Ziqitza HealthCare Ltd

JANUARY 29, 2024

A person’s mental health is just as important as their physical health in a society where physical health is frequently given priority. Sadly, there is still a stigma associated with mental health problems, which keeps many people from getting the care they require. However, companies like Ziqitza Healthcare are doing a great job of removing these stigmas and raising awareness of mental health issues.

Wellness 52

Wellness Ambulance Services 52

EMergucate

JANUARY 29, 2024

The wrist x-rays show multiple fractures but the main injury is trans scaphoid perilunate dislocation.

Dislocations 52

Dislocations Fractures EMS 52

Mind The Bleep

JANUARY 29, 2024

Pupillary reflex pathway: Light reaches the retina , travels via ganglion cells to the optic nerve , which then forms the optic chiasm before diverging into the left and right optic tracts (nasal fibers decussate to the contralateral optic tract whilst temporal fibers continue ipsilaterally). The optic tracts travel to the pretectal nuclei , which then sends signals to bilateral Edinger-Westphal nuclei (preganglionic parasympathetic nuclei in the midbrain) giving rise to direct consensual reflex

Poisoning 52

Poisoning Radiology Radiology 52

EMergucate

JANUARY 29, 2024

The following shoulder x-ray is from an adult who is complaining of shoulder pain following MVA. What can be seen?

EMS 52

EMS 52

Mind The Bleep

JANUARY 29, 2024

Glaucoma can be divided into open-angle or closed-angle glaucoma. Closed-angle glaucoma has been described in a separate article. Open-angle glaucoma accounts for the majority (74%) of glaucoma cases worldwide. What is it? Chronic open angle glaucoma is a progressive and irreversible optic neuropathy. It is characterised by: Progressive loss of peripheral vision Patient’s often complain of “tunnel vision”, difficulty driving, or running into objects around the home In the late stages there can b

COPD 52

COPD 52