ACEP Now
AUGUST 15, 2023
Emergency medicine is stressful. There are charged moments of powerful highs and lows. In one shift, you may achieve return of spontaneous circulation in a college student with a massive pulmonary embolism, who will survive neurologically intact. The next shift you may feel inadequate as you realize the antibiotics you prescribe will never be picked up by your patient.
Pediatric EM Morsels
AUGUST 4, 2023
In the age of Ozempic, everyone seems to be losing weight! This seems to have had an overall positive benefit on the health of many. Losing weight is a good thing, until it is a bad thing! Too much of a good thing is a bad thing. Of course, there can be many complications of rapid weight loss including gallstones , malnutrition , and electrolyte imbalances.
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The Trauma Pro
AUGUST 29, 2023
Traumatic injury is a continuum ranging from very minor to immediately fatal. The mortality rate along that continuum rises exponentially as the Injury Severity Score (ISS) increases. We long ago moved away from the philosophy of keeping someone alive at all costs to embracing the concept of quality of life. We have become more thoughtful about considering patient and family input in difficult cases.
Ken Grauer, MD
AUGUST 4, 2023
The long lead II rhythm strip shown in Figure-1 — was obtained from a previously healthy 30-year old woman, who presented with new abdominal pain. Her vital signs were stable — and she did not have an acute abdomen. QUESTIONS: Is there complete AV block? If not — How would YOU interpret this rhythm? What is unusual about this conduction disturbance?
Mount Sinai EM
AUGUST 20, 2023
Causes Inadvertent intravascular injection (even without exceeding max dose) Overdose (with single or multiple doses) Absorption from a vascular area Prevention Calculate max dose, considering comorbidities Direct US guidance, use saline to improve needle tip visualization Add epinephrine when possible. Epi decreases the systemic absorption of LA by reducing local blood flow, also if inadvertently injected IV will provoke tachycardia that can be seen on the monitor.
Emergency Medicine News
AUGUST 31, 2023
An abstract is unavailable.
Emergency Live
AUGUST 31, 2023
Rapid H2O Flood Barriers: A New and Innovative Solution to Flood Control They say that sometimes you have to fight fire with fire. But what about fighting water with water? In the realm of innovative flood control, the Rapid H2O flood barriers are making waves in the UK market. This ingenious system utilizes water as […] The post Fighting Water with Water: A Revolutionary Solution to Flooding appeared first on Emergency Live.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
The Trauma Pro
AUGUST 25, 2023
I am trying to figure out how I missed it! The Eastern Association for the Surgery of Trauma (EAST) snuck a new practice management guideline into the Injury journal last fall. And it desperately tries to answer a question that has been hanging around for several years. Do we vaccinate spleen injury patients who undergo angioembolization or not? I’ve been pondering this for some time and have reached my own conclusion based on some very old literature.
Ken Grauer, MD
AUGUST 26, 2023
The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. In view of this history — How would YOU interpret this ECG? Should the cath lab be activated? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).
Mount Sinai EM
AUGUST 23, 2023
Today is a 2 parter: 1) The Supraorbital (+supratrochlear) block for forehead lacs and 2) Comments on decision-making TNF at Ethyl’s 84th and 2nd again, 8 PM TLDR: The Supraorbital block will save you time and make your life easier/patient happier – WATCH THE 3 MIN VID ; We are DECISION MAKERS – make decisions, learn from them, READ THE ATTACHMENT, get amped THE SUPRAORBITAL/TROCHLEAR FOREHEAD BLOCK A must-have in your Elmhurst tool belt.
Emergency Medicine News
AUGUST 31, 2023
An abstract is unavailable.
Emergency Live
AUGUST 30, 2023
Takotsubo syndrome, also known as stress cardiomyopathy, is a temporary non-ischaemic cardiomyopathy that results from stressful and emotionally intense situations The post Stress cardiomyopathy: broken heart syndrome (or Takotsubo syndrome) appeared first on Emergency Live.
Pediatric EM Morsels
AUGUST 11, 2023
This is the 601st Ped EM Morsel ! Having authored 575 ( well, now 576 ) of them, I am often quite convinced that there are no new topics to discuss. Then July happens and we get 14 more amazing interns who help educate me and remind me that there is always more to learn. Recently, Dr. Teresa Crow encountered an important topic in children that deserves its own Morsel.
The Trauma Pro
AUGUST 15, 2023
My series on the massive transfusion protocol (MTP) continues! Today, I’ll provide some tips on the logistics of your MTP. MTP logistics include details such as who will be delivering the blood, what actually goes in each cooler, what ratios should be used, limitations imposed by the use of frozen plasma, and documentation. I’ll discuss details about ratios and FFP in the next Trauma MedEd newsletter.
Ken Grauer, MD
AUGUST 18, 2023
This patient was seen in the office — and during his exam, was found to have an “irregular heart beat”. He was not symptomatic with the ECG shown in Figure-1. How would YOU interpret this ECG? As the primary care clinician — What would YOU do? Extra Credit ( which is a HINT to the Answer! ): How many beats are recorded on the ECG in Figure-1 ? Figure-1: The initial ECG in today’s case. ( To improve visualization — I've digitized the original ECG using PMcardio ).
Mount Sinai EM
AUGUST 6, 2023
Materials Materials to build a DIY homemade low-cost ultrasound model for intravenous access Shallow plastic container x 2 Pipes, different sizes (Suction tubing, oxygen tubing, plastic cover for needles) Metal screw or nail Some waterproof glue or glue gun Beef gelatin 150g + warm tap water 800ml + Rubbing alcohol 50ml Hand mixer Spoon or strainer Cooking oil Making the mold Make holes to both sides of the container to pass the tubings through and through (I used a hot screw for this) Pass the
Emergency Medicine News
AUGUST 31, 2023
An abstract is unavailable.
Emergency Live
AUGUST 30, 2023
The UK’s leading business event for the rotorcraft industry After the success of Helitech Expo 2022 which saw over 3,000 key buyers in attendance and 50 hours worth of unmissable content, we can now confirm the show will be returning on the 26th & 27th of September at the ExCeL London and we have some […] The post Helitech Expo 2023: Shaping the Future of Air Mobility appeared first on Emergency Live.
Medagadget
AUGUST 30, 2023
Researchers at New York University have developed a new method to target many viruses that cause disease. For viruses with a lipid membrane, which includes many that commonly cause disease, this new technique could prove to be fatal. By targeting the lipid membrane, the approach may circumvent the treatment resistance that arises when viruses mutate to alter their surface proteins, which are the most common targets for conventional anti-viral drugs.
The Trauma Pro
AUGUST 8, 2023
In my last post, I detailed the following case: This male patient was brought to the trauma center after a high-speed car crash. He was unresponsive with GCS 3. A bleeding facial laceration was present, as was vomitus in the airway. Prehospital providers rapidly intubated the patient and inserted an orogastric tube. They rapidly packaged and transported him to the nearest trauma center.
Ken Grauer, MD
AUGUST 11, 2023
I was sent the ECG in Figure-1 , with a request for my opinion — without the benefit of any history. How would YOU interpret the ECG in Figure-1 ? What might you suspect clinically? Figure-1: The initial ECG in today’s case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Thoughts on the ECG in Figure-1: In these days of widespread smart phone availability — transmission of ECGs to request expert opinion is an increasingly used practice, that on many occasions o
RebelEM
AUGUST 30, 2023
Take Home Points Clinical presentation is very nonspecific; evaluate all patients presenting with back pain for infectious risk factors. Baseline labs should not guide diagnosis, but may assist in later management. MRI is key to diagnosis, obtain this imaging in all patients who raise clinical suspicion Patients with hemodynamic instability and neurologic compromise warrant empiric antibiotics.
Emergency Medicine News
AUGUST 31, 2023
An abstract is unavailable.
NIOSH Science Blog
AUGUST 31, 2023
As the occupational safety and health community continues to combat very real and serious hazards, we are closing out the summer with a little fun. This summer Barbie and friends have recaptured national attention breaking box office records with movie ticket sales exceeding one billion dollars in just a few weeks. While Barbie’s first “job” in 1960 was as a fashion designer, she went on to hold over 200 jobs[1] across various industries (of course with the corresponding outfits and accessories)
Mount Sinai EM
AUGUST 13, 2023
Background Hip fractures are a very frequent presentation, even in non trauma centers. Usually affects senior patients with comorbidities, and it’s associated with high morbidity and mortality. Adequate pain control, and early surgical treatment and mobilization are the main goals of hip fracture treatment; to reduce complications including infections, DVT and delirium.
The Trauma Pro
AUGUST 4, 2023
Please help figure out what is wrong here. I’m not going to give you much information, though. This male patient was brought to the trauma center after a high-speed car crash. He was unresponsive with GCS 3. A bleeding facial laceration was present, as was vomitus in the airway. Prehospital providers rapidly intubated the patient and inserted an orogastric tube.
SheMD
AUGUST 31, 2023
When I started looking at where I wanted to spend my residency during the fourth year of medical school, I considered numerous factors, as every student does. Many of them are quite similar: location, quality or style of learning, fellowship options, benefits, personality fit, etc. However, not everyone is at the same place in life when they are matching.
Emergency Live
AUGUST 29, 2023
Emergency Response Driver Simulator: A Safe and Effective Way to Train for Intersection Dangers Intersections contain several potential hazards and risks for an emergency driver. The driver must assess and negotiate an intersection without risking an accident. Potential hazards, which may be pedestrians or other road users hiding behind vehicles, can stress drivers when an […] The post Intersection Dangers – Emergency Response Drive Training With A Simulator appeared first on Emergency Liv
Emergency Medicine News
AUGUST 31, 2023
An abstract is unavailable.
ECG Guru
AUGUST 26, 2023
Does something about this ECG look "different" to you? This ECG shows a “classic” presentation of inferior-posterior M.I. when it is caused by a lesion in the right coronary artery (RCA). There are ST elevations in leads II, III, and aVF. Reciprocal ST depression is seen in Leads I and aVL. There is also reciprocal ST depression in Leads V1 – V3.
Don't Forget the Bubbles
AUGUST 23, 2023
Siren and blue lights. Team allocated and primed. Voices command, ears listen, and hands swiftly execute. Monitors beep—loops of communication. As the second hand sweeps, loud voices grow quieter, and pulse checks fall into an unfortunate pattern. Realisation, its time, knowing looks, a shake of the head, a pain, heaviness. Winding down…. “Time of Death 10:43”.
The Trauma Pro
AUGUST 1, 2023
I wrote about posterior hip dislocation and how to reduce it using the “standard” technique quite some time ago (see link below). Emergency physicians and orthopedic surgeons at UCSF-Fresno have published their experience with a reduction technique called the Captain Morgan. Named after the pose of the trademark pirate for Captain Morgan rum , this technique simplifies the task of pulling the hip back into position.
RebelEM
AUGUST 21, 2023
Background Information: Cardiac arrest is a devastating event that imposes considerable human and financial burdens. While it is widely recognized that cardiac arrest leads to brain injury, what is often overlooked is the persistent cerebral hypoperfusion that continues even after circulation is restored. The sustained cerebral hypoperfusion can be attributed to impaired cerebrovascular auto-regulation, which renders normal arterial carbon dioxide tension (PaCO2) insufficient in achieving and ma
Emergency Live
AUGUST 28, 2023
Renewing Air Rescue in Ireland: Bristow and the New Era of Search and Rescue for the Coastguard On 22 August 2023, Bristow Ireland officially signed a contract with the Irish government to provide search and rescue (SAR) services using helicopters and turboprop aircraft to serve the Irish Coast Guard. Starting in the fourth quarter of […] The post Bristow signs search and rescue contract in Ireland appeared first on Emergency Live.
EM Ottawa
AUGUST 17, 2023
Drug rashes are fairly common, but like much of dermatology, diagnostic clarification can be hard to achieve. Here, we present a standardized approach to drug rashes in the Emergency Department. Differential Diagnosis Clinical Approach Assessment History Distribution and progression, recent exposures, new meds Physical Exam Dangerous features: abnormal vital signs; […] The post Drug Rashes appeared first on EMOttawa Blog.
PulmCCM
AUGUST 15, 2023
What is EG.5.1? Don’t worry about it. But what is it? There are many circulating strains of SARS-CoV-2; all are genomic subvariants of Omicron. EG.5.1 is one of these Omicron subvariants. You don’t need to worry about it. Can I worry about it, though? Well … EG.5.1 is the genomic subvariant of Omicron that is rising fastest as a proportion of viruses detected by genomic surveillance of wastewater.
Science Based Medicine
AUGUST 14, 2023
Last week, the Ohio State Medical Board suspended the medical license of Dr. Sherri Tenpenny, a longtime antivax quack. The only question is: What took them so long, and why did it take the pandemic for them to act? Also, is there less to this action than meets the eye? The post The Ohio State Medical Board has finally suspended the medical license of antivax quack Sherri Tenpenny first appeared on Science-Based Medicine.
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