Emergency Live
NOVEMBER 20, 2023
Specialized Solutions for the Safety of Small Passengers During Emergency Transport Transporting children by ambulance requires special care and precautions. In emergency situations, ensuring the safety of young patients is a top priority. This article explores international regulations and technological innovations that help make pediatric ambulance transport safe and effective.
The Trauma Pro
NOVEMBER 17, 2023
Ever been in a trauma activation where it seems like the first thing that happens is that someone steps up to the patient with the ultrasound probe in hand? And then it takes 5 minutes of pushing and prodding to get the exam done? Well, it’s not supposed to be that way. The whole point of adhering to the usual ATLS protocol is to ensure that the patient stays alive through and well after your exam.
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Broome Docs
NOVEMBER 17, 2023
This is another lecture by the always amazing Dr Justin Morgenstern from the series of talks he delivered on his tour of Perth in September 2023. In this talk I challenged Justin to go on a very deep dive into the literature around the modern management of the massively bleeding trauma patient. What is the best way to resuscitate and replace all those blood products in these severely unwell people?
Ken Grauer, MD
NOVEMBER 10, 2023
== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. HOW would you interpret this tracing?
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
Pediatric EM Morsels
NOVEMBER 3, 2023
Imported Malaria , like all imported tropical illnesses, is a Tale of Two Cities. The infection was unknowingly obtained while enjoying a delightful holiday and then brought back in transit to a country where it is not endemic. In these non-endemic countries, we need to always be attentive to patient’s history of recent travel to correctly identify any concerns related to their recent travel.
Sensible Medicine
NOVEMBER 30, 2023
Three recent events tell us that US healthcare is doomed. First, health care premiums have risen to new heights. Second, Medicare has agreed to pay for GRAIL cancer screening as part of coverage with evidence development and third, many doctors protested Cigna’s denial of coverage for a double lung transplant for stage IV lung cancer, leading the insurer to agree to cover it.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
The Trauma Pro
NOVEMBER 28, 2023
The November issue of the Trauma MedEd newsletter will be sent out soon! It’s chock full of tips and tricks dealing with trauma practice guidelines This issue is being released over the weekend. If you are already a subscriber, you will receive it automatically. If not and you sign up any time before then, you will receive it, too. Otherwise, you’ll have to wait until it goes out to the general public a week or two later.
Greater Sydney Area HEMS
NOVEMBER 4, 2023
Airway Registry learning points reflect the challenges described and wisdom shared by Sydney HEMS personnel and guests at the Clinical Governance Airway Registry presentations. Cases are discussed non-contemporaneously, anonymised and amalgamated over a period of time to draw together unifying take-home messages. Details of specific cases are removed and/or changed, such that any similarity to real-life patients or scenarios is coincidental.
Ken Grauer, MD
NOVEMBER 25, 2023
== CLICK HERE — for a V ideo presentation of this case! ( 19:40 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #191 — == The 2-lead rhythm strip shown in Figure-1 was obtained from an elderly woman who presented to the ED following a syncopal episode. On the basis of this rhythm strip — she was diagnosed as being in complete AV Block.
Pediatric EM Morsels
NOVEMBER 17, 2023
While doing literature review for my scholarly project it dawned on me that it might be time to dust off a classic morsel from the bottom of the cookie jar. On this 10 year anniversary, we chose to throw this one back in the oven to include some even more delicious data on cuffed endotracheal tube (ETT) use. No matter whether you have the wisdom of many years of practice ( old doc like Dr.
Sensible Medicine
NOVEMBER 10, 2023
The CDC has just reported that more parents than ever are getting vaccine exemptions for their children entering Kindergarten. For many of us who have witnessed the CDC’s repeated blunders with kids COVID19 vaccines, this result is entirely predictable. The CDC has lost the trust of the American people, and it will keep getting worse. First, let me say, I warned them.
Don't Forget the Bubbles
NOVEMBER 27, 2023
Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. He presented tachycardic and hypotensive with a capillary refill time of 5 seconds. After 40ml/kg of IV 0.9% NaCl, his HR came down a little, but the effect was short-lived. He has an HR of 190/min, and his BP is 85/35 mmHg. The CRT is unchanged.
The Skeptics' Guide to EM
NOVEMBER 25, 2023
Date: November 22, 2023 Reference: Stopyra et al. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. AEM November 2023. Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She is the cofounder of FOAMcast and a […] The post SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area?
Stop and Think
NOVEMBER 26, 2023
I have changed my mind about a lot of things over the past two decades of practice. No change has been bigger than how I feel about preventing heart disease. The medical jargon here is primary prevention. (Re: preventing a first cardiac event). I will tell this story in three chapters. Chapter 1: What I used to think about primary prevention In years past, I interpreted the studies of primary prevention as only slightly positive.
Ken Grauer, MD
NOVEMBER 4, 2023
You are told that the patient next door is in the regular SVT ( S upra V entricular T achycardia ) rhythm shown in Figure-1. QUESTIONS: Is the rhythm AVNRT or AVRT? Is Adenosine likely to convert this rhythm? Figure-1: How would YOU interpret this ECG? MY Thoughts on the ECG in Figure-1: When faced with a challenging cardiac arrhythmia — It is a "luxury" to have access to a long lead rhythm strip containing 3 simultaneously -recorded leads.
Emergency Medicine News
NOVEMBER 17, 2023
An abstract is unavailable.
Sensible Medicine
NOVEMBER 5, 2023
Years ago, I was late to a dinner party at a new, trendy downtown restaurant. I had been working as an attending on the bone marrow transplant service, and the day got away from me. I had to take care of a patient who had a serious adverse reaction when she received her stem cell infusion. Another patient was suffering from a catastrophic fungal infection, and graft versus host disease threatened the life of a third.
Don't Forget the Bubbles
NOVEMBER 29, 2023
You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. A 12-year-old male is being transported by ambulance after a road traffic accident. His name is Ben. Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. While waiting, another call comes in. Ben suddenly woke up and accidentally self-extubated.
St. Emlyn
NOVEMBER 24, 2023
St.Emlyn's - Emergency Medicine #FOAMed Emergency care practitioners are known for creating order from chaos, being pragmatic amidst difficult circumstances and advocating for patients when others cannot. The post The Emergency Care Voice Rescued from a Sea of Politics appeared first on St.Emlyn's.
PulmCCM
NOVEMBER 17, 2023
Jon-Emile S. Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. Within the sphere of macrohemodynamics, the OP is the true dependent variable – meaning that P ra and CO do not affect each other [1, 2].
Ken Grauer, MD
NOVEMBER 18, 2023
== — CLICK HERE — for a V ideo presentation of this case! ( 15 minutes ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #344 — == How would YOU interpret the lead II rhythm strip shown in Figure-1 ? Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? Or — Is it “ something else ”? Figure-1: How would YOU interpret this lead II rhythm strip?
EMCrit
NOVEMBER 4, 2023
AHA Guidelines on Critical Care Toxicology EMCrit Project by Scott Weingart, MD FCCM.
Sensible Medicine
NOVEMBER 23, 2023
I want to begin this post by saying: I wish the nothing but the best to the patient, Carol, who has a diagnosis of lung cancer. I hope that our medicines are able to give her a long and rich life, and that a new discovery can eliminate this disease. This is a post about her doctors at Vanderbilt. I also want to say that I am confident insurers can behave poorly, peer to peer is an insult, and prior auth is a broken system, but medicine has to be careful not to offer unproven and costly things to
Life in the Fast Lane
NOVEMBER 1, 2023
James Miers and John Mackenzie Ocular foreign body removal Emergency Procedure: Ocular foreign body removal.
St. Emlyn
NOVEMBER 16, 2023
St.Emlyn's - Emergency Medicine #FOAMed We review a paper from the EMJ looking at the diagnosis of acute aortic syndrome in the ED and the accuracy of clinical decision rules and clinician gestalt The post JC: The DAShED Study – Diagnosis of Acute Aortic Syndrome in the Emergency Department appeared first on St.Emlyn's.
The Skeptics' Guide to EM
NOVEMBER 11, 2023
Date: November 2, 2023 Reference: Coventry et al. Which clinical features best predict occult scaphoid fractures? A systematic review of diagnostic test accuracy studies. Emerg Med J. Aug 2023 Guest Skeptic: Dr. Matt Schmitz is an Orthopaedic Surgeon who sub-specializes in adolescent sports and hip preservation. He will soon be transitioning out of the US military after […] The post SGEM#420: I get knocked down, but I get up again – do I have a scaphoid fracture?
Don't Forget the Bubbles
NOVEMBER 22, 2023
One-liner… Although commonly used, Propofol can have severe adverse effects. Propofol Infusion Syndrome (PRIS) can lead to significant morbidity and mortality in children. What is Propofol? Commonly referred to as “the milk of amnesia”, propofol is a drug used for induction and maintenance of general anaesthesia and for procedural sedation. Propofol is prepared in a lipid emulsion, giving it a characteristic milky white appearance, and due to its ability to dissolve in fats, it is rapidly redist
Dr. Smith's ECG Blog
NOVEMBER 29, 2023
Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both were awake and alert with normal vital signs. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" What do you think? Here they are: Patient 1, ECG1: Zoll computer algorithm stated: " STEMI , Anterior Infarct" Patient 2, ECG1: Zoll computer algorithm stated: "ST elevation, probably benign early repolarization.
Sensible Medicine
NOVEMBER 6, 2023
Many doctors believe that closing the left atrial appendage (with a device) will help reduce stroke and bleeding. The idea behind stroke reduction is that occluding the appendage takes away a common area where clots form. The reason for less bleeding is that patients with proper occlusion can often be taken off anticoagulant drugs. These are nice ideas.
Life in the Fast Lane
NOVEMBER 13, 2023
Sheralyn Guilleminot and Mike Cadogan How to Make a Logo using AI AI in healthcare: A review of the AI tools Midjourney and DALL•E•3 to create logos and images; their unique features, differences, and the importance of effective instruction (prompting).
NIOSH Science Blog
NOVEMBER 8, 2023
Despite legislation and improved technology, data from Massachusetts hospitals show that sharps injuries have increased in the operating room (OR) [1]. These injuries place healthcare workers at risk of exposure to bloodborne pathogens (BBPs). There is an urgent need to renew efforts to protect healthcare workers inside the operating room. The Massachusetts data highlight a gap and the need to establish a national surveillance program that would help hospitals develop further measures to prevent
First 10 EM
NOVEMBER 27, 2023
Evidentiary amnesia is a term I use to describe the phenomenon I frequently encounter in which evidence seems to be forgotten over time. When I hear people lecture about the management of intracranial hemorrhage, and even when I invite incredibly smart people to write about neurologic emergencies, blood pressure management is always recommended. But why?
Don't Forget the Bubbles
NOVEMBER 20, 2023
Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Thorough history taking and detailed examination can aid in diagnosis. Causes of paediatric neck lumps can be broadly divided into three categories – congenital , inflammatory and neoplastic.
Dr. Smith's ECG Blog
NOVEMBER 17, 2023
I was texted this ECG just as I was getting into bed. It is of an elderly woman who complained of shortness of breath and had a recent stent placed. I was told that the Queen of Hearts had called it OMI with high confidence. What do you think? Ken (below) is appropriately worried about pulmonary embolism from the ECG. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema.
Sensible Medicine
NOVEMBER 14, 2023
For someone like me who only knew Matthew Perry from occasional glimpses of Friends during my “lost decade” of medical training, I was surprised by the attention paid to his death. After reading a few articles, however, I realized the impact that his disease, and his writing and speaking about it, had. Stefan Kertesz is Professor of Medicine at the Heersink School of Medicine at the University of Alabama at Birmingham where his work includes leading VA and non-VA supported research f
EM Ottawa
NOVEMBER 2, 2023
Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1) These injuries can be debilitating requiring surgical intervention, debridement or amputation in the most severe cases.
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