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?
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 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.
Science Based Medicine
NOVEMBER 13, 2023
Over the weekend, Jeffrey Tucker, founder of the Brownstone Institute, crowed about how the Great Barrington Declaration and its recommendation of a "natural herd immunity" approach to the pandemic changed everything three years ago. Unfortunately, as the John Snow Project pointed out last week, the "natural herd immunity" approach has done what could be irreparable damage to public health science and, more importantly, the political and social will to promote public health practices not just fo
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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 2, 2023
Doctors and ‘experts’ who got COVID policy wrong are asking for forgiveness. Their errors hurt children— resulting in massive learning losses— and caused broader destabilization to the economy, work life, social communities and more. Do they deserve forgiveness? And, why did they err in the first place? Recently Scott Galloway, the NYU professor, appeared on Bill Maher.
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.
Science Based Medicine
NOVEMBER 27, 2023
Recent evidence shows that public trust in science and vaccines has declined markedly since the pandemic. Why is this, and is there anything we can do about it? The post Trust in science and vaccines continues to decline. Why? first appeared on Science-Based Medicine.
Emergency Medicine News
NOVEMBER 17, 2023
An abstract is unavailable.
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.
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.
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.
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.
Science Based Medicine
NOVEMBER 20, 2023
The BMJ, once a bastion of evidence-based medicine, has become disturbingly susceptible to publishing biased "investigations" that feed antivax narratives. Its latest report on VAERS by Jennifer Block, who in the past has defended Gwyneth Paltrow and Goop and whose history is not one of supporting science, is just another example of this deterioration.
St. Emlyn
NOVEMBER 14, 2023
St.Emlyn's - Emergency Medicine #FOAMed Simplifying urgent care data translation is essential for hospital flow improvement. This post provides a perspective on how to achieve this. The post Speaking urgent care flow fluently appeared first on St.Emlyn's.
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?
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].
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 1, 2023
James Miers and John Mackenzie Ocular foreign body removal Emergency Procedure: Ocular foreign body removal.
Science Based Medicine
NOVEMBER 12, 2023
"Many were fine with exposing kids (and school workers) to a deadly virus, with no vaccine or treatment, in the name of herd immunity. That’s a fact."- Dr. Jerome Adams The post Dr. Jerome Adams Was Right. They Wanted Them Infected. That’s a Fact. first appeared on Science-Based Medicine.
Stop and Think
NOVEMBER 19, 2023
I had thoughts. Maybe you did too. There were just so many media reports of cardiac arrest in athletes. This is a column about two things—a medical problem (cardiac arrest) and the way our brains work. During the pandemic we learned that the vaccine against SARS-CoV-2 could cause myocarditis—or inflammation of the heart. Young males had the highest risk of this adverse effect.
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 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
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 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).
Science Based Medicine
NOVEMBER 14, 2023
After 41 years of private practice as a chiropractor and 60 years of writing books and articles, the age of 94 finds me rethinking my career, wondering if my contributions to the literature justify the path I took. The post The Swan Song of a Chiropractic Heretic first appeared on Science-Based Medicine.
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
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.
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.
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.
First 10 EM
NOVEMBER 20, 2023
When caring for pregnant women, I frequently find myself searching for information on radiation risks from diagnostic imaging, to help guide our shared decision making process, so I decided to create a summary in a spot I would always know where to find it. I have ranted in the past about the many problems with […] The post Diagnostic imaging during pregnancy and lactation appeared first on First10EM.
Science Based Medicine
NOVEMBER 29, 2023
Results of the largest study on internet use, well-being, and mental health. The post Internet Use and Mental Well-Being first appeared on Science-Based Medicine.
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