Imaging Case of the Week 502 Answer
EMergucate
APRIL 29, 2022
The wrist x-ray shows 2 injuries. Radial styloid fracture (Chauffeur’s fracture) & scapholunate dissociation (Terry Thomas Sign).
April, 2022
52 
The Weekly Cheese 2.0 - Is Droperidol (still) Deadly?
Cook County EM Blog
APRIL 27, 2022
Background : Droperidol is primarily D2 antagonist used for nausea/vomiting, agitation, headache, and pain. Previously droperidol was a commonly used medication in the ED until it received a black box warning for concerns related to QT-prolongation and risk of potential fatal arrhythmias. Shortly after, the use of droperidol greatly decreased, however there is continued debate over its safety.
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ECG Cases 30 Beware Computer Interpretation Errors
Emergency Medicine Cases
APRIL 26, 2022
Computer interpretation of the ECG has been called a double-edged sword: when correct, it increases physician accuracy, but when incorrect it increases errors. This is especially problematic in the emergency department, where computer accuracy drops as clinical significance increases—with common errors for arrhythmias and ischemia. Jesse McLaren guides us through 10 cases where the computer interpretation misguides us and how to avoid these pitfalls.
Adrenal Crisis: Early Recognition and Management Save Lives
Critical Care Now
APRIL 26, 2022
Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director. His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. Find him on Twitter @HagahmedMD The Pre-brief A 19-year-old female suddenly collapsed at the mall where she was in the company of her friends.
Traumatic Arthrotomy
Northwestern EM Blog
APRIL 25, 2022
Written by: Parisa Kermani, MD (NUEM ‘23) Edited by: Alex Herndon, MD (NUEM ‘21) Expert Commentary by : Matt Levine, MD Case: A 25-year-old male comes into the ER after a saw accident at work. The patient was using a circular saw to cut wood when it slipped and the saw touched up against his knee. The patient has a 10cm linear vertical laceration over the anterior surface of his left knee (Figure 1).
A woman in her 60s with palpitations
Dr. Smith's ECG Blog
APRIL 24, 2022
Case sent by Magnus Nossen MD, edits by Meyers A previously healthy woman in her 60s presented to an outpatient clinic for palpitations. Vitals were within normal limits other than heart rate. The ECG there reportedly showed an irregular tachycardia, and the patient was immediately referred to the emergency room. Here is her ECG on arrival: There is a wide complex tachycardia that is irregularly irregular (this is difficult to determine at these very high rates).
Imaging Case of the Week 503 Answer
EMergucate
APRIL 29, 2022
The chest x-ray shows The PA chest x-ray shows obscuration of the right heart border by a density.
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Ep 168 Financial Planning for Emergency Physicians
Emergency Medicine Cases
APRIL 26, 2022
In this episode we discuss how to earn, spend, save and invest wisely and answer questions such as: What is time affluence and how should it guide our financial planning? Why should our goal be financial independence rather than retirement? What are the 4 evidence-based cornerstones for financial planning for happiness? What is the 4% rule for figuring out how much money one needs to be happy?
SGEM Xtra: She Blinded Me with Science Communication
The Skeptics' Guide to EM
APRIL 23, 2022
Date: April 19th, 2022 Guest Skeptic: Sarah Mojarad is a Lecturer in Advanced Writing, #SciComm, & Mis/disinfo topics • Kavli Fellow • Reed Awardee. This is an SGEM Xtra episode. When planning a brief trip to Los Angeles for the EMRAP One Conference, I remembered that Sarah is from LA. I thought to myself, perhaps […] The post SGEM Xtra: She Blinded Me with Science Communication first appeared on The Skeptics Guide to Emergency Medicine.
US-Guided Arthrocentesis
Ultrasound Gel
APRIL 22, 2022
In this episode, Mike and Jacob dive into an important intersection of musculoskeletal and procedural ultrasound - the ultrasound-guided arthrocentesis. People have been doing arthrocentesis without the help of ultrasound for a while, and most would agree it is feasible. BUT what about those smaller joints - like the wrist, elbow, and ankle? Perhaps that is where the greatest benefit would be in making sure your needle gets to the right place.
Chest pain, a ‘normal’ ECG, a 'normal trop', and low HEART and EDACS scores: Discharge home? Stress test? Many errors here.
Dr. Smith's ECG Blog
APRIL 22, 2022
Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chest pain without associated symptoms. ECG was labeled ‘normal’ by the computer (confirmed by the overreading cardiologist) and the high-sensitivity Troponin I was normal at a value of 11 ng/L (Abbott Alinity assay, where normal is S in V2.
ECG of the Week 27th April 2022 Answer
EMergucate
APRIL 27, 2022
A 53 year old male presents to ED complaining of chest pain.
How to Dose Medications During a PIRRT
Critical Care Now
APRIL 21, 2022
Reading Time: 3 minutes Nishika Patel Critical care pharmacist with a fondness for cats, wine, and all things vintage. Also an insta-nerd who likes to teach ICU tidbits on her IG page @dr.scriptsndrips. The Pre-brief Renal replacement therapy (RRT) in the critical care setting is common. Due to issues with hemodynamic instability, patients are often unable to receive hemodialysis (HD) and instead must be placed on continuous renal replacement therapy (CRRT).
135. TCA toxicity: Narrow Windows
Board Bombs
APRIL 17, 2022
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. If you could invent a drug that caused the biggest constellation of bad juju. it would already be invented because it's called a TCA. These are scary overdoses. Let's talk about presentation, diagnoses, and management of TCA toxicity.
The Weekly Cheese 2.0: MG for AF with RVR?
Cook County EM Blog
APRIL 14, 2022
This week we’ll be covering the LOMAGHI trial and use of magnesium in atrial fibrillation (AF) with RVR Background : AF with RVR is a common arrhythmia encountered in the emergency department. Typical initial rate control agents include beta blockers (BB) or calcium channel blockers (CCB), but what is the role of magnesium sulfate (MgSO4) as an adjunct in the treatment of AF with RVR?
Aerosol terapia durante ventilazione meccanica. Parte 1
Trigger Lab
APRIL 13, 2022
A cura di Alice Galesi Background La somministrazione di farmaci aerosolizzati è comunemente utilizzata per il trattamento di malattie polmonari [1], (ad esempio, asma, disturbi polmonari ostruttivi, fibrosi cistica, ipertensione arteriosa polmonare, malattia polmonare infettiva) [2]. L’uso dell’aerosolterapia durante la ventilazione meccanica è frequente per la somministrazione di broncodilatatori e steroidi nella broncopneumopatia ostruttiva e … Leggi tutto Aerosol terapia du
EM Quick Hits 37 Introducing QI Corner, Skin Abscess, O2 Sat Monitor Pearls, Infantile Spasms, Atrial Fibrillation Rate Control
Emergency Medicine Cases
APRIL 12, 2022
Tahara Bhate's new QI corner Quick Hits series, Hans Rosenberg & Michael Gottlieb on the evidence around ED diagnosis and management of skin abscesses using PoCUS, Anand Swaminathan on what the oxygen saturation monitor can tell you besides oxygen saturation, Sarah Reid on how to pick up infantile spasms and prevent poor neurologic outcomes, Elisha Targonsky on battle of the ED rate control medications for rapid atrial fibrillation.
Imaging Case of the Week 503
EMergucate
APRIL 26, 2022
The chest x-ray is from a 40 year old with runny nose & dry cough. What can be observed?
Pain (& analgesia)
PHEM Cast
APRIL 11, 2022
This is the book Jon quotes, “Pain is a symphony…” The International Association for the Study of Pain’s revised definition of pain is available here. If you’d like to read more about ‘nocebo’ i.e. the non-pharmacological adverse effects of an intervention, have a look at this article. Penthrox For more information on Penthrox, you can read about it in the BNF , The Emergency Medicines Compendium and on the manufacturers own website.
Are Roundabouts Safe?
Medical Law
APRIL 11, 2022
A roundabout is an alternative to a traditional intersection. Using a roundabout can be confusing because it has no traffic lights or stops signs. Also known as a traffic circle , the traffic in a roundabout flows continuously in a counterclockwise direction. Roundabouts are common in Europe, and they are growing in popularity across the United States, including in Santa Barbara.
A woman in her 30s with sudden chest pain, nausea, and diaphoresis. Was her cardiology management appropriate?
Dr. Smith's ECG Blog
APRIL 8, 2022
Case written and submitted by Brandon Fetterolf MD, edits by Meyers A woman in her early 30s with multiple autoimmune disorders including vasculitis presented with 2-3 hours of mid-left side chest discomfort with radiation to neck and left arm and associated with nausea, diaphoresis and dizziness. Initial ECG on presentation at 1554 (no prior for comparison): What do you think is happening to his 30s woman?
Intussusception
Ultrasound Gel
APRIL 7, 2022
Intussusception is a big deal and an area where POCUS can potentially make a difference. The literature has been promising, but there hasn't been any definitive studies.until now? The GEL Jr hosts dive into this impressive prospective, multicenter, non-inferiority study and (much like an air enema) they try to get to the bottom of this question to reduce our impacted uncertainty.
So I Don’t Have to Feel Like Death?
Critical Care Now
APRIL 7, 2022
Reading Time: 4 minutes Rachel Rafeq Emergency medicine pharmacist and toxicology enthusiast. Trained in medication safety and I apply that to everything. I love photography and world schooling my kids. The Pre-brief Supraventricular tachycardia (SVT) is a common arrhythmia with a prevalence of 2 per 1000 adults SVT is an umbrella category of rhythm abnormalities that includes atrial fibrillation, atrial flutter, sinus tachycardia, atrioventricular nodal reentrant tachycardia, and atrioventricul
ECG of the Week 20th April 2022 Answer
EMergucate
APRIL 20, 2022
The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. He presents to ED complaining of increasing shortness of breath and leg swelling.
Ortho Pearls: The Maisonneuve Fracture
Cook County EM Blog
APRIL 7, 2022
Background: A 43-year-old otherwise healthy man presented to the ED with ankle pain and swelling. Patient was playing basketball 5 days ago and twisted his left ankle. He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. He presented to our ED for worsening pain and swelling of his lower leg.
5 Must-Knows for Travel Nurses Today
Core Medical Group
APRIL 6, 2022
Whether you’re already a nurse or studying to become a nurse, you’ve undoubtedly heard about travel nursing. It’s gained enormous popularity in recent years, and it’s become a hot topic in the medical field due to the variety of benefits it offers.
134. Mind blown: Abd pain with Dr. O’Brien
Board Bombs
APRIL 3, 2022
Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Dr. O’Brien joins us again this week to change the way you think about abdominal pain. This podcast isn’t very board relevant, but who cares. Clinical practice changing? Yep you betcha. Want to experience the greatest in board studying?
SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety
The Skeptics' Guide to EM
APRIL 2, 2022
Date: March 31st, 2022 Reference: Butt et al. Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She is the cofounder of FOAMcast and is a pulmonary embolism […] The post SGEM#363: View Master – Virtual Reality Immersion Tool to Reduce Pediatric Anxiety fir
Prehospital Management of Traumatic Brain Injury
Critical Care Now
APRIL 5, 2022
Reading Time: 5 minutes Simon Taxel NRP, BA Simon is a paramedic, crew chief, and public safety diver with the Pittsburgh Bureau of EMS. He also serves as a medical specialist on Pennsylvania USAR Strike Team 1, a contributing author for a variety of EMS platforms, a public speaker, and a harm reduction advocate The Pre-brief Traumatic brain injuries (TBIs) are caused by blunt and or penetrating forces that impact the brain and disrupt its function.
Imaging Case of the Week 502
EMergucate
APRIL 19, 2022
Following wrist x-rays are from a 38 year old with wrist pain and swelling after a fall on outstretched hand.
Episode 68 -- Meningitis and Encephalitis – An Interview with Dr. Andrew Hogan
EB Medicine
APRIL 1, 2022
Episode 68 -- Emergency Department Management of Adults With Infectious Meningitis and Encephalitis – An Interview with Dr. Andrew Hogan EMplify -- April 2022 Interview with the Author: Andrew N. Hogan, MD 1.Meningitis vs encephalitis Why this topic? What do the words mean? What's the difference? 2.Bacterial meningitis How common is it in the US? Is it more common in third world countries?
CTPA Incidentals | Headache Nerve Blocks
JournalFeed
APRIL 30, 2022
The JournalFeed podcast for the week of April 25-29, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. CTPA Incidentals Spoon Feed: Computed tomography pulmonary angiography (CTPA) yields an alternative diagnosis to pulmonary embolism (PE) in ~40% of patients with a negative PE study.
Cardioverting Atrial Fibrillation: Ant-Lat vs AP
Emergency Medicine Education
APRIL 25, 2022
Does Anterior-Posterior electrode pad work better than the Anterior-Lateral position? A multicenter Danish study in 468 patients with atrial fibrillation showed the Ant-Lat position was more effective than AP for biphasic cardioversion and converting to sinus rhythm. There was no safety concern between these 2 methods.
Overworked in the ER?
ER Nurses
APRIL 24, 2022
Are you overworked? Working double 12 hour shifts? COVID got you working 2 years of overtime? What are you doing, or your unit, to ensure nurses and doctors are well rested and prepared for their shifts? Or what could be done to improve work place conditions?
Consider The Probe: Spine Sign - It's Got Your Back!
Cook County EM Blog
APRIL 22, 2022
The Case: A 68-year-old male with a history of CHF, COPD, CAD s/p stenting, HTN, and DM presents to the emergency department with worsening dyspnea and bilateral lower extremity edema for one week with associated orthopnea, and increased home oxygen requirement. VS: T 36.6, HR 95, BP 114/85, RR 28, O2 97% on 3L nasal cannula (home O2 settings) On examination, the patient is tachypneic and diaphoretic.
Imaging Case of the Week 501 Answer
EMergucate
APRIL 16, 2022
The chest x-ray shows : There is consolidation involving the left upper lobe with silhouetting of the left cardiac border … Continue reading →
Conversations - Dr. Lorna Breen Legislation
EB Medicine
APRIL 27, 2022
The first episode of Conversation, an EMplify podcast series. Episodes are shorter, more conversational, and cover a single topic relevant to practice in Emergency Medicine. Take the listener survey: [link] More on the Dr Lorna Green Legislation here: [link] The first episode of Conversation, an EMplify podcast series. Episodes are shorter, more conversational, and cover a single topic relevant to practice in Emergency Medicine.
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