The Trauma Pro
OCTOBER 29, 2024
CT scans are commonly used to aid the workup of patients with blunt trauma. They are occasionally useful in penetrating trauma, specifically when penetration into a body cavity is uncertain, and the patient has no hard signs that would send him or her immediately to the operating room. Is there any role for CT in operative penetrating trauma, after the patient has already been to the OR?
Ken Grauer, MD
OCTOBER 10, 2024
I was sent the ECG shown in Figure-1 — told only that the patient was a middle-aged man with septicemia. QUESTIONS: Is this rhythm too fast to be sinus tachycardia? Are flutter waves hidden within the QRS and T waves? Are we seeing the retrograde P waves of AVNRT? Is this ATach ( A trial T achycardia )? Figure-1: The initial ECG in today's case. MY Thoughts on Today’s CASE: In my opinion — none of the above answers are optimal to describe the rhythm in Figure-1.
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American Medical Compliance
OCTOBER 31, 2024
A survey reveals that falls are the most frequent health issue affecting seniors in long-term care facilities. Interestingly, while 90% of caregivers feel confident in implementing fall prevention measures, only 60% have adequate knowledge to do so effectively. As the aging population grows, so does the demand for specialized healthcare tailored to the unique needs of seniors and individuals with disabilities, posing new challenges and responsibilities for healthcare providers.
EM Ottawa
OCTOBER 31, 2024
Delirium is a medical emergency. It is characterized by acute disturbance of consciousness, with changes in perceptual disturbances and fluctuation of symptoms. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever, tachypnea, tachycardia, or hypoxia. There is an ED prevalence ranging from 7-24%, with increased mortality rates […] The post Delirium revisited appeared first on EMOttawa Blog.
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!
First 10 EM
OCTOBER 28, 2024
As with everything that comes out of the PECARN group, this is a huge study, and is therefore one that everyone needs to know about. That being said, despite working in two very busy community hospitals with a high percentage of pediatrics visits, c-spine injuries are just not an issue I struggle with. I have […] The post The PECARN c-spine rule could cause a lot of harm appeared first on First10EM.
Sensible Medicine
OCTOBER 28, 2024
The study of the week will take a short break. I head to Curitiba Brazil tomorrow for the Brazilian EP society meeting. I have five lectures. I will be back next week. And there will be plenty of studies to choose from because we are entering the fall season of medical meetings. This week, Sensible Medicine features a guest column from Zachary R. Caverley, a Cardiology Physician Assistant working in the Northwest coast of Oregon.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Ken Grauer, MD
OCTOBER 19, 2024
The patient whose ECG is shown in Figure-1 — presented with acute dyspnea and hypotension. QUESTION: In Figure-1 — Is the rhythm VT? — How certain are you of your answer? 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: Although at first glance, the ECG in Figure-1 appears to be wide — this is a false initial impression!
American Medical Compliance
OCTOBER 14, 2024
Assisted living facilities are a lifeline for elderly and vulnerable individuals who need care and support in a safe, nurturing environment. Yet, even in these compassionate settings, caregivers often face the challenge of managing aggressive behaviors among residents. Imagine the case of Mrs. Stevens, a once gentle and kind woman who, after the onset of dementia, began exhibiting sudden outbursts of anger.
Mount Sinai EM
OCTOBER 10, 2024
The Case: A woman in her twenties with no significant medical history presents with one month of progressive frontal headaches radiating to her occiput. Her headaches have been intermittent, however over the past few days she has had a few episodes of vomiting and brief episodes of blurred vision. Her headache is 8/10 currently. Last emesis and blurred vision were both 12 hours prior.
St. Emlyn
OCTOBER 30, 2024
St.Emlyn's - Emergency Medicine #FOAMed All the best from the blog from August 2024, in our easy to digest podcast. The post August 2024 Round-Up – Goldilocks Moments, Nasal Analgesia, and Public Health in the ED appeared first on St.Emlyn's.
ACEP Now
OCTOBER 29, 2024
On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? His vitals are fine…”. Seemingly unsure, she pauses, “I’m getting an interpreter, and I think he has belly pain, but something just doesn’t seem right.” Coming into triage, I see a young man—Georgian-speaking—bracing himself with a hand against the wall and holding his lower abdomen.
The Trauma Pro
OCTOBER 18, 2024
All trauma centers admit some of their patients to nonsurgical services. This usually occurs when patients have medical comorbidities that overshadow their injuries. Unfortunately, the decision-making that goes into balancing the medical versus trauma issues is not always straightforward. The fear is that if trauma patients are inappropriately placed on a nonsurgical service, mortality and morbidity may be higher because their injuries may not receive adequate attention.
Ken Grauer, MD
OCTOBER 25, 2024
The ECG in Figure-1 was obtained from a middle-aged man who presented with a 2 week history of progressively increasing CP ( C hest P ain ) with exertion. He had his most severe episode of CP the day before he was seen with this ECG. His CP was much less compared to the day before — but it had not yet completely resolved. An initial Troponin drawn less than 1 hour after the ECG in Figure-1 was recorded was over 10,000.
Sensible Medicine
OCTOBER 20, 2024
In a world where doctors are increasingly treated like cogs in a machine, the question arises: Would you recommend your son or daughter pursue the field? Recently, I saw this poll: I said ‘unsure’, but that is just a fragment of what I think. Here is my answer (leave yours in the comments). My answer is: it depends on who is asking. I would strongly encourage you to pursue medicine if… Your primary goal in a career is using your talents to improve the well being of others.
Mind The Bleep
OCTOBER 29, 2024
Chemical burns are a unique subset of burns that require specialised management due to the nature of the substances involved. Proper initial management is critical to prevent further tissue damage and systemic complications. The majority of acid burns cause coagulative necrosis and cytotoxicity leading to skin and mucosal changes that limit deeper injury.
EM Ottawa
OCTOBER 28, 2024
Methodology: 4/5 Usefulness: 4/5 Geraghty LE, et al. N Engl J Med. 2024 May 30;390(20):1885-1894. doi: 10.1056/NEJMoa2402785. Question and Methods: Study aimed to determine if video laryngoscopy improves first-attempt intubation success in neonates compared to direct laryngoscopy through a randomized controlled trial. Findings: 74% first pass success with video laryngoscopy and 45% with direct laryngoscopy […] The post Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infa
Emergency Live
OCTOBER 27, 2024
Changing the way surgeons prepare for surgery can reduce water consumption in hospitals A recent study by the Campus Bio-Medico in Rome has revealed an astonishing truth: changing the way surgeons prepare for surgery can drastically reduce water consumption in hospitals. The study For two years, researchers have closely monitored water consumption during thousands of […] The post The green revolution in operating rooms: reducing water use appeared first on Emergency Live.
PulmCCM
OCTOBER 30, 2024
A majority of patients with significant strokes experience fever within the first week after their vascular injury. The presence, intensity, and persistence of fevers are associated with worse outcomes after strokes of any type. For example: Patients with ischemic strokes who develop fever within the first 24 hours have more than double the risk of death, compared to patients without fevers.
The Trauma Pro
OCTOBER 1, 2024
In this day and age of ride-sharing apps like Uber and Lyft, it is possible to get a cheap ride virtually anywhere there is car service and a smartphone. And, of course, some people have used these services for transportation to the hospital instead of an ambulance ride. What might the impact of ride services on patient transport be for both patient and EMS?
Sensible Medicine
OCTOBER 15, 2024
It is my pleasure to introduce this article by Joseph Marine, MD in response to mandatory masking policies in a number of California hospitals. There is simply no randomized evidence to support these policies, and they make little sense in 2024. I worry about the mental abilities of the public health officers who instituted these policies, and that their actions will further erode trust in public health.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness. The syncope lasted about 2-3 minutes according to his wife. He woke up alert and with chest pain which he also had experienced intermittently over the previous few days.
EM Ottawa
OCTOBER 24, 2024
Precedex (dexmedetomidine) is an alpha-2 adrenergic agonist increasingly used in critical care environments for sedation and anxiolysis. It offers a unique profile of sedation without respiratory depression, making it an attractive option in various clinical scenarios. Historically, it has been used more frequently in the ICU than in Emergency Departments, likely due to provider comfort. […] The post Is there a Precedence for Precedex in the ED?
Emergency Live
OCTOBER 29, 2024
People who spend long hours on their cell phones are more likely to develop heart problems, according to a study In the digital age, our smartphone has become an extension of ourselves, an inseparable companion that accompanies us at every moment of the day. But this intimate relationship could hide risks for our health, especially […] The post Smartphone: a new alarm bell for the heart?
St. Emlyn
OCTOBER 22, 2024
St.Emlyn's - Emergency Medicine #FOAMed This post accompanies the podcast “Simulation for Elite Team Performance,” which was recorded live at the Tactical Trauma 2024 conference in Sundsvall, Sweden. We are grateful to the organizing team […] The post Podcast – Simulation for Elite Team Performance with Andrew Petrosoniak at Tactical Trauma 2024 appeared first on St.Emlyn's.
The Skeptics' Guide to EM
OCTOBER 5, 2024
Date: October 2, 2024 Reference: Paxton et al. Headpulse measurement can reliably identify large-vessel occlusion stroke in prehospital suspected stroke patients: Results from the EPISODE-PS-COVID study. AEM Sept 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the UMass Chan Medical School – Baystate.
Sensible Medicine
OCTOBER 10, 2024
I appreciate this essay for its reframing of our debates about cancer screening; viewing them through an ethical lens. The speculation that we might eventually be able to identify individuals harmed by radiographic screening and how this would alter our approach is both intriguing and alarming. Adam Cifu Sensible Medicine is a reader-supported publication.
Dr. Smith's ECG Blog
OCTOBER 3, 2024
This was sent to me from Sam Ghali ( @EM_Resus ) with no other information. I assumed it was a patient with acute chest pain. "What do you think, Steve? Real or just fake?" What do YOU think? It has some inferior ST elevation with some reciprocal ST depression and inverted T in aVL. This usually indicates inferior OMI. My answer: "Fake: pretty certain, but not 100% certain.
Emergency Medicine Cases
OCTOBER 1, 2024
In this ECG Cases blog we look at 5 cases of ECGs falsely labeled 'normal'. Can you spot the critical abnormality? Written by Jesse McLaren; Peer Reviewed and edited by Anton Helman. October 2024 Five patients presented with ECGs labeled ‘normal’. Can you use systematic ECG interpretation to identify the [.] The post ECG Cases 51 – ECGs falsely labeled “normal” appeared first on Emergency Medicine Cases.
Emergency Live
OCTOBER 30, 2024
By 2050, back pain could outnumber Alzheimer’s as the leading cause of disability globally Back pain, a nuisance that accompanies many of us in our daily lives, is taking on ever more alarming proportions. According to recent scientific studies, by 2050 it could outnumber Alzheimer’s as the leading cause of disability globally. This should make […] The post Schiena a rischio: una nuova epidemia appeared first on Emergency Live.
St. Emlyn
OCTOBER 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed Day one report of the Annual Scientific Conference of the Royal College of Emergency Medicine #RCEMASC #FOAMed @stemlyns The post RCEM ASC 2024. appeared first on St.Emlyn's.
The Trauma Pro
OCTOBER 25, 2024
Earlier this year, I wrote a series of posts on the two commonly used pelvic fracture interventions: preperitoneal packing (PPP) and angioembolization (AE). To sum up, both are equally effective in controlling hemorrhage, but the hospital costs for patients undergoing angioembolization are significantly less. This is probably because there is no need to perform repeated operations to insert and remove the preperitoneal packs when angiography is used.
Sensible Medicine
OCTOBER 2, 2024
This post continues yesterday’s. If you have not read Part I, I suggest you read it first. Adam Cifu Sensible Medicine is a reader-supported publication. Please consider becoming a free or paid subscriber. There was a time when, right or wrong, there was a consensus within medicine regarding what kind of person would make a good doctor. It was believed that being a doctor meant you had to remember a great number of obscure things, and so we designed tests that heavily weighted memorization
Dr. Smith's ECG Blog
OCTOBER 8, 2024
This was sent to me by a reader who wishes to remain anonymous. A lady in her 60s came to the ER with chest discomfort and shortness of breath. She had a history of previous anterior MI treated by primary PCI to the proximal LAD. The first EKG is from 2:30 PM on the day of presentation to the ER. Smith : To me this is a blatantly obvious acute anterior OMI.
First 10 EM
OCTOBER 21, 2024
I love toxicologists, but it’s time for someone to call them out. (I also love ranting. Let’s see if I can get myself cancelled by a group of physicians that are definitely smarter than me.) I am sick of the anti-science rhetoric. Every time a toxicologist takes the stage at a conference, or grabs the […] The post Toxicology: the excuses must stop appeared first on First10EM.
Emergency Live
OCTOBER 28, 2024
Cutting-edge robotic technique for removal of thymus tumours introduced The Molinette hospital in Turin has marked a new milestone in thoracic surgery, introducing a cutting-edge robotic technique for the removal of large-scale thymus tumors. This innovative procedure, never before applied in Italy, represents a decisive breakthrough in the treatment of these pathologies, offering patients a […] The post Life-saving surgical innovation: robotics takes the heart appeared first on Emergency
Life in the Fast Lane
OCTOBER 30, 2024
Casey Parker and James Rippey Ultrasound Case 112 A 30 year old woman who is currently 30 weeks gestation presents to the ED with abrupt, severe right loin pain.
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