Ken Grauer, MD
DECEMBER 28, 2024
I was sent the ECG in Figure-1 told only that the patient was an older adult who reported dizziness with activity. QUESTIONS: What is the rhythm? ( HINT: There are at least 4 important findings that should be noted ). Is there AV block? Figure-1: The initial ECG in today's case. ( To improve visualization I've digitized the original ECG using PMcardio ).
The Trauma Pro
DECEMBER 17, 2024
Anyone who takes care of blunt trauma has seen the Morel-Lavallee lesion (M-L). Heres an obvious one because its acute: The M-L lesion is essentially a closed degloving injury in which the skin remains intact. The subcutaneous tissue is sheared off of the underlying fascia, and typically blood accumulates in the potential space that is created. This picture shows a less acute lesion; the bruising and ecchymosis on the surface have resolved.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Pediatric EM Morsels
DECEMBER 20, 2024
Its been a BIG year for Mycoplasma! If your EDs have been anything like ours, youve been seeing more patients with Mycoplasma Pneumonia than you expected. Many kids are presenting to the ED for failure of outpatient antibiotic therapy of community acquired pneumonia, only to find out thats because they werent on the right meds! Let’s debrief on this atypical bug.
Don't Forget the Bubbles
DECEMBER 31, 2024
The Childrens Emergency Department is a busy, challenging, and dynamic environment. The skills needed to deliver the best possible outcomes for children and young people are multifaceted and constantly evolving. They involve a mixture of clinical, communication, and leadership traits. Having recently moved from a leadership position within the Childrens Emergency Department to a more system-based role involving children of all ages, its apparent to me how transferable my experiences on the shop
Science Based Medicine
DECEMBER 20, 2024
If RFK Jr. "researches" vaccines, he will certainly "discover" they cause autism. It's possible that this "research" will be used as justification to revoke authorization for vaccines. That's always been the endgame. The post Trusting RFK Jr. to Research Vaccines is Like Trusting a Hungry Python to Babysit a Kitten first appeared on Science-Based Medicine.
Sensible Medicine
DECEMBER 28, 2024
Dharini Bhammar, PhD, MBBS, is a respiratory physiologist and evidence enthusiast. As a new mum, her pediatrician recommended the RSV monoclonal antibody for her baby. After reviewing the evidence, she declined it. We are excited to share her clearly written argument as an excellent example of evidence translation. Core concepts discussed include effect size, net benefit and the external validity of clinical trials.
EMCrit
DECEMBER 1, 2024
John Holcomb, author of the PROPPR trial, on massive transfusion in 2024 EMCrit Project by Scott Weingart, MD FCCM.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
.jpg) |
St. Emlyn
DECEMBER 9, 2024
St.Emlyn's - Emergency Medicine #FOAMed Explore key takeaways from the DAS 2024 meeting, including airway management in obstetrics, ethics of training, challenges in critical care, and international practices. Insights tailored for emergency and anaesthesia professionals. The post Difficult Airway Society Meeting 2024 appeared first on St.Emlyn's.
Dr. Smith's ECG Blog
DECEMBER 3, 2024
This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He had recently returned from overseas travel where these symptoms had been intermittently bothersome over the preceding weeks and had been attributed to heartburn.
Science Based Medicine
DECEMBER 6, 2024
Doctors who gushed over RFK Jr. made their bed, and they'll lie in it. The post Dr. Vinay Prasad Sabotaging RFK Jrs Confirmation Will Increase Vaccine Hesitancy & Doctors Criticizing RFK Jr. Paved the Way for His Ascendancy first appeared on Science-Based Medicine.
RebelEM
DECEMBER 23, 2024
Background: Sickle cell disease (SCD) affects an estimated 300,000 infants born worldwide each year and has a total estimated prevalence of 100,000 in the United States alone ( Piel 2017 ). Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) ( Kidwell 2021 ). VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ).
Emergency Medicine Cases
DECEMBER 3, 2024
On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips.
The Trauma Pro
DECEMBER 20, 2024
A new class of anticoagulants, the direct oral anticoagulants (DOACs), were introduced in 2010. I started writing about them more than five years ago and was initially pessimistic about their safety profile in patients with head injuries. However, reversal agents and/or protocols were introduced, and the literature has borne out the fact that they appear to be safer than the old stand-by warfarin.
St. Emlyn
DECEMBER 23, 2024
St.Emlyn's - Emergency Medicine #FOAMed David Purkarthofer reviews the highlights from the fantastic EuSEM conference held in Copenhagen earlier this year. #FOAMed @stemlyns The post EuSEM 2024 in review appeared first on St.Emlyn's.
EMDocs
DECEMBER 18, 2024
Authors: Kyler Osborne (EM-3 Resident Physician; Tacoma, WA); Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA); Rachel Bridwell, MD (EM Attending Physician; Charlotte, NC) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician) Welcome to emDOCs revamp!
Science Based Medicine
DECEMBER 27, 2024
The time to start speaking out to defend vaccines from RFK Jr. is now. The post Dr. Marty Makary, What Are You Going To Do If RFK Jr. Demands That Revoke Approval For Vaccines? first appeared on Science-Based Medicine.
Taming the SRU
DECEMBER 17, 2024
Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none. Considering the nationwide IV fluid shortage, judicious use of fluids is imperative.
The Skeptics' Guide to EM
DECEMBER 21, 2024
Date: December 15, 2024 Guest Skeptics: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Today, were sleighing through the holiday season with a special episode filled with statistical cheer, a dash of skepticism, and a hint of eggnog-flavoured nerdiness. This is an SGEM Xtra like the one we did on What I Learned from Top Gun. Its fun to mix it up and not do a structured critical appraisal of a recent publication and have a more philosophical chat.
The Trauma Pro
DECEMBER 3, 2024
In my last post, I described the Pediatric Readiness Score and its components. Today, I’ll explain why maintaining a high score may benefit your trauma center and what it costs to do so. Research groups at the Oregon Health Sciences University and the University of Utah combined multiple data sources to estimate current levels of ED pediatric readiness, the cost to achieve it, the number of pediatric deaths in emergency departments, and the number of potential lives saved if readiness is m
Dr. Smith's ECG Blog
DECEMBER 16, 2024
Which patient needs a CT Scan? Case 1: 20-something woman with chest pain Case 2: 50-something man with chest pain Case 1 A 20-something yo woman presented in the middle of the night with severe crushing chest pain. It had begun 4 hours before arrival and was initially dull, but became severe and "unbearable" 2 hours prior to arrival. She was a walk-in at triage.
The Bottom Line
DECEMBER 11, 2024
Whats new in the Critical Care literature monthly updates
Science Based Medicine
DECEMBER 3, 2024
Yesterday, Dr. David Gorksi invited us to come up with questions for Senators to ask our future public health leaders. Here are mine. The post Questions For Senators to Ask Drs. Marty Makary and Jay Bhattacharya first appeared on Science-Based Medicine.
EM Ottawa
DECEMBER 18, 2024
Methodology: 4/5 Usefulness: 2/5 McMullan JT, et al. Ann Emerg Med. 2024 Oct;84(4):363-373. doi: 10.1016/j.annemergmed.2024.04.018. Question and Methods: This out of hospital, placebo-controlled, blinded, parallel group RCT compared reduction in pain scores between Fentanyl + IN Placebo and Fentanyl with IN Ketamine. Findings: There was no significant difference in reduction of pain scores or adverse […] The post Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatme
St. Emlyn
DECEMBER 16, 2024
St.Emlyn's - Emergency Medicine #FOAMed The blog highlights the updated 2024 guidelines from the Royal College of Radiologists (RCR) on imaging in pediatric trauma. It emphasizes critical changes from the previous 2014 guidelines, focusing on the judicious use of imaging to minimize ionizing radiation exposure in children. Key updates include algorithms for blunt trauma, penetrating trauma, and blast injuries.
ACEP Now
DECEMBER 31, 2024
The first time I met Dr. Greg Henry, he promptly informed me that he had shoes and belts older than me. Not knowing whether to laugh or be intimidated, I stared at him blankly and he chuckled. He quickly took me under his wing. Beyond his professional achievements, Greg was revered for his larger-than-life personality, sharp wit, and generous mentorship.
EM Literature of Note
DECEMBER 4, 2024
The emergency department is a place of risk and errors. Those who work in the ED are acutely aware of this, and it conjures up tremendous cognitive pressures on staff every shift. Every ED clinician knows the most benign-appearing triage complaint may obfuscate lurking catastrophe. The vision changes that are actually an acute aortic dissection. A sore shoulder that is necrotizing fasciitis.
The Bottom Line
DECEMBER 11, 2024
Whats new in the Critical Care literature monthly updates
Science Based Medicine
DECEMBER 22, 2024
If pro-RFK Jr. propaganda wins the day, I am confident we will soon find out a tough truth- MAHA is all about RFK and has everything to do with vaccines. The post Dr. Joseph Marine: MAHA is More Than RFK and Has Little to do With Vaccines first appeared on Science-Based Medicine.
Dr. Smith's ECG Blog
DECEMBER 6, 2024
A 50-something man presented with worsening severe exertional chest pain which was just resolving as he had an ECG recorded in triage. Time zero. Are the T-waves in leads I and II hyperacute? Hard to tell. How can we know? By the evolution of the ECG! Watch what happends as the heart recovers from its episode of ischemia. The T-waves deflate, demonstrating that the first one was indeed hyperacute. 2 hours T-waves in lead II are significant smaller In lead I not much difference Troponins returned
St. Emlyn
DECEMBER 26, 2024
St.Emlyn's - Emergency Medicine #FOAMed Does early exercise after blunt chest trauma make a difference? Find out when we review the ELECT trial. #FOAMed @stemlyns The post EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial) appeared first on St.Emlyn's.
ACEP Now
DECEMBER 6, 2024
By some definitions, you could call former Maryland state legislator Dan Morhaim, MD, FACEP, a retired emergency physician. He thinks of it as re-deployed. Dr. Morhaim spent more than two decades in the Maryland House of Delegates, fighting for legislation to protect health care workers and patients before his final legislative term ended in 2019. His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of
Emergency Medicine News
DECEMBER 1, 2024
No abstract available
Total Medical ComplianceHIPAA
DECEMBER 16, 2024
The U.S. Department of Health and Human Services (HHS) has issued the Final Privacy Rule to support reproductive health care and the protection of related health information under the Health Insurance Portability and Accountability Act (HIPAA). This amendment was designed to strengthen privacy and security for individuals seeking reproductive health care.
Emergency Medicine Journal
DECEMBER 30, 2024
Introduction Emergency doctors routinely face uncertainty—they work with limited patient information, under tight time constraints and receive minimal post-discharge feedback. While higher uncertainty tolerance (UT) among staff is linked with reduced resource use and improved well-being in various specialties, its impact in emergency settings is underexplored.
First 10 EM
DECEMBER 2, 2024
Despite being widely talked about in glowing terms, the original WOMAN trial was clearly negative, with no benefit in their primary outcome, and no change in all cause mortality, and therefore no hint of benefit. (There is a lot of confusion about what disease specific mortality means when this paper is discussed, but it only […] The post WOMAN-2: TXA has no role in postpartum hemorrhage appeared first on First10EM.
St. Emlyn
DECEMBER 2, 2024
St.Emlyn's - Emergency Medicine #FOAMed Uncover the truth about alcohol poisoning. Find out how toxic alcohols can be ingested accidentally or intentionally and the serious consequences they can have with a focus on Emergency medicine management. #FOAMed @stemlyns The post Toxic alcohol poisoning: What do we know about fomepizole, methanol and ethylene glycol?
Science Based Medicine
DECEMBER 13, 2024
We don't need "spirited debate" about RFK Jr. We've been trying to warn you about him for years. It's not our fault that some people didn't listen. The post Anyone Who Supports Pro-RFK Jr. Doctors, Is Also Pro-RFK Jr. first appeared on Science-Based Medicine.
Expert insights. Personalized for you.
395 
.jpg)
Let's personalize your content