February, 2022

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Dedicated POCUS vs Primary Team

Ultrasound Gel

If you have listened to this podcast for any amount of time, you know how POCUS studies usually go. Someone does an ultrasound on something cool and then compares it to another test to see how good it is. Well this study is different. In this case, we are taking a tried and true application of POCUS (undifferentiated dyspnea) and comparing a dedicated ultrasound team's POCUS to the treating emergency team's POCUS.

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Crashing Patient on a Ventilator

Northwestern EM Blog

Written by: Patrick King, MD (NUEM ‘23) Edited by: Adesuwa Akehtuamhen, MD (NUEM ‘21) Expert Commentary by : Matt McCauley, MD (NUEM ‘21) Expert Commentary Thank you for this succinct summary of an incredibly important topic. We as emergency physicians spend a lot of time thinking about peri-intubation physiology but the challenges do not end once the plastic is through the cords.

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ECG Cases 28 Approach to Atrial Fibrillation

Emergency Medicine Cases

Jesse McLaren explains his AFIB mnemonic for approach to atrial fibrillation that involves 4 questions: 1. Is it atrial fibrillation? 2. If it is atrial fibrillation and there is rapid ventricular response, is it fast from a secondary cause? 3. If it is atrial fibrillation with a rapid ventricular response without a secondary cause, what is the intervention?

EKG/ECG 52
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132. Lithium toxicity: a battery of problems

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com Don’t be too salty. Lithium can cause quite the battery of problems so let’s review them while you recharge for your next shift. See what we did there? Want to experience the greatest in board studying?

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SGEM#360: We Care a Lot – The EmPATH Study

The Skeptics' Guide to EM

Date: February 21st 2022 Reference: Kim et al. Emergency psychiatric assessment, treatment, and healing (EmPATH) unit decreases hospital admission for patients presenting with suicidal ideation in rural America. AEM February 2022. Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England).

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Imaging Case of the Week 493 Answer

EMergucate

The chest x-ray shows a double left heart border.

EMS 52
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What Entity or Person Serves As ABIM's "Restricted" Contributors?

Dr. Wes

In late 2018 through 2020, The American Board of Internal Medicine (ABIM) was involved in a class action antitrust lawsuit for claims of illegal creation and maintenance of their monopoly power in the market for maintenance of certification (MOC).

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Nasal CPAP for neonates

Trigger Lab

Invasive mechanical ventilation induces, on the preterm neonate’s lungs, an interruption of both growth and alveolar maturation, as a direct consequence of the inflammation caused by the prolonged ventilatory support, which can increase the risk of development of bronchopulmonary dysplasia (1).

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131. One vasopressor to rule them all

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com One vasopressor to rule them all! Let’s break down this ACEP PEER question that tells us what the ultimate pressor is in certain patients. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com One vasopressor to rule them all!

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SGEM Xtra: Everybody Hurts, Sometime

The Skeptics' Guide to EM

Date: February 15th, 2022 Guest Skeptic: Dr. Tim Graham is a Clinical Professor of emergency medicine at the University of Alberta, and Associate Chief Medical Information Officer, Edmonton Zone, of Alberta Health Services from Edmonton, Alberta. Reference: Graham T. Physician heal thyself. CMAJ 2021 TRIGGER WARNING: As a warning to those listening to the podcast or […] The post SGEM Xtra: Everybody Hurts, Sometime first appeared on The Skeptics Guide to Emergency Medicine.

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Imaging Case of the Week 494 Answer

EMergucate

The chest x-ray shows triangular peripheral based pleural opacity with apex towards the hilum. This is Hampton’s hump.

EMS 52
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Why health care interoperability is so important

Advanced Medical Reviews

The wide array of technologies utilized in the health care industry offers providers a number of advantages, from enhancing patient care and streamlining clinician workflows to increasing access to data and reducing costs. When such solutions don’t integrate with other technologies and systems, though, they often result in problems, mitigating the benefits they’re designed to offer.

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Tips for Maximizing Your Car Accident Injury Claim

Medical Law

Financial compensation can’t take away the pain, stress, and upset of a serious car accident caused by someone else’s negligence. It can make it easier to receive the medical care you need and ease the stress of being forced to take time away from work because of your injuries. Our experienced Southern California personal injury lawyers can help you maximize your compensation for a car injury claim.

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Ectopic Pregnancy

Ultrasound Gel

Can you believe we have never talked about ectopic pregnancy on this podcast?? Fortunately for you, a new research article allows our faithful hosts to dive into this core application of POCUS. These authors ask the practical question of whether or not a POCUS saves time in patients with ectopic pregnancy requiring an operation. The results may not be too surprising, but there are many twists and turns to this discussion - not unlike the course traversed from the uterus to the adnexa!

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Nasal CPAP nel neonato

Trigger Lab

La ventilazione meccanica invasiva prolungata determina, sul polmone del neonato pretermine, un arresto di crescita e maturazione alveolare, conseguente all’infiammazione polmonare indotta dal supporto prolungato, a cui si correla un aumento del rischio di sviluppo di displasia broncopolmonare (1).

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Review of the ATHOS 3 trial

Northwestern EM Blog

Written by: Saabir Kaskar, MD (NUEM ‘23) Edited by: Amanda Randolph, MD (NUEM ‘20) Expert Commentary by : Matt McCauley, MD (NUEM’ 21) Review of the ATHOS 3 Trial: Angiotensin II for the Treatment of Vasodilatory Shock Angiotensin, first isolated in the late 1930s, in recent years has become the new innovative vasopressor used in intensive care units, a change driven largely by the results of the ATHOS-3 trial.

Shock 52
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Imaging Case of the Week 495

EMergucate

The following knee x-rays are from a 15 year old with knee pain & swelling after a twisting injury.

EMS 52
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2 Minutes Advanced Airways

MEDEST118

An original video by Mario Rugna

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JJ 20 Outpatient Medications for COVID-19

Emergency Medicine Cases

In this Journal Jam podcast we dig deep into the science of FDA-approved outpatient medications for COVID with 3 critical appraisal masters: Dr. Andrew Morris, Dr. Rohit Mohindra and Dr. Justin Morgenstern. What is the evidence for the neutralizing monoclonal antibody medications like Sotrovimab? The nucleoside analogs like Remdesivir and Paxlovid? The inhaled corticosteroids like Budesonide and Ciclesonide?

EMS 52
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Hot Takes from Super Bowl Sunday

Dr. Mike Sevilla

Super bowl 56 has come and gone. Bummed that the Cincinnati Bengals (#WhoDey) didn’t win, but it was actually a good game this year. I had all of my big game treats and food ready to go. And, don’t ask me why, but I actually watched most of that NBC five hour pre-game show. And, don’t ask me why, I actually enjoyed most of it. But, here are some random opinions (my hot takes) from today: 1) About the game itself: Really enjoyed it.

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130. Lightning strikes and selfie sticks

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com When you go to the Grand Canyon, our advice is to not bring a 10 foot-long selfie stick…you don’t want to fall victim to nature’s most frightful weather effect. Let’s break down this ACEP PEER question for your boards!

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SCGH DDU Meeting Roster

SCGH ED

Monthly Thursday, 16:00 – 17:30, ED Seminar Room The post SCGH DDU Meeting Roster appeared first on Charlie's ED.

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ECG of the Week – 23rd February 2022

EMergucate

The following ECG is from an 82 year old man with metastatic mesothelioma on immunotherapy treatment with a background of … Continue reading →

EKG/ECG 52
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NeuroResus April 2022

Intensive Care Network

Neuro Resus on 7-8th April 2022. The Ultimate Preparation for Neuro Crises. Info and Registration details. The post NeuroResus April 2022 appeared first on Intensive Care Network.

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Ultrasound of the Month: A Case of Unilateral Knee Swelling

Downeast Emergency Medicine

THE CASE A 44 year old male with a history of right ACL repair 1 year ago presents with right knee pain and swelling after a fall. He was helping his neighbor fix their snowblower when he slipped and fell backwards. He denies hitting his knee on the ground but felt a pop in his right knee during the fall. He reports feeling as though his patella was “out of place” but then it popped back in and his pain improved somewhat.

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Life Lessons from Re-Connecting

Dr. Mike Sevilla

Are there long time friends that you just haven’t talked with since the start of the pandemic? Of course, you were like me, saying to yourself, “Well, we will chat again soon.” Or, “One of these days I’ll give them a call again.” But, it’s now been two years. Two long years. I challenged myself this week. I had some days off from work, and it was my goal to re-connect with some people whom I haven’t talked with in a while.

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Cold Injury

PHEM Cast

This podcast is dedicated to the memory of Emmanuel Cauchy. George’s adventures! Grading frostbite Stages of frostbite. From Cauchy et al, 2016. Grade 1 Grade 2 Grade 3 Grade 4 Stages of frostbite. From Cauchy et al. 2001 The GELOX study The Hyperbaric oxygen study described by Carron is now in print and available here. Guidelines The guidelines mentioned by Chris can be found on the Wilderness Medical Society website.

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Nursemaid's Elbow

Northwestern EM Blog

Written by: Richmond Castillo, MD (NUEM ‘23) Edited by: Shawn Luo, MD (NUEM ‘22) Expert Commentary by : Jacob Stelter, MD (NUEM ‘19) Expert Commentary This is an excellent summary of the diagnosis and management of radial head subluxation (nursemaid’s elbow) in children. Clinically, as pointed out, these patients are usually toddlers and will come in after an injury to the arm.

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Imaging Case of the Week 494

EMergucate

The following chest x-ray is from an adult patient with right sided chest pain. What can be seen?

EMS 52
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The Circle of Safety and Physician Burnout

33 Charts

In his book, Leaders Eat Last — Why Some Teams Pull Together and Others Don’t , Simon Sinek discusses the importance of a safe work environment for innovation, productivity and survival. He calls this leader-driven space the Circle of Safety. It is easy to know when we are in the Circle of Safety because we can feel it. We feel valued by our colleagues and we feel care for by our superiors.

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Episode 66 - Acute Asthma

EB Medicine

Episode 66 – Acute Asthma Exacerbations – An Interview with Dr. Steven Hochman and Dr. Brandon Somwaru EMplify – February 2022 Emergency Department Management of Acute Asthma Exacerbations Interview with the authors: Steven M. Hochman, MD, and Brandon Somwaru, DO Episode Outline: Epidemiology Risk factors for death from asthma (Table 1) Triggers for asthma attacks Variants of asthma (Table 2) Differential diagnosis (Table 3) Can PE be a trigger for an acute asthma attack?

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Olympics 2022

Dr. Mike Sevilla

I don’t know what it is, but the Olympic games has always captured my imagination, even going back to when I was 11 years old, and watching Scott Hamilton ice skating in Sarajevo. Has it really been 38 years since that performance? Whether it be the winter games, or the summer games, I always have tried to think about what has been like to be an Olympic athlete.

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SGEM#359: Meet Me Halfway on the Duration of Antibiotics for Non-Severe Pediatric Community-Acquired Pneumonia

The Skeptics' Guide to EM

Date: February 7th, 2022 Reference: Williams et al. Short- vs standard-course outpatient antibiotic therapy for community-acquired pneumonia in children: the scout-cap randomized clinical trial. JAMA Pediatrics 2022 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Case: A three-year-old boy presents to the emergency department (ED) with fever […] The post SGEM#359: Meet Me Halfway on the Duration of Antibiotics for Non-Seve

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This ECG was interpreted as completely NORMAL by the computer: What about it is THE critical finding??

Dr. Smith's ECG Blog

A 40 something otherwise healthy man presented with substernal chest pain. It had occurred once 3 days prior and resolved without any medical visit. He had a triage ECG at time zero: Here is the computer interpretation (Normal) This was the Veritas algorithm. What do you think? This ECG is DIAGNOSTIC of acute LAD Occlusion. The T-waves are hyperacute, but most important, the minimal ST Elevation is accompanied by Terminal QRS Distortion , or at least nearly so.

EKG/ECG 52
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ECG of the Week 16 February 2022 Interpretation

EMergucate

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.

EKG/ECG 52
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4 Tips for Explaining Gaps in Your Healthcare Resume

Core Medical Group

Are you about to apply for a new job in healthcare, but unsure how to address the gaps in your resume? There’s no need to stress. It’s extremely common! In fact, gaps in employment history have never been higher. This shouldn’t come as a surprise given the state of the world over the past several years.

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ECG Basics: Second-degree AV Block, Type I

ECG Guru

This two-lead rhythm strip shows a normal sinus rhythm at about 63 bpm. The P waves are regular. After the sixth P-QRS, there is a non-conducted P wave. The normal rhythm then resumes. The two most common reasons for a non-conducted P wave in the midst of a normal sinus rhythm are 1) non-conducted PAC, and 2) Wenckebach conduction. The first is easy to rule out.

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