May, 2022

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ADA Cybersecurity Attack

Total Medical ComplianceHIPAA

In the past week the American Dental Association has confirmed that they fell victim to a cybersecurity event. There is a banner posted on the home page of the website alerting their members of this continuing situation and asking for their patience as the issue is resolved. News outlets are consistently reporting the following information related to the incident: Web-based chat, email and telephone services were all impacted.

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ECG of the Week 25th May 2022 Answer

EMergucate

A 79 year old male presents to ED after a syncope. The patient has had diarrhoea and vomiting over the past week. He has a background of hypertension, atrial fibrillation and CCF.

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Trending Sources

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Tasty Morsels of Critical Care 062 | Diuretics

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Today we’re going to talk about some of the basics of some of our favorite drugs intensive care – the diuretics. As always this is planned to be a brief overview of the essentials rather than the deep dive. Click for source As a starter pretty much all diuresis is conducted by convincing the kidney to lose more Na.

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140. Massive Hemoptysis: cough it up! TB or not TB

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. TB or not TB? Well let’s not hope not, but either way massive hemoptysis is NO FUN! Let’s talk critical care airway management here, what test you MUST do in the ED, and how to reduce bleeding. Want to experience the greatest in board studying?

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Outback Obstetric Anaesthesia

Broome Docs

Hey all. This week I am making a guest appearance on the excellent ABCS of Anaesthesia podcast with Dr Lahiru Amaratunge. Specifically we are discussing the way that we can approach Obstetric Anaesthesia in rural hospitals. We discuss how we can manage risk, a lot about our paranoia and pessimism when it comes to higher risk Obstetric scenarios. It is a great topic that illustrates the way that GPAs need to balance the medical, social and logistical considerations in discussion with our team and

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4Ts versus 3Ls: heparin induced thrombocytopenia probability scoring

Critical Care Now

Reading Time: 3 minutes Lauren Igneri Critical care pharmacist and proud Rutgers University graduate. Enjoys rock climbing, cycling, travel, and lively discussions on the finer points of pharmacokinetics and critical care over a beer with friends. The Pre-brief Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction to heparin that places patients at increased risk for venous or arterial thrombosis.

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Ortho Pearls: Tongue-Type Calcaneus Fractures (TTCF)

Cook County EM Blog

The Case: A 16-year-old male presented to the ED 3 days after slipping on ice and landing on his right heal with significant impact. On examination he is neurovascularly intact, however, has significant tenderness to palpation over the right heal, and the rest of his lower extremity exam is limited secondary to pain. Interpretation: Comminuted mildly displaced tongue-type calcaneal fracture.

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ECG Cases 31 Is a 15 lead ECG better than 12? Diagnosing Posterior MI and RVMI

Emergency Medicine Cases

Is 15 lead ECG better than 12 lead for diagnosing posterior MI or right ventricular infarction? When do you need a 15 lead ECG? Jesse McLaren guides us through 8 cases to highlight the steps and pitfalls in diagnosing posterior MI and RVMI in light of recent ECG literature. The post ECG Cases 31 Is a 15 lead ECG better than 12? Diagnosing Posterior MI and RVMI appeared first on Emergency Medicine Cases.

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A 30-something with Chest pain, elevated troponin, with Subtle ST Elevation and hyperacute T-waves.

Dr. Smith's ECG Blog

A 30-something male presented in the middle of the night with several hours of sharp, non-radiating, left sided chest pain. It was there earlier, went away, and then returned approximately 1 hour prior to arrival. He is a smoker and has some family history of early MI. Exam and vital signs were normal. Here was the triage ECG: There appears to be diffuse ST Elevation (II, III, aVF with reciprocal STD in aVL, V3-V6, and lead I, with T-waves that appear to be hyperacute (broad and fat, but on the

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Health Worker Mental Health Initiative

NIOSH Science Blog

A new Surgeon General’s Advisory highlights the urgent need to address the health worker burnout crisis across the country. Workers providing health services face many on-the-job challenges that can lead to work-related stress. For many of the 20 million health workers in the U.S., the COVID-19 pandemic has led to new and worsening mental health concerns, including burnout, compassion fatigue, depression, anxiety, substance use disorders, and suicidal ideation.

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Winner of Sonogames Round Zero

Ultrasound Gel

This is a Special Edition podcast which features the winner of a competition at the recent SAEM Sonogames! The challenge was to create the best infographic for a POCUS article of the team's choice. The winning team was from Boston Medical Center. This podcast is a brief discussion of the article and the graphic this talented team created. [link] [link] This is a Special Edition podcast which features the winner of a competition at the recent SAEM Sonogames!

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139. Thyroid Storm: brace yourselves, its coming

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. What’s worse than Winter Is Coming? Thyroid Storm of course! Let’s cover this awesome ACEP PEER Review question and tackle the most dramatic endocrine problem- its presentation, diagnosis, and most importantly, the order of medications you give.

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How to write a successful PhD application

RCEM Learning

Author: Govind Oliver / Code: / Published: 06/02/2020 In December 2019 the NIHR announced a themed call for applications in urgent and emergency care, injuries and accidents. The NIHR Academy fellowship scheme is included in this themed call. Join (free) an online hangout, hosted and delivered by leading experts as part of the NIHR incubator in Emergency Care, for some pearls of wisdom about how to write a successful application.

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Ep 169 Cardiac Arrest Controversies – Chest Compressions, Dual Defibrillation, Medications and Airway

Emergency Medicine Cases

In this first part of our 2-part series on Cardiac Arrest Controversies Rob Simard, Bourke Tillman, Sara Gray and Scott Weingart discuss with Anton how best to ensure high quality chest compressions, the pros and cons of mechanical CPR, the literature on dual sequential defibrillation and optimizing pad placement, epinephrine vs vasopressin, amiodarone vs lidocaine, when to consider IV calcium and sodium bicarbonate, esmolol, airway considerations, sedation in cardiac arrest, the pros and cons o

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Chest pain, shortness of breath, T wave inversion, and rising troponin in a young healthy runner.

Dr. Smith's ECG Blog

Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode of chest pain and shortness of breath after finishing a 4-mile run. He typically runs 4 to 8 miles per day. This episode was unusual to him because he was still "huffing and puffing" about 30 minutes after finishing his strenuous run in the outdoor heat.

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Conversation- Airway Management

EB Medicine

This is the second episode of Conversation, an EMplify podcast series. Episodes are shorter, more conversational, and cover a single topic relevant to practice in Emergency Medicine. This episode is a conversation between Dr. T.R. Eckler and Dr. Sam Ashoo about airway management and how it has changed in their practice over the last decade. This podcast makes reference to the EB Medicine course – Current Topics in Airway Management: Mechanical Ventilation, Supraglottic Airway Devices, and Intuba

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Journal Club - Optimal Pharmacology for Alcohol Withdrawal

Downeast Emergency Medicine

Background Alcohol abuse is common in the United States with 14.1 million adults estimated to have some degree of alcohol use disorder. Emergency physicians will encounter this quite often, either as the primary presenting problem or as a complicating factor in a patient’s care. Unfortunately, alcohol consumption appears to be increasing, with the World Health Organization projecting ongoing increases through at least 2025.

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Nephrolithiasis: Ultrasonography versus Computed Tomography

Northwestern EM Blog

Written by: Kishan Ughreja , MD (NUEM ‘23) Edited by: Ade Akhentuamhen, MD (NUEM ‘21) Expert Commentary by : Tim Loftus, MD, MBA Journal Club: Ultrasonography versus Computed Tomography for Suspected Nephrolithiasis A 70-year-old man with BPH s/p TURP, hypertension, hyperlipidemia and stroke presents to the ED with acute onset of intermittent sharp left flank pain radiating into the groin that awoke him from sleep.

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Academic Emergency Medicine: An oxymoron or opportunity?

RCEM Learning

Author: Damian Roland / Editor: Govind Oliver / Code: / Published: 06/02/2020 There are many old and unhelpful stereotypes in medicines. The burly orthopaedic surgeon ignoring everything but the bone, the pipe-smoking, cardigan-wearing psychiatrist and the jack-of-all-trades emergency doctor just looking for the next cool gadget to play with. None of these represent a true reality.

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138. Alcohol Withdrawal: Live from SAEM22!

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. Abstract abdominal pain complaint, no good diagnostic test, unreliable presentation. Sounds like the perfect storm for a tricky diagnosis. Let’s talk presentation, diagnosis, pitfalls, and management of PID.

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Biker’s Arm Is a Serious Injury

Medical Law

In a motorcycle collision, it is second nature for a person to protect themselves by using their arms. Biker’s arm covers a broad range of injuries to the nerves in the upper arm that can result when a biker uses their arm to brace their fall in a crash, or if the motorcycle lands on their arm. The nerves at risk of being damaged when a biker crashes are the median, ulnar, and radial nerves.

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A 30-something with palpitations and lightheadedness

Dr. Smith's ECG Blog

A 30-something male without any significant past medical history presented with palpitations and presyncope. Here is his ED ECG: Regular Wide Complex Tachycardia at a rate of 229 First : What do you want to do? Next : What do you think is the ECG diagnosis? First. Before getting into analysis, a regular wide complex tachycardia could be 1. ventricular tachycardia ( VT ) or 2.

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SGEM#366: Relax, Don’t Do It – Skeletal Muscle Relaxants for Low Back Pain

The Skeptics' Guide to EM

Date: May 13th, 2022 Reference: Abril et al. The Relative Efficacy of Seven Skeletal Muscle Relaxants. An Analysis of Data From Randomized Studies. J Emerg Med 2022 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading […] The post SGEM#366: Relax, Don’t Do It – Skeletal Muscle Relaxants for Low Back Pain first appeared on The Skeptics Guide to Emergency Medicine.

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Docusate for Cerumen Impaction? I Sh*t You Not

Critical Care Now

Reading Time: 5 minutes Ruben Santiago Emergency Medicine Pharmacist and medication hustler at a level I trauma center in Miami, FL. Interests include trauma, toxicology, and infectious diseases. The Pre-brief When we think of lysing things in the emergency department (ED), we think of alteplase busting up a blood clot in either ischemic stroke or in patients experiencing a massive pulmonary embolism.

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The NIHR Incubator for Emergency Care

RCEM Learning

Author: Rick Body / Editor: Govind Oliver / Code: / Published: 06/02/2020 In 2017 the National Institute for Health Research (NIHR) published its Training Review. In that document, the NIHR proposed that, to build research capacity in key areas, it would develop a small number of networking structures, to be called “NIHR Incubators” The Incubators would support capacity building and multidisciplinary career development in priority areas with a low critical mass of clinical academics.

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EM Quick Hits 38 ACS in Older Patients, Rural Neonatal Resuscitation, Hemophilia, Hiccups, ECG Computer Interpretation

Emergency Medicine Cases

On this month's EM Quick Hits: Christina Shenvi on ACS in older people, Nour Khatib on rural NRP, Jess McLaren on how not to get fooled by ECG computer interpretation, Brit Long on hemophilia recognition and workup, Maria Ivankovic on persistent and intractable hiccups from EM Cases Summit 2021. The post EM Quick Hits 38 ACS in Older Patients, Rural Neonatal Resuscitation, Hemophilia, Hiccups, ECG Computer Interpretation appeared first on Emergency Medicine Cases.

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Episode 69 – Cellulitis and Other Skin and Soft Tissue Infections

EB Medicine

In this episode, Sam Ashoo, MD interviews Kyle Howarth, MD and Joby Thoppil, MD, PhD – two of the authors of the May, 2022 EMP article on Cellulitis and Skin and Soft Tissue Infections. Listen to the discussion to hear more about the emergency department management of cellulitis and necrotizing skin infections. Episode 69 – Emergency Department Management of Cellulitis and Other Skin and Soft-Tissue Infections ( [link] ) EMplify – May 2022 Episode Outline: 1.

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Felipe Teran

Ultrasound Gel

In the first of our new series of author interviews, hosts Zach Risler and Mike Prats interview the illustrious Felipe Teran. They discuss Felipe's take on our coverage of the Quantitative LV Function in PEA article (ep 119) as well as thoughts on ultrasound and cardiac arrest research in general. [link] In the first of our new series of author interviews, hosts Zach Risler and Mike Prats interview the illustrious Felipe Teran.

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Neuroleptic Malignant Syndrome

Northwestern EM Blog

Written by: Maren Leibowitz, MD (NUEM ‘23) Edited by: Nick Wleklinski, MD (NUEM ‘22) Expert Commentary by : Zachary Schmitz, MD (NUEM '21) Expert Commentary This is an awesome, focused review of neuroleptic malignant syndrome (NMS). NMS is hard to diagnose because it's rare. There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department).

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Advice from a Resident: Virtual Interviewing and Transitioning to Residency

Downeast Emergency Medicine

Interviewing and beginning your career in medicine comes with challenges! Dr. Sarah Bunting, MD is a PGY-1 emergency medicine resident at Maine Medical Center. Listen in to hear her advice on transitioning from medical school to residency, virtual interviewing, and what to look for in a residency! TAKE HOME POINTS: 1. COVID has impacted all medical training.

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Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?

Dr. Smith's ECG Blog

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. He complained of generalized weakness and left lower extremity numbness. He reported that 12 hours prior to arrival he used fentanyl and cocaine.

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137. Pelvic Inflammatory Disease: Tricky Diagnosis

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. Abstract abdominal pain complaint, no good diagnostic test, unreliable presentation. Sounds like the perfect storm for a tricky diagnosis. Let’s talk presentation, diagnosis, pitfalls, and management of PID.

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Imaging Case of the Week 504 Answer

EMergucate

The knee x-rays show: There is a lipohaemarthrosis on the HBL view with AP knee x-ray showing compression type injury … Continue reading →

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Bosch – Implementation of a Phenobarbital Pathway for Severe Alcohol Withdrawal Syndrome

University of Maryland CC Project

Dr. Nicholas Bosch MD, Msc, Assistant Professor of Pulmonary, Allergy, Sleep & Critical Care Medicine at Boston University School of Medicine presents a lecture on the "Implementation of a Phenobarbital pathway for Severe Alcohol Withdrawal Syndrome" as part of the Critical Care Grand Rounds. Dr. Nicholas Bosch MD, Msc, Assistant Professor of Pulmonary, Allergy, Sleep & Critical Care Medicine at Boston University School of Medicine presents a lecture on the “Implementation of a Ph

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Beyond the Burns: Toxic House Fire Gases

Northwestern EM Blog

Written by: Adam Payne, MD (NUEM ‘24) Edited by: Emily Wessling, MD (NUEM ‘22) Expert Commentary by : Justin Seltzer, MD (NUEM ‘21) Expert Commentary Congratulations to Drs. Payne and Wessling on an excellent post. Management of toxic gas exposure from a house fire is essential knowledge for all emergency physicians. The two major toxic gases of interest are carbon monoxide and hydrogen cyanide; it is important to note that fires in other environments, such as factories or industrial sites, may

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PE post-D/C | UTICalc Recalibrates

JournalFeed

The JournalFeed podcast for the week of May 23-27th, 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. PE post-D/C Spoon Feed: Risk for venous thromboembolism (VTE) was highest during hospitalization but the risk remained elevated 3-fold at 3 months post-discharge.

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SGEM#367: GRACE2 – Low-Risk, Recurrent Abdominal Pain

The Skeptics' Guide to EM

Date: May 24th, 2022 Reference: Broder et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE) 2: Low-Risk, Recurrent Abdominal Pain in the Emergency Department. AEM May 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 33-year-old male presents to […] The post SGEM#367: GRACE2 – Low-Risk, Recurrent Abdominal Pain first appeared on The Skeptics Guide to Emergency Medicine.