June, 2022

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SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study

The Skeptics' Guide to EM

Date: June 12th, 2022 Reference: Finfer et al. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. NEJM 2022. Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in the Department of Critical Care Medicine at Mayo Clinic Arizona. He is board certified […] The post SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study first appeared on The Skeptics Guide to Emergency Medicine.

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Conversation - Meningococcal Meningitis

EB Medicine

In this episode of EMplify: Conversation , Sam Ashoo, MD and TR Eckler, MD discuss meningococcal meningitis and the recent outbreak in Florida. Topics discussed include: Which vaccines are currently approved by the FDA and recommended by the CDC. The difference between the MEN ACWY vaccine and the meningococcal B vaccine. What the current recommendations are for those exposed.

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The Tale of Two “Negative” Studies

Stop and Think

This is a story of two medical studies. One enhances faith in the scientific process. The other induces cynicism. The specifics of the interventions—one for atrial fibrillation (AF), the other for heart failure—are not the point. The point is the opposite ways in which scientists interpreted and presented the results. Chapter 1: The DECAAF II trial tested two approaches to the ablation of patients with persistent AF.

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143. Hydrocarbon Toxicity: Sniff and DIE

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. Anytime you can talk about Sudden Sniffing Death Death Syndrome is an intriguing day. Also, we cover some ASMR. Let’s talk hydrocarbons- presentation, what you need to look out for, and how to manage these potentially very sick patients.

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ECG Cases 32 Prehospital ECG pearls and pitfalls

Emergency Medicine Cases

In this ECG Cases blog we review 8 cases of patients with prehospital ECGs and explore prehospital ECGs for diagnosing STEMI, Occlusion MI, false STEMI, code STEMI, dynamic ischemic changes, truncated voltages. Can you avoid the pitfalls and spot the pearls that help to make the diagnosis? The post ECG Cases 32 Prehospital ECG pearls and pitfalls appeared first on Emergency Medicine Cases.

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Antitrust 101: How to Build Medical Monopolies by Discrediting U.S. Physicians

Dr. Wes

Recently, there have been a rash of initiatives by unaccountable non-profit physician credentialing organizations (Federation of State Medical Boards, the American Boards of Internal Medicine, Family Medicine and Pediatrics), and the American Medical Association to come to the public's rescue by de-credentialing U.S.

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Enforcement Against HIPAA Violations

American Medical Compliance

In March of 2022, the US Health and Human Services Office of Civil Rights (HHS OCR) released four new enforcement actions. The Department took these actions against healthcare workers when they took place in medical practices that led to HIPAA violations. Half of the enforcement actions are from the HIPAA Right of Access Initiative, created by the HHS.

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How Dangerous Property Conditions Cause Slip and Fall Accidents

Medical Law

A slip and fall accident can occur nearly anywhere, ranging from the supermarket, to the parking lot of a business, or even in a stranger’s property. Slips, trips, and falls are some of the most common injury-causing accidents throughout America. This may be because there are plenty of opportunities for falls everywhere that you go! Property owners have a duty to make sure their property is safe for those who enter it.

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142. Bonus Bomb! Acute Gout Therapies

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. Do we love our subscribers and listeners? Absolutely. Do we like to release cool bonus content for them to be better physicians? Yes of course. Let’s dive in to the details on all you need to know with acute gout therapies in <10 minutes.

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EM Quick Hits 39 Overdiagnosis, Lytics for Submassive PE, Pericardial Effusion, Hemophilia Treatment

Emergency Medicine Cases

In this month's EM Quick Hits podcast Justin Morgenstern & Eddy Lang discuss the problem of overdiagnosis in EM, Anand Swaminathan's approach to indications and dosing of thrombolytics for submassive (intermediate risk) pulmonary embolism, Tahara Bhate's QI Corner on a patient with unexplained shortness of breath, Brit Long on emergency treatment of the bleeding hemophilia patient.

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Jugular Venous Pressure

Ultrasound Gel

Jugular venous distention (JVD) is a classic physical exam finding taught for ages, but assessing it can be a challenge. Can ultrasound do a better job and therefore offer a non-invasive evaluation of the patient’s right heart pressures? This goal has been the pursuit of many ultrasounds before. This time we have a new vessel to assess and a nice reference standard (right heart cath)!

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Presentation Preparation Training for Healthcare Providers

American Medical Compliance

Presentation Preparation Training for Healthcare Providers is designed to educate healthcare providers (HCP) on how to plan, develop, write, and deliver an effective presentation. Presenting is often very nerve-racking and strenuous for many people. Properly preparing is a great way for employees and employers to feel ready and able to deliver outstanding presentations, as well as conquer any nerves they may have.

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Conversation – Cognitive Reframing

EB Medicine

In this episode of EMplify: Conversation , Sam Ashoo, MD and Rob Orman, MD discuss cognitive reframing. What is cognitive reframing you ask? It is a tool for dealing with a particularly difficult event. In our case, we discuss the “near miss” medical case and how it impacted a physician. Then we discuss how the use of cognitive reframing can help improve our perception of these “near miss” events in medicine.

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Ortho Pearls: Metacarpal Fracture Management

Cook County EM Blog

The Case: A 40-year-old male with no past medical history presented to the emergency department after he was assaulted with closed fists just prior to arrival. The patient’s injuries included a blow to the back of his right hand. On exam he was found to have swelling and tenderness to the dorsal aspect of his right hand. He had brisk capillary refill and normal sensation to light touch in all fingers.

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141. Gout: The Rich Man's Plague

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. Long ago, it was called the "rich man's plague" because it was associated with extravagant indulgence of food and drink. Sure, those demographics have changed nowadays, but its a catchy name that turns heads and gets you hooked to listen!

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Ep 170 Cardiac Arrest – PoCUS Integration, Communication Strategies, E-CPR, Calling the Code

Emergency Medicine Cases

In this part 2 of our 2-part podcast series on Cardiac Arrest - The When, Why & How, we discuss some of the finer art of cardiac arrest care and answer questions such as: how should we best communicate to EMS, the ED team and the family of the patient to keep the team focused, garner the most important info and keep the flow of the code going? How should we integrate PoCUS into cardiac arrest care so we do not interrupt the core components, yet we gain valuable data?

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Why do we NOT name Occlusion MI (OMI) after an EKG finding? (In contrast to STEMI, which is named after ST Elevation)

Dr. Smith's ECG Blog

A 40-something male with no previous cardiac disease presented with chest pain. Here is his ECG: There is no clear evidence of OMI or ischemia. There is a tiny amount of STE in aVL, but it is NOT in the context of a tiny R-wave. There is a tiny amount of STD in lead III, with some non-specific T-wave flattening. I am glad that Ken Grauer (below) brings up the issue of whether the presence of "T-wave in V1 taller than T-wave in V6" is evidence for OMI.

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Presentation Preparation Training for Dental Healthcare Providers

American Medical Compliance

Presentation Preparation Training for Dental Healthcare Providers is designed to educate dental healthcare providers (DHCP) on how to plan, develop, write, and deliver an effective presentation. Presenting is often very nerve-racking and strenuous for many people. Properly preparing is a great way for employees and employers to feel ready and able to deliver outstanding presentations, as well as conquer any nerves they may have.

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Procedural Sedation & Analgesia

EB Medicine

In this episode, Sam Ashoo, MD interviews Prayag Mehta, MD and Joshua Kern, MD – two of the authors of the June, 2022 EMP article on Procedural Sedation and Analgesia in the Emergency Department. Listen to the discussion to hear more about the emergency medicine approach to sedation in adults and pediatrics ! Procedural Sedation and Analgesia in the Emergency Department EMplify – June 2022 Episode Outline: 1.Procedural sedation and analgesia (PSA): terminology 2.Levels of sedation Minimal Moder

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4 Things to Expect from Your First Placement as an Interim Healthcare Leader

Core Medical Group

By now, you’ve probably heard about interim healthcare management and know a little bit about what a temporary leadership position in the medical field might look like.

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Breaking Down Barriers to Care

MDisrupt

In a world where many people lack access to appropriate care, Dr. Shapiro is working to bring down the barriers experienced by marginalized populations.

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ECG of the Week 8th June 2022 Answer

EMergucate

A 50 year old male presents to ED at 06h45 with chest pain radiating to his left arm which woke him up at 02h00 Below is the patients ECG

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1 or 2 Dex | Rx: Paxlovid

JournalFeed

The JournalFeed podcast for the week of June 20-25th, 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. 1 Or 2 Dex Spoon Feed: A single dose of dexamethasone was as effective as two in treatment of mild to moderate pediatric asthma exacerbations in the emergency department.

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Presentation Preparation Training

American Medical Compliance

Presentation Preparation Training is designed to educate employees on how to plan, develop, write, and deliver an effective presentation. Presenting is often very nerve-racking and strenuous for many people. Properly preparing is a great way for employees and employers to feel ready and able to deliver outstanding presentations, as well as conquer any nerves they may have.

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Conversation – Ukraine with Dr. JP McBryde

EB Medicine

The war in Ukraine has now been ongoing for 100 days. In today’s episode of EMplify: Conversations we hear from Dr. J.P. McBryde about his experience as an emergency physician volunteering in Ukraine. You can read more about Med Global and their efforts in Ukraine, on their home page: [link] We would love to have your feedback. Please take the listener survey: [link] Thanks for being a listener.

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Brief Echo in Cardiac Arrest

Ultrasound Gel

This clever study questions which cardiac view is best to obtain during a cardiac arrest. By using a simulated arrest scenario on living non-cardiac arrest patients, they compare the subxiphoid window and the parasternal long axis view in terms of speed and image quality. [link] [link] This clever study questions which cardiac view is best to obtain during a cardiac arrest.

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Women’s Health Investment: Top Trends, Issues, and Opportunities (2022)

MDisrupt

Why is women's healthcare so important and why should digital health companies invest in it? Learn about some unmet needs and opportunities here.

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ECG of the Week – 22nd June 2022

EMergucate

A 24 year old Indigenous female P2 G3 31/40 pregnant presents to ED with left sided non pleuritic chest pain and shortness of breath.

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SGEM#369: Romeo is Bleeding – Does He Need a RePHILL?

The Skeptics' Guide to EM

Date: June 18th, 2022 Reference: Crombie et al. Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. The Lancet Haematology 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anaesthesia and critical care.

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OSHA Work Related Illnesses

American Medical Compliance

OSHA mandates every employer keeps a record of every work related illness and injury. There are three forms: one describes the incident, the second describes the establishment, and the third describes the employee involved. Employers must keep these forms five years after the incident because it will be easier to update them. These forms are crucial to keeping the workplace safe and finding patterns of illness and injury.

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Sent Home Abnormal | Guided IVs | Lessons from Tuskegee

JournalFeed

The JournalFeed podcast for the week of June 13-17th, 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. Sent Home Abnormal Spoon Feed: 18% of children in this cohort were discharged from a pediatric ED with at least one abnormal vital sign.

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Your Patients’ Right of Access

Total Medical ComplianceHIPAA

The HIPAA Privacy Rule grants patients the right to access their health information in a way that is easy and affordable for them. Providers are required to give patients access to their health information. There are some exceptions, of course, so getting the process right can be as confusing as being in a house of mirrors. Patients are entitled to receive all information a provider maintains about them in one or more designated record sets.

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What makes a great CMO? Emergency medicine physicians are the answer

MDisrupt

Learn about the essential skills you want in a Chief Medical Officer and why EM Physicians are serious candidates for your company.

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ECG of the Week 15 June 2022 – Answer

EMergucate

A 52 year old male presents to ED with shortness of breath for the last 2 weeks. The patient had been on a 6 hour flight 2 weeks ago.

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The Constant Struggle

Stop and Think

When I review evidence for the This Week in Cardiology podcast , I fight the urge to become cynical. No, John, don’t go there. A voice in my head says it would be foolish to diminish the gains that medical scientists have made in recent years. Certain types of cancers are routinely cured or transformed into chronic diseases. New cardiac drugs and devices have extended life and diminished suffering.

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Work Burnout and Stress Rising Among Healthcare Personnel

American Medical Compliance

A recent survey from the American Medical Association on work stress, burnout, and job satisfaction has shown an increase in physician burnout and stress. Job satisfaction among healthcare personnel has decreased by 4% from the previous year. 72% of the 11,000 healthcare workers surveyed reported job satisfaction. This is the first time a drop in job satisfaction has occurred.

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Vapocoolant Please | Mystery ECG

JournalFeed

The JournalFeed podcast for the week of June 6th to 10th , 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. Vapocoolant Please Spoon Feed: Vapocoolant spray may improve a patient’s experience of digital blocks for repair of finger injuries.

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