The Trauma Pro

FEBRUARY 14, 2025

The Advanced Trauma Life Support course lists “classes of hemorrhage”, and various other sources list a similar classification for shock. I’ve not been able to pinpoint where these concepts came from, exactly. But I am sure of one thing: you will be tested on it at some point in your lifetime. Here’s the table used by the ATLS course: The question you will always be asked is: What class of hemorrhage (or what % of blood volume loss) is the first to demonstrate systolic hy

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Shock Resuscitation 158

Science Based Medicine

FEBRUARY 24, 2025

When Robert F. Kennedy Jr. was nominated to be Secretary of Health & Human Services, I called him an "extinction-level threat" to public health. Here's how he will attempt to make vaccines extinct in the US. The post How Robert F. Kennedy Jr. will undermine and ultimately destroy US vaccination programs first appeared on Science-Based Medicine.

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PulmCCM

FEBRUARY 5, 2025

Neurologists’ job just got harder. Patients who present with ischemic stroke more than 4.5 hours after symptom onset generally do not receive intravenous thrombolytics (tPA or TNK). That’s because outside that accepted window, the risk of intracranial hemorrhage was believed to outweigh the benefits of thrombolytics in restoring blood flow to at-risk brain tissue.

Stroke 101

Stroke Documentation/Coding Outcomes 101

Mind The Bleep

FEBRUARY 2, 2025

As a new F1 in August, it can feel like quite a daunting task to verify a death, particularly if you have never seen this done before. This step by step guide will take you through the process of death verification to help make this task easier as you settle into your new role. Verifying a Death You will usually be asked to verify a death by nursing staff from the ward the patient is on.

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Documentation/Coding Resuscitation Hospitals EKG/ECG 105

EMCrit

FEBRUARY 23, 2025

The Stellate Ganglion Block for Electrical Storm EMCrit Project by Scott Weingart, MD FCCM.

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EM Ottawa

FEBRUARY 6, 2025

Medicine often carries an aura of mystiquea profession elevated by society as a noble calling, a higher pursuit. But for those of us in the trenches, the reality is far simpler (: medicine is a job. A demanding, high-stakes, and sometimes unforgiving job, but a job nonetheless. This isnt a dismissal of its importance but […] The post There IS Beauty in Medicine appeared first on EMOttawa Blog.

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The Trauma Pro

FEBRUARY 24, 2025

There are two broad categories of things that kill trauma patients. No, Im not talking about violent penetrating injury, falls, car crashes, or any other specific mechanisms. I am referring to the end events (on a macro scale) that take their lives. These two basic killers are: hemorrhage and brain injury. The vast majority of the time, a dying trauma patient has either suffered a catastrophic brain injury, or has ongoing and uncontrolled bleeding.

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Operations Shock 136

Sensible Medicine

FEBRUARY 17, 2025

John is sick, so I have big shoes to fill. Today’s study of the week is a cancer trial. I know many of you aren’t cancer doctors, and you are thinking about skipping this essay. Let me assure you: you will learn something. The trial has issues with control arm, skewed randomization (2:1), drop out and endpoints. It is a rollercoaster ride of critical appraisal.

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Hospice Wellness Research 100

Mind The Bleep

FEBRUARY 2, 2025

This guide is designed to help you identify the key areas you need to focus on when clerking a surgical patient. There are several differences when compared to clerking a medical patient, namely getting a more extensive surgical past medical history, examination and assessing frailty. Your clerking needs to be succint, pertinent and clear. Presenting Complaint This needs to be clear and brief – a headline to tell any reader why that patient has presented: Good example: “1/7 colicky R

Documentation/Coding 95

Documentation/Coding COPD EKG/ECG Wellness 95

St. Emlyn

FEBRUARY 23, 2025

St.Emlyn's - Emergency Medicine #FOAMed What does it truly mean to be dead? In 2025, updates to Death by Neurological Criteria (DNC) challenge long-standing medical definitions, raising new ethical and practical questions. This post explores the latest AOMRC guidelines, the evolving role of brainstem death, and how these changes impact emergency and intensive care medicine.

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PulmCCM

FEBRUARY 27, 2025

Balanced crystalloids are considered to be probably superior to normal saline as a resuscitation fluid in critically ill patients. But there are multiple balanced crystalloid products available, with varying compositions. Does the choice of balanced solution make a difference in patient outcomes from critical illness? Balanced solutions are formulated with electrolyte and solute concentrations closer to plasma’s, compared to normal saline’s simple composition of sodium and chloride (

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Resuscitation Outcomes Research 95

The Trauma Pro

FEBRUARY 7, 2025

In my last post, I wrote about the usual reasons for delayed diagnosis: insufficient diagnostic technique or insufficient recognition. What about the time of day? An interesting paper looked at the correlation between admission time and the rate of missed injuries. The work was done at a large teaching hospital and Level I trauma center in Australia.

Hospitals 121

Hospitals 121

Science Based Medicine

FEBRUARY 21, 2025

There is no doubt the "studies" in this journal will conclude We Want Them Infected doctors were right about everything the whole time; mitigation measure were an epic catastrophe while COVID was a harmless cold for everyone but grandma. The post Misinformation Doctors Start a Misinformation Journal to Spread Misinformation first appeared on Science-Based Medicine.

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RebelEM

FEBRUARY 24, 2025

Background In 1979, Hiroshi Natori was the first to appreciate the sonographic changes that occur in the inferior vena cava (IVC)s diameter with ventilation in spontaneously breathing patients, mechanically ventilated patients, and those with carcinogenic and tuberculoid cardiac tamponade. 1 They noticed how spontaneously breathing patients had their IVC collapse with inspiration; and ventilated patients had their IVC dilate during positive pressure ventilation.

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Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Mind The Bleep

FEBRUARY 2, 2025

Often one of the scariest things you can do as you will most likely be speaking to a more senior colleague in an unfamiliar speciality. However, as an F1, you may well know the patient best and therefore you may be best placed to refer the patient. Our Webinar Introduce yourself and say on whose behalf you are making the referral Remember, you hold all the information about the patient and are therefore in the driving seat Use the SBAR approach and you wont go far wrong Know why you are referrin

Radiology 96

Radiology Radiology Sepsis Documentation/Coding 96

Sensible Medicine

FEBRUARY 18, 2025

For decades, the treatment of acute appendicitis was appendectomy. Nobody even questioned this treatment approach. The appendix was acutely inflamed, at risk of perforation, it needed to be removed. The idea that there could be a simple, non-surgical management could not have been imagined. But, eventually evidence would accumulate casting doubt on this paradigm.

Outcomes 82

Outcomes Research Emergency Department Pediatrics 82

St. Emlyn

FEBRUARY 7, 2025

St.Emlyn's - Emergency Medicine #FOAMed This blog post provides concise summaries of recent critical care trials, including HEMOTION, PREOXI, BLING III, CLASSIC, EVIDENCE, VICTOR, and PARAMEDIC-3. Each trial is examined for its key findings, strengths, limitations, and practical implications for clinical practice. The post aims to inform healthcare professionals about the latest evidence-based practices in critical care.

Evidence-Based Practice 76

Evidence-Based Practice Research Resuscitation 76

Emergency Medicine Cases

FEBRUARY 18, 2025

Eating disorders have the highest mortality rate of any psychiatric illness, yet they are frequently missed in the Emergency Department as they can be elusive. Only one in 246 patients who screen positive for an eating disorder at triage have a chief complaint suggesting it. These patients dont always fit the stereotypemany appear healthy, have normal BMI, or present with vague GI, cardiac, or neurological symptoms.

Psychiatric 84

Psychiatric Emergency Department EMS Outcomes 84

Science Based Medicine

FEBRUARY 22, 2025

Policy-based evidence making means working back from a predefined policy to produce underpinning evidence. The post Dr. Vinay Prasad Embraces Policy-Based Evidence Making first appeared on Science-Based Medicine.

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Northwestern EM Blog

FEBRUARY 4, 2025

Written by: Dean Hayes (NUEM 27) Edited by: Andrew Long (NUEM 25 ) Expert Commentary by: Rafael Lima, MD A mid 20s male presents to the ED after seizure-like activity. Per the patient's partner at bedside, he had a 2-3 minute convulsive episode and the description is consistent with a likely seizure. The patient has never had a seizure before and is A&Ox4 upon arrival to the ED with reassuring examination.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

Mind The Bleep

FEBRUARY 2, 2025

This is a tricky area to cover as it can be challenging to us both personally and professionally when things dont go well with a colleague, particularly when we know that this might impact patient care and/or our own mental health. The longer these negative interactions go on, the more likely they are to significantly impact on outcomes for our patients, our colleagues and ourselves.

Documentation/Coding 98

Documentation/Coding Outcomes Burns Wellness 98

The Skeptics' Guide to EM

FEBRUARY 1, 2025

Reference: Leonard JC et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. June 2024. Date: Oct 15, 2024 Dr. Tabitha Cheng Guest Skeptic: Dr. Tabitha Cheng is a Southern California native and board-certified emergency medicine physician and completed an EMS fellowship as well.

Pediatrics 65

Pediatrics EMS Emergency Department Research 65

St. Emlyn

FEBRUARY 11, 2025

St.Emlyn's - Emergency Medicine #FOAMed This months St Emlyns podcast wraps up Season 11 with a review of key emergency medicine topics. We cover new evidence on chest trauma management, intraosseous access safety, pediatric imaging updates, AI in medicine, toxic alcohol poisoning, and airway management. Plus, insights from major conferences like EUSEM 2024.

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Airway Management Poisoning Pediatrics Resuscitation 72

Don't Forget the Bubbles

FEBRUARY 24, 2025

Two-month-old Isla presents to their local hospital following a prolonged apnoea at home. They had a two-day history of reduced feeding. Their clinical examination is unremarkable: normal heart sounds, palpable femoral pulses bilaterally, and no rashes, bruises, or signs of injury. They have a soft anterior fontanelle and no focal neurology. Because of their worsening respiratory acidosis, they were intubated in the ED, The initial chest-x ray shows a right-sided consolidation, in keeping with b

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Science Based Medicine

FEBRUARY 15, 2025

Although many doctors who spread COVID misinformation act as if its in poor taste to bring it up today, we don't need their permission to remember. The post Dont Worry About the NIH From the Same Doctors Who Brought You Dont Worry About COVID. first appeared on Science-Based Medicine.

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EMCrit

FEBRUARY 4, 2025

EMCrit RACC-Lit for January 2025 All the literature goodness! EMCrit Project by Scott Weingart, MD FCCM.

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Mind The Bleep

FEBRUARY 2, 2025

As a resident doctor, you will have face situations where you have to convey potentially distressing information, whether it is explaining a diagnosis or blood results to a patient or giving difficult news to relatives. Breaking bad news well is an essential communication skill which can strengthen the relationship between a patient and a doctor and create an environment where the patient and/or their families feel respected and supported.

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Wellness 98

Sensible Medicine

FEBRUARY 3, 2025

We are back with a riveting discussion

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St. Emlyn

FEBRUARY 25, 2025

St.Emlyn's - Emergency Medicine #FOAMed Discover how the GoodSAM app is revolutionizing emergency response, from cardiac arrest alerts to real-time video triage and crime prevention. Learn how you can get involved today. The post Podcast – GoodSam App Update with Mark Wilson at LTC appeared first on St.Emlyn's.

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Resuscitation 79

EMDocs

FEBRUARY 22, 2025

Authors: Caleb Graham, MD (EM Resident Physician, UTSW/ Dallas, TX); Colin Danko, MD (EM Faculty Physician, UTSW/ Dallas, TX) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

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EMS Fractures Operations Wellness 59

Science Based Medicine

FEBRUARY 14, 2025

$160 million is a lot of money, especially when you consider its not just money. It's lost dreams, careers, and discoveries. The post Open Letter II: President Levin, There Are Now 160 Million Reasons Why You Shouldnt Have Censored We Want Them Infected Doctors first appeared on Science-Based Medicine.

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The Skeptics' Guide to EM

FEBRUARY 22, 2025

Reference: Agnello et al. Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Clinical Chemistry and Laboratory Medicine 2022; 60(5):786-792 Clin Chem Lab Med. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Sepsis 60

Sepsis Infectious Diseases Emergency Department Pediatrics 60

Mind The Bleep

FEBRUARY 2, 2025

Here we assume you know the basics , and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients but the underlying principles are of great value if youre doing an FY1-led ward round. Be Thorough The expectation is that you are slow and thorough if you rush you can make mistakes & you end up spending more time worrying than seeing patients.

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Dehydration Documentation/Coding Wellness 97

EMCrit

FEBRUARY 7, 2025

Part 2 of Inotropes with Trina - we discuss specific scenarios. EMCrit Project by Scott Weingart, MD FCCM.

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First 10 EM

FEBRUARY 24, 2025

I have covered calcium channel blockers for atrial fibrillation a number of times. If you are pursuing a rate control approach, calcium channel blockers probably result in more rapid control. Thus, if you are trying to send these patients home, they might be a good choice. However, for long term management, cardiologists seem to prefer […] The post Diltiazem for atrial fibrillation: does calcium pretreatment help?

EMS 66

EMS 66

EB Medicine

FEBRUARY 5, 2025

In this episode, Sam Ashoo, MD interviews Erin D'Agostino, MD about the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department Pathophysiology Types of Traumatic Brain Injuries Pre-Hospital Care Critical History and Physical Examination Neurological Assessment and Monitoring Laboratory and Imaging Studies Emergency Department Treatment Surgical Interventions and Considerations Patient DemographicsSummary of major points disc

Emergency Department 69

Emergency Department Hospitals 69

Science Based Medicine

FEBRUARY 28, 2025

The many doctors who are just now realizing that misinformation wasn't "COVID hysteria nonsense" have a lot of catching up to do to understand how the forces they've legitimized the led to this moment. The post Welcome to the Resistance UCSF Doctors first appeared on Science-Based Medicine.

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