Sat.Nov 09, 2024 - Fri.Nov 15, 2024

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Why Is Your Hospital’s Pediatric Readiness Score Important?

The Trauma Pro

The Pediatric Readiness Score (PRS) is a new(er) metric that is now required for all US trauma centers verified by the American College Surgeons. There is no specific threshold that must be met, but the value must be reported for review at the time of the site visit. What is the PRS? It is a measure introduced by the National Pediatric Readiness Project.

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Targeted Temperature Management in Paediatric Traumatic Brain Injury

Don't Forget the Bubbles

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. Should we aim to prevent fever, or should we cool patients? A 12-year-old boy presents with a significant head injury following a road traffic accident. At the scene, his lowest GCS was 5 (E1V2M2).

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If You Sanewashed RFK Jr., Or If You Sanewashed Doctors Who Did, You Own the Next 4 Years

Science Based Medicine

When RFK Jr. does to the U.S. what he did to Samoa, doctors will say they are horrified, that they love vaccines, blah blah blah. But it will be too late. The post If You Sanewashed RFK Jr., Or If You Sanewashed Doctors Who Did, You Own the Next 4 Years first appeared on Science-Based Medicine.

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MAHA and Medical Conservatism

Sensible Medicine

What does our philosophy have to do with RFK Jr and MAHA?

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Ep 199 Trauma Airway and Airway Trauma

Emergency Medicine Cases

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma?

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IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO)

First 10 EM

In the most recent BroomeDocs podcast, we talk about an attempt to use the IM route to give cardiac arrest victims epinephrine faster. (The podcast and Research Roundups blog post might actually come out next week.) I was skeptical about the outcomes, partly because the evidence that epinephrine helps at all in cardiac arrest is […] The post IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO) appeared first on First10EM.

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Dr. Vinay Prasad: “I Don’t Believe in Forgiveness Because in My Opinion These Pieces of S**t Are Still Lying.”

Science Based Medicine

Mass purges and prosecutions of scientists have happened before. We shouldn't pretend they can't happen here. The post Dr. Vinay Prasad: “I Don’t Believe in Forgiveness Because in My Opinion These Pieces of S**t Are Still Lying.” first appeared on Science-Based Medicine.

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Meta-analysis: Leg ergometry helps vented patients in ICUs worldwide

PulmCCM

Critically ill patients receiving mechanical ventilation are highly prone to developing severe weakness and long-term disability. Although early mobilization and physical therapy for vented patients would intuitively seem to have indisputable benefits, early mobility programs have failed to consistently show improvements in meaningful patient-centered outcomes (e.g, increased functional independence or exercise ability after ICU discharge).

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PulmCrit Wee: Why MedTwitter should move to Bluesky

EMCrit

Medtwitter was great. We met amazing people and exchanged ideas. There were endless arguments about electrolytes and intubation. But the strength of Medtwitter was never the platform – it was the people. Twitter has been deteriorating for years. For example, the algorithm is horrific, the blocking feature has been largely removed, posts from paid users […] EMCrit Project by Josh Farkas.

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REBEL Core Cast 131.0 – Traumatic Arthrotomy

RebelEM

Take Home points : Always suspect an open joint if there is a laceration, regardless of size, the lies over joint CT scan of the affected joint is widely considered to be the standard approach to evaluation but the saline load test may be useful in certain circumstances. Obtain emergency orthopedics consultation for all open joints and administer antibiotics and update tetanus in all patients REBEL Core Cast 131.0 – Traumatic Arthrotomy Click here for Direct Download of the Podcast.

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emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the literature on evaluation and management of primary SBP. Episode 110: Primary Spontaneous Bacterial Peritonitis Background: End-stage liver disease with cirrhosis and ascites is a major cause of death worldwide. Primary spontaneous bacterial peritonitis (SBP) is one of the most common infections in those with cirrhosis and ascites.

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More data on Impella complications emerge

PulmCCM

The DanGer-Shock randomized trial allowed interventional cardiologists to breathe a bit easier, knowing that the Impella device resulted in improved survival 6 months after ST-elevation myocardial infarction with cardiogenic shock: The trial also underscored the high risks associated with the Impella device: Many more patients with Impellas required renal replacement therapy (41.9% vs 26.7%).

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2nd degree AV block: is this Mobitz I or II? And why the varying P-P intervals?

Dr. Smith's ECG Blog

Written by Willy Frick A middle aged man presented for elective outpatient surgery. The following ECG was obtained in the preoperative area. What do you think? The ECG shows sinus rhythm with a rate of about 78 and 2:1 AV conduction along with right bundle branch block and left anterior fascicular block. The PR interval on the conducted beats is prolonged, about 220 ms.

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Buying What SELECT is Selling: Semaglutide

Sensible Medicine

I am huge of fan of the The Skeptical Cardiologist, who I will refer to as TSC. His opinions are often ones I hope I would have come to if I was thinking about the same topic. His substack and twitter feed are totally worth following. I read his post last week on Sensible Medicine and agreed with pretty much everything he said. I also was left with a different conclusion.

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ECG Pointers: A Dynamic Approach to Tachydysrhythmias Part 3

EMDocs

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.

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INTERESTING HOLTER-STRIP

ECG Guru

Sometimes you see an ECG and feel overwhelmed at first. This ECG rhythm strip is challenging at first glance. However, if you take a systematic approach to the analysis, it is usually possible to decipher the case.

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Blurred Lines: The Ethical Pitfalls of Urine Drug Screens

EM Ottawa

Urine drug (or toxicologic) screens are a fairly standard tool used in addictions, psychiatry and the Emergency Department (ED), often employed to detect substance use in patients presenting with altered mental status, trauma, psychiatric or abnormal behaviour. Yet, the reliance on these screens is fraught with inaccuracies, clinical irrelevance, and significant ethical concerns, particularly from […] The post Blurred Lines: The Ethical Pitfalls of Urine Drug Screens appeared first on EMOt

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Podcast – Care in the Hot Zone with Claire Park at Tactical Trauma 2024

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Emergency medicine is shaped by our ability to respond effectively to both routine cases and extreme, high-stakes incidents. While civilian incidents dominate prehospital care, the intersection of civilian and military […] The post Podcast – Care in the Hot Zone with Claire Park at Tactical Trauma 2024 appeared first on St.Emlyn's.

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Systematic reviews 101

Sensible Medicine

4 mistakes people make in systematic reviews

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ATRIAL TACHYCARDIA WITH PARTLY ABERRANT CONDUCTION

ECG Guru

This ECG comes from Germany, where unfortunately recording is still often done at 50 mm/s. Nevertheless, I believe that you can easily recognize the important changes in this ECG, even if you are not familiar with this recording format. The first two beats are the limb leads, the other beats are the precordial leads.

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SGEM#459: Domo Arigato Misuta Roboto – Using AI to Assess the Quality of the Medical Literature

The Skeptics' Guide to EM

Date: October 28, 2024 Reference: Woelfle T et al. Benchmarking Human–AI collaboration for common evidence appraisal tools. J Clin Epi Sept 2024. Guest Skeptic: Dr. Laura Walker is an Associate Professor of Emergency Medicine and the vice chair for digital emergency medicine at the Mayo Clinic. In addition to finding ways to use technology in emergency department (ED) care, she is interested in how health systems work and how patients move through the healthcare system.

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Global EM 6 Palliative Care in Low-Resource Settings: Challenges and Solutions

Emergency Medicine Cases

Dr. Sara Alavian describes some of the challenges of providing palliative care in low-income/low resource settings and offers some simple solutions in this Global EM column. The post Global EM 6 Palliative Care in Low-Resource Settings: Challenges and Solutions appeared first on Emergency Medicine Cases.

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239. Torsades & Charcuterie

Board Bombs

We're seeing a lot of "bespoke" things lately. but there's only one true bespoke cure for Torsades. Let's cover this HARD board-style question. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 239. Torsades & Charcuterie.

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Procedure: Radial Arterial Line

Life in the Fast Lane

James Miers and Daniel Gaetani Procedure: Radial Arterial Line Emergency Procedure: Radial Arterial Line, with a guide made in partnership with a recent publication in Emergency medicine Australasia

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VENTRICULAR TACHYCARDIA ATRIAL FIBRILLATION AND ABERRANT CONDUCTION

ECG Guru

It is not uncommon for several different abnormal changes to occur simultaneously in an ECG, as in this Holter ECG strip.

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Clinical Governance Day – Wednesday 20th November

Greater Sydney Area HEMS

Visit the post for more.

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Imaging Case of the Week 609

EMergucate

The ankle images are from a patient who has sustained a twisting injury to their ankle. What can be seen?

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Much Ado About Diet and Lifestyle, for Good Reason

Clinical Correlations

By Enoch Jiang Peer Reviewed “Counseled patient on diet and lifestyle.” Over the past few weeks on my Ambulatory Care rotation, this phrase has rapidly shot to the top of my internal gestalt of a prototypical.

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It’s Your Call – November 2024

Total Medical ComplianceHIPAA

HIPAA: How does ransomware spread? Ransomware commonly spreads through phishing emails, malicious attachments, or compromised websites. Once a user clicks on a link or downloads infected content, the ransomware installs itself on the device, often spreading across the network to other systems.

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Cooper University Health Care selects NRC Health as new patient experience partner

NRC Health

Cooper University Health Care has selected NRC Health to be its partner in building Human Understanding across its network through humanized healthcare solutions and data-driven insights inline with Cooper’s mission: “To serve, to heal, to educate.” The post Cooper University Health Care selects NRC Health as new patient experience partner appeared first on NRC Health.

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ECG of the week 13th Nov 24

EMergucate

This week our patient is a 34yr old gentleman who presents to the ED with a 1 week history of chest pain and palpitations, his initial ECG is: His potassium and magnesium are borderline low so you …

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UAVs and prehospital care

PHARM

The potential emerging role of UAVs in prehospital care

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Grand Rounds Recap 11.13.24

Taming the SRU

sports medicine grand rounds - Rabies Phophylaxis - R2 qi/kt: Acetaminophen overdose - Landmark studies of emergency medicine - R4 Discharge/Transfer/Treat - Pediatric Lecture sports medicine grand rounds WITH dr. gawron Team physicians deal with a variety of medical complaints, including sports-related injuries as well as non-traumatic concerns Case 1: Clavicular Osteomyelitis 18-year-old female athele presented with a soccer injury but developed fevers, erythema, and warmth of the medial clavi

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Under pressure: Addressing workplace violence in healthcare

NRC Health

This episode of the Becker's Healthcare Podcast explores the challenges and solutions with Shelby Chapman, Director of Patient-Family Experience at Children's Hospital Colorado and Toya Gorley, Improvement Advisor at NRC Health. They discuss a human-centered framework and successful strategies to create a safer and more respectful environment for everyone.

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Is Pip-Tazo Harming Sepsis Patients?

RebelEM

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. Literature comparing the two regimens has largely focused on the adverse effects of each medication, rather than on overall efficacy.

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Changing to soft neck collars in Melbourne prehospital trauma care

PHARM

Protection of the cervical spine is recommended following multisystem injury. In 2021, Ambulance Victoria changed clinical practice guidelines to apply soft collars instead of semi‐rigid collars for suspected cervical spine injury. The aim of this … — Read on pmc.ncbi.nlm.nih.

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ECG Blog #456 — Acute MI or Something Else?

Ken Grauer, MD

Today's case was contributed by Dr. Magnus Nossen ( from Fredrikstad, Norway ). Dr. Nossen was at his computer — reviewing ECGs from patients recently admitted to his group's hospital service. He came across the ECG shown in Figure-1 — obtained from a woman in her 70s who was admitted to the hospital for new CP ( C hest P ain ). QUESTION: How would YOU interpret the ECG in Figure-1 ?

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