Sat.Jun 10, 2023 - Fri.Jun 16, 2023

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Pet Peeve: Conflicts Of Interest

The Trauma Pro

For the longest time, one of my pet peeves has been potential conflicts of interest (COI) involving authors on research papers. There is no simple definition of the term “conflict of interest.” However, a simple way to think of it is a situation where one’s personal interests may influence their professional responsibilities. Upton Sinclair said it more simply in a book he was writing in the 1930s: “It is difficult to get a man to understand something when his salary depends up

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Morel-Lavallée Lesion in Children

Pediatric EM Morsels

The subcutaneous space is a vast region of potential space where things can collect. Sometimes this can be used to our advantage, like when we need to give subcutaneous fluids to a dehydrated patient without an IV, or when we need to give SQ medications for things like Sulfonylurea overdose , Hereditary Angioedema , or DVTs. Sometimes, however, these deeper layers of the subcutaneous space can collect dangerous infections , like Necrotizing Fasciitis.

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A routine resuscitation

Don't Forget the Bubbles

I remember how I felt when. I first watched “ Just a Routine Operation “, – the story of the events that led to the tragic death of Elaine Bromiley. Elaine Bromiley went into hospital for a routine operation. Despite an appropriate pre-operative assessment, the anaesthetists tasked with intubating Elaine found themselves in a Can’t Intubate, Can’t Oxygenate scenario, though they failed to recognise it at the time.

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Anaphylactic Shock

RebelEM

Anaphylactic Shock is an acute, life-threatening hypersensitivity disorder, with a generalized, rapidly evolving, multi-systemic allergic reaction (IgE-mediated disorder). If not treated rapidly can become fatal. Scott Weingart, MD put together a manual titled the Resuscitation Crisis Manual , which in short, is composed of two-page protocols for various situations that involve crashing patients.

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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AMAX4 Algorithm

Life in the Fast Lane

Neil Long and Chris Nickson AMAX4 Algorithm AMAX4 is a best-practice algorithm for critical care clinicians in anaphylaxis and asthma resuscitation.

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Finally, a cure fore sepsis: Herbs

First 10 EM

Can herbs cure sepsis? The EXIT-SEP trial was just published, and demonstrated a decrease in all cause mortality from xuebijing – a product manufactured by a pharmaceutical company from a combination of Carthamus tinctorius flowers (Honghua in Chinese), Paeonia lactiflora roots (Chishao), Ligusticum chuanxiong rhizomes (Chuanxiong), Angelica sinensis roots (Danggui), and Salvia miltiorrhiza roots (Danshen). […] The post Finally, a cure fore sepsis: Herbs appeared first on First10EM.

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Pyelonephritis: causes, symptoms, diagnosis and treatment

Emergency Live

Pyelonephritis is an inflammatory disease of the kidney and renal pelvis that can be acute or chronic. The disease is often associated with a more or less extensive infection of the organ parenchyma The post Pyelonephritis: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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April 2023 podcast round up. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed The latest from the @stemlyns podcast with the best of the blog from April 2023. #FOAMed @docib and @EMManchester talk about HALO, Blood and the future of #FOAMed The post April 2023 podcast round up. St Emlyn’s appeared first on St.Emlyn's.

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Pet Peeve: “High Index of Suspicion”

The Trauma Pro

How often have you heard this phrase in a talk or seen it in a journal article: “Maintain a high index of suspicion” What does this mean??? It’s been popping up in papers and textbooks for at least 30 years. And to me, it’s meaningless. You try to figure out that sentence! An index is a number, usually mathematically derived in some way. Yet whenever I see or hear this phrase, it doesn’t apply to anything quantifiable.

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Issue #4: The Latest in Critical Care, 6/12/23

PulmCCM

Induced hypothermia after cardiac arrest is also called “active temperature control” or “targeted temperature management.” The treatment became widespread after a trial ( NEJM 2002, n=275) showed large neurologic and survival benefits from hypothermia; however, subsequent trials mostly failed to replicate those findings. A Cochrane review analyzing 12 studies with 3956 participants concluded that: There was no detectable benefit to cooling to temperatures lower than 36 &#

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Genetic heart disease: Brugada syndrome

Emergency Live

Brugada syndrome is a disease that most commonly affects young males in adulthood. The genetic defect is in proteins that control the entry of sodium into the cardiac cell The post Genetic heart disease: Brugada syndrome appeared first on Emergency Live.

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Just a routine resuscitation. The AMAX4 algorithm for anaphylaxis/asthma. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed This post is from Australia and was brought to us by Dr Ben McKenzie. The events that precede this blog are utterly tragic, but from such tragedy there is hope … Just a routine resuscitation. The AMAX4 algorithm for anaphylaxis/asthma. St Emlyn’s Read More » The post Just a routine resuscitation.

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Malpractice: Could a Zebra Be Grazing Nearby?

Emergency Medicine News

An abstract is unavailable.

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Tips for Thriving During Intern Year

SheMD

Currently, I am a neurology resident and neuroscientist at Mayo Clinic in Rochester, MN. As a neurology resident, I conducted my intern year rotating within internal medicine. In less than 2 weeks, I will be a PGY-2 neurology resident. As I reflect over my experience, it has been a year of tremendous excitement and extreme difficulty. I have grown into becoming a more independent physician-scientist.

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Urethral stenosis: definition, causes, symptoms, diagnosis and treatment

Emergency Live

The obstruction or narrowing of the urethra, the channel that allows urine to flow outwards, is called urethral stricture The post Urethral stenosis: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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ACMT Toxicology Visual Pearl: The Heart Won’t Go On and On

ALiEM

Which cardiotoxic plant is shown? Lily of the valley Moonflower Morning glory Water hemlock White snakeroot Reveal the Answer 1. Lily of the Valley What type of plant is lily of the valley? Lily of the valley ( Convallaria majalis ) is a woodland perennial with a sweet scented, white bell-shaped flower. It blooms from April to June in North America and bears orange-red berries in July [1].

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Agitation Podcast Series Episode 5: Management of the child with mental health problems who is boarded in the ED

PEMBlog

We are in the midst of a staggering mental health crisis. Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. This podcast episode hosted by Brad Sobolewski ( @PEMTweets ) and co-authored by Dennis Ren ( @DennisRenMD ) is all about what we should consider when boarding children in the ED for mental health reasons.

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Two ECGs texted to me in the same hour. What would you recommend?

Dr. Smith's ECG Blog

Written by Pendell Meyers Both of these cases were sent to me with no information other than adults with acute chest pain. What would be your response? Case 1: Case 2: What if I told you that Case 1 has an abnormal initial troponin, and Case 2 has a normal initial troponin? Case 1 An elderly male presented with chest pain. His vitals were within normal limits except some mild hypertension.

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Electrical cardioversion: what it is, when it saves a life

Emergency Live

Electrical cardioversion, CVE, is a therapeutic procedure used to restore normal heart rhythm in patients with atrial fibrillation, flutter, or tachycardia and in whom pharmacological cardioversion has failed The post Electrical cardioversion: what it is, when it saves a life appeared first on Emergency Live.

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I am not cynical but these two studies.

Stop and Think

Before I tell you about two recent (mind-boggling) studies, I want to say thank you for the support. It’s shocking how many have subscribed and supported this newsletter. This will be the first of a two-part series regarding two curious studies. I have built a 30-minute lecture on critical appraisal of medical evidence. I give the talk in seven chapters.

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The Case Files: A Rare Cause of Syncope

Emergency Medicine News

An abstract is unavailable.

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Quality initiative to improve emergency department sepsis bundle compliance through utilisation of an electronic health record tool

EM Ottawa

Methodology: 2/5 Usefulness: 3/5 Warstadt NM, et al. BMJ Open Qual. 2022 Jan;11(1):e001624. Questions and Methods: Using a cohort and QI approach, to demonstrate the effectiveness of a multidisciplinary educational intervention and EHR tool to increase sepsis bundle compliance. Findings: Overall EHR tool use increased from 23.3 to 87.2% with an improvement in sepsis bundle […] The post Quality initiative to improve emergency department sepsis bundle compliance through utilisation of an ele

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Semeiotics of the heart: history in the complete cardiac physical examination

Emergency Live

The objective examination of the heart includes auscultation, inspection and percussion, but to arrive at a diagnosis the doctor checks the history and may prescribe exams The post Semeiotics of the heart: history in the complete cardiac physical examination appeared first on Emergency Live.

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The PREMIER Wessex Conference – Day 1

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed A summary of the talks from Day 1 of the PREMIER conference The post The PREMIER Wessex Conference – Day 1 appeared first on St.Emlyn's.

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A young man with another episode of tachycardia. What is it? And why give adenosine in sinus rhythm?

Dr. Smith's ECG Blog

Written by Bobby Nicholson MD and Pendell Meyers A man in his 30s presented to the ED for evaluation of chest pain and palpitations. He described it as a "jackhammering" sensation, associated with palpitations, diaphoresis, and shortness of breath, and he stated it started soon after consuming an "energy drink" (product/contents unknown). He stated these symptoms were the same as a prior episode which required cardioversion.

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Blood Pressure Medications: A Bedtime Story - Clinical Correlations

Clinical Correlations

By Jonah Klapholz Peer Reviewed Telling patients.

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What is genital prolapse?

Emergency Live

Genital prolapse refers to the descent of the pelvic organs through the vaginal canal. To better understand how it happens, it is useful to frame the functioning of the pelvic floor The post What is genital prolapse? appeared first on Emergency Live.

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The PREMIER Wessex Conference – Day 2

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed A summary of the talks from Day 2 of the PREMIER conference covering a wide range of topics in paediatric trauma. The post The PREMIER Wessex Conference – Day 2 appeared first on St.Emlyn's.

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Medical Conservatism, the ELAN Trial, and Residents Striking

Sensible Medicine

Links The Case for Being a Medical Conservative [link] ELAN Trial [link] Mandrola on NYC Residents’ Strike [link]

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What I Wish I Knew Before Residency

SheMD

I wish I really knew how hard it would be. “ It” being these 4 years of my clinical training called residency. Throughout residency everything has been tried including my patience, sanity, mind and marriage. When we are in medical school we are so concerned with graduating and getting to the next step, not realizing that this next step is unlike anything we have ever experienced.

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Let's talk about flat foot: what problems does it cause?

Emergency Live

Flat foot - from the Latin pes planus - is a dysmorphism that occurs with altered anatomical relationships of the foot, in particular with the characteristic reduction or total disappearance of the plantar arch with consequent enlargement of the support surface of the foot itself The post Let's talk about flat foot: what problems does it cause?

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Wellness 911: Stop: The Giving Tree: Model of Medicine

Emergency Medicine News

An abstract is unavailable.

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Part 2 - The ELAN Trial Forces Doctors to Be Mature About Using Medical Evidence

Sensible Medicine

If you have not read part 1 of this series, do that now. It is short. We will wait. NEJM published the ELAN trial in May of this year. Early vs late initiation of oral anticoagulation after an ischemic stroke due to atrial fibrillation. The primary outcome was a composite of lots of bad things—stroke, systemic embolism, intracranial bleeding, extracranial bleeding, and death due to cardiovascular causes.

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What's the word on Health IT street?

Eolas Medical

It’s been a busy few months at Eolas, and as usual the blog is the first thing to suffer! The good news, though, is that we’ve been busy attending some of the world’s leading health IT events.

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Vaginismus: causes, symptoms, diagnosis and treatment

Emergency Live

Vaginismus is a conditioned reaction that probably results from the association of pain and fear with attempts at vaginal penetration or even with penetration fantasy alone The post Vaginismus: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Grandma Broke Her Neck? Prevalence of C-Spine Injuries from Ground Level Fall Over 65 Years Spoon Feed This systematic review found that the prevalence of cervical spine injuries in patients 65 years or older after