RebelEM
JULY 5, 2023
Take Home Points Provider assessment of how the patient looks is extremely important. If it looks and feels like a STEMI clinically, get serial ECGs and consult Cardiology immediately. POCUS has been a phenomenal tool in the management and early diagnosis of a lot of abnormal ECG and chest pain presentations. Isolated elevation in aVR with diffuse ST depressions can be a sign of Left Main occlusion.
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Pediatric EM Morsels
JULY 7, 2023
In the past, we have discussed several causes of Knee Pain in children. Some of those causes are benign (ex, Osgood Schlatter’s Disease ) while others are scary (ex, osteosarcoma ). Evaluating the limping child , though, requires us to ponder not only the common (ex, Toddler’s Fracture ), but also to be vigilant for the severe (ex, Septic Arthritis ).
Science Based Medicine
JULY 2, 2023
Robert F. Kennedy, Jr. has resurrected the antivax claim that the childhood vaccine schedule has never been tested in randomized controlled trials (RCTs) with a saline placebo controls (and therefore the vaccine schedule is unsafe). This is an old and deceptive antivax half-truth that ignores both what constitutes a scientifically valid placebo and the ethical requirements for RCTs.
Don't Forget the Bubbles
JULY 5, 2023
Topic Sickle Cell Disease Author Beatrice Zanetti Duration Up to 2 Hours Facilitator Level ST4+ Learner Level Most useful for those in experience seeing paediatric patients regularly. From FY1 + and 5+ nurses on Equipment Required None Outline Pre-reading Basics Case 1: Salmonella osteomyelitis Case 1: Discussion Case 2: Acute painful crisis and Priapism Case 2: Discussion Advanced Case 1: Acute chest syndrome Advanced Case 1: Discussion Advanced Case 2: Stroke in sickle cell disease patient Adv
Emergency Live
JULY 4, 2023
Telangiectasias are caused by enlarged blood vessels. This condition is much more common than you think and you will probably have come across this problem at least once in your life The post Teleangiectasias: what are they? appeared first on Emergency Live.
The Skeptics' Guide to EM
JULY 2, 2023
Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma. NEJM 2023. Guest Skeptic: Dr. Salim Rezaie is a community emergency physician in San Antonio, TX. He is the Creator and founder of REBEL EM, a free, critical appraisal blog that tries to cut down knowledge translation gaps of […] The post SGEM#408: Hey, I, Oh I’m Still Alive – Is it due to TXA?
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Science Based Medicine
JULY 5, 2023
Despite the leaked new classification as a "possible" carcinogen, the evidence still shows aspartame is safe. The post Aspartame and Cancer first appeared on Science-Based Medicine.
Emergency Live
JULY 1, 2023
Water retention is a problem that affects most women. However, most people confuse water retention and cellulite The post Water retention, how to deal with it appeared first on Emergency Live.
The Bottom Line
JULY 1, 2023
What’s new in the Critical Care literature – monthly updates
PulmCCM
JULY 3, 2023
Video laryngoscopy was superior to direct laryngoscopy in first-pass success among ED residents and CCM fellows intubating critically ill patients (DEVICE trial). Surprisingly to me, video laryngoscopy (VL) has not consistently been shown to increase first-pass intubation success over direct laryngoscopy (DL) in critically ill patients. Most studies have been small, single center, and only some have favored video.
Science Based Medicine
JULY 4, 2023
817,000 thousand Americans had already died of COVID by December 23, 2021, and 244,000 more would die the next year. Millions more survived, but were injured. These numbers could have been lower if doctors not become defense attorneys for SARS‑CoV‑2 and prosecutors against the vaccine, and instead applied similar standards of evidence to both. The post When Doctors Have Different Standards of Evidence for the Virus and the Vaccine first appeared on Science-Based Medicine.
Emergency Live
JULY 3, 2023
Schizophrenia comes from the Greek and literally means “separate mind”: those affected struggle to distinguish reality from imagination It is a psychiatric disorder that seriously compromises self-perception. In addition to negatively affecting social relationships and the performance of normal daily activities. This disease also affects perception, memory, attention, learning and emotions.
First 10 EM
JULY 3, 2023
The pace of these literature summaries has decreased over the years, but perhaps that means that quality has increased? I think there is an interesting variety of papers this time around, from sepsis, to b t, to patient access to their own results online. A few huge papers dropped in the past few weeks, including RCTs […] The post Research Roundup (July 2023) appeared first on First10EM.
ACEP Now
JULY 7, 2023
Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. 2,3 In general, patients who develop cardiac arrest with an initial r
PDC Healthcare
JULY 5, 2023
If you’re involved in security within a healthcare facility, you’re responsible for the safety of all people within the building – visitors, employees, and patients. Balancing the wants and needs of these parties in a healthcare facility can be difficult, especially when attempting to create a secure and welcoming site. Visibly identifying all visitors is […] The post Best Practices for Visitor Identification in Healthcare Facilities appeared first on connectID - PDC Healthcare Blog.
Emergency Live
JULY 3, 2023
Bladder cancer is a malignant transformation of the cells - mainly those called transitional cells - which cover the inner walls of the bladder, the organ responsible for collecting and expelling urine once it has been filtered by the kidneys The post Bladder cancer: what is it? appeared first on Emergency Live.
RebelEM
JULY 3, 2023
Background: Atrial fibrillation and atrial flutter with rapid ventricular rate (AF/AFL with RVR) are the most common subtypes of SVT, comprising a large number of ED visits in aging populations. Currently, rhythm and rate control are the mainstays of therapy in acute settings. One common strategy for rate control in stable patients is the use of non-dihydropyridine calcium channel blockers.
ACEP Now
JULY 7, 2023
CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. She notes that the wound has been present for greater than a year and it becomes malodorous and painful and oozes intermittently. She reports fevers up to 103 degrees Fahrenheit. She endorses a one-year history of near-syncopal episodes associated with shortness of breath, headache, and neck pain.
The Bottom Line
JULY 1, 2023
In critically ill adults undergoing tracheal intubation, does the use of a videolaryngoscope (VL) compared to a direct laryngoscope (DL) improve the first-pass success rate?
Emergency Live
JULY 4, 2023
The aircraft was carrying five people, prompt rescue, all survived A helicopter, involved in the route between the high altitude refuges Capanna Gnifetti and Regina Margherita on Monte Rosa, crashed in the area of the municipality of Alagna Valsesia. The helicopter was performing its usual service connecting the two refuges, offering tourists and climbers, all […] The post Helicopter crashes on Monte Rosa, no fatalities appeared first on Emergency Live.
Emergency Medicine Ireland
JULY 3, 2023
Welcome back to the tasty morsels of critical care podcast. Today we tackle a somewhat nebulous syndrome. Something we throw around with a few hand wavy explanations but often light on detail. Hopefully in a few minutes you’ll at least have a few morsels more of information to stave off all the trainees who are undoubtedly much smarter than you on the ward round.
Medagadget
JULY 6, 2023
Researchers at Harvard University have developed a technique that lets them create biomaterial heart valves in a matter of minutes. The approach, called ‘Focused Rotary Jet Spinning’, has been described by the researchers as ‘a cotton-candy machine with a hair dryer behind it.’ Essentially, the technique involves using jets of air to direct polymer strands onto a heart valve shaped frame.
The Bottom Line
JULY 1, 2023
What’s new in the Critical Care literature – monthly updates
Emergency Live
JULY 3, 2023
The incidence of melanoma - until a few years ago considered a rather rare disease - has increased by 4% in the last twenty years, reaching 14.3 cases per 100,000 men and 13.6 cases per 100,000 women The post Melanoma: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.
Taming the SRU
JULY 3, 2023
Mahajan P, VanBuren JM, Tzimenatos L, et al. Serious Bacterial Infections in Young Febrile Infants With Positive Urinalysis Results. Pediatrics 2022;150(4). 10.1542/peds.2021-055633 Question What is the prevalence of bacteremia and/or bacterial meningitis (“invasive bacterial illness”, ISI) in febrile infants ≤60 days of age with a positive urinalysis (UA) result?
Science Based Medicine
JULY 7, 2023
Is your child allergic to penicillin? Are you sure about that? Penicillin allergy is much less common than widely believed and there is a big push to delabel pediatric and adult patients who actually can tolerate these antibiotics. The post Delabeling Penicillin Allergies: A Public Service Announcement from Science-Based Medicine first appeared on Science-Based Medicine.
ACEP Now
JULY 7, 2023
Question: A 67-year-old man presents to the emergency department (ED) following syncope. He denies any antecedent symptoms. He has a witnessed episode of syncope in the ED, and the following ECG, is obtained What is the likely diagnosis? Left bundle branch block Supraventricular tachycardia with aberrancy Wolff-Parkinson-White syndrome Ventricular tachycardia See the answer here.
Emergency Live
JULY 1, 2023
Also called trapeziometacarpal osteoarthritis, rhizarthrosis is a particular form of osteoarthritis that affects the carpometacarpal joint of the hand The post Rhizarthrosis: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.
Taming the SRU
JULY 2, 2023
End-Tidal CO2 monitoring has a variety of uses in the Emergency Department. Whether used diagnostically or for monitoring of a patient’s physiology, clinicians must possess an understanding of the information that you can gather from EtCO2 waveform tracings. Knowing how to interpret the waveforms makes EtCO2 much more than a number, allowing the clinician to gain insight into minute to minute changes in a patients physiological state.
Science Based Medicine
JULY 6, 2023
A large randomized controlled trial of vitamin D supplementation generates good data to show there is likely no benefit. The post The effects of vitamin D supplementation on major cardiac events first appeared on Science-Based Medicine.
Sensible Medicine
JULY 5, 2023
I am a total sucker for an article that argues for the importance of primary care. I am also obsessed with our diagnostic reasoning biases. Pat Croskerry’s 2002 article in which he identifies 30 “failed heuristics, biases, and cognitive dispositions” is one of my absolute favorites that I reference a few times a year. In this article, Dr.
Emergency Live
JULY 3, 2023
De Quervain's tenosynovitis is an inflammatory process affecting the synovial sheath of the thumb tendons The post What is De Quervain's Tenosynovitis? appeared first on Emergency Live.
EB Medicine
JULY 5, 2023
In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2023 Emergency Medicine Practice article, Diagnosing and Treating Pericarditis and Myocarditis in the Emergency Department Epidemiology Nomenclature Etiology Differential diagnosis Prehospital care ED history and physical Diagnostics ECG Labs Imaging (X-ray, CT, US, MRI) Treatment Special populations COVID-19 Athletes MIS-C In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2023 Emergency Medicine Practice a
Medagadget
JULY 6, 2023
Scientists at the Swiss Federal Laboratories for Materials Science and Technology (EMPA) have developed an advanced surgical sealant that can alert clinicians to the presence of an intestinal leak after gastrointestinal surgery. Such leaks can be very dangerous, but until now clinicians had few ways to detect them before they start causing symptoms.
EM Ottawa
JULY 4, 2023
Methodology: 2.5/5 Usefulness: 2/5 Mathura P, et al. CJEM. 2022 Sep;24(6):636-640. Editorial: When evidence-based medicine and quality improvement collide. Question and Methods: Can we decrease physician ordering of the BUN (blood urea nitrogen) test, using an evidence-based multicomponent quality improvement intervention? Findings: Monthly average BUN ordering declined from 1905 to 448, and BUN test to […] The post Reduction of urea test ordering in the emergency department: multicomponen
Emergency Live
JULY 4, 2023
Myasthenia gravis is an autoimmune disorder that presents itself as increased fatigability and muscle weakness throughout the day The post Ocular myasthenia: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.
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