Sat.Jul 01, 2023 - Fri.Jul 07, 2023

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SGEM#408: Hey, I, Oh I’m Still Alive – Is it due to TXA?

The Skeptics' Guide to EM

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?

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Proximal Tibiofibular Joint Dislocation in Children

Pediatric EM Morsels

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 ).

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Confirming Tracheal Intubation: stop wasting your time!

MEDEST118

By Mario Rugna

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REBEL Core Cast 104.0 – Subtle ECGs in Acute Coronary Occlusion

RebelEM

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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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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Teleangiectasias: what are they?

Emergency Live

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.

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JC: The UK-REBOA trial. Has the balloon popped? St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Zaf Qasim @resusone reviews the UKREBOA trial. No benefit shown, but is this really the end of REBOA in trauma? #FOAMed @stemlyns The post JC: The UK-REBOA trial. Has the balloon popped? St Emlyn’s appeared first on St.Emlyn's.

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The Latest in Critical Care, 7/3/23 (Issue #7)

PulmCCM

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.

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Water retention, how to deal with it

Emergency Live

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.

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Research Roundup (July 2023)

First 10 EM

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.

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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

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

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Best Practices for Visitor Identification in Healthcare Facilities

PDC Healthcare

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.

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Schizophrenia: definition, causes, symptoms, diagnosis and treatment

Emergency Live

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.

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DEVICE

The Bottom Line

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?

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Xylazine: “Zombie Drug” is an Emerging Threat

ACEP Now

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.

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Why Attribution Bias Might be the Costliest Bias

Sensible Medicine

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.

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Bladder cancer: what is it?

Emergency Live

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.

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Critical Care Evidence Updates – May 2023

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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Tasty Morsels of Critical Care 072 | Cardiorenal syndrome

Emergency Medicine Ireland

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.

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The Concomitant Use of Calcium and Diltiazem for Rapid Atrial Fibrillation

RebelEM

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.

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Helicopter crashes on Monte Rosa, no fatalities

Emergency Live

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.

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Visual Wednesdays: Neurocritical Care

EMDocs

Author: Walid Malki, MD ( @Wandering_ER ) // Reviewed by: Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK); Manny Singh, MD (@MPrizzleER) Welcome the Visual Wednesdays, a series that provides focused EM updates with infographics. Please follow us on Instagram to see past, current and future infographics! Share this: The post Visual Wednesdays: Neurocritical Care appeared first on emDOCs.net - Emergency Medicine Education.

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Heart Valves Made in Minutes

Medagadget

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.

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Hunting for Invasive Bacterial Illness in Infants with a Positive UA

Taming the SRU

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?

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Melanoma: causes, symptoms, diagnosis and treatment

Emergency Live

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.

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EM@3AM: Kawasaki Disease

EMDocs

Authors: Maha Khalid, MD (EM Resident Physician, Advocate Christ Medical Center); Thaer Ahmad, MD (EM Attending Physician, Advocate Christ Medical Center) // Reviewed by: Sophia Görgens, MD (EM Resident Physician, Zucker-Northwell NS/LIJ, NY); 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

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VisualDX Question: What Does This Electrocardiogram Following Syncope Indicate?

ACEP Now

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.

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Riding the Waves: End-Tidal CO2 Monitoring

Taming the SRU

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.

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Rhizarthrosis: definition, causes, symptoms, diagnosis and treatment

Emergency Live

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.

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Lipid lowering - a Bempedoic Acid Subset Analysis – To be right, you have to also look at what is left.

Sensible Medicine

Dear Readers, This guest post from Professor McCormack is the type of content we strive for here at Sensible Medicine. Bempedoic Acid is a cholesterol-lowering drug. In the CLEAR Outcomes trial, it was found effective in modestly reducing cholesterol and cardiovascular outcomes in statin-intolerant patients. The authors have now published a subanalysis of the main CLEAR Outcomes study.

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Acute Pericarditis & Myocarditis

EB Medicine

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

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Surgical Patch Alerts to Intestinal Leaks

Medagadget

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.

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What is De Quervain's Tenosynovitis?

Emergency Live

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.

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The Study of the Week Celebrates Independence Day

Sensible Medicine

I am at the lake, in Kentucky, with family, ages 2 to 86 years. We have no Wi-Fi. The cell signal is weak. It rained—a lot. That changes things. I picked up my Kindle (40% battery left) and opened to one of my favorite “books” — the entire collection of the works of Mark Twain. At the suggestion of Walter Kirn and Matt Taibbi, I read the Twain short story. “The Man That Corrupted Hadleyburg” Walter Kirn called it more of a fable.

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Reduction of urea test ordering in the emergency department: multicomponent intervention including education, electronic ordering, and data feedback

EM Ottawa

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

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EMCrit RACC-Lit Update – June 2023

EMCrit

So much lit goodness!!! EMCrit Project by Scott Weingart, MD FCCM.

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Blurred vision? It might be time to think about glasses

Emergency Live

If you have blurred vision, the cause could be failing eyesight and you may need new glasses. The reasons, however, could also be others! In fact, if the blurred vision is persistent, it may also be a sign of other health problems: let's see what they are and when it is a good idea to contact your doctor and have a more thorough examination The post Blurred vision?

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