MEDEST118

JULY 2, 2023

By Mario Rugna

Airway Management 143

Airway Management 143

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 ).

Dislocations 141

Dislocations Fractures Pediatrics EMS 141

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

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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.

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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.

EKG/ECG 122

EKG/ECG Sepsis EMS 122

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?

EMS 120

EMS Outcomes Hospitals Research 120

St. Emlyn

JULY 2, 2023

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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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.

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The Bottom Line

JULY 1, 2023

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

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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.

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

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.

Psychiatric 119

Psychiatric 119

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.

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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.

Best Practices 98

Best Practices 98

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?

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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.

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119

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.

Sepsis 96

Sepsis Shock Wellness Documentation/Coding 96

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.

Research 94

Research Operations 94

The Bottom Line

JULY 1, 2023

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

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97

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.

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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.

Research 93

Research Sepsis EMS 93

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?

Pediatrics 90

Pediatrics Research Outcomes 90

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

Resuscitation 88

Resuscitation Shock Stroke Hospitals 88

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.

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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.

Administration 88

Administration Outcomes Documentation/Coding Emergency Department 88

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.

Emergency Department 87

Emergency Department Pediatrics CPR Administration 87

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.

Forensics 87

Forensics Airway Management Administration Emergency Department 87

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.

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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.

Pediatrics 83

Pediatrics 83

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

Emergency Department 83

Emergency Department EKG/ECG 83

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.

Ultrasounds 77

Ultrasounds Research 77

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.

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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.

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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.

EKG/ECG 76

EKG/ECG Stroke Academics 76

University of Maryland CC Project

JULY 6, 2023

Dr. Willard Applefeld attended the University of Maryland School of Medicine and did his internal medicine residency at Johns Hopkins. He completed a fellowship in critical care at the National Institutes of Health. He is currently a cardiology fellow at Duke University Medical Center. His talk focuses on right ventricle. Dr. Willard Applefeld attended the University of Maryland School of Medicine and did his internal medicine residency at Johns Hopkins.

Ultrasounds 74

Ultrasounds 74

Emergency Live

JULY 2, 2023

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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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.

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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 Department 73

Emergency Department 73