Pediatric EM Morsels

JULY 21, 2023

In emergency medicine, we often use illness scripts and protocols to help drive our decision-making. I recall a shift I had with Dr. Fox while I was early in fellowship ( not so many years ago ). We had just received a young child from EMS who was post-ictal with decreased mentation. Dr. Fox asked me what I wanted to do next to care for the child, and as I calculated his GCS… 7 at the time… I felt somewhat obligated to say that I should intubate the child. “ Less than 8, intubate!

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Head Injuries Pediatrics Outcomes Shock 246

Ken Grauer, MD

JULY 15, 2023

The ECG in Figure-1 was obtained from a previously healthy middle-aged man — who while performing his regular exercise routine, developed "slight" chest discomfort and "palpitations". These symptoms persisted for over an hour, which led the patient to contact EMS. Surprisingly — he was hemodynamically stable with minimal discomfort at the time his initial ECG in Figure-1 was recorded.

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Mount Sinai EM

JULY 21, 2023

Why is this a pearl? We get G-tube dislodgments quite often at Sinai, and they can be an easy patient encounter with a quick note and quick dispo. But they made me so nervous as an intern and early 2! Now I love ‘em and you can love ‘em too! ** GJ-tubes or J-tubes do not get replaced in the ED. Tell me about the PEG tube. Gastrostomy tube (G-tube) or Percutaneous Endoscopic Gastrostomy tube (PEG tube) is a tube placed in the stomach for long-term enteral nutritional support.

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The Trauma Pro

JULY 21, 2023

In the last post, I discussed what to do if your hospital is thinking about switching to an electronic trauma flow sheet (eTFS). Today I’ll give you some tips on what to do if the cat’s already out of the bag and it’s already been implemented. The number one priority is to show the impact of the eTFS on the trauma program. This involves the same two components I’ve already written about: Accuracy.

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Emergency Live

JULY 21, 2023

On the evening of Tuesday 19, the award-winning volunteers for the third edition of the ‘Palma d’argento – Iustus ut palma florebit’ prize were announced in Acireale The award-winning volunteers for 2023 were announced and made public during an event at the Casa del Volontariato in Via Aranci. The afternoon was opened by a Eucharistic […] The post Luigi Spadoni and Rosario Valastro awarded the Silver Palm appeared first on Emergency Live.

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Ziqitza HealthCare Ltd

JULY 21, 2023

Ambulance emergency number It’s heartbreaking to know that millions of emergencies end in the loss of lives. What shakes us is the lack of awareness of ambulance emergency numbers and the affordability of ambulance services. These reasons may sound a little weird in the digital era we are living in, but it’s true. You may argue that one can simply Google for an emergency number when needed.

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Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. She went to the optician today to get a new pair of glasses. When they examined her and found that she had enlarged optic discs, they sent Olivia to the ophthalmology ED. The Ophthalmology SHO agreed and referred Olivia to you. They had explained to Olivia and her parents that she needed urgent neuroimaging as the enlarged optic discs could be a sign of a brain tumour.

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Emergency Live

JULY 20, 2023

While it is true that in some cases red eyes are due to external factors such as air pollution or dryness, other times the redness is a symptom of something better investigated through an eye examination The post Red eyes: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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EM Ottawa

JULY 17, 2023

Methodology: 2/5 Usefulness: 1/5 Lim P, et al. Eur Heart J Acute Cardiovasc Care. 2022 Jan 12;11(1):2-9. Question and Methods: Does diuresis with single-dose IV furosemide improve hemodynamic parameters and prevent oligo-anuria in normotensive patients with intermediate-risk PE? Multi-centre, placebo-controlled, double-blind trial of furosemide 80mg IV vs. placebo.

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Don't Forget the Bubbles

JULY 17, 2023

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

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RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. RSI inherently carries with it risks of complications such as post-intubation hypotension and cardiac arrest in the most extreme cases. It is possible that the induction agent used could play an important role on hemodynamic effects in critically ill adults.

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Emergency Live

JULY 21, 2023

Sea rescue, what is the POS rule The Coast Guard has numerous rules regarding rescuing people on board boats. Although it is therefore easy to think that rescuing someone in distress at sea is straightforward and without many bureaucratic hurdles, unfortunately there are several rules to follow. Safe harbour or nearby port In this case, […] The post The Crucial Role of the 'Place Of Safety' appeared first on Emergency Live.

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First 10 EM

JULY 17, 2023

I have written about the resuscitation of anaphylaxis and asthma before. However, I was forwarded the AMAX4 algorithm for the patient with asthma or anaphylaxis who is either unconscious or requiring assisted ventilation, and I think it is an important addition for our sickest patients. The heartbreaking backstory to this algorithm and website, created by […] The post Critical anaphylaxis and asthma: The AMAX4 algorithm appeared first on First10EM.

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Ziqitza HealthCare Ltd

JULY 15, 2023

Prevention of Road Accidents Misfortunes one can endure- they come from outside, they are accidents. Every year, approximately 1.5 lakh people die on Indian roads, which translates, on average, into 1130 accidents and 422 deaths every day or 47 accidents and 18 deaths every hour. Nowadays, road crashes are the biggest challenge of our life. Road accidents not only take lives but also leave survivors with life-long chronic injuries and disabilities.

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Science Based Medicine

JULY 17, 2023

Late last week, RFK Jr. endured some hilariously bad press about an NYC press event at which two of his supporters argued over climate change, one with lots of farts. However, the fart jokes soon gave way to darker side of the fundraise, a Q&A in which RFK Jr. shared an antisemitic conspiracy theory claiming that COVID-19 might have been "targeted" against Caucasians and Blacks, while sparing Jews and the Chinese.

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Emergency Live

JULY 19, 2023

Two Canadairs depart from Italy to provide relief in Greece In response to a request for help from the Greek authorities, the Italian Civil Protection Department decided to send two Canadair CL415 aircraft of the Italian Fire Brigade to fight the extensive fires that have been affecting parts of the country for days. The planes […] The post Forest fires in Greece: Italy activated appeared first on Emergency Live.

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Core Medical Group

JULY 21, 2023

As a Recruiter in the Travel Nursing Division, Tristan has played a crucial role in connecting skilled medical professionals with rewarding placements. He recently was promoted to Surg Tech Team Lead. Today, we take a closer look at Tristan's trajectory and the positive impact he has made on both his colleagues and the healthcare industry.

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Dr. Smith's ECG Blog

JULY 17, 2023

A young man presented with weakness and fever. His pulse was 186. An ECG was recorded: What do you think? There is a regular narrow complex tachycardia. Thus, it is supraventricular tachycardia. It is important to remember that SVT includes Sinus Tachycardia! That is why I like to call re-entrant SVT "Paroxysmal" SVT, or PSVT). The sinus node is "supraventricular" and in young people it can beat VERY fast.

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Science Based Medicine

JULY 21, 2023

Childhood vaccination rates worldwide tanked during the first two years of the pandemic. A recently released report from the UN revealed that 2022 was better, but the improvements weren't seen everywhere. And we still have a long way to go. The post Childhood Vaccination Rates Move (Slowly) in the Right Direction first appeared on Science-Based Medicine.

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Emergency Live

JULY 17, 2023

REAS 2023: an unmissable event for innovation in emergency Not long to go before the most eagerly awaited event of the year in the Italian emergency sector: the International Emergency Exhibition, better known as REAS. In the 2022 edition, REAS shone for the resonance it had, with 20 conferences, more than 100 speakers, and a […] The post REAS 2023, The Benchmark in the Emergency Sector appeared first on Emergency Live.

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Sensible Medicine

JULY 17, 2023

Coronary heart disease is a leading killer. Coronary heart disease can be silent until it presents with a severe heart attack or silent death. The idea of using technology to find these partial blockages before they cause a severe event makes perfect sense. You can call this the clogged pipe frame of cardiology. Many people, now including prominent podcasters, has joined the advocacy for early detection of atherosclerotic disease.

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Emergency Medicine Cases

JULY 18, 2023

On this month's EM Quick Hits podcast David Carr on differential diagnosis of normal unenhanced CT renal colic, Leeor Sommer on recognition and management of perichondritis and auricular abscess, Suzanne Schuh on IV magnesium sulphate for pediatric asthma, Jess McLaren on Occlusion MI ECG interpretation requiring cath lab activation and Justin Morgenstern on update on steroids for pneumonia.

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Pediatrics EMS EKG/ECG 90

Science Based Medicine

JULY 19, 2023

A third drug either FDA approved or showing clinical benefit for Alzheimer's disease confirms that the world of AD treatment has changed forever. The post Yet Another Alzheimer’s Drug first appeared on Science-Based Medicine.

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Emergency Live

JULY 16, 2023

According to the WHO (World Health Organization), back pain is the leading cause of disability in the world. A very common disorder that, according to estimates, affects 40% of people The post Back pain: what causes low back pain and when to be alarmed appeared first on Emergency Live.

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Taming the SRU

JULY 21, 2023

Setting the scene You sign up for “eye problem” on the board and you walk in the room. You think the eye might be infected… but now what? Do you treat them with antibiotics? Do nothing? Call ophthalmology? Let’s take a closer look and see just what you need to focus in on your H&P so you can triage and appropriately manage the most common eye infections you might see walk into the ED.

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EMCrit

JULY 20, 2023

So we used a mean guy on twitter to spur a discussion on Oxygenation Physiology and talk about when PaO2s are necessary and you can't use the pulse ox (hint: not often). My discussant is Alex Yartsev. EMCrit Project by Scott Weingart, MD FCCM.

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Medagadget

JULY 18, 2023

Researchers at the University of British Columbia have developed a protein-based hydrogel that is highly adapted for articular cartilage repair. A major challenge in creating biomaterial therapies to repair damaged articular cartilage is matching the mechanical properties of this highly specialized tissue. Cartilage is very tough, resisting breaking under force, but also very stiff, meaning that it resists being bent or deformed.

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Emergency Live

JULY 21, 2023

From extreme drought to unprecedented destruction: the fire crisis in British Columbia The year 2023 marks a sad record for British Columbia (BC): the most destructive forest fire season ever recorded, according to data provided by the BC Wildfire Service (BCWS). Since 1 April, a total of about 13,986 square kilometres of land has been […] The post Forest fires in British Columbia: a record balance sheet appeared first on Emergency Live.

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Taming the SRU

JULY 19, 2023

Fundamentals of ECMO - leadership curriculum - ultrasound GR - macgyver techniques fundamentals of ecmo WITH dr. bonomo ECPR from the ED: The ideal patients: Young patients with refractory VF/VT arrest ≤ 30 min since arrest onset Poisonings with cardiogenic shock Severe hypothermia with arrest Massive PE with arrest Key points: Good CPR/advanced ACLS LUCAS Initial rhythm identification Epinephrine drip Speed to cath lab Pre-procedural checklist (must meet all inclusion criteria): No asystole Lac

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Ultrasounds Leadership Hyperthermia / Hypothermia Poisoning 84

Science Based Medicine

JULY 16, 2023

The second installment in debunking the antivaxxer book "Turtles All the Way Down": Chapter 2, supposedly concerned with “The Science of Adverse Events”. The post The Grand Debunk of the antivaxxer book “Turtles All the Way Down” (part 2/10) first appeared on Science-Based Medicine.

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St. Emlyn

JULY 18, 2023

St.Emlyn's - Emergency Medicine #FOAMed Our regular podcast round up from June 2023. AMAX4, PATCH trial, Wessex conference, ICSSOA conference and more. #FOAMed @stemlyns The post June 2023 Podcast. St Emlyn’s appeared first on St.Emlyn's.

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Emergency Live

JULY 15, 2023

Carpal tunnel syndrome (CTS) is pressure on a nerve in your wrist. It causes tingling, numbness and pain in your hand and fingers The post Carpal tunnel syndrome (CTS): Causes, Symptoms, Diagnosis And Treatment appeared first on Emergency Live.

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EMDocs

JULY 17, 2023

Authors: Christopher Whiting, MD (EM Resident Physician, University of Vermont) and Joseph Kennedy (EM Attending Physician, University of Vermont) // Reviewed by: Joshua Lowe (EM Attending Physician, USAF), Marina Boushra (EM-CCM Attending Physician, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 57-year-old man with a past medical history of hypertension and tobacco use presents to the emergency department (ED) with five days of abdominal pain.

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RebelEM

JULY 20, 2023

INTRODUCTION You’re moonlighting in a remote access hospital. EMS radios in for a burn patient and to anticipate a difficult airway. You can hear the tension in their voice. They’re rolling up now. The patient is horribly burned. She was smoking with her home O2 on and has severe mixed partial and full thickness burns to the chest, neck, face, and airway.

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Science Based Medicine

JULY 20, 2023

His ‘Biggest Secret’ is a tiny sticker selling for hundreds of dollars The post Novak Djokovic credits the TaoPatch for his success: What does the science say? first appeared on Science-Based Medicine.

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Emergency Live

JULY 18, 2023

Spitz's nevus is a benign tumour that affects the skin and usually develops in childhood. The lesion is caused by a proliferation of epithelioid and spindle-shaped melanocytes The post Nevus of Spitz, an overview of the benign tumour also known as juvenile melanoma appeared first on Emergency Live.

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The Bottom Line

JULY 19, 2023

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

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