Sat.Sep 14, 2024 - Fri.Sep 20, 2024

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Field Amputation Part 3: Who Performs It?

The Trauma Pro

Various trauma professionals (prehospital, emergency physician, surgeon) may provide this “service” at various places around the world. In the US, it is usually a physician and typically a surgeon. In my opinion, anyone can be trained to do a basic field amputation. Much depends on local policies and procedures, training, as well as availability. In most cases, prehospital providers are on the scene, so it makes sense that they could do a field amputation with appropriate training.

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Challenging Arrhythmias — MIS-C Case Report (9-16.1-2024) - NOT_YET_FINISHED

Ken Grauer, MD

== Review of ECG Rhythms — MIS-C Case Report ( 9/5 /2024 ): == What follows below are my first impressions of the ECG rhythms sent to me from the Case Report by Dimah Jarmakani et al — of a 12-year old boy with MIS-C ( M ultisystem I nflammatory S yndrome in C hildren ). For full discussion of the case — CLICK HERE — ECG Rhythm Overview: A 12-year-old boy was admitted to our hospital with severe myocardial dysfunction and chaotic rhythm with tachy- and bradycardic arrhythmias.

EKG/ECG 195
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The 50-year Failure of American Health Care

Sensible Medicine

Dr. Marty Makary has a powerful new book, BLIND SPOTS: When medicine gets it wrong and what it means for our health , that came out on Tuesday and instantly hit #2 bestselling book on Amazon. I loved the book and highly recommend it. In this piece, he discusses one of those blind spots of the modern medical establishment—America is getting sicker right before our eyes.

Research 144
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A Simple Challenge For Drs. Vinay Prasad and Tracy Hoeg: Denounce Robert Kennedy Jr. For Promoting The Movie Vaxxed 3: Authorized to Kill

Science Based Medicine

If Drs. Vinay Prasad and Tracy Hoeg want to prove they actually care about routine vaccines, they can do what the should have done a long time ago and openly and unequivocally denounce Mr. Kennedy and his fire hose of anti-vaxx disinformation. The post A Simple Challenge For Drs. Vinay Prasad and Tracy Hoeg: Denounce Robert Kennedy Jr. For Promoting The Movie Vaxxed 3: Authorized to Kill first appeared on Science-Based Medicine.

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Field Amputation Part 4: Logistics

The Trauma Pro

Now it’s time to look at the logistics involved in carrying out a field amputation/dismemberment. There are two main considerations here: getting the right people and equipment to the scene and keeping them safe. The following presumes that the procedure will be done by a physician who is based at a trauma center. It will be different if performed by other trauma professionals.

Hospitals 187
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Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. The pain radiated to both shoulders. He arrived to the ED at around 6:45am, and stated the pain has persisted. He has had similar pain in recent weeks that has occurred at rest, but it typically goes away after about an hour.

EKG/ECG 125
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The Dirty Adrenaline (Epi) drip.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Case series of dirty epi drips in Australia. A potentially useful tool in austere/remote settings, but lots of caveats and cautions before we all start doing this! Be careful, but do learn about this potential therapy. #FOAMed @stemlyns The post The Dirty Adrenaline (Epi) drip. appeared first on St.Emlyn's.

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Is there a such thing as 'too little benefit' in oncology?

Sensible Medicine

Recently John Mandrola, once again, stepped out of his lane. About a recent, cancer trial, which was celebrated by oncologists, he said this: In fact, John’s observation is broadly true for this revolutionary class of medications. Although these drugs— checkpoint inhibitors— are great for melanoma and cutaneous squamous cell cancer, they aren’t wonder drugs and many uses are marginal.

Hospitals 123
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Can we trust clinical trials from China?

PulmCCM

China has supplanted the U.S. as the largest producer of scientific articles. More and more Chinese clinical trials are being published in Western medical journals, including elite publications like the New England Journal of Medicine , JAMA , and The Lancet. The trend can only be expected to grow. Many of these trials report new findings that could significantly impact the practice of medicine in the U.S. and worldwide.

Academics 105
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The Promises, Pitfalls & Personalization of AI in Healthcare

NRC Health

Healthcare experiences are human experiences, and the use of advanced technology has often come at the expense of human connections – until now. The post The Promises, Pitfalls & Personalization of AI in Healthcare appeared first on NRC Health.

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Why Is ADHD On The Rise

Science Based Medicine

Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed neurodevelopment disorders and seems to be on the rise, in both children and adults. The diagnosis in children requires having various symptoms of attention deficit or hyperactivity which is functionally impairing with onset by age 12. Recognition of the disorder actually goes back farther than you might think – the observation that […] The post Why Is ADHD On The Rise first appeared on Science-Base

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Thickened Liquids for Older Adults is Likely a Useless Therapy, but a Current Study Cannot Prove It.

Sensible Medicine

Few things interest my writing brain more than when a common practice gets overturned. That’s why I was drawn to Paula Span’s column in the New York Times titled, Three Medical Practices That Older Patients Should Question. One of these practices is the prescription of thickened liquids to older patients with swallowing problems. The idea goes like this: aspiration pneumonia is a common cause of death in the frail and elderly.

Outcomes 116
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Using AI to improve scientific literature search results

First 10 EM

Readers of First10EM will know that I spend way too much time on PubMed searching the medical literature. I use the website daily. It is probably the most used link on my computer. Despite that, I am more than willing to admit that PubMed – and specifically the search function – sort of sucks. It […] The post Using AI to improve scientific literature search results appeared first on First10EM.

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The Promises, Pitfalls & Personalization of AI in Healthcare

NRC Health

Healthcare experiences are human experiences, and the use of advanced technology has often come at the expense of human connections – until now. The post The Promises, Pitfalls & Personalization of AI in Healthcare appeared first on NRC Health.

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EM is a great job. After 11 years is Cliff Reid still right?

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed A reminder of a great lecture from Cliff Reid on why emergency medicine is a great (but really challenging) job. This talk is 11 years old but is arguably still true today. #FOAMed @stemlyns The post EM is a great job. After 11 years is Cliff Reid still right? appeared first on St.Emlyn's.

EMS 98
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Diagnostic Limitations

Sensible Medicine

Dr. Milyavsky submitted this piece in response to my most recent Friday Reflection. It looks at similar issues from a different angle -- the ground floor ER rather than the 3 rd floor medicine clinic -- and comes to subtly different conclusions. Adam Cifu Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.

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CV-EMCrit – MCS Minute Series: Differential Gas Exchange on Peripheral Femoral VA ECMO with Trina

EMCrit

There is more than one form of differential gas exchange on VA ECMO--remember differential ventilation! EMCrit Project by Katrina Augustin.

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Even with AI, healthcare must be in ‘the humanity business’

NRC Health

In a joint discussion, they offered their perspectives on AI’s potential, the need for ethical safeguards and building trust in AI. The post Even with AI, healthcare must be in ‘the humanity business’ appeared first on NRC Health.

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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: Sedation, Aspiration, and the Risk of GLP-1 Agonists Spoon Feed Patients on GLP-1 agonists might be at risk of delayed gastric emptying, which has significant implications for procedural sedation and endotracheal in

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Back to Sleep Series in Audio Format

Sensible Medicine

I learned a lot from Elizabeth Fama’s multipart series on the back-to-sleep recommendation for infants. She agreed to put the entire series into an audio file. Here you go. JMM Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.

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REBEL Core Cast 127.0 – Penetrating Neck Injuries

RebelEM

Take Home Points Anticipate anatomically challenging airways and consider early intubation prior to loss of airway anatomy. Skip the zones of the neck and focus on hard signs of vascular ( Shock w/o another source, Pulsatile bleeding, Expanding hematoma, Audible bruit, Signs of stroke) or aerodigestive (Airway compromise, Bubbling wound, Extensive SubQ air, Stridor, Significant hemoptysis/hematemesis).

Stroke 77
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Even with AI, healthcare must be in ‘the humanity business’

NRC Health

In a joint discussion, they offered their perspectives on AI’s potential, the need for ethical safeguards and building trust in AI. The post Even with AI, healthcare must be in ‘the humanity business’ appeared first on NRC Health.

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AI and the SCAM Literature

Science Based Medicine

AI reviews the medical literature on the mechanisms of various SCAMs The post AI and the SCAM Literature first appeared on Science-Based Medicine.

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The Art of the Oral Presentation: An Intern’s Guide

EMDocs

Author: Joshua Lowe, MD (EM Attending Physician, San Antonio, TX) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Manpreet Singh, MD (@MPrizzleER); Brit Long, MD (@long_brit) The fluorescent lights above cast a clinical pallor over the bustling ED. A cacophony of sounds envelops you. The relentless beeping and chirping of monitors created a dissonant symphony.

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SAEM Clinical Images Series: Below the Chin, Badness Lies Within

ALiEM

A 50-year-old male with insulin-dependent Type 2 Diabetes presented to the emergency department with three days of pain and swelling on the right side of his neck. He endorsed progression of his symptoms, reporting that he was now having fevers, myalgias, and intermittent difficulty swallowing solid foods. Additional Images Physical Exam Vitals : BP 153/96; HR 110; T 100.0°F; RR 16; O2 sat 97% General : Appears uncomfortable HEENT : Mild right-sided facial swelling.

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How a pause can cause cardiac arrest

Dr. Smith's ECG Blog

Written by Magnus Nossen — with edits by Grauer The tracings in today’s case is from a patient in his 80s being admitted due to dyspnea. Below is the presentation ECG. What do you think? The above ECG shows sinus rhythm. There is one premature atrial contraction which is blocked and this causes a short pause. The following sinus P wave conducts with a slightly shorter PR interval.

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SGEM#452: I’m Still Standing – After the Allergy Challenge

The Skeptics' Guide to EM

Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. AEM August 2024. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: It’s another day, another dollar in the emergency department (ED). The next patient is a 63-year-old woman with a cough and fever.

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The Promises, Pitfalls & Personalization of AI in Healthcare

NRC Health

Healthcare experiences are human experiences, and the use of advanced technology has often come at the expense of human connections – until now. The post The Promises, Pitfalls & Personalization of AI in Healthcare appeared first on NRC Health.

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Essential guide to choosing a defibrillator for home use

AED Leader

You’re lounging comfortably at home, enjoying family time, when out of the blue, a family member takes a sudden fall. It’s a moment that makes your heart miss a beat, quite literally. During a cardiac crisis, every tick of the clock matters significantly. This is where owning a defibrillator for home use shifts the scales in your favor. Now, getting your hands on the Philips HeartStart Home AED Machine is even more appealing with an enticing $200 discount – yes, you saw that correctly!

CPR 52
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New hope for young people with type 1 diabetes: the Meyer research in Florence

Emergency Live

An international study is testing a new drug that can preserve the function of pancreas beta cells Type 1 diabetes, an autoimmune disease that mainly affects children and adolescents, is a major challenge for the scientific community. The progressive destruction of the beta cells in the pancreas, which are responsible for producing insulin, leads to […] The post New hope for young people with type 1 diabetes: the Meyer research in Florence appeared first on Emergency Live.

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Boating trauma

EM SIM Cases

This case comes from JoAnne Slinn. JoAnne is a nurse (background in emergency nursing) and one of the Sim Knowledge Coordinators based at the Pritchard Simulation Centre in Kelowna, BC. JoAnne has her master of nursing degree and nurse practitioner designation and is passionate about all things sim! WHY IT MATTERS Patients in hemorrhagic shock require blood products expeditiously as well as identification and definitive management of the source of bleeding.

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What to Look for in a Healthcare IT Company

Total Medical ComplianceHIPAA

Selecting the right IT company for a healthcare organization is critical to safeguarding data security, regulatory compliance, and optimal operational performance. Healthcare providers need to find a partner that can meet their specific needs while maintaining high standards of compliance, particularly with regulations like HIPAA. Below is a breakdown of key factors to consider when evaluating healthcare IT companies, along with critical questions to ask. 1.

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Imaging Case of the Week 604

EMergucate

The chest x-ray is from a toddler taken post choking episode at home. What can be seen?

EMS 52
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Bird flu alert: California dairy farms to show outbreak

Emergency Live

The discovery of the virus in three dairies in the region raised national and international alarm A recent and unexpected outbreak of bird flu H5N1 has hit the Californian dairy industry hard. The discovery of the virus in three dairies in the region has raised national and international alarm bells, underlining the complexity and evolution […] The post Bird flu alert: California dairy farms to show outbreak appeared first on Emergency Live.

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Clinical Governance Day – Wednesday, 25th September

Greater Sydney Area HEMS

Visit the post for more.

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It’s Your Call – September 2024

Total Medical ComplianceHIPAA

OSHA: TRUE or FALSE? Federal law requires employers to notify OSHA of a work-related hospitalization, amputation, or loss of an eye within 24 hours of the incident? TRUE: Standard Number 1904.39(a)(3) states you must report inpatient hospitalization, amputation, or loss of an eye within 24 hours using one of the following methods: By telephone or in-person to the OSHA Area Office nearest the incident’s site.

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Lab case 450

EMergucate

10-years-old asthmatic boy, presented with croupy cough and wheezy chest. His blood gases showed the following: PH = 7.

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