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

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Hemolytic Uremic Syndrome (HUS): Rebaked Morsel

Pediatric EM Morsels

Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. Bloody diarrhea makes up approximately 15% of these enteritis presentations and though many causes are benign, some may be harboring something more insidious… Shiga Toxin-producing E.coli ( STEC ) and this may be associated with a terrible problem – Hemolytic Uremic Syndrome (HUS) !

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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 171
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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.

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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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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 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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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.

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We Want Them Infected Doctors Sanewashed Robert F. Kennedy Jr. Will He Reward Them With Appointments at the CDC, FDA, and NIH?

Science Based Medicine

Maybe this isn't a drill. The post We Want Them Infected Doctors Sanewashed Robert F. Kennedy Jr. Will He Reward Them With Appointments at the CDC, FDA, and NIH? first appeared on Science-Based Medicine.

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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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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.

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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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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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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.

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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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Diagnostics: Blood Transfusion Reactions

Taming the SRU

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. While they are a lifesaving staple of medicine, they also come with risks that emergency providers must be aware of. Transfusion reactions are a spectrum of adverse events that can occur with the transfusion of whole blood or any of its components.

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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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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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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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Is Your Head Spinning? The Sudbury Vertigo Risk Score

Taming the SRU

Ohle R, Savage DW, Roy D, et al. Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department. Ann Emerg Med 2024 Aims The authors cite a wide variation in practice, particularly in obtaining neuro-imaging in patients presenting with vertigo. Many patients are imaged and subjected to a longer length of stay, and on the other side of the coin, some patients with serious pathology fall through the cracks.

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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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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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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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SAEM Clinical Images Series: Dusky Feet

ALiEM

A 94-year-old female with a past medical history of hypertension, coronary artery disease, chronic venous stasis, and permanent pacemaker placement initially presented to triage complaining of left hip pain in the setting of a fall shortly prior to arrival. Upon further evaluation, she endorsed developing sudden bilateral lower extremity weakness causing her to fall to the floor.

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Syncope while on a treadmill

Dr. Smith's ECG Blog

A 60-something ow healthy male had syncope while on treadmill. 911 was called and the patient was found by medics to be diaphoretic and hypotensive. This strip was obtained: Apparent Wide Complex Tachycardia at a rate of 280 What do you think? What do you want to do? Appropriately, the medics electrically cardioverted immediately. They did not feel they had time to sedate.

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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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Measles… its backkkk (again)

EM Ottawa

In the past year, there’s been a growing concern about the rising number of measles cases globally, including in Canada. This resurgence of measles cases in major centers has sparked worry. But is it something we should truly be alarmed about? How concerned should we be? We’re going to do a deep dive refresher so […] The post Measles… its backkkk (again) appeared first on EMOttawa Blog.

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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!

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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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Animal Bites

Mind The Bleep

Introduction Patients regularly present to the emergency department with animal bites. This article aims to help guide you through managing these patients and what factors you might want to consider. Epidemiology The number of animal bites presented to A&E is largely underestimated, as many who are bit don’t present to receive medical care 1 or won’t receive treatment in a hospital setting so they are not counted in the statistics for bites 2.

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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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234. The Littlest Resus: neonatal care

Board Bombs

This is the Little Resus that could! We are covering Neonatal Resuscitation on this episode, simplifying the most complex, most scary aspects of caring for the tiniest humans. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here. Cite this podcast as: Briggs, Blake. 234. September 17th, 2024.

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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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The Holistic Approach to Wellbeing

Mind The Bleep

There’s a myriad of resources out there to help with maintaining your mental well-being, but it can be overwhelming to understand where to start or what to focus on. This article will cover several fundamental aspects that contribute towards well-being, providing you with a basic understanding of various factors that influence mental wellbeing. If you find the overview helpful, you can explore further at a pace that is suitable for you.

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REAS 2024: Driver of the Year Trophy returns

Emergency Live

An unmissable edition for emergency enthusiasts REAS 2024, the International Emergency Exhibition, is preparing to host an event that has become a classic: the Driver of the Year Trophy. Organized by Formula Safe Driving, the contest will see the best drivers of rescue vehicles compete. Driving skills in the spotlight On Saturday 5 October, the […] The post REAS 2024: Driver of the Year Trophy returns appeared first on Emergency Live.

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Sono Pro Tips and Tricks for Evaluation of Elevated Intracranial Pressure

Northwestern EM Blog

Written by: Emma Greever (NUEM ’25) Edited by: Maurice Hajjar, MD (NUEM ’22) Expert Commentary by : John Bailitz, MD Welcome to the NUEM SonoPro Tips and Tricks Series where Local and National Sono Experts team up to take you scanning from good to great for a particular diagnosis or procedure. For those new to the probe, we recommend first reviewing the basics in the incredible FOAMed Introduction to Bedside Ultrasound Book , 5 Minute Sono , and POCUS Atlas.