Ken Grauer, MD
APRIL 5, 2024
The ECG in Figure-1 was obtained from a middle-aged woman — who presented with low back pain, shortness of breath and marked hypertension — but no CP ( C hest P ain ). QUESTIONS: In view of this history — How would YOU interpret this ECG? Are the large, peaked T waves ( especially in lead V2 ) — likely to indicate hyperacute deWinter T waves? Figure-1: The initial ECG in today's case.
Pediatric EM Morsels
APRIL 5, 2024
Traveling Ticks are more than just ticking off a checklist before you get ready to travel! Climate change and changes in land usage have contributed to an expanded range of ticks (Beard 2016). There are species of ticks found on every continent and carrying a variety of vectors capable of infecting humans. Globally, ticks are the second most common vector to transmit illnesses after mosquitos (Parola 2018).
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The Trauma Pro
APRIL 2, 2024
Extraperitoneal rectal injury repair has evolved considerably over the past 40 years. Way back when, this injury automatically triggered exploration, diverting colostomy with washout of the distal colon, and presacral drain insertion (remember those?). We eventually backed off on the presacral drains (pun intended), which didn’t make a lot of sense anyway.
First 10 EM
APRIL 2, 2024
Give your patients a break. Nobody is a perfect diagnostician. Not even the best trained physician can determine, with 100% accuracy, which patients have serious pathology. Even with advanced testing, we aren’t close to perfect. However, if you listen to the subtext of breakroom complaints, it seems like we expect patients to be better diagnosticians […] The post Are you a perfect diagnostician?
Stop and Think
MARCH 31, 2024
My career in cardiology can be separated into two decade-long blocks. The first decade I practiced like most other cardiologists. I went with the flow, followed the guidelines. I went to few meetings, read few studies and as a result had little (mental) tension. Then I started writing about medical evidence. This required studying the evidence. Over time, I learned the skill of critical appraisal.
Emergency Medicine Cases
APRIL 2, 2024
In this part 2 of our 2-part podcast on asthma with Dr. Sameer Mal and Dr. Leeor Sommer, we dig into the recognition and management of life-threatening asthma. We answer such questions as: what are the key elements in recognition of threatening asthma? What are the most time-sensitive interventions required to break the vicious cycle of asthma? What are the best options for dosing and administering magnesium sulphate, epinephrine, fentanyl and ketamine in the management of the crashing asthmatic
The Trauma Pro
APRIL 5, 2024
The American College of Surgeons requires all US Trauma Centers to publish a call schedule that includes a backup trauma surgeon. This is important for several reasons: It maintains a high level of care when the on-call surgeon is encumbered with multiple critical patients, or has other on-call responsibilities such as acute care surgery It reduces the need to place the entire trauma center on divert due to surgeon issues However, the ACS does not provide any guidance regarding the criteria for
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Dr. Smith's ECG Blog
APRIL 2, 2024
An elderly man collapsed. There was no bystander CPR. Medics found him in ventricular fibrillation. He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED.
Emergency Medicine Cases
APRIL 2, 2024
In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain. The post ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain appeared first on Emergency Medicine Cases.
Sensible Medicine
APRIL 1, 2024
First of all, Happy April Fools day. I thought about writing a fake-trial post. But thought the better of it. I normally tell you about a single study on Monday. This week, I want to alert you to the potential bigness of next weekend, when the American College of Cardiology meets in Atlanta. Sunday is an especially important day, as we will hear the results of three clinical trials—each of which could change cardiology in major ways.
Science Based Medicine
MARCH 31, 2024
Part 1: Doctors who said the pandemic ended 3-years ago now have the audacity to lament the "damaged public trust in the medical profession." The post Dr. Marty Makary: “We’ll Have Herd Immunity by April” & “It’s Okay To Have an Incorrect Scientific Hypothesis. But When New Data Proves It Wrong, You Have To Adapt.” first appeared on Science-Based Medicine.
St. Emlyn
APRIL 4, 2024
St.Emlyn's - Emergency Medicine #FOAMed This week Cliff Reid highlighted a recent meta-analysis of the use of bougies in tracheal intubation. This is something that has been routine practice in Virchester ED for many years, […] The post JC: Bougie use in tracheal intubation. St Emlyn’s appeared first on St.Emlyn's.
Emergency Live
APRIL 4, 2024
Taiwan grappling with the aftermath of the quake: casualties, missing persons, and destruction after the devastating earthquake A morning marked by terror On April 3, 2024, Taiwan faced the most powerful earthquake ever recorded in a quarter of a century, unleashing an immediate crisis on the island and in the surrounding areas. The quake measured […] The post Taiwan: strongest earthquake in 25 years appeared first on Emergency Live.
Taming the SRU
MARCH 30, 2024
Visiting lecturer: structural leadership - taming the sru - r4 sim and oral boards “Innovation Meets the Bedside: The Evolution of New Models of Emergency Care Delivery” WITH dr. ben bassin “What problem are you trying to solve?” Emergency Critical Care Center (EC3) at the University of Michigan: Dedicated critical care unit within the emergency department that was created to improve access to timely, high-quality critical care after identifying a gap in emergency care delivery for patients Redu
Science Based Medicine
APRIL 5, 2024
Part 2: In 2020, pro-infection doctors said "It’s fantastic news that we have a lot of cases." Today, they performatively lament "learning loss for children, especially in poor families". What happened to their assurances that the mass infection of unvaccinated youth will rapidly lead to herd immunity? The post The Failed “We Want Them Infected” Movement Is Trying to Rebrand Itself As The “All We Really Wanted Was Poor Kids in School” Movement. first appeared on Science-Based Medicine.
Dr. Smith's ECG Blog
MARCH 31, 2024
Sent by anonymous, written by Pendell Meyers I received a text with this image and no other information: What do you think? I simply texted back: "Definite posterior OMI." The person I was texting knows implicitly based on our experience together that I mean "Definite posterior OMI, assuming the patient's clinical presentation is consistent with ACS.
Emergency Live
APRIL 4, 2024
Endocervical curettage, a critical gynecological procedure that allows physicians to accurately diagnose precancerous conditions and cervical cancer Endocervical curettage, a procedure of critical importance in the field of gynecology, provides physicians with the ability to diagnose precancerous states and cervical cancer with considerable precision.
EMDocs
APRIL 2, 2024
Today on the emDOCs cast Brit Long interviews Zachary Aust on the use of a mental model in post ROSC patients. Episode 98: Post ROSC Mental Model What’s the problem? The Code Whatever caused the initial arrest Iatrogenic injuries from CPR Patients are in a pathophysiologic state that is being called “post-cardiac arrest syndrome” Hypoxic brain injury Myocardial dysfunction Systemic ischemia/reperfusion injury SIRS Response Very fragile state Hard to diagnose what is going on Small Things
Sensible Medicine
APRIL 2, 2024
This post introduces an occasional series, available to our paid subscribers, aimed at helping people improve their ability to read and interpret the medical literature. Improving Your Critical Appraisal Skills will be made up of “chapters” dealing with how to read articles about various study types. These chapters are adapted from my former course, Critical Appraisal of the Landmark Literature.
EB Medicine
APRIL 1, 2024
In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2024 Pediatric Emergency Medicine Practice article, Brief Resolved Unexplained Events: Practical Evaluation and Management in the Emergency Department Introduction The Evolution of BRUE Understanding BRUE Guidelines The Importance of Pre-Hospital Care in BRUE Cases Investigating the Event: Questions to Ask Medical and Family History: Key Factors Environmental and Social Considerations Definitions and Risk Assessment Physical
Emergency Live
APRIL 4, 2024
Hepatectomy, a crucial surgical intervention, removes portions of the diseased liver, saving human lives by treating various liver disorders This surgical procedure involves partial or complete resection of the liver, depending on the severity and extent of the disease. Its primary purpose is to treat benign and malignant liver tumors, providing a valid therapeutic solution. […] The post Hepatectomy: A Vital Procedure Against Liver Tumors appeared first on Emergency Live.
EMDocs
MARCH 30, 2024
Authors: Luke Bailey (Medical Student, Texas A&M SOM, Bryan, TX) and Scott Wieters, MD (Associate Dean Temple Campus, Texas A&M SOM, Temple, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, 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 review of clinical basics.
St. Emlyn
APRIL 2, 2024
St.Emlyn's - Emergency Medicine #FOAMed The ARC-H principle: re-defining global health & shifting the balance. Anisa Jafar @EMergeMedGlobal takes us through why definitions really matter. The post The ARC-H principle: re-defining global health & shifting the balance. appeared first on St.Emlyn's.
First 10 EM
MARCH 31, 2024
The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the format means the focus is mostly on content I have found, but I hope […] The post The First10EM monthly wrap-up for March 2024 appeared first on First10EM.
Emergency Live
APRIL 2, 2024
Embracing Differences: Understanding Autism Today Blossoming alongside spring flowers, World Autism Awareness Day is celebrated on April 2, 2024, for its 17th edition. This globally recognized event, approved by the United Nations, aims to raise public awareness about autism. Touching countless lives, autism remains shrouded in myths and misconceptions.
Science Based Medicine
APRIL 1, 2024
As the HBO documentary The Truth vs. Alex Jones shows, Alex Jones promoted the conspiracy theory that the Sandy Hook massacre was a hoax to sell his supplement line. It's a model that many Internet conspiracy theorists use, like Mike Adams. Did the DSHEA help create Alex Jones and the modern conspiracy industry? The post The Truth vs. Alex Jones: How the DSHEA of 1994 gave conspiracy mongers the means to fund their empires first appeared on Science-Based Medicine.
ALiEM
APRIL 1, 2024
A 23-year-old female with no known past medical history presented with a rash concentrated on her legs, with a few areas on her arms and chest. The rash began the day before presentation when she became overheated while wearing sweatpants in 104°F weather. The rash was mildly pruritic but not painful. She denied any prior reaction to her sweatpants that she has had for several months.
PDC Healthcare
APRIL 2, 2024
Every year the ISBT 128 publishes labeling standards for essential items that hospital lab professionals use, including blood bags. The ISBT 128 is the “global standard for the terminology, identification, coding and labeling of medical products of human origin (including blood, cell, tissue, milk, and organ products). It is used on six continents in disparate […] The post Meet ISBT 128 Blood Bag Labeling Standards with PDCs Blood Bag Labels appeared first on connectID - PDC Healthcare Blo
Emergency Live
APRIL 4, 2024
A Detailed Analysis of the Current State of Avian Influenza and Recommended Prevention Measures The threat of avian flu Avian influenza is caused by influenza viruses that infect birds. One strain, the A/H5N1 virus of clade 2.3.4.4b, is being monitored by scientists and is of concern. Although few people have fallen ill so far, it […] The post Aviary Alert: Between Virus Evolution and Human Risks appeared first on Emergency Live.
Science Based Medicine
MARCH 30, 2024
Saturday. Just another workday when the Cholera is flowing. I woke early, at 6 a.m., and went to the office before anyone else. On the way, I went to the grocer’s and bought some supplies. I started, as usual, in the cubby room, and I was happy to see that as of yesterday that cases of the Cholera were staying down: there were […] The post Skeptics in the Pub.
ACEP Now
APRIL 5, 2024
A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. Vital signs on arrival are: Temperature: 38.8 degrees Celsius Heart rate:128 Blood pressure: 74 over 48 Respiratory rate: 10 Oxygen saturation: 77 percent Physical examination was notable for lethargy and confusion. He has an absent gag reflex. He has a Class I Mallampati view and lung sounds were diminished in all fields.
EM Ottawa
APRIL 4, 2024
Point-of-care ultrasound (PoCUS) is becoming a cornerstone tool in our assessment of patient presentations and is helping us guide our clinical management. This is also represented in the amount of literature that has been published on the use of PoCUS in 2023. In this post, Dr. Murray reviews 5 articles (with case examples and videos), […] The post Probing 2023: PoCUS Articles to Change Your Practice appeared first on EMOttawa Blog.
Emergency Live
APRIL 4, 2024
A detailed journey into the enigmatic realm of chromosomes, the pillars of life that safeguard the genetic blueprint of every organism These intricate structures, composed of complex strands of DNA intertwined with proteins, reside within the nucleus of cells, where they orchestrate a multitude of vital functions, transcending mere storage and transmission of hereditary information. […] The post Chromosomes: The Keepers of the Genetic Code appeared first on Emergency Live.
EMCrit
APRIL 5, 2024
The 2nd FoundStab SOP is on standard intubation. EMCrit Project by Scott Weingart, MD FCCM.
American Medical Compliance
APRIL 1, 2024
The following Indiana Ethics and Professional Responsibility in Dentistry Training is designed to educate dental healthcare providers (DHCP) in Indiana on the ADA Code of Ethics, which includes the Principles of Ethics, the Code of Professional Conduct, and Advisory Opinions, as well as Indiana guidelines regarding the licensure and practice of dentists and dental hygienists.
PEMBlog
APRIL 4, 2024
Be sure to check out our previous posts on: BRONCHIOLITIS , EPIGLOTTITIS , PNEUMONIA , and CROUP The Problem: Free open access medical education (aka FOAM) is great in that it allows for asynchronous, focused learning. But there are some challenges when it comes to the utilization of FOAM: – Decentralization of FOAM resources – Concerns about the quality of information being presented The Solution: The Systematic Online Academic Resource, or SOAR, review was created in an effort to address some
Sensible Medicine
APRIL 3, 2024
Why start this series with the RCT? RCTs are used to determine if one treatment is better than another. They are clinical experiments that provide medicine’s most reliable data. When there is a good RCT, one that can be generalized to a specific patient’s situation, there is no better guide. However, RCTs are far from perfect. Individually, their design may lead them to include important biases and not be generalizable.
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