Ken Grauer, MD

AUGUST 29, 2024

The ECG in Figure-1 was obtained from an 80-year old woman — who presented to the ED ( E mergency D epartment ) — with a several hour history of "palpitations" and CP ( C hest P ain ). She was hemodynamically stable at the time ECG #1 was recorded. QUESTIONS: The ECG in Figure-1 was seen by a number of physicians — the majority of whom thought the rhythm was some form of SVT ( S upra V entricular T achycardia ) with LBBB ( L eft B undle B ranch B lock ) aberration.

EKG/ECG 392

EKG/ECG Hospitals Wellness 392

The Trauma Pro

AUGUST 27, 2024

Here’s the last one… for now. If you have followed this blog for any period of time, you are aware of the skepticism I bring to bear when I am reading new material or learning of new ideas. Why is this? Because it is very difficult in this day and age to ascertain the veracity of anything we see, hear, or read. This is not new compared to, say, a hundred years ago.

Head Injuries 239

Head Injuries Operations Research 239

EMCrit

AUGUST 26, 2024

We often joke that the right ventricle is the “forgotten ventricle,” but there is a sad truth behind this joke. Recently, there has been increased recognition of the importance of right ventricle failure and systemic congestion within some circles (e.g., nephrologists and resuscitationists). However, overall the right ventricular failure continues to be commonly overlooked.

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Science Based Medicine

AUGUST 26, 2024

This week, Stanford University announced a conference on pandemic policy that features several of the usual suspects who spread misinformation during the COVID-19 pandemic. Truly, Stanford has become the "respectable" academic face of efforts to undermine public health. The post Stanford University will host a conference on pandemic planning featuring the usual (COVID-19) suspects first appeared on Science-Based Medicine.

Academics 132

Academics 132

Stop and Think

AUGUST 28, 2024

One area continues to dominate my field of cardiology. It is the search for and treatment of ischemic heart disease. Coronary heart disease dominates the minds of patients and doctors alike. Find blockages so they can be fixed before a heart attack or death occurs—goes the thinking. Coronary artery scans are the newest tool. But stress labs run days and weekends.

Outcomes 117

Outcomes Shock Hospitals Wellness 117

Dr. Smith's ECG Blog

AUGUST 26, 2024

A 60-something woman with no cardiac history presented with epigastric and right upper quadrant pain after eating spicy food. She had an ECG recorded at triage: What do you think? This was sent to me without any info while I was out and about, and I looked at it on my phone. I responded: "That is a tough one. V2 is very worrisome. But no other leads are.

EKG/ECG 105

EKG/ECG Outcomes 105

Life in the Fast Lane

AUGUST 26, 2024

Caleb Lin Hyperbaric Oxygen for the ICU Patient OVERVIEW INTENSIVE CARE INDICATIONS PRACTICAL ISSUES IN CRITICAL CARE Consideration & Prior to Treatment In the Chamber A: ETT cuff to be filled with sterile water or connected to dynamic cuff inflator B: Titrate ventilation to PaCO2, note that EtCO2 is not linearly proportionate at higher pressures C: Haemodynamic shifts related to hyperoxic vasoconstriction D: Increased […]

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Don't Forget the Bubbles

AUGUST 26, 2024

While enjoying a well-deserved lunch break recently, a group of Paediatric Registrars and I discussed the usual topics of family-friendly dinners, recent interesting cases from the birth centre and fun scrub tops. As is typical in a large teaching hospital, this dialogue progressed to staffing levels and skill mix in Paediatrics. Then one of the Registrar’s said, ‘If not a single doctor turned up to work tomorrow I am sure that all of the patients would be fine, but I seriously doubt it if not a

Hospitals 98

Hospitals Wellness 98

Emergency Live

AUGUST 29, 2024

The virus is spreading rapidly in all age groups, with a peak among children aged 5-9 Parvovirus B19, also known as “slap cheek disease” due to the characteristic rash it causes, is on the rise in the United States. According to a recent warning from the Centers for Disease Control and Prevention (CDC), the virus […] The post Parvovirus B19 on the rise in the USA appeared first on Emergency Live.

CDC 95

CDC 95

St. Emlyn

AUGUST 27, 2024

St.Emlyn's - Emergency Medicine #FOAMed Is it time to rethink peer review? Delve into the pros and cons of this crucial process in scientific research. Is open peer review a better option for the future? @richardbody has tried it and we think he likes it. @stemlyns #FOAMed The post Open and Ongoing Peer Review: A New Model for Scientific Research appeared first on St.Emlyn's.

Research 101

Research 101

Science Based Medicine

AUGUST 24, 2024

Dr. Jay Bhattacharya and the merging of political pandemic narratives The post Great Barrington Declaration Author Joins COVID-19 Lab Leak-Pushing Group first appeared on Science-Based Medicine.

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American Medical Compliance

AUGUST 27, 2024

According to Rock Health , digital health funding still totaled $15.3 billion in 2022, despite economic challenges. This figure underscores the critical role technology continues to play in healthcare, particularly in advancing access and equity. As healthcare providers, organizations, and policymakers increasingly recognize the persistent disparities in health outcomes across different populations, technology is emerging as a powerful tool to bridge these gaps.

Outcomes 92

Outcomes 92

EM Literature of Note

AUGUST 25, 2024

Move over ketamine and TXA, there’s another medication gradually approaching do-it-all darling status in Emergency Medicine: dexamethasone. Sore throats? Croup? Headaches? Non-specific aches? Well, yes to all of the above, in the appropriate clinical context – But, most prominently, as featured in this brief report, for asthma – particularly childhood asthma.

Administration 92

Administration Emergency Department Wellness Pediatrics 92

EB Medicine

AUGUST 29, 2024

In this episode, Sam Ashoo, MD interviews social media marketing expert Adam Goodcoff, DO, Founder and CEO of MedFluencers. Meet Dr. Adam Goodcoff The Role of Physicians on Social Media Legal Considerations for Physicians on Social Media Employer Policies and Social Media Creating Engaging Content Balancing Professionalism and Personal Life on Social Media Navigating Negative Comments and Trolls Handling Low Engagement and Negative Feedback Becoming a Medfluencer: Tips and Strategies Connecting

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Science Based Medicine

AUGUST 30, 2024

Vaccines save lives and money according to a recently published CDC report. This shouldn't come as a surprise, but it's still nice to see. The post Vaccines: Saving Lives and Money for Over 200 Years first appeared on Science-Based Medicine.

CDC 99

CDC 99

American Medical Compliance

AUGUST 27, 2024

As the global population ages, the demand for assisted living facilities has surged dramatically. In the United States alone, over 800,000 Americans currently reside in assisted living, according to the National Center for Assisted Living. These facilities play a vital role in providing essential care and support for elderly individuals who may no longer be able to live independently.

Elder Abuse 90

Elder Abuse Domestic Violence Administration Incident Reporting 90

Sensible Medicine

AUGUST 27, 2024

We’ve had a number of articles on Sensible Medicine about medical education. It is probably not surprising as many of our writers and readers have had personal experience with medical education and/or work with trainees everyday. One of our early series (fall 2022) featured these two pieces. Today we have a current trainee extending Dr. Prasad’s most recent critique.

Outcomes 94

Outcomes Research Wellness 94

Taming the SRU

AUGUST 27, 2024

Bullous skin lesions, a subset of cutaneous blistering disorders, are a group of illnesses with predominately dermatologic findings that can occur in a wide variety of clinical settings, including autoimmune, pharmacologic reactions, infection, genetic disorders, or physical injury. This differential is broad and reflects the clinical diversity of their presentations - in this post we will parse through the specifics of bullous lesions as well as what there is to do for them acutely.

Emergency Department 83

Emergency Department Dehydration Burns Sepsis 83

Science Based Medicine

AUGUST 29, 2024

A new paper that looks at homeopathy in pharmacy education raises more questions than answers. The post Homeopathy in Pharmacist Education first appeared on Science-Based Medicine.

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95

American Medical Compliance

AUGUST 29, 2024

In today’s healthcare environment, ensuring compliance with the Health Insurance Portability and Accountability Act (HIPAA) is more crucial than ever, especially for business associates. Business associates, including vendors, contractors, and third-party service providers, play a vital role in handling protected health information (PHI). This HIPAA Business Associates Refresher Training is designed to reinforce the responsibilities of business associates under HIPAA, highlighting the impo

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Sensible Medicine

AUGUST 30, 2024

KN is a 90-year-old man I visit at an inpatient hospice. His son warned me that my visit might “be a waste of time” because he sleeps much of the day and “can’t even get out of bed.” When I arrive, however, I find him in good spirits. He is pain free, cognitively intact, and genuinely pleased to see me. He is not only happy for the company but touched that I made the effort to come.

Hospice 91

Hospice Dehydration Wellness Outcomes 91

ALiEM

AUGUST 26, 2024

A 27-year-old male with no past medical history presents to the Emergency Department with right eye pain. He states that approximately one week prior, he was working on a wire fence when he lost hold of a wire under tension, and it subsequently hit him in his right eye. He had immediate pain in his affected eye and was unable to see anything but light for the next three days.

Emergency Department 70

Emergency Department Academics Ultrasounds 70

Science Based Medicine

AUGUST 28, 2024

Are we ready for the next potential pandemic? It seems like we are just get over COVID and already we have to worry about the next one. We first covered the monkey pox (now mpox) in 2022. Since then it has continued to be a concern. Where do our efforts to contain this infection stand? To recap, the disease mpox is the […] The post Are We Ready for Mpox first appeared on Science-Based Medicine.

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Pediatric Education

AUGUST 25, 2024

Patient Presentation A 4-year-old male came to clinic for his well-child evaluation. He was doing well and would start pre-school in the fall. The past medical history showed that after birth he had a history of macroglossia and possible hemihypertrophy, both of which he outgrew. Genetic consultation had recommended testing for Beckwith-Wiedemann syndrome which was done and was negative.

Pediatrics 64

Pediatrics Ultrasounds Wellness 64

Sensible Medicine

AUGUST 28, 2024

In Post #1 , Ms. Fama introduced her critical appraisal series on the back-to-sleep recommendation. In Post #2 , she explored the downsides of back sleeping. Post #3 explained the nuances of sudden infant death syndrome. Post #4 featured an evidence review. This week, Ms Fama concludes this amazing series. JMM Sensible Medicine is a reader-supported publication.

Research 80

Research CDC Documentation/Coding 80

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. The patient had no significant past medical history. She also endorsed three weeks of cough and congestion, and one day of muffled voice. She denied difficulty swallowing, fatigue, cold intolerance, or hair and nail changes.

Pediatrics 64

Pediatrics Ultrasounds Academics Emergency Department 64

Science Based Medicine

AUGUST 27, 2024

The Problem of Quackademic Medicine The post The Biopolitics of Quackademic Medicine in Iran first appeared on Science-Based Medicine.

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American Medical Compliance

AUGUST 29, 2024

Providing high quality care for seniors and people with disabilities requires specialized knowledge, skills, and a compassionate approach. This Comprehensive Care training is designed specifically for healthcare personnel to enhance their understanding of comprehensive care tailored to the unique needs of these vulnerable populations. Participants will learn about best practices in caregiving, communication strategies, and techniques to ensure safety, dignity, and improved quality of life for se

Best Practices 52

Best Practices Wellness 52

Sensible Medicine

AUGUST 26, 2024

Atrial fibrillation ablation began around the turn of the century. Millions of people have had this procedure over the past 24 years. Millions. In population studies, AF associates with worse outcomes. Strokes and heart failure are the main complications of AF. Plus, many patients have symptoms from AF. Drugs to suppress AF are not the best. Their efficacy is modest; their side effects can be problematic.

Stroke 80

Stroke Outcomes Shock Research 80

Emergency Live

AUGUST 29, 2024

Increasing numbers of boys and girls are dealing with substance abuse, gambling and digital addictions Substance use and digital addiction among young people is an emergency that requires increasing attention. According to the latest data, an increasing number of boys and girls are facing issues related to substance abuse, pathological gambling and internet addiction.

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52

EMergucate

AUGUST 29, 2024

Dental Trauma in Paediatrics Learn about how to number children’s teeth correctly, what lateral luxation vs subluxation means, and how … Continue reading →

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American Medical Compliance

AUGUST 29, 2024

Accurate injury identification and timely reporting are vital components of patient care in healthcare settings. This Comprehensive Injury Identification and Reporting training is designed to equip healthcare professionals with the skills and knowledge necessary to identify various types of injuries accurately, understand their causes, and report them effectively.

Patient Safety 52

Patient Safety Documentation/Coding Wellness 52

Sensible Medicine

AUGUST 25, 2024

A few weeks ago John Mandrola broke twitter (as we used to say) with this tweet. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber. I’ll admit that nothing I have ever said or written has every garnered 4.5M views. He followed it up with an article. Vinay Prasad took a swipe at him.

Academics 62

Academics Leadership Wellness Research 62

PulmCCM

AUGUST 28, 2024

Tranexamic acid (TXA) is a synthetic analog of the amino acid lysine which reversibly binds to plasminogen, reducing its fibrinolytic action. TXA has FDA indications for the prevention of heavy bleeding during tooth extraction in patients with hemophilia, and also for heavy menstrual bleeding. It’s sold inexpensively in the U.S.

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Emergency Live

AUGUST 28, 2024

Prolonged loneliness can induce neurobiological alterations, with cognitive and emotional consequences Social isolation, understood as a lack of meaningful social interactions, is an increasing public health problem with profound implications for the mental and physical health of individuals. Numerous studies have shown that prolonged loneliness can induce neurobiological alterations, with significant consequences on cognitive and […] The post Social isolation: a risk factor for brain heal

Research 52

Research 52

American Medical Compliance

AUGUST 29, 2024

Healthcare providers play a critical role in identifying and reporting elder and domestic violence abuse. This training is designed to equip healthcare professionals with the knowledge and skills needed to recognize signs of abuse, understanding reporting requirements, and take appropriate action to protect vulnerable individuals. In this comprehensive Elder and Domestic Violence Abuse Reporting course, participants will learn about the different types of abuse, mandatory reporting laws, and bes

Domestic Violence 52

Domestic Violence Elder Abuse Best Practices Fractures 52

Sensible Medicine

AUGUST 29, 2024

I discuss how medical students are selected, and perhaps how they should be selected.

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