Sensible Medicine

JANUARY 30, 2025

A limited mask mandate is returning to my state this week. In 2023, the Maryland Department of Health (DOH) adopted a standard for return to universal masking in healthcare facilities when hospitalizations with respiratory viruses (covid, influenza, or RSV) reach a level of 10 cases per 100,000 population. Maryland has a population of 6.3 million and about 10,000 licensed hospital beds, so that works out to about 6% of hospital beds.

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CDC Hospitals Academics 71

The Trauma Pro

JANUARY 28, 2025

In my last two posts, I reviewed some older papers on the efficacy of Andexxa (andexanet alfa) for the reversal of Factor Xa inhibitor anticoagulants. Those results were not very impressive, especially considering the high cost of this drug. In 2021, an article was published (reference 1) that performed a systematic review of the literature from 2017 to 2020.

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Administration Outcomes Hospitals 189

Science Based Medicine

JANUARY 29, 2025

Shrug, move on and never admit you were wrong The post The willful blindness of RFK Jrs supporters first appeared on Science-Based Medicine.

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Emergency Medicine Cases

JANUARY 28, 2025

On this month's EM Quick Hits podcast: Anand Swaminathan on optimizing RSI medication timing, Brittany Ellison ED boarding challenges in older patients and solutions to ED crowding and flow, Dave Jeromeon managing prolonged tourniquet application, Nour Khatib and Phil Gillick on a rural peer support case, Jesse McLaren on ECG reciprocal changes in acute coronary occlusion, and Melody Ngon practical nutrition tips for shift workers.

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EMS EKG/ECG Resuscitation 92

Sensible Medicine

JANUARY 28, 2025

Just out, we have a new paper on a provocative question. What factors were blamed for the 2019 Samoa measles outbreak in the peer reviewed literature and news coverage? At the time, and now 5 years later? Subscribe now First, we assembled every single peer reviewed article and mainstream media news story on the Samoa measles outbreak. 163 studies met our criteria.

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Academics CDC Administration 120

Dr. Smith's ECG Blog

JANUARY 28, 2025

Written by Hans Helseth A 34 year old man with no known medical history presented to the ED after an hour of chest pain. He described the pain as a mid sternal "burning sensation" and rated it 8.5 out of 10 at onset, but on presentation to the ED, reported that the pain had improved to 4.5. His first EKG is shown below, with a lead II rhythm strip: EKG 1, 1645 A provisder who is looking for STEMI would not see much in this EKG.

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EKG/ECG Burns Hospitals Emergency Department 75

Science Based Medicine

JANUARY 28, 2025

Doctors who mourned the loss of a single speech or YouTube video are fine with the the mass censorship of public scientists. The post Well Well Well, We Want Them Infected Doctors Are OK With Censorship After All first appeared on Science-Based Medicine.

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Wellness 91

Life in the Fast Lane

JANUARY 27, 2025

Michael Gibbs MD Neuroimaging Cases 007 Nail gun injury. First in our Neuroimaging case study series with Teresa Crow , Troy Carnwath, Scott DiMeo, L.

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Radiology Radiology 78

EMCrit

JANUARY 25, 2025

The basics of inotropes - part 1 EMCrit Project by Scott Weingart, MD FCCM.

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Science Based Medicine

JANUARY 31, 2025

Defenders of Dr. Vinay Prasad fake a concern about tone to intimidate critics and create a safe space for his misinformation. The post Defenders of Dr. Vinay Prasads Vulgar, Vengeful Vitriol Have No Right to Sanctimoniously Scold Anyone About Decorum first appeared on Science-Based Medicine.

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ECG Guru

JANUARY 30, 2025

In this 12-lead ECG there is a bradycardic rhythm, which is regular, heart rate about 45 bpm. The QRS complexes are narow. What is this rhythm called? There are no P waves present, and no flutter or fibrillation waves can be seen. There are 2 possibilities: 1. There is a sinus arrest with a junctional escape rhythm. The junctional rhythm either cannot conduct retrograde to the atria (therefore no inverted retrograde P wave can be seen) or the retrograde P wave is hidden in the QRS complex (atria

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EKG/ECG 72

EMDocs

JANUARY 25, 2025

Authors: Michael Sperandeo, MD (Assistant Professor, Dept of Emergency Medicine, Long Island Jewish Medical Center, Associate Program Director EMSL Medical Simulation Fellowship, Zucker School of Medicine at Hofstra/Northwell); Sophia Grgens, MD (EM Physician, BIDMC, MA) // Reviewed by: Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK) Welcome to EM@3AM, an emDOCs series designed to foster your wo

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EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 67

Mind The Bleep

JANUARY 28, 2025

Pretibial lacerations are common injuries, especially among older adults, because the skin over the shin becomes thinner and more susceptible to tears with age. Epidemiology Pretibial lacerations may occur following minor trauma to the shin area, particularly in elderly individuals with fragile skin. The prevalence of these injuries is estimated at 5.2 per 1000 emergency department attendances in the UK (1).

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Documentation/Coding Head Injuries Fractures Emergency Department 52

The Evolution & Medicine Review

JANUARY 28, 2025

Oxygen is essential for human life, yet a growing body of preclinical research is demonstrating that chronic continuous hypoxia can be beneficial in models of mitochondrial disease, autoimmunity, ischemia, and aging. This research is revealing exciting new and unexpected facets of oxygen biology, but translating these findings to patients poses major challenges, because hypoxia can be dangerous.

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Research 52

Emergency Medicine Cases

JANUARY 28, 2025

Discover how Global EM principles can be applied to rural medicine in North America. Dr. Arjun Sithamparapillai challenges misconceptions about Global Health sustainability, and highlights the critical role of teamwork, adaptability, and equity in underserved communities. Perfect for EM professionals balancing family, career, and a passion for global impact.

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Teamwork EMS 54

Science Based Medicine

JANUARY 30, 2025

Please recognize that you are now influencing the national public health policy and understand that being in authority is a very different job than simply questioning authority The post An Open Letter to Dr. Vinay Prasad first appeared on Science-Based Medicine.

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St. Emlyn

JANUARY 27, 2025

St.Emlyn's - Emergency Medicine #FOAMed What is the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. The post JC: Do physician led prehospital teams improve outcomes? appeared first on St.Emlyn's.

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Outcomes Hospitals Research Resuscitation 54

The Evolution & Medicine Review

JANUARY 31, 2025

Carrera, S. C., Godoy, I., Gault, C. M., Mensing, A., Damm, J., Perry, S. E., & Beehner, J. C. (2025). Stress responsiveness in a wild primate predicts survival across an extreme El Nio drought. Science Advances, 11(4), eadq5020.

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Research 52

The Bottom Line

JANUARY 30, 2025

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections BALANCE Investigators. NEJM 2024; DOI: 10.1056/NEJMoa2404991 Clinical Question In hospitalised patients with bloodstream infections (BSI), is antibiotic treatment for 7 days, compared to treatment for 14 days, non-inferior with respect to mortality at 90 days?

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EMergucate

JANUARY 28, 2025

An 86yr male presents with syncope and melena. Hb 76. His ECG is below: What is the Rythm? What is you management plan for this patient?

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EKG/ECG EMS 52

PHARM

JANUARY 27, 2025

St.Emlyn’s – Emergency Medicine #FOAMed This article explores the impact of physician-led interprofessional pre-hospital teams on survival and JC: Do physician led prehospital teams improve outcomes?

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Outcomes Hospitals 52

Thinking Critical Care

JANUARY 31, 2025

It was so great to meet, hang out and talk ECPR with Paris’ SAMU ECPR leader Lionel Lamhaut last month in Montreal, a city we are actively trying to bring pre-hospital ECPR to, thanks to the relentless work of Lawrence Leroux. In the meantime, we are super excited to host the North American Premiere of Lionel’s famous pre-hospital ECMO course and open the registration for a two day, small-group affair with hands on workshops, lectures and discussions with ECPR experts.

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Hospitals CPR Ultrasounds 52

The Skeptics' Guide to EM

JANUARY 25, 2025

Date: January 9, 2025 Reference: White et al. Evidence of questionable research practices in clinical prediction models. BMC Med 2023 Guest Skeptic: Dr. Jestin Carlson is the Program Director for the AHN-Saint Vincent EM Residency in Erie Pennsylvania. He is the former National Director of Clinical Education for US Acute Care Solutions and an American Red Cross Scientific Advisory Council member.

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Research EMS Documentation/Coding Operations 47

NRC Health

JANUARY 30, 2025

Ryan Hatt, Director of Customer Success at NRC Health, and Tom Kirby, Senior Director of Strategic Marketing and Intelligence at UPMC, discussed the importance of brand strength amid new competition from companies like Amazon and Dollar General during a special recording of SHSMDs Rapid Insights podcast. The post Building resilience in healthcare through brand strength appeared first on NRC Health.

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PHARM

JANUARY 25, 2025

I never thought that I would come out of blogging retirement. Didnt have anything else to say.

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Sensible Medicine

JANUARY 25, 2025

I recently recorded a conversation with Michael Easter from the TWO/PERCENT , a Substack and podcast. Michael offers “practical, accurate, and useful health, performance, and mindset information,” and in a space where there is a lot of drive, I find him remarkably thoughtful. Our conversation is on the podcast feed. Below are my notes for our conversation with links to many of the things we discussed.

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Wellness 52

JournalFeed

JANUARY 25, 2025

The JournalFeed podcast for the week of Jan 20-24, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Tuesday Spoon Feed : Preoperative antibiotics significantly decreased the microbiologic yield of operative cultures (10.9%) in patients with native joint septic arthritis.

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Operations 52

NRC Health

JANUARY 29, 2025

This years lineup includes many great presentations, including a discussion focused on the human side of healthcare providers and the case for compassionate care. The post Peds Collab Preview | Embracing compassionate care appeared first on NRC Health.

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Pediatrics 40

Board Bombs

JANUARY 25, 2025

Can you imagine how efficient the world would be without TikTok? Maybe we would be better at learning neonatal jaundice. Time to summarize a classic neonatal emergency! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Wosiski-Kuhn, Marlena. 248.

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Don't Forget the Bubbles

JANUARY 27, 2025

We are always taught to consider testicular torsion in any young male with abdominal pain. How often do you see posters up reminding you to think about ovarian torsion in a female with abdominal pain? Missing both diagnoses are never events, but ovarian torsion is not discussed nearly as often and is arguably harder to diagnose. You might think it will be obvious when the patient walks in.

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Ultrasounds Emergency Department Pediatrics Dehydration 59

The Trauma Pro

JANUARY 31, 2025

There is a presumption that more education and attainment of more advanced skills lead to greater expertise in just about any field. The same argument holds true for prehospital provider training. Training to be an ALS provider (advanced EMT or paramedic) should add extra value in patient care over and above BLS training (emergency medical responder or EMT).

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Emergency Medical Responders Documentation/Coding EMS Hospitals 127

Sensible Medicine

JANUARY 25, 2025

Over the years, I have been saddened to see several colleagues die. Recently, a famous physician passed away. I did not know him well. The Department honored him with an in person eulogy. A powerpoint show was loaded on the screen, and several doctors spoke. Here is what I learned. He: “Had appointments in 3 divisions.” “Was an expert in team building, with over 50 people in his laboratory.” “He gave every person in the lab their own project” “His lab wa

Academics 124

Academics Research Wellness 124

ALiEM

JANUARY 27, 2025

A 20-year-old previously healthy student-athlete female presented with a 2-week history of bilateral periorbital swelling unresponsive to steroids and anti-histamines prescribed by her PCP. The edema had been worsening, and there was a new development of throat tightening and discomfort. She denied rash, allergies, fever, URI symptoms, urinary symptoms, or new medications.

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Academics Infectious Diseases 109

St. Emlyn

JANUARY 27, 2025

St.Emlyn's - Emergency Medicine #FOAMed This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. Drawing on a systematic review and meta-analysis, it examines the evidence, evaluates key benefits, and critically appraises the limitations. The discussion highlights the potential of this model to enhance pre-hospital emergency care while addressing challenges in implementation across dive

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Outcomes Hospitals Research Resuscitation 98

Stop and Think

JANUARY 29, 2025

Robert F Kennedy, Jr will face confirmation hearings today. Health will be in the news. I want to write a few things about the MAHA movement. There is much to be happy about, but there are areas to clarify. Stop and Think is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. I have long advocated for healthy living measures—especially for our children.

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Poisoning Wellness 90

Sensible Medicine

JANUARY 27, 2025

Doctors seek therapies that reduce the chance of bad outcomes. When treating patients with suspected coronary disease, typical bad outcomes to prevent are myocardial infarction (MI) and death due to heart disease. This usually requires drugs or interventions, such as urgent percutaneous coronary intervention (PCI) with stents during an acute MI. (PCI in stable disease does not reduce events.

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Outcomes EKG/ECG Documentation/Coding Academics 98

PulmCCM

JANUARY 27, 2025

"Should palliative care concurrent with oncology care be standard practice? Answer: Yes, unequivocally. And EARLY, within 8 weeks, not at the end of life." —"Using the New ASCO Clinical Practice Guideline for Palliative Care” (2017) “Oncology clinicians should refer patients with advanced solid tumors and hematologic malignancies to specialized interdisciplinary palliative care teams that provide outpatient and inpatient care beginning early in the course of the disease, alongs

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Hospice Outcomes Sepsis Emergency Department 89