The Trauma Pro
NOVEMBER 8, 2024
Patients with severe TBI frequently undergo surgical procedures to remove clot or decompress the brain. Most of the time, they undergo a craniotomy, in which a bone flap is raised temporarily and then replaced at the end of the procedure. But in decompressive surgery, the bone flap cannot be replaced because doing so may increase intracranial pressure.
Science Based Medicine
NOVEMBER 8, 2024
Doctors who are concerned about members of our profession enabling powerful anti-vaxx disinformation agents should speak up before it's too late. But its probably too late already. The post Robert Kennedy Jr. & His Doctor Friends May Just Be Getting Started first appeared on Science-Based Medicine.
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St. Emlyn
NOVEMBER 6, 2024
St.Emlyn's - Emergency Medicine #FOAMed Creating a learning culture in the emergency department (ED) fosters psychological safety, open communication, and continuous improvement. This approach supports team resilience, enhances patient care, and reduces burnout. Learn practical steps to build a strong learning culture in your ED, promoting growth and collaborative excellence in emergency medicine.
Sensible Medicine
NOVEMBER 4, 2024
Nearly a thousand news outlets covered the recent publication of the positive results of the STEP-9 trial of semaglutide vs placebo for the treatment of knee pain due to osteoarthritis in patients with obesity. Twitter overflowed with positive messages after the New England Journal of Medicine publication. I am not sold on the trial. STEP-9 had many flaws but one fatal flaw.
PulmCCM
NOVEMBER 7, 2024
During cardiac arrest, every second matters (at least potentially). For out-of-hospital cardiac arrest in particular, intravenous access can be difficult to establish, delaying the administration of epinephrine and other drugs and possibly worsening outcomes. Intraosseous (IO) devices—inserted by punching a needle loaded on a trocar into the tibia or femur—can be placed more easily than IV catheters, leading to faster injection of epinephrine.
ACEP Now
NOVEMBER 6, 2024
Native American emergency physicians make up 0.1 percent of physicians in U.S. emergency departments, according to research published in 2020 in Annals of Emergency Medicine. Three Native American emergency physicians in Oklahoma—three of five in the state—discussed with ACEP Now their approach to health care and how their careers in medicine began.
Life in the Fast Lane
NOVEMBER 7, 2024
Mike Cadogan November 8, 1895 On November 8, 1895 Wilhelm Röntgen, chair of physics at Würzburg, noted an unusual phenomenon, that would change the world of medicine
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
The Skeptics' Guide to EM
NOVEMBER 2, 2024
Date: October 29, 2024 Reference: Galili et al. Low dose ketamine as an adjunct to morphine: a randomized controlled trial among patients with and without current opioid use. AEM Oct 2024. Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department and Program Director of the EM residency program at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County.
PulmCCM
NOVEMBER 4, 2024
“I can’t prove it was the reason, but we kept everyone’s K over 4 and Mag over 2 and we didn’t have a single code this month.” – my senior resident on an internal medicine rotation, circa 2005 As many as one-fifth of hospitalized patients develop hypokalemia, commonly defined as serum potassium less than 3.5 mEq/L.
Life in the Fast Lane
NOVEMBER 2, 2024
Mike Cadogan Waiting Room Medicine With exponential Emergency Department over-crowding and spiraling waiting times, the Utopian College has produced a series of guidelines to assist fondling members.
Sensible Medicine
NOVEMBER 8, 2024
I was pretty proud of my post last Friday, Screening Can Do Silent Harm. I described five cases that demonstrated the silent harms of screening. Unfortunately, unless you were both REALLY clued into the potential harms of screening AND basically live inside my head, the post left something to be desired. Reactions on twitter and in the comments were well-represented by these two: “It’s an odd article as people not already in the know won’t realise what it’s about !
American Medical Compliance
NOVEMBER 8, 2024
In healthcare settings, injuries among staff and patients are unfortunately not uncommon. According to a National Institutes of Health article , there are 34.1 total injury incidences for all professions per 1,000 healthcare workers. Additionally, according to the World Health Organization, around 1 in every 10 patients is harmed in health care. Incidents can happen even with the best protocols in place.
Dr. Smith's ECG Blog
NOVEMBER 8, 2024
Written by Magnus Nossen The below ECG was obtained from a 65 year old man with ongoing chest pain. He has a history of hypertension an d tobacco use. He is otherwise healthy. There is no prior ECG for comparison. What do you think? ECG #1 Interpretation: The quality of the above ECG is not optimal. There is significant baseline wander that does make it more challenging to interpret ischemic changes.
EM Literature of Note
NOVEMBER 4, 2024
It is clear LLMs have an uncanny ability to find associations between salient features, and to subsequently use those associations to generate accurate probabilistic lists of medical diagnoses. On top of that, it can take those diagnoses and use its same probabilistic functions to mimic the explanations it has seen in its training set. A powerful tool – clearly an asset to patient care?
St. Emlyn
NOVEMBER 5, 2024
St.Emlyn's - Emergency Medicine #FOAMed At the Tactical Trauma 24 conference in Sundsvall, Sweden, St Emlyn’s hosts Iain Beardsell and Liz Crowe had the opportunity to speak with Alice Hutin, an emergency physician with Service […] The post Podcast – Prehospital eCPR with Alice Hutin at Tactical Trauma 2024 appeared first on St.Emlyn's.
Critical Care North Hampton
NOVEMBER 2, 2024
“Quick Draw Anatomy for Medical Students” by Joanna Oram Fox is a unique educational book designed to help medical students learn anatomy through drawing. It provides step-by-step instructions on drawing, understanding, and interpreting key anatomical structures. Her fantastic methodology for learning by illustration really impressed us with her first book!
EMDocs
NOVEMBER 6, 2024
Authors: Robert Nicholson, MD (EM Resident Physician, Carolinas Medical Center, Charlotte, NC) and Ann-Jeannette Geib, MD (EM Attending Physician, Medical Toxicologist, Carolinas Medical Center, Charlotte, NC) // Reviewed by: James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Anthony Spadaro, MD (@TSpadaro91, Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); Alex Koyfman, MD (@EMHighAK); Brit Long
EM Ottawa
NOVEMBER 7, 2024
Inhalational injuries are a critical yet often overlooked aspect of trauma care, with far-reaching consequences in emergency medicine. These injuries can arise from various sources, including thermal injuries from fires, recreational activities such as smoke exposure during camping or outdoor events, and chemical inhalation in both industrial and household settings.
Sensible Medicine
NOVEMBER 7, 2024
When the New England Journal of Medicine published the placebo-controlled SELECT trial of semaglutide in patients with established vascular disease, I had thought cardiology had discovered another disease-modifying drug. SELECT found a statistically significant and clinically meaningful lowering of a composite endpoint with semaglutide. My former partner, who writes under the pseudonym, the Skeptical Cardiologist, has a different take.
AENJ: Current Issue
NOVEMBER 4, 2024
As demands in the way of healthcare delivery increase, nurse practitioners have become essential components in optimizing access to healthcare and improving outcomes around the globe. The authors recognize the vital role nurse practitioners play globally and that education, practice, and credentialing differ significantly across countries. Many countries have a wide variation in educational requirements, resulting in a lack of adequate advanced practice nursing training and regulation of practic
Science Based Medicine
NOVEMBER 7, 2024
Can the Oatzempic diet deliver Ozempic-like weight loss? The post #Oatzempic – The viral oat-based alternative to Ozempic? first appeared on Science-Based Medicine.
Dr. Smith's ECG Blog
NOVEMBER 3, 2024
Written by Magnus Nossen ( with comments and laddergram by Ken Grauer ) The patient in today’s case is a man in his 60s — who presented with palpitations and lightheadedness. He had no history of syncope. The patient had hypertension, but was otherwise healthy. Due to the reported symptoms, he was admitted for observation and put on telemetry monitoring.
Don't Forget the Bubbles
NOVEMBER 6, 2024
Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.
AENJ: Current Issue
NOVEMBER 4, 2024
The Clinical Nurse Specialist (CNS) role has been instrumental in advancing nursing practice, healthcare delivery, and patient outcomes across various specialties, particularly in emergency care. This manuscript provides an extensive review of the history of CNSs in emergency settings, exploring the development of the practice model, the challenges encountered, and their impact on patient and organizational outcomes.
ACEP Now
NOVEMBER 7, 2024
Dr. Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. The emergency department (ED) was frequently overwhelmed by suicidal adolescents who needed inpatient psychiatric treatment but couldn’t be admitted, because the hospital had no free beds.
RebelEM
NOVEMBER 6, 2024
Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (80%) Demographics Most commonly affects patients between ages 10-20 years old As age increases, elbow dislocation rates tend to d
First 10 EM
NOVEMBER 4, 2024
It is pretty rare for the phrase “we need more research” to be immediately followed by more research, but that seems to have happened here.v On October 7 I published my post about the HEMOTION trial, looking at transfusion thresholds in traumatic brain injury, and concluding that despite being a statistically negative trial, the results […] The post Liberal or restrictive transfusion in brain injury part 2 (The TRAIN trial) appeared first on First10EM.
Total Medical ComplianceHIPAA
NOVEMBER 8, 2024
Key Lessons from the Cascade Eye and Skin Centers Settlement The recent settlement between the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and Cascade Eye and Skin Centers underscores OCR’s expectations for healthcare providers regarding cybersecurity under the HIPAA Security Rule. Following a ransomware attack that compromised nearly 291,000 patient records, Cascade agreed to a $250,000 settlement and a corrective action plan.
ACEP Now
NOVEMBER 8, 2024
The quick-moving, high-stress practice of emergency medicine means health care professionals need to be prepared for anything. Among emergency physicians’ diverse patient populations, neurodivergent individuals represent a unique group with distinct challenges and requirements. Neurodivergence is an umbrella term that refers to a variety of neurological differences (not deficits), including autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and dyslexia, among other
Life in the Fast Lane
NOVEMBER 7, 2024
Mark Corden Funtabulously Frivolous Friday Five 361 Funtabulously Frivolous Friday Five 360 - Just when you thought your brain could unwind, enter the medical trivia of FFFF.
AENJ: Current Issue
NOVEMBER 4, 2024
The creation of the American Academy of Emergency Nurse Practitioners (AAENP) marked a significant milestone in the professionalization of emergency nurse practitioners (ENPs). This interview with Dr. Elda Ramirez, the founder of AAENP, explores the critical moments and challenges that led to the establishment of the organization. Driven by the need for a dedicated body to advocate for the unique role of ENPs, AAENP was founded to address gaps in regulatory recognition and professional standards
Emergency Live
NOVEMBER 7, 2024
A project realized not only through the allowance I gave up, but thanks to the citizens of Sarnia who wanted me to be mayor of this city by giving me their trust So said Sarno Mayor Francesco Squillante during the presentation of the “Sarno Cardioprotected City” project. With the inauguration of the first defibrillator placed […] The post Sarno, mayor gives up allowance to make city Cardioprotected appeared first on Emergency Live.
ACEP Now
NOVEMBER 7, 2024
This is the second visit in two weeks for an elderly gentleman who is concerned about his legs being red and swollen. During the first visit, he was diagnosed with cellulitis and placed on cephalexin. Today, he notes worsening swelling and a blister forming near his left ankle. The pain makes it difficult for him to ambulate unassisted through his home.
Don't Forget the Bubbles
NOVEMBER 6, 2024
Consider Maddie, a 12-year-old girl in your ED with a virally induced moderate asthma exacerbation, currently having her third set of 12 puffs in her burst therapy; thankfully, she’s responding pretty well, and you’re hoping to avoid an admission at this stage. This is her third presentation with a viral exacerbation of asthma. You take a history and discover that she takes her salbutamol every week before and during her soccer matches.
PEMBlog
NOVEMBER 4, 2024
Did you know that post tonsillectomy bleeding occurs approximately 3 to 5% of the time, most often at days 5 to 7 after the surgery? Of course you did. Unstable children with active bleeding may need a trip to the OR. Otherwise ENT can help determine management. Lyrics Nasty strep or OSA Take those tonsils out today Remove adenoids just in case Now there’s blood all over the place Post T&A bleeds frequently now you call ENT If active bleed resuscitate maybe operate on this date If not
Emergency Live
NOVEMBER 6, 2024
Global Medical Response expands fleet with Airbus Global Medical Response (GMR) has ordered 28 Airbus helicopters, including six H125s, five H130s, fourteen H135s, and three H145s, to continue expanding its medical airlift fleet. Following an order for five Airbus helicopters in early 2024, GMR will operate a fleet of nearly 200 Airbus helicopters, strengthening its […] The post Global Medical Response expands fleet with Airbus appeared first on Emergency Live.
ACEP Now
NOVEMBER 7, 2024
While many of us are familiar with spontaneous coronary artery dissection (SCAD) as a common cause of myocardial ischemia in young people, traumatic coronary artery dissection (TCAD) is a rare, potentially life-threatening diagnosis that is challenging to diagnose and often missed in the emergency department (ED), as the clinical features overlap with more common diagnoses that result from blunt chest trauma. 1 It is important to pick up this diagnosis early, as emergency treatment with percutan
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