Sensible Medicine

DECEMBER 28, 2024

Dharini Bhammar, PhD, MBBS, is a respiratory physiologist and evidence enthusiast. As a new mum, her pediatrician recommended the RSV monoclonal antibody for her baby. After reviewing the evidence, she declined it. We are excited to share her clearly written argument as an excellent example of evidence translation. Core concepts discussed include effect size, net benefit and the external validity of clinical trials.

Hospitals 136

Hospitals CDC Documentation/Coding Outcomes 136

Don't Forget the Bubbles

DECEMBER 31, 2024

The Childrens Emergency Department is a busy, challenging, and dynamic environment. The skills needed to deliver the best possible outcomes for children and young people are multifaceted and constantly evolving. They involve a mixture of clinical, communication, and leadership traits. Having recently moved from a leadership position within the Childrens Emergency Department to a more system-based role involving children of all ages, its apparent to me how transferable my experiences on the shop

Leadership 140

Leadership Emergency Department Outcomes Operations 140

Dr. Smith's ECG Blog

JANUARY 2, 2025

By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.

EKG/ECG 117

EKG/ECG Sepsis Wellness Documentation/Coding 117

Science Based Medicine

JANUARY 1, 2025

In 2020, the GBD was all about herd immunity via natural immunity. Today, its defenders censor that. The post A Challenge For Dr. Edward Livingston: Defend the Great Barrington Declaration Without Censoring the Great Barrington Declaration first appeared on Science-Based Medicine.

113

113

ACEP Now

DECEMBER 31, 2024

The first time I met Dr. Greg Henry, he promptly informed me that he had shoes and belts older than me. Not knowing whether to laugh or be intimidated, I stared at him blankly and he chuckled. He quickly took me under his wing. Beyond his professional achievements, Greg was revered for his larger-than-life personality, sharp wit, and generous mentorship.

Stroke 98

Stroke 98

ECG Guru

JANUARY 3, 2025

Here we see a 30 s long strip of a 1-leadECG, recorded with a modern Smartwatch (Apple watch). The ECG has been graphically processed for better visualization. The paper speed is 25 mm/s as usual. The lead shown corresponds to ECG lead I of the limb leads.

EKG/ECG 80

EKG/ECG 80

EMDocs

JANUARY 1, 2025

Authors:Brit Long, MD ( @long_brit EM Attending Physician, San Antonio, TX);Manpreet Singh, MD ( @MPrizzleER Assistant Professor of Emergency Medicine / Department of Emergency Medicine Harbor-UCLA Medical Center); andAlex Koyfman, MD ( @EMHighAK EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) Happy New Year, and thank you for everything you do!

Sepsis 74

Sepsis EMS EKG/ECG Hospitals 74

Emergency Medicine Cases

DECEMBER 31, 2024

Based on a blend of number of listens, views, feedback from listeners, website traffic and personal faves, EM Cases Top 10 Best of 2024 podcasts, videos and blog posts. The post EM Cases Top 10 Best of 2024 appeared first on Emergency Medicine Cases.

EMS 57

EMS 57

ECG Guru

JANUARY 3, 2025

This ECG is from a 65-year-old woman who had previously had no cardiac abnormalities but has now suffered several syncopes within 2 weeks. During the last syncope she suffered a fracture of the left femur.

Fractures 78

Fractures EKG/ECG 78

Sensible Medicine

DECEMBER 29, 2024

An introduction to oncology for medical students

56

56

Emergency Medicine Journal

DECEMBER 30, 2024

Trauma and emergency care is a national priority in Uganda due to the high burden of injury, impacting a primarily young and rural population. With a significant gap in qualified emergency medicine professionals, a need exists to rapidly upskill the current health workforce and to strengthen access to learning for non-specialist emergency care providers nationally.

52

52

ACEP Now

JANUARY 2, 2025

Thanks to Drs. Harrell and Bower for their excellent case discussion in the October issue of ACEP Now. They made a final diagnosis of hypertrophic obstructive cardiomyopathy and discussed how that diagnosis was made despite the initial anchoring on the wrong diagnosis. They continued to work the patient when they noted that the main presenting signtachycardiapersisted after the treatment for the initially anchored diagnosis, anxiety and panic disorder, and, possibly, hypovolemia.

52

52

ECG Guru

JANUARY 3, 2025

Here we see a 30 s long strip of a 1-lead ECG rhythm strip, recorded with a modern Smartwatch (Apple watch). The ECG has been graphically processed for better visualization. The paper speed is 25 mm/s as usual. The lead shown corresponds to ECG lead I of the limb leads.

EKG/ECG 52

EKG/ECG 52

Life in the Fast Lane

JANUARY 1, 2025

Leon Lam, Jennifer Davidson, Parvathy Suresh Kochath and Georgina Beech CT Case 096 30-year-old male presents following a work place injury. A 20cm metal rod has fallen on his face, resulting in a penetrating orbital injury.

Radiology 52

Radiology Radiology 52

Emergency Medicine Journal

DECEMBER 30, 2024

Happy New Year and welcome to the first primary survey for the Emergency Medicine Journal of 2025. I hope there was an opportunity to rest over the holiday period and for those that were working, thank you. A new year brings us straight into another exciting edition of the journal. This month, the journal brings a prehospital extravaganza of papers, along with global health and staff well-being.

Emergency Department 52

Emergency Department Wellness 52

PulmCCM

DECEMBER 30, 2024

PEERLESS, ABC-SEPSIS, IV vs IO, BALANCE, FAST, SAHARA, TESLA/LASTE, Epic sued, ChatGPT vs MDs, more

Sepsis 52

Sepsis 52

EMergucate

DECEMBER 29, 2024

PH = 7.39, that is within the normal range. pCO2 = 30 mmHg, that is slightly low. This patient might have respiratory alkalosis. Next, we should look at the compensation for respiratory acidosis.

52

52

Don't Forget the Bubbles

DECEMBER 31, 2024

We love learning and sharing what we learn. In this post, we will discuss Bubble Wraps , one of the many ways to get further involved in the Dont Forget The Bubbles (DFTB) community. What is a Bubble Wrap? The DFTB team releases Bubble Wraps each month. They are a roundup of interesting and useful articles that our Bubble Wrappers have found during the month.

Emergency Department 59

Emergency Department Pediatrics Research 59

Emergency Medicine Journal

DECEMBER 30, 2024

Background Calls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response (‘pre-alerts’) have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke). However, little is known about their usefulness for other patients and the processes involved in ED responses to them.

Emergency Department 52

Emergency Department Stroke Documentation/Coding Outcomes 52

Core Ultrasound

DECEMBER 30, 2024

In part two of this series on using ultrasound during cardiac arrest, we dive into advanced strategies to further optimize your resuscitation care. Building on the foundation from part one, this video focuses on actionable tips to take your ultrasound skills to the next level during cardiac arrest scenarios. Cardiac Arrest Part 1 RUSH exam Courses The post Cardiac Arrest Update 2024 (Part 2) first appeared on Core Ultrasound.

Ultrasounds 40

Ultrasounds Resuscitation 40

PEMBlog

DECEMBER 30, 2024

Guess who’s back? Back again. Epi Pen. Jab a friend. Give that EpiPen even if you think it might possibly be anaphylaxis! Lyrics His palms are sweaty, knees weak, arms are heavy, He’s allergic, it’s anaphylaxis already. He’s chokin’, his throat’s closin’, hives all over, IgE mediated, peanut exposure Mucosa swollen, he’s gaspin’ for breath, Heart poundin’ like a drum, he’s scared to death. multi system reaction, puking and wheezin

Anaphylaxis 52

Anaphylaxis 52

ACEP Now

JANUARY 2, 2025

To tell a story, all you need is information. To tell an accurate story, when it comes to patient care in the emergency department (ED), you need much more, according to ED data experts and emergency physicians James Augustine, MD, FACEP, and Stephen Epstein, MD, MPP, FACEP. An accurate story requires information from millions of ED visits, a way to analyze the data, and a way to use that analysis across different settings and patient populations for better outcomes.

Best Practices 52

Best Practices Stroke Emergency Department Research 52

Emergency Medicine Journal

DECEMBER 30, 2024

Does your emergency department (ED) feel like a constant battle? Has the function of your ED been destroyed by external forces? It might strike the reader as extreme to use words related to battle regarding current working conditions in EDs but for most of us this is probably not far from the truth. When you think about battles, you think about frontline casualties (an irony given the origins of emergency medicine (EM)) and how there must be sacrifice for the majority to succeed.

EMS 52

EMS Emergency Department Hospitals 52

Ken Grauer, MD

JANUARY 2, 2025

I was sent the ECG shown in Figure-1 told only that this tracing was obtained prior to elective electric cardioversion of a patient who had long been in persistent AFlutter ( A trial F lutter ). Serum electrolytes were normal at the time of cardioversion. The patient tolerated cardioversion well and later that day was discharged from the hospital. ( The post-cardioversion tracing will be shown momentarily in Figure-3 ).

EKG/ECG 420

EKG/ECG Wellness Hospitals 420

St. Emlyn

JANUARY 2, 2025

St.Emlyn's - Emergency Medicine #FOAMed This feasibility study described the delivery of ECMO CPR (ECPR) for the first time in the UK The post Pre Hospital Extracorporeal CPR (ECPR) in the UK: The Sub30 study appeared first on St.Emlyn's.

CPR 134

CPR Hospitals Resuscitation 134

Dr. Smith's ECG Blog

DECEMBER 31, 2024

Written by Pendell Meyers A woman in her 70s with known prior coronary artery disease experienced acute chest pain and shortness of breath. The chest pain was described as severe pressure radiating to both shoulders. Vital signs were within normal limits. She presented to the Emergency Department at around 3.5 hours since onset. She had taken aspirin at home.

EKG/ECG 120

EKG/ECG Documentation/Coding Emergency Department Resuscitation 120

Emergency Medicine Journal

DECEMBER 30, 2024

Background The Emergency Department(ED) team need to make sense of an ever-changing dynamic environment. The stories people tell about everyday occurrences are central to how sense-making occurs. These stories also contribute to organisational culture, with the frequently told narratives maintaining organisational identity and shaping behaviour. By capturing stories in the ED, valuable insights can be gained into organisational culture and identity.

Emergency Department 52

Emergency Department Hospitals 52

Ken Grauer, MD

DECEMBER 28, 2024

I was sent the ECG in Figure-1 told only that the patient was an older adult who reported dizziness with activity. QUESTIONS: What is the rhythm? ( HINT: There are at least 4 important findings that should be noted ). Is there AV block? Figure-1: The initial ECG in today's case. ( To improve visualization I've digitized the original ECG using PMcardio ).

EKG/ECG 424

EKG/ECG 424

Sensible Medicine

JANUARY 3, 2025

Doctors of a certain age tend to fetishize the physical exam. I think this is because learning the physical exam is an important part of the socialization of the doctor. It is also a skill that doesn’t really wither with time. Though with every passing day I feel more and more like part of the old guard, I can only give the exam a tepid defense.

Urgent Care 115

Urgent Care Ultrasounds Wellness 115

American Medical Compliance

JANUARY 1, 2025

Restorative nursing is an essential pillar of healthcare, dedicated to helping patients regain and maintain their physical and psychological well-being. With approximately 12.2% of adults in the United States facing mobility challenges, according to the CDC, the demand for effective restorative care has never been greater. For healthcare providers, these programs go beyond improving patient outcomesthey create a holistic and supportive care environment.

CDC 105

CDC Best Practices Wellness Stroke 105

Emergency Medicine Journal

DECEMBER 30, 2024

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Research 52

Research 52

PulmCCM

JANUARY 2, 2025

Many randomized trials have tested the biomarker procalcitonin as a guide to de-escalate or stop antibiotic therapy in patients with known or suspected infection. A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. But most such trials have been small, often single-center, and vulnerable to bias due to the unblinded nature of the intervention.

Sepsis 98

Sepsis Outcomes Stroke Shock 98

Sensible Medicine

JANUARY 2, 2025

This post really needs no introduction. Dr. Miller disagreed with a lot in my introduction and Dr. Ostacher’s recent piece about seeking motives for senseless acts of violence. Obviously, we at Sensible Medicine love to post well-reasoned responses to our articles. This is a great one. Adam Cifu Sensible Medicine is a reader-supported publication.

Psychiatric 108

Psychiatric Wellness Hospitals 108

The Skeptics' Guide to EM

DECEMBER 28, 2024

Date: December 26, 2024 Reference: Steinhauser S et al. Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder. AEM December 2024 Guest Skeptic:Dr. Suchismita Datta. She is anAssistant Professor and Director of Research in theDepartment of Emergency Medicine at the NYU Grossman Long Island Hospital Campus.

Emergency Department 89

Emergency Department Research Academics Outcomes 89

Emergency Medicine Journal

DECEMBER 30, 2024

This month’s update is by the Aberdeen Royal Infirmary Emergency Department in Scotland. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper.

EKG/ECG 52

EKG/ECG Emergency Department Outcomes 52

EM Updates

DECEMBER 29, 2024

Depending on how you count, I’ve now been doing emergency medicine for 20 years. This is how I see patients. The protocol below does not apply to resuscitation patients. For resuscitation patients, see The First Five Minutes of Resuscitation. I apply this protocol to just about every patient. When you are systematic, you don’t miss stuff.

Emergency Department 87

Emergency Department Documentation/Coding Resuscitation Wellness 87

Sensible Medicine

JANUARY 1, 2025

For New Year’s, I thought an important post would be one looking back at health threats from the 1970s that we have overcome. These were scourges that children were incessantly warned about that have now been defeated. Maybe we can be inspired to consider the current plagues which we might overcome during the next 50 years. Sensible Medicine is a reader-supported publication.

Military 103

Military 103