The Trauma Pro
JULY 30, 2024
There’s a lot of dogma in trauma care, as well as in the field of medicine generally. The knee dislocation dogma is that the incidence of vascular injury is high (around 50%) with posterior dislocation and somewhat lower with non-posterior dislocation. At least, that’s what I learned way back when. After recently finding myself spouting off those numbers, I wondered if it was really true.
Pediatric EM Morsels
AUGUST 2, 2024
It’s never comfortable and is often very distressing to have skin problems and infections, such as intertrigo , folliculitis , panniculitis , omphalitis , or even preseptal or periorbital cellulitis. It’s even more distressing when the skin problem affects the penis. While summer is starting to wind down, and Summer Penile Syndrome is less likely to occur, we must still be vigilant for penile problems that can occur all year long.
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ETM Course
JULY 31, 2024
In this episode of the ETM Course Podcast we talk to Dr Chris Partyka, Emergency Physician and Prehospital and Retrieval Specialist from Sydney and lead author for the recently published SABRE trial which compared Serratus Anterior Plane Blocks to a standard analgesia package for patients with rib fractures. Also available on Apple Spotify YouTube iHeart Podchaser PlayerFM This was a really well designed and executed study, and the results will be practice changing for anyone who treats trauma p
St. Emlyn
AUGUST 1, 2024
St.Emlyn's - Emergency Medicine #FOAMed "Time Critical: Information Light" decision-making is vital in emergency medicine, requiring swift actions with minimal data. However, uncertainty decreases over time as more information becomes available. This model highlights the importance of making high-stakes decisions promptly, avoiding premature or delayed interventions.
The Trauma Pro
AUGUST 2, 2024
The perimortem C-section (PMCS) is a heroic procedure designed to salvage a viable fetus from a moribund mother. Interestingly, in some mothers, delivery of the fetus results in return of spontaneous circulation. The traditional teaching is that PMCS should be started within 4-5 minutes of the mother’s circulatory arrest. The longer it is delayed, the (much) lower the likelihood that the fetus will survive.
Sensible Medicine
JULY 28, 2024
In a recent post on Sensible Medicine, written on my phone while traveling, I criticized a randomized trial of masking in the BMJ that found Norweigans told to wear masks for 2 weeks had a lower self-reported rate of cold symptoms from 12% to 9%. A reduction of 3%. In a follow up post , Adam Cifu, my friend and colleague, took me to task. Let me highlight his criticism, and why he is wrong both about the trial, and my Kurt Cobain shirt.
Dr. Smith's ECG Blog
AUGUST 2, 2024
Written by Willy Frick A 50 year old man with no medical history presented with acute onset substernal chest pain. His ECG is shown below. Pretty obvious anterior current of injury. This was a machine read STEMI positive OMI. Readers of this blog can easily appreciate the hyperacute T waves in the precordium, clearest in V1-V4. What would you guess is the culprit artery?
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
First 10 EM
JULY 29, 2024
Gestalt for sepsis? This paper hits two of my biggest pet peeves in medicine. 1) The endless emphasis on rushing to hit treatment targets in sepsis or otherwise and 2) the assumption that decision instruments must be better than basic clinical judgment. I am aware, therefore, that my interpretation is more likely to be biased, […] The post Gestalt is better than decision tools for identifying sepsis appeared first on First10EM.
Sensible Medicine
JULY 27, 2024
When a friend makes a mistake, it is your responsibility to let him know. In the words of the Ad Council and the US Department of Transportation, “friends don’t let friends drive drunk.” They also “don’t let friends misinterpret the medical literature because they have been blinded by their priors.” Friends do this even if the results of the paper in question should change nobody’s behavior and if calling them out will invite the wrath of Sensible Medici
St. Emlyn
JULY 30, 2024
St.Emlyn's - Emergency Medicine #FOAMed Listen to the podcast recorded live at the Premier Conference 2024. The post Podcast – Button Battery Ingestion appeared first on St.Emlyn's.
Science Based Medicine
JULY 29, 2024
On Friday, JAMA Health Forum published a study that is just more evidence that public health interventions against COVID-19 saved lives. The post As imperfect as they are, public health interventions save lives first appeared on Science-Based Medicine.
Emergency Medicine Cases
JULY 30, 2024
In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity.
Sensible Medicine
JULY 29, 2024
Let’s think today about one of evidence-based medicine’s biggest blind spots: the study of policies. Drugs, devices and treatment strategies often face the challenge of randomized trials. Yet policies mostly escape this challenge. It seems all a policy needs is a strong champion and plausibility. Yet the failure of the hospital readmission penalty policy and sepsis protocols expose the risks of implementing a policy because it sounds good.
Emergency Medicine News
JULY 31, 2024
An abstract is unavailable.
Science Based Medicine
AUGUST 1, 2024
Opponents of birth control don't object to condoms because they think they don't work, and Dr. Vinay Prasad doesn't object to masks because he thinks they don't work. The post Dr. Adam Cifu Should Recognize, Dr. Vinay Prasad Will Never Admit Measures to Limit Viruses “Work” first appeared on Science-Based Medicine.
EM Ottawa
AUGUST 1, 2024
Social media headlines and evolving literature have highlighted the abysmal life expectancy of emergency room doctors. For example, Dr. Ken Milne, the creator behind The Skeptics Guide to Emergency Medicine, recently shared this post on sobering life-expectancy data for ER physicians. In this post, we delve into the contributing factors to the increased mortality […] The post Is Shift Work Shortening your Life?
Sensible Medicine
JULY 31, 2024
Hi everyone. It is John. I am pleased to once again feature writer and economist Elizabeth Fama, PhD , who delved into the evidence underpinning the recommendation to place babies on their back to sleep. Her critical appraisal is a tour de force in everything we love here at Sensible Medicine. I had no idea how weak the evidence was for this recommendation.
Emergency Medicine News
JULY 31, 2024
An abstract is unavailable.
Science Based Medicine
AUGUST 2, 2024
Measles cases are increasing. Kids and even many adults are at risk of injury and death from this vaccine-preventable illness that should be a historical footnote. The post Measles 2024: ‘Merica, are you okay? first appeared on Science-Based Medicine.
EMCrit
JULY 29, 2024
Is THAM the better bicarb? Find out in this jam-packed episode in the acid base series. EMCrit Project by Scott Weingart, MD FCCM.
Sensible Medicine
JULY 30, 2024
A pretty good portion of what we post on Sensible Medicine could be considered critical appraisal of the medical literature. Whether it is John Mandrola’s Study of the Week column, my “Improving Your Critical Appraisal Skills” articles, or Vinay Prasad calling out articles that contend something other than what they actually show, this is clearly an interest of ours.
Emergency Medicine News
JULY 31, 2024
An abstract is unavailable.
Kings County Downstate EM
JULY 30, 2024
Author: Dante Robinson, MDEditor: Esteban Davila, MDCase:A 77-year-old male with a history of hypertension and diabetes is brought into the ED by EMS after being found unresponsive. According to the patient’s daughter, the patient had been growing weak and complaining of pain on urination along with urinary frequency. While en […] The post AV Dissociation and Complete AV Block: What’s the Difference?
The Skeptics' Guide to EM
JULY 27, 2024
Reference: Knack et al. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Date: July 25, 2024 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: Your hospital is running Morbidity and Mortality (M&M) rounds after a few recent cases in which the diagnosis of sepsis was identified late, and antibiotics were delayed.
ECG Guru
JULY 30, 2024
The ECG shows an example of a patient with bradycardia/tachycardia syndrome. Initially, a sinus rhythm with a heart rate of approx. 70 bpm is seen. This is followed by my sinus arrest of just under 3000 ms, followed by a junctional escape beat (no preceding P wave, QRS remains narrow). After a further pause of just under 2000 ms, 2 sinus node beats follow, which merge into a sinus tachycardia or atrial tachycardia (heart rate approx. 120 bpm here).
AENJ: Current Issue
JULY 31, 2024
An abstract is unavailable.
St. Emlyn
AUGUST 1, 2024
St.Emlyn's - Emergency Medicine #FOAMed "Time Critical: Information Light" decision-making is vital in emergency medicine, requiring swift actions with minimal data. However, uncertainty decreases over time as more information becomes available. The post Optimal Timing for Life-Saving Procedures in Critical Care: Finding the Goldilocks Moment appeared first on St.Emlyn's.
ECG Guru
JULY 27, 2024
Why is the pause after the PVCs relatively long? We see a sinus arrhythmia in the rhythm strip. The ventricular extrasystoles penetrate the AV node retrogradely and reset the sinus rhythm, which then restarts.
AENJ: Current Issue
JULY 31, 2024
Measles, or rubeola, remains a highly contagious infectious disease with a concerning resurgence in the United States. Despite previous control efforts, the number of reported cases continues to rise, surpassing the total for the previous year in just the first quarter of 2024 (CDC, 2024a). Emergency nurse practitioners and other emergency clinicians are likely to encounter patients presenting with concerns of or exposure to measles.
NRC Health
JULY 30, 2024
Imagine navigating the complexities of modern healthcare, constantly adapting to new challenges while striving to provide an exceptional patient experience. This is the journey of Katie Arnett and Janet Hall from UK King’s Daughters. They will share their inspiring story and valuable lessons learned at Human Understanding Beyond | HUB 24 in San Diego, August 21–23.
EMDocs
JULY 30, 2024
Authors: Rosa Malloy Post (@postponemyloanz, Emergency Medicine Resident, Atrium Health’s Carolinas Medical Center); Christine Murphy, MD (Emergency Medicine Attending, Medical Toxicologist, Atrium Health’s Carolinas Medical Center) // Reviewed by: Christopher Counts, MD (Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); Cynthia Santos, MD (Emergency Medicine Attending, Medical Toxicologist, Rutgers New Jersey Medical School); James Dazhe Cao, MD (@JamesCaoMD, Associate
Emergency Medicine News
JULY 31, 2024
An abstract is unavailable.
Sensible Medicine
AUGUST 2, 2024
At risk of sounding like a broken record (and sounding old by using this cliché), little about Sensible Medicine makes me happier than when a reader disagrees with one of us and writes a cogent retort. It is best when the reader disagrees with Vinay or John rather than me. Adam Cifu On July 14 th , Dr. Vinay Prasad published an opinion piece titled “ When the Patient is in the Room, Stop Typing Your Note ” He argued that it disconnects the doctor from the visit, and keeps the do
Emergency Live
AUGUST 2, 2024
The startup Inspire has developed a fleet of drones capable of operating autonomously, monitoring fires Smart drones for effective monitoring Thanks to an innovative system called M.A.R.S. (Multiple Airdrone Response System), Inspire has developed a fleet of drones capable of operating autonomously, Monitoring fires in real time and providing fire fighters with crucial information to […] The post Drones for the fire service: the Inspire revolution appeared first on Emergency Live.
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