Sat.Dec 14, 2024 - Fri.Dec 20, 2024

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What Is: A Morel-Lavallee Lesion?

The Trauma Pro

Anyone who takes care of blunt trauma has seen the Morel-Lavallee lesion (M-L). Heres an obvious one because its acute: The M-L lesion is essentially a closed degloving injury in which the skin remains intact. The subcutaneous tissue is sheared off of the underlying fascia, and typically blood accumulates in the potential space that is created. This picture shows a less acute lesion; the bruising and ecchymosis on the surface have resolved.

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Mycoplasma Pneumonia in Children

Pediatric EM Morsels

Its been a BIG year for Mycoplasma! If your EDs have been anything like ours, youve been seeing more patients with Mycoplasma Pneumonia than you expected. Many kids are presenting to the ED for failure of outpatient antibiotic therapy of community acquired pneumonia, only to find out thats because they werent on the right meds! Let’s debrief on this atypical bug.

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Trending Sources

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emDOCs Revamp: Alcohol Withdrawal

EMDocs

Authors: Kyler Osborne (EM-3 Resident Physician; Tacoma, WA); Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA); Rachel Bridwell, MD (EM Attending Physician; Charlotte, NC) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician) Welcome to emDOCs revamp!

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Health Care Worker Unionization Uncommon, But Sometimes Necessary

ACEP Now

Medical training is a difficult task. As residents and fellows, we move wherever the Match sends us, endure grueling hours, and sacrifice time with loved onesall in pursuit of becoming the best doctors we can be and delivering excellent patient care. But we should not have to sacrifice our own well-being in the process. In Washington, D.C., more than 450 residents and fellows employed by George Washington University (GW) spent the past 15 months fighting for our first contract.

Burns 105
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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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Imaging decisions in paediatric trauma. RCR update 2024

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed The blog highlights the updated 2024 guidelines from the Royal College of Radiologists (RCR) on imaging in pediatric trauma. It emphasizes critical changes from the previous 2014 guidelines, focusing on the judicious use of imaging to minimize ionizing radiation exposure in children. Key updates include algorithms for blunt trauma, penetrating trauma, and blast injuries.

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But Can You Just PO?

Taming the SRU

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none. Considering the nationwide IV fluid shortage, judicious use of fluids is imperative.

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The resurgence of vaccine preventable infections: Measles and Pertussis

Don't Forget the Bubbles

Over the last decade, there has been a concerning decline in childhood vaccination rates in the UK. This has been mirrored in many parts of the world. This trend, exacerbated by the COVID-19 pandemic, has led to a resurgence of vaccine-preventable diseases such as measles and pertussis. Once on the brink of eradication, these diseases now pose significant public health risks, especially to vulnerable groups like infants, young children, and the immunocompromised.

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Podcast – Grief at Christmas

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed The holiday season, a time typically marked by joy and celebration, presents unique challenges for those working in emergency and intensive care units. This is a reminder of a podcast from 2016, where Liz Crowe discusses how to navigate the complexities of grief and gratitude during this time of year. The post Podcast – Grief at Christmas appeared first on St.Emlyn's.

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Clean Hands, Healthy Holidays: Protect Loved Ones from Illness with Effective Hand Hygiene

Total Medical ComplianceHIPAA

With the upcoming holidays and many family gatherings, one of the most important ways to protect yourself and loved ones is performing frequent hand hygiene. Good hand hygiene protects against sickness and disease such as the flu, respiratory syncytial virus (RSV), COVID-19, and other respiratory illnesses. Hand hygiene has been known to be the single most critical measure for reducing transmitting organisms (infectious agents) to patients and to each other.

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RENOVATE – High-Flow vs NIV

The Bottom Line

High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients with Acute Respiratory Failure RENOVATE and BRICNet Authors. JAMA 2024. doi: 10.1001/jama.2024.26244 Clinical Question In adult patients with acute respiratory failure does the use of high-flow nasal oxygen compared to noninvasive ventilation reduce the rate of endotracheal intubation or death at 7 days?

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Traumatic Cardiac Arrest

SCGH ED

Here are some algorithms to assist in the management patients who present with cardiac arrest related to trauma – that is suspected to be resulting from either hypovolaemic shock, obstructive shock or neurogenic shock. Note – In the case of an isolated traumatic brain injury (TBI): “in the absence of other injuries, such patients should […] The post Traumatic Cardiac Arrest appeared first on Charlie's ED.

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Cardiac Arrest Update 2024 (Part 1)

Core Ultrasound

Ultrasound is a powerful tool that can significantly enhance patient care during cardiac arrest. In Part 1 of this lecture, we break down how ultrasound can be effectively utilized in three key areas: identifying reversible causes, assisting in critical procedures, and guiding resuscitation. RUSH exam Courses The post Cardiac Arrest Update 2024 (Part 1) first appeared on Core Ultrasound.

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SGEM #463: Like the Legend of the Phoenix… Criteria for Sepsis

The Skeptics' Guide to EM

Reference: Sanchez-Pinto, L.N., et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA 2024. Guest Skeptic: Prof. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Professor for the University of Leicesters SAPPHIRE group. He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed.

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A Strong Critical Appraisal of the CHAGASICS Trial in patients with Chagas Cardiomyopathy

Sensible Medicine

Sensible Medicine aims to give public voice to critical appraisal that is rejected by medical journals. I see two important messages in Dr. Rassi’s appraisal: one is the specific mistakes that this trial could lead to regarding treatment of patients with Chagas cardiomyopathy but the more important message is what it says about scientific conduct and publishing.

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EMCrit 390 – Hyperangulated Video Laryngoscopy

EMCrit

All thing for HyperAngulated Blade Mastery EMCrit Project by Scott Weingart, MD FCCM.

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TRAUMOX2 – Early Restrictive vs Liberal Oxygen for Trauma Patients

The Bottom Line

Early Restrictive vs Liberal Oxygen for Trauma Patients Arleth. JAMA 2024. doi: 10.1001/jama.2024.25786 Clinical Question In adult patients experiencing blunt or penetrating trauma does an early restrictive oxygen strategy compared to a liberal oxygen strategy reduce death and/or major respiratory complications within 30 days?

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Is AI the key to understanding patient experience data?

NRC Health

As AI continues to proliferate in the healthcare industry, health IT vendors are testing the waters with an emerging use case: understanding patient experience data. The post Is AI the key to understanding patient experience data? appeared first on NRC Health.

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Critical Care 2024 Year in Review (Part 3)

PulmCCM

PREOXI, BLING III, ASTER, ANNEXA, GRECO, plus reviews on PPIs, TRALI, nutrition, more

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When Is It Too Late to Get a Lawyer for a Car Accident?

Medical Law

Delaying the hiring of a car accident attorney can have serious repercussions on your case. Waiting too long can lead to the loss of vital evidence, compromised witness testimony, and manipulation by unsavory insurance agents. All of these factors will seriously weaken a car accident injury claim. Why You Should Consider Hiring a Lawyer After a Car Accident Proactive legal consultation helps ensure that you will be well-prepared to handle the complexities of your case.

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Procedure: Lateral Canthotomy

Life in the Fast Lane

Kevin Ostrowski and James Miers Procedure: Lateral Canthotomy Today we cover lateral canthotomy and cantholysis, with a guide made in partnership with a recent publication in Australasian Emergency Care

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Imaging Case of the Week 612

EMergucate

The following elbow x-ray is from an adolescent who has pain & swelling in the elbow after a fall on outstretched hand. What can be seen?

EMS 52
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Critical Care 2024 Year in Review (Part 2)

PulmCCM

Danger-Shock, video vs. DL, PROPHY-VAP, ENRICH, MARVEL, C.

Shock 52
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243. Enter Sandman: Procedural Sedation

Board Bombs

Who needs a sleep medicine fellowship when you can perform procedural sedations as an EM physician? Let's cover fundamental tips and tricks of this core competency of EM! 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; Husain, Iltifat. 243.

EMS 52
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Dimers For The High-Risk | No ARDSNET In TBI

JournalFeed

The JournalFeed podcast for the week of Dec 9-13, 2024. 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. Monday Spoon Feed : A post-hoc analysis of 3 studies conducted in Europe (PROPER, MODIGLIANI, TRYSPEED) analyzed patients with a high pretest probability for PE based on Wells or revised Geneva score and found that using D-dimer alone would have missed 0 PEs, but this strategy is not re

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The evolution of healthcare employee experience: From surveys to continuous listening

NRC Health

Lukas Voss hosts Adam Tanner from NRC Health to discuss evolving healthcare employee experience strategies. The post The evolution of healthcare employee experience: From surveys to continuous listening appeared first on NRC Health.

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Blood transfusion targets in acute brain injury: Review (Updated)

PulmCCM

This review was first published in October 2024; it is updated here with important new results from the SAHARA trial (English et al NEJM 2024) , with a series of (rough) meta-analyses of recent data. -Ed. When deciding whether to transfuse red blood cells to critically ill patients with anemia, less is more, generally speaking. Because transfusion can be harmful, current practice is to usually restrict it in the ICU to patients with hemoglobin less than 7 g/dL.

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243. Enter Sandman: Procedural Sedation

Board Bombs

Who needs a sleep medicine fellowship when you can perform procedural sedations as an EM physician? Let's cover fundamental tips and tricks of this core competency of EM! 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; Husain, Iltifat. 243.

EMS 52
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ECG of the week 18/12/24

EMergucate

This week our case involves complications around elective cardioversion.

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The Word “Mental” in Project 2025. (ix + x + xi)

Maria Yang, MD

The ninth, tenth, and eleventh instances of the word mental in Project 2025 are on page 875 in the section about the Federal Trade Commission: Protecting Children Online. The FTC has long protected children in a variety of different contexts. Internet platforms profit from obtaining information from children without parents knowledge or consentand social medias effect on the well-being of American children is well-documented.

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Medical Ethics in the Emergency Department: Part I

Kings County Downstate EM

Author: Aaron S. Conway, MD Resident Editor: Philippe Ayres, MD Guest Faculty Editor: James Willis, MD Its nearly midnight in your busy urban emergency department (ED). As the senior resident, you just received sign-out from the day team on eight patients in addition to keeping up with new patients. […] The post Medical Ethics in the Emergency Department: Part I appeared first on County EM.

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Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatment of Acute Traumatic Pain: A Randomized Clinical Trial

EM Ottawa

Methodology: 4/5 Usefulness: 2/5 McMullan JT, et al. Ann Emerg Med. 2024 Oct;84(4):363-373. doi: 10.1016/j.annemergmed.2024.04.018. Question and Methods: This out of hospital, placebo-controlled, blinded, parallel group RCT compared reduction in pain scores between Fentanyl + IN Placebo and Fentanyl with IN Ketamine. Findings: There was no significant difference in reduction of pain scores or adverse […] The post Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatme

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Direct Oral Anticoagulant (DOAC) Reversal: Part 1

The Trauma Pro

A new class of anticoagulants, the direct oral anticoagulants (DOACs), were introduced in 2010. I started writing about them more than five years ago and was initially pessimistic about their safety profile in patients with head injuries. However, reversal agents and/or protocols were introduced, and the literature has borne out the fact that they appear to be safer than the old stand-by warfarin.

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The Futile Quest for "Why"

Sensible Medicine

Frequently, after a school shooting, The Onion publishes the headline , “‘No Way To Prevent This,' Says Only Nation Where This Regularly Happens." 1 I find this a brilliant response. Admittedly, less brilliant is my response every time the media predictably starts reporting on a “motive”: “Why are people looking for a motive?

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Which patient needs a CT scan?

Dr. Smith's ECG Blog

Which patient needs a CT Scan? Case 1: 20-something woman with chest pain Case 2: 50-something man with chest pain Case 1 A 20-something yo woman presented in the middle of the night with severe crushing chest pain. It had begun 4 hours before arrival and was initially dull, but became severe and "unbearable" 2 hours prior to arrival. She was a walk-in at triage.

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Compliance with HIPAA’s Final Privacy Rule for Reproductive Health Care, Deadline Approaching: December 23, 2024

Total Medical ComplianceHIPAA

The U.S. Department of Health and Human Services (HHS) has issued the Final Privacy Rule to support reproductive health care and the protection of related health information under the Health Insurance Portability and Accountability Act (HIPAA). This amendment was designed to strengthen privacy and security for individuals seeking reproductive health care.

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Ep 254 – Monthly Round Up October 2024 – Toxicology, Cardiac Arrest and more

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed All the best from the blog from October 2024, in our easy to digest podcast, including toxicology and cardiac arrest pearls The post Ep 254 – Monthly Round Up October 2024 – Toxicology, Cardiac Arrest and more appeared first on St.Emlyn's.