Ken Grauer, MD

APRIL 13, 2024

I was sent the ECG in Figure-1 — told only that the patient was 70 years old, and had a history of an ASD ( A trial S eptal D efect ). Serum K+ was normal. The patient was hemodynamically stable with ECG #1. QUESTIONS: How would YOU interpret the rhythm in Figure-1 ? Are there P waves? Figure-1: The initial ECG in today's case. MY Initial Thoughts on Today's CASE: Knowing that today's patient has a history of an ASD ( A trial S eptal D efect ) — is relevant to the interpretation of today's inter

EKG/ECG 296

EKG/ECG Wellness 296

Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. We see all different flavors of upper extremity injuries. Yes, we’re talking about your clavicular , proximal humeral, supracondylar, lateral condylar , scaphoid and metacarpal fractures.

Fractures 286

Fractures Pediatrics Best Practices Outcomes 286

The Trauma Pro

APRIL 19, 2024

In my previous post, I described the early days of penetrating neck injury management and introduced a paper suggesting that this concept should be revised. Today, I will summarize a paper by Siletz and Inaba that is currently in press and outlines what the contemporary way of treating these injuries should be. Step 1. If present, rapidly control external hemorrhage and airway compromise.

Operations 263

Operations EMS 263

Sensible Medicine

APRIL 14, 2024

Last week, the US FDA held a meeting to decide if a new surrogate endpoint (Minimal Residual Disease or MRD negativity) could be used to give more & faster drug approvals for patients with newly diagnosed multiple myeloma. Multiple myeloma drugs can cost $600,000 per year of treatment, but if MRD is permitted for drug approval, I suspect we will see a deluge of uncertain drugs added to the roster, and the costs per year per patient will swell to a million dollars or more.

Patient Safety 142

Patient Safety Academics Outcomes Wellness 142

Science Based Medicine

APRIL 14, 2024

Trying to limit pediatric COVID was literally the pandemic's worst sin for pro-infection doctors, warranting severe punishment. This is how desperately they wanted them infected. The post Dr. Vinay Prasad: It’s “Good” That Parents Who Want To Vaccinate Their Kids Against COVID Get Reported To Child Protective Services first appeared on Science-Based Medicine.

Pediatrics 130

Pediatrics 130

First 10 EM

APRIL 15, 2024

One of the biggest headaches in modern medicine is the apparent requirement to call busy specialists just to confirm what seems like an obvious treatment plan. In emergency medicine, this often happens when a patient needs to be admitted under one service, but with a medical problem related to another speciality. We get stuck in […] The post The Brain Injury Guidelines: Can we avoid talking to neurosurgeons?

EMS 127

EMS 127

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. The pain recurred at rest 90 minutes prior to presentation, felt like the patient’s prior MIs, and was not relieved by 6 sprays of nitro.

EKG/ECG 124

EKG/ECG Documentation/Coding Fractures Emergency Department 124

EM Ottawa

APRIL 18, 2024

In this Prehospital Journal Club Recap, let us take a deep dive into the use of blood products, as well as the adjunct use of automated controlled elevation in CPR. Resuscitation with blood products in patients with trauma-related hemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomized, controlled, phase 3 trial Background The use […] The post PTM Journal Club: Blood Product and ACE-CPR use Prehospital appeared first on EMOttawa Blog.

CPR 112

CPR Resuscitation Shock Wellness 112

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. NEJM Feb 2024 Date: April 12, 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA. He is an assistant professor in Emergency […] The post SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke first appeared on The Skeptics Guid

Stroke 112

Stroke Documentation/Coding Emergency Department EMS 112

Dr. Smith's ECG Blog

APRIL 14, 2024

A 56 year old male with PMHx significant for hypertension had chest pain for several hours, then presented to the ED in the middle of the night. He reported chest pain that developed several hours prior to arrival and was 5/10 in intensity. The pain was located in the mid to left chest and developed after riding his bike. There was associated fatigue when symptoms developed and mild shortness of breath at onset of chest pain however that has since resolved.

EKG/ECG 116

EKG/ECG Ultrasounds EMS Wellness 116

St. Emlyn

APRIL 13, 2024

St.Emlyn's - Emergency Medicine #FOAMed Our conference report from the 11th Kongress der Arbeitsgemeinschaft fur Notfallmedizin in Graz Austria in 2024. r@stemlyns Blog themes on trauma, cardiac arrest and research. #FOAMed The post 11th Kongress der Arbeitsgemeinschaft fur Notfallmedizin. St Emlyn’s appeared first on St.Emlyn's.

Research 109

Research EMS 109

Sensible Medicine

APRIL 17, 2024

If you can’t believe we are still talking about this, that is sort of the point of the post. Personally, I could not wait to put mask wearing behind me, but I still find the issue of masking in healthcare facilities interesting. I have written my own essays about it on Sensible Medicine on September 28 th , 2022 , and January 11 th , 2024. The parallels to universal precautions, the balance of comfort, communication, and patient safety, and the issues of power in the doctor patient relatio

Patient Safety 108

Patient Safety Hospitals 108

EMCrit

APRIL 15, 2024

A razor is a rule of thumb that is helpful, although it isn't always correct. In medicine we're familiar with Occam's razor (the rule of parsimony). The cutoff razor states: if a continuous variable is dichotomized using a cutoff, then values near the cutoff provide little information. A simple illustration of the cutoff razor is […] EMCrit Project by Josh Farkas.

108

108

EB Medicine

APRIL 17, 2024

In this episode, Sam Ashoo, MD interviews Ashley A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A. Hoffmann, MD, MS on the March 2024 Pediatric Emergency Medicine Practice article, Evaluation and Management of Suicidal Ideation and Self-Harm in Children in the Emergency Department Introduction Understanding Suicidal Ideation and Self Harm in Youths Screening Tools and Approaches Ask Suicide-Screening Questions (ASQ) Toolkit Columbia Suicide Severity Rating Scale (C-SSRS) Prehospital Care

Emergency Department 102

Emergency Department Pediatrics 102

Emergency Live

APRIL 18, 2024

Being prepared to deal with cardiac arrests is vital for any area. Thanks to the initiative of the Municipality, Capri is becoming a safe area in this regard A way to make citizens and tourists feel safer With the installation of over 20 modern defibrillators and the organization of training events, the island proves to […] The post Capri becomes a cardioprotected island appeared first on Emergency Live.

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98

Dr. Mike Sevilla

APRIL 15, 2024

I’m excited to share that I will be joining a new Primary Care office in Salem, Ohio called Salem Family Care. My current patients will have nothing to worry about, since I will not be leaving Salem, and my patients will not need to find a new doctor. Salem Family Care is located at 718 East Third Street in Salem, Ohio. Salem Family Care was created with the partnership of Dr.

Hospitals 98

Hospitals Wellness 98

Northwestern EM Blog

APRIL 15, 2024

Written by: Chezlyn Patton, MD (NUEM ‘27) Edited by: Keara Kilbane, MD (NUEM ‘25) Expert Commentary by : Matt McCauley, MD (NUEM ‘21) Introduction Tracheostomy is a common procedure in the US with over 110,000 trachs placed annually (1). Complications occur at a rate of approximately 40-50%, however most complications are minor, with only 1% being catastrophic (1).

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

Taming the SRU

APRIL 17, 2024

Haber EN, Sonti R, Simkovich SM, Pike CW, Boxley CL, Fong A, Weintraub WS, Cobb NK. Accuracy of Noninvasive Blood Pressure Monitoring in Critically Ill Adults. J Intensive Care Med. 2024 Jan 12:8850666231225173. doi: 10.1177/08850666231225173. Epub ahead of print. PMID: 38215002. P: 1852 patients admitted to tertiary care MICU with a variety of precipitating conditions I: Invasive blood pressure monitoring C: Noninvasive blood pressure monitoring O: 67 % of measurements in agreement using 10 % M

Sepsis 93

Sepsis Research Stroke Academics 93

Emergency Live

APRIL 18, 2024

What should have been a routine journey turned into a nightmare for a family eagerly awaiting the arrival of their child: a man suffers a sudden and fatal illness during a commercial flight The day seemed to start like any other flight: Giuseppe Stilo, 33, and his pregnant wife were on their way back to […] The post Tragedy during a Ryanair flight: man dies on board appeared first on Emergency Live.

98

98

Science Based Medicine

APRIL 17, 2024

UK MPs have just passed the Tobacco and Vapes Bill by a 383 to 67 vote. If the measure becomes law it will ban the sale of tobacco products to anyone born after January 1, 2009. This is not just an age limit – this is a permanent phased ban. If the law passes and stands, anyone born after that date will […] The post UKs Phased Smoking Ban first appeared on Science-Based Medicine.

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EMDocs

APRIL 18, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

Patient Safety 88

Patient Safety Hospitals Documentation/Coding EMS 88

Taming the SRU

APRIL 14, 2024

Hernias 101 A hernia is described as, “the abnormal protrusion of abdominal contents through a defect involving the normal confines of the abdominal compartments” (9). It often involves a portion of the intestine protruding through a weak point of the abdominal wall. The location and size of the hernia often determines the symptoms and complications that a patient will present with.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

Emergency Live

APRIL 18, 2024

An innovative study has uncovered an alarming threat: the presence of microplastics in the ovarian follicular fluids of women undergoing Assisted Reproductive Techniques (ART) This research, led by Luigi Montano and a multidisciplinary team of experts, found an average concentration of 2191 particles per milliliter of nano and microplastics with a mean diameter of 4.48 […] The post Microplastics and fertility: a new threat appeared first on Emergency Live.

Research 98

Research 98

Science Based Medicine

APRIL 19, 2024

Part 3: Dr. John Ioannidis said his biggest mistake was the he "underestimated how much power politics and media and powers outside of science, could have on science." Really? The post Dr. John Ioannidis: “The Biggest Mistakes I am Sure Are Mine.” first appeared on Science-Based Medicine.

88

88

EMCrit

APRIL 13, 2024

10 heuristics for the new Crit Care doc from Ross Prager EMCrit Project by Scott Weingart, MD FCCM.

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87

American Medical Compliance

APRIL 16, 2024

The following Survey Readiness Training for Healthcare Providers is designed to educate healthcare providers on the purpose and importance of survey readiness in healthcare. Surveys may play a large role in your healthcare facility. Also, it is important to understand the purpose and the regulations associated with them. Because of this, AMC can help your healthcare organization become more aware of healthcare surveys.

Outcomes 85

Outcomes 85

Emergency Live

APRIL 17, 2024

A Columbia University study reveals a gene that reduces the risk of Alzheimer’s by up to 70%, paving the way for new therapies A Remarkable Scientific Discovery An extraordinary breakthrough in Alzheimer’s treatment has sparked new hopes for addressing the disease. Researchers at Columbia University have identified a gene that reduces the risk of developing […] The post Protective Gene Discovered Against Alzheimer's appeared first on Emergency Live.

Research 98

Research 98

Science Based Medicine

APRIL 15, 2024

A recent presentation at AACR found a link between markers of accelerated aging and an increased risk of cancer. Then antivaxxers got a hold of it to blame COVID-19 vaccines not just for cancer, but for "accelerated aging" causing it. The post There is no evidence that COVID-19 vaccines are causing cancers associated with “accelerated aging” first appeared on Science-Based Medicine.

Research 84

Research 84

Core Medical Group

APRIL 17, 2024

Occupational Therapy (OT) is a crucial healthcare profession dedicated to helping individuals achieve independence and improve their daily life activities. Central to this mission is the integration of assistive technology, a dynamic field that continues to revolutionize patient care and inclusivity. Let's explore why assistive technology is vital in occupational therapy and how it's shaping the future of independence.

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Sensible Medicine

APRIL 16, 2024

I’ve been using Tuesday to post the “Improving Your Critical Appraisal Skills” articles recently. Even though I’ve got the case-control study ready to go, I’m taking a quick break because I spent way too much time thinking about this article last week. Sensible Medicine is a reader-supported publication. To receive all posts and support our work, consider becoming a paid subscriber.

Radiology 82

Radiology Radiology Stroke Hospitals 82

Emergency Live

APRIL 18, 2024

A transplant that is incredible and opens new avenues for both research and patients with rare diseases Two 16-year-old twin boys have been given a new lease on life thanks to the generosity of a donor family and the medical expertise of the Bambino Gesù Hospital in Rome. Both were suffering from methylmalonic acidemia, a […] The post Organ transplant saves twins with rare disease appeared first on Emergency Live.

Research 98

Research Hospitals 98

EMCrit

APRIL 18, 2024

A critical care bounce back case with Mike Weinstock EMCrit Project by Scott Weingart, MD FCCM.

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EMDocs

APRIL 13, 2024

Authors: Jacob Tauferner, MD (EM Resident Physician, UTSW/ Dallas, TX); Mihir Patel, MD (EM Attending Physician, Dallas, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK) ; Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

EMS 82

EMS Emergency Department Pediatrics Wellness 82

Core Ultrasound

APRIL 16, 2024

We identify the presence of kidney stones using ultrasound with a pretest suspicion of kidney stones then identifying the presence or absence of hydronephrosis.

Ultrasounds 76

Ultrasounds 76

Emergency Live

APRIL 17, 2024

In Italy, the situation regarding the accessibility of inpatient hospital beds shows considerable variation among different regions. This uneven distribution raises questions about equal access to medical care across the country The Landscape of Hospital Beds in Italy: A Detailed Analysis Recent data from the Statistical Yearbook of the National Health Service, published by the […] The post Increasing increase in private sector beds in Italy appeared first on Emergency Live.

Hospitals 98

Hospitals 98

Sensible Medicine

APRIL 18, 2024

Yesterday, we published a piece by Catherine Sarkisian about her experience with, and reaction to, masking during a recent stint on an inpatient service. It would be an understatement to say that the piece stimulated a lot of discussion — in its first 12 hours, there were 186 comments on Sensible Medicine and my tweet about the article had been viewed 16,000 times.

Academics 75

Academics Wellness Hospitals 75

American Medical Compliance

APRIL 16, 2024

The following Understanding Medication Safety Training educates healthcare providers on common medication safety issues. Ensuring patient safety during health services delivery is fundamental for an efficient healthcare system. Additionally, a strong organizational culture of patient safety and quality enables service providers to prepare for a variety of reasons.

Patient Safety 74

Patient Safety Administration Outcomes 74