Sat.Oct 29, 2022 - Fri.Nov 04, 2022

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EMCrit 336 – Team NeuroEMCrit’s Critical Neuro Cases – Part 2

EMCrit

SAH and Hypoxic Encephalopathy. EMCrit Project by NeuroEMCrit Team (Casey & Neha).

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90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. BP was 110 and oxygen saturation was normal. What is your ECG interpretation and what would you do next?

EKG/ECG 52
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Pediatric Ocular Trauma

EB Medicine

In this episode, Sam Ashoo, MD, interviews Ami Shah, MD, MPH, and Don Walker, MD, about eye injuries in the pediatric population. Why ocular injuries? Why did you pick this topic? What kind of injuries are included and at what age are they most common? Injury zones and terminology Differential Diagnosis What should we keep in mind when we are confronted with an ocular injury?

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Etomidate Vs. Ketamine: A Systematic Review and Meta-Analysis

RebelEM

Background: Rapid sequence intubation (RSI) induction agent selection remains a heavily debated matter. Etomidate causes adrenal suppression in critically ill patients triggering a groundswell of support in favor of ketamine. (Albert 2011, Jabre 2009) However, the existing literature comparing etomidate and ketamine is conflicting. In 2017, a single-centered, retrospective study found a lower incidence of clinical hypotension with ketamine compared to etomidate following endotracheal intubation

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EMCrit Wee – Resus SCRAM Kit Dump Bag, Crash RX Drug Bag, and the Equipment I prefer for Resuscitative Intubation

EMCrit

Finally it is here. EMCrit Project by Scott Weingart, MD FCCM.

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Doctor Burnout Levels Increasing as a Result of the Pandemic

American Medical Compliance

Amidst the COVID-19 pandemic, there has been an influx of doctor burnout. A recent study published in the medical journal Mayo Clinic Proceedings found that physician burnout increased during the first two years of the COVID-19 pandemic following a six-year drop that ended in 2020. Helping Doctors Through Extensive Burnout. In a press release, American Medical Association President Dr.

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The All-Important Endpoint of a Medical Study

Stop and Think

We need to stop and think about the endpoints measured in a medical experiment. In cardiology, we have long tested new treatments in randomized controlled trials. This means that patients with a specific problem, say, heart failure, get randomized to either the new drug or a placebo. Both groups are treated with the most up-to-date medications. The question is if the new drug adds benefit to the standard regimen.

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Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

Dr. Smith's ECG Blog

I was reading EKGs on the system and saw this one. What did I put in as my interpretation? Interpretation : "Acute LAD occlusion until proven otherwise. " There is non-diagnostic ST Elevation in V1-V3, with rather large T-waves but in the context of a deep S-wave (high voltage). HOWEVER, lead V4 is diagnostic of OMI. This is massive ST Elevation, huge hyperacute T-wave, and loss of S-wave (which in V4, unlike V2-3, can be normal but should greatly raise suspicion.

EKG/ECG 52
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EMTALA and Patient Transfers

Northwestern EM Blog

Written by: Mike Tandlich, MD (NUEM ‘24) Edited by: David Feiger, MD (NUEM ‘22) Expert Commentary by : Michael Schmidt, MD Expert Commentary While EMTALA was first enacted to address issues with “patient dumping”, it has had broad influence on how patients are treated, dispositioned, and transferred in emergency department and hospital settings. In addition, EMTALA law has taken on almost mythic proportions among healthcare workers and administrators, likely due to high-profile cases, the fear o

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First10EM Journal Club: October 2022

Broome Docs

Ketamine vs etomidate in ICU intubation ? Matchett G, Gasanova I, Riccio CA, Nasir D, Sunna MC, Bravenec BJ, Azizad O, Farrell B, Minhajuddin A, Stewart JW, Liang LW, Moon TS, Fox PE, Ebeling CG, Smith MN, Trousdale D, Ogunnaike BO; EvK Clinical Trial Collaborators. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial.

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SGEM#381: Put Your Hand on My Shoulder and Reduce It

The Skeptics' Guide to EM

Date: October 27th, 2022 Reference: Hayashi et al. Comparative efficacy of sedation or analgesia methods for reduction of anterior shoulder dislocation: A systematic review and network meta-analysis. AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency […] The post SGEM#381: Put Your Hand on My Shoulder and Reduce It first appeared on The Skeptics Guide to E

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Lab case 384

EMergucate

30 year-old-lady sent by her GP for increasing tiredness over the last few months. She has been under too much stress, due to increasing work demands and hers wedding planning.

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Chiefs’ Inquiry Corner – 11/3/2022 - Clinical Correlations

Clinical Correlations

Chief residents of the NYU Langone Internal Medicine Residency give quick-and-easy, evidence-based answers to interesting questions posed by house staff, both in their clinics and on the wards.

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Bell’s Roids | WATEFALL RCT

JournalFeed

The JournalFeed podcast for the week of Oct 24-28, 2022. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Bell’s Roids Spoon Feed There was no statistical difference in 1, 3, or 6 month facial recovery with prednisolone vs placebo for children with Bell's palsy in this underpowered RCT.

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The LOVIT Trial: Orange Crushed

RebelEM

Background: Vitamin C dissociates to ascorbate at physiological pH and is not organically synthesized by the human body. Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. (Amrein 2018) A small, single-center, before-and-after study utilized a sepsis cocktail consisting of IV thiamine, hydrocortisone, and vitamin C and discovered a significant decrease in mortality compared to the control group.

Sepsis 52
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Imaging Case of the Week 527

EMergucate

The chest x-ray is from a 14 year old who has presented with dyspnea. What can be seen?

EMS 52
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Lab case 384 interpretation

EMergucate

Question 1 PH = 7.47 that is mild alkalaemia. HCO3 = 39.

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Imaging Case of the Week 524 Answer

EMergucate

The forearm x-ray shows lunate dislocation. A dedicated view of the wrist is needed to assess associated wrist injuries.

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ECG of the Week 2nd Nov 2022

EMergucate

A 55 year old male presents to ED feeling unwell.

EKG/ECG 52
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Imaging Case of the Week 526 Answer

EMergucate

The chest x-ray view shows a widened mediastinum.

EMS 52
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Imaging Case of the Week 525 Answer

EMergucate

The knee x-ray shows Segond fracture.