Ken Grauer, MD
AUGUST 8, 2024
I was sent the ECG shown in Figure-1 — told only that that this middle-aged woman noted chest tightness and nausea an hour earlier. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? — IF told that this patient arrested shortly after ECG #1 — Does this change your interpretation? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original EC G using PMcardio ).
Mount Sinai EM
AUGUST 7, 2024
Ultrasound during cardiac arrest has quickly become standard. Initially, data suggested that the use of ultrasound during arrest increased pauses between compressions which worsens outcomes. To decrease time between compressions, many protocols were proposed (see here ). One such protocol that successfully decreased time between compressions is the CASA (Cardiac Arrest Sonographic Assessment) protocol.
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Pediatric EM Morsels
AUGUST 9, 2024
Neonates presenting to the Emergency Department often cause a lot of uncertainty. Is this scalp swelling normal? Is this bloody stool concerning? Are this odd movements part of normal development? Is that umbilical area ok or concerning? Fortunately, we have addressed many neonatal issues in the PedEMMorsels. Obviously, one of the most concerning considerations in neonates is the potential for infection.
The Trauma Pro
AUGUST 9, 2024
I’m going to be (re)sharing the laws of trauma over the next few posts. I’ve identified a total of eleven over the past 12 years, and I wanted to share them with you. But first, I’d like to share another trauma surgeon’s observations. Dr. Norman McSwain was an icon in trauma surgery during the early years of my career. I knew Norm for decades and literally grew up reading about his advancements and accomplishments.
Sensible Medicine
AUGUST 3, 2024
Last week Adam Cifu and Vinay Prasad offered dueling interpretations of a randomized trial of masking. These posts were read by nearly a hundred thousand readers, and you can read them below. One reader, Ben Recht, a Berkeley Professor, thinks both of them are wrong. This is his column. Sensible Medicine Adam Cifu is Wrong About Masking 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 w
Science Based Medicine
AUGUST 8, 2024
Hypocritical articles on politics and medicine weren't really about politics and medicine, they were a message- the standards we set for you, don't apply to us and everyone knows it. The post The Hypocrisy Is The Point. Doctors Who Said Not To Mix Politics & Medicine. first appeared on Science-Based Medicine.
PEMBlog
AUGUST 9, 2024
Recently, I had the opportunity to present a morning report to the residents and medical students at Cincinnati Children’s, focusing on the topic of febrile seizures. The session was highly engaging, with a lot of interest from the audience, as febrile seizures are a common but often frightening experience for families. During the presentation, we covered a range of topics, including the definition and incidence of febrile seizures, their causes, and how to manage and counsel families when their
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Sensible Medicine
AUGUST 4, 2024
Editors note: a shortened version of this post was originally submitted to the New England Journal, but it was rejected. Refusing to host debates is why journals will die. By Joseph Marine, MD In a recent NEJM Perspective piece , Drs. Mullen, Topol, and Verghese argue “in support of institutional voices” to take public positions on matters of public controversy “when it concludes that a faculty member’s opinion could cause public harm.” Their essay (ironically publi
Science Based Medicine
AUGUST 5, 2024
Ever since COVID-19 first emerged in 2020, evidence-free claims that it had arisen due to a "lab leak" have proliferated. A recent paper argues that this conspiracy theory has been very harmful to science. I argue that it's more than just lab leak that is harmful. The post How conspiracy theories like COVID-19 “lab leak” harm science and public health first appeared on Science-Based Medicine.
American Medical Compliance
AUGUST 7, 2024
More than a million hospitalized patients each year acquire healthcare-associated infections (HAIs) while being treated for other health conditions. Despite rigorous training and established protocols, mistakes in infection control can still occur, leading to severe consequences, including the spread of healthcare-associated infections (HAIs). In this blog, we will explore common infection control mistakes and provide practical tips on how to avoid them, helping to create a safer healthcare envi
Dr. Smith's ECG Blog
AUGUST 4, 2024
Written by Pendell Meyers Try first to interpret the ECG without any clinical context: What do you think? Sinus rhythm with abnormal STE in V2-V6, and I, II, aVF. Reciprocal STD in aVR and V1. Most leads with STE have remarkably non-hyperacute, flat T waves. Most would say that there is Spodick's sign. The PR depression in II (and its reciprocal PR elevation in aVR) is probably beyond normal baseline values.
Sensible Medicine
AUGUST 7, 2024
In Post #1 last Wednesday, Elizabeth Fama introduced her critical appraisal series on the Back to Sleep recommendation. This week, she explores the downsides of sleeping babies on their backs. JMM Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Possible Downsides of Back Sleeping Sleep Quality For adults, it’s fairly interchangeable to sleep on the stomach, side, or back.
St. Emlyn
AUGUST 8, 2024
St.Emlyn's - Emergency Medicine #FOAMed Is intranasal ketorolac an option for analgesia in renal colic. A review of a paper from the Annals of Emergency Medicine. The post Intranasal ketorolac in renal colic appeared first on St.Emlyn's.
American Medical Compliance
AUGUST 7, 2024
Patient safety is a critical concern, with the World Health Organization (WHO) estimating that 1 in 10 patients is harmed while receiving healthcare. Notably, many of these incidents are preventable and could have been avoided with proper compliance measures. Compliance with healthcare regulations is crucial not only for avoiding legal repercussions but also for ensuring high standards of patient care and safety.
Dr. Smith's ECG Blog
AUGUST 9, 2024
Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. He reported a history of “Wolf-Parkinson-White” and “heart attack” but said neither had been treated. These diagnoses were not found in his medical records nor even a baseline ECG.
Sensible Medicine
AUGUST 5, 2024
First some background from my clinic. Here is how the conversation goes: Patient: “Doc, should I take this cholesterol drug that my primary care doctor prescribed?” Me: “What did your risk score come out as?” Patient: “What?” It stuns me how few doctors use the pooled cohort equation to guide use of primary prevention treatments.
St. Emlyn
AUGUST 4, 2024
St.Emlyn's - Emergency Medicine #FOAMed Background Smoking is a leading cause of preventable morbidity and mortality worldwide. In the words of the packaging: ‘Smoking Kills’ If we could persuade more people to give up, it […] The post Cessation of Smoking Trial in the Emergency Department (COSTED): A Critical Appraisal appeared first on St.Emlyn's.
Taming the SRU
AUGUST 4, 2024
Capacity Management - Sports medicine grand rounds - introduction to bedside teaching - skin adhesives - hypertensive emergency - ultrasound qa review - how to give a presentation capacity management WITH Dr. lane Emergency Department flow can be characterized as Input - Throughput - Output In the ED, we do not have much control over patient input or output, but we do have control over patient throughput Simulation modeling was used in our Emergency Department to determine our threshold for “at
Dr. Smith's ECG Blog
AUGUST 6, 2024
Written by Magnus Nossen with Edits by Grauer and Smith The ECGs in today’s case are from 3 different patients all presenting with new-onset CP ( Chest Pain ). All ECGs were recorded by EMS, and transferred to a PCI capable center for evaluation. For 2 of the 3 patients — the cath lab was activated based on the ECG. One of the patients was lucky to have expert ECG interpretation by the Queen Of Hearts AI model.
American Medical Compliance
AUGUST 7, 2024
According to OSHA’s report , hospitals pose significant hazards, including the risk of violence, making them among the most hazardous workplaces. Effective leaders understand that prioritizing safety not only protects employees from harm but also enhances productivity. More importantly, it boosts morale and overall business success. In this blog, we will delve into the critical role that leadership plays in promoting safety.
St. Emlyn
AUGUST 6, 2024
St.Emlyn's - Emergency Medicine #FOAMed The latest St Emlyn's monthly podcast with all the best from the blog in June 2024. The post Podcast – June 2024 Monthly Round Up – Nebulised Ketamine, Risky Intubations, Better Presentations, DSED, Preoxygenation and more appeared first on St.Emlyn's.
Sensible Medicine
AUGUST 4, 2024
I’ve got a pretty stable approach to reading the medical literature. I even have a talk, “keeping up on the literature.” I have the JAMA, NEJM, and JAMA IM email me their TOC. I then use my other “media” – NYT, NPR, twitter, office chatter – to find other articles I should be reading. Last week, there were no articles that changed my practice but there were a few that I found interesting.
Core Medical Group
AUGUST 9, 2024
Choosing your next travel assignment is like picking a new adventure. It’s not just about the job - it’s about the location, the experience, and the memories you’ll create along the way! Sure, most of us dream of landing that first contract on a sunny beach in Hawaii or in the snow-capped Rockies, but sometimes the real gems are found in places you might not expect.
EMDocs
AUGUST 3, 2024
We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Keith Wrenn Always Said, “Presyncope IS Syncope.” He Was Right Spoon Feed This systematic review found that approximately 4%-27% of patients presenting to the ED with presyncope experienced serious outcomes within a
EM Ottawa
AUGUST 8, 2024
Shoulder injuries are a common yet complex presentation in emergency medicine, presenting a unique challenge due to the intricate anatomy and diverse range of potential pathologies, where imaging may not always be helpful. In this post, we will explore the various aspects of shoulder injuries from a clinical standpoint to help your bedside assessment; focusing […] The post Rotating Around the Cuff of Shoulder Injuries appeared first on EMOttawa Blog.
Sensible Medicine
AUGUST 6, 2024
Vinay and I started talking about and writing about churnalism about 5 years ago. He gets full credit for the term, which I initially resisted but later embraced. We thought we’d be able to write a book about churnalism – sort of a follow-up to Ending Medical Reversal – but that book was not meant to be. When Sensible Medicine got off the ground, it seemed like a perfect home for the chapters we had already written and a place to put ongoing coverage of the topic.
NRC Health
AUGUST 6, 2024
In his upcoming presentation at HUB24, Dr. Beeson will outline a tested method for systemic skill-building that targets team engagement and patient experience goals. The post A pathway to patient connection and team collaboration appeared first on NRC Health.
EMCrit
AUGUST 5, 2024
All the RACC Lit goodness for Aug 2024 EMCrit Project by Scott Weingart, MD FCCM.
ACEP Now
AUGUST 9, 2024
Lionfish ( Pterois species) are members of the family Scorpaenidae, which includes lionfish ( Pterois ), scorpionfish ( Scorpaena ), and stonefish ( Synanceia ). They also are commonly called butterfly cod, firefish, peacock lionfish, and turkeyfish in some places. They deliver one of the most painful stings a human can receive from a marine creature.
Emergency Live
AUGUST 9, 2024
The earthquakes were felt in Miyazaki and Kagoshima prefectures, numerous buildings have been damaged Japan trembles: a powerful earthquake shakes The island of Kyushu in southern Japan has been shaken by a violent earthquake of magnitude 7.1, an earthquake that has put to the test the resilience of a nation accustomed to living with similar […] The post Japan trembles: powerful earthquake shakes Kyushu appeared first on Emergency Live.
Greater Sydney Area HEMS
AUGUST 8, 2024
Register now for the ITIM Prehospital Trauma Evening, hosted by Sydney HEMS. Wed 18th Sept 2024, 1630-2000 In person at Bankstown Aerodrome or via Livestream – REGISTRATION ESSENTIAL FOR FACE-TO-FACE ATTENDANCE The NSW Institute of Trauma and Injury Management proudly presents the Pre-Hospital Trauma Evening in collaboration with the NSW Ambulance Service.
SCGH ED
AUGUST 7, 2024
Here is some information regarding the developing SCGH HITH Service: Team: Admission Criteria: Exclusion Criteria: HITH Catchment Areas (yellow and orange areas): Investigation/Mx in HITH: Referrals: Date implemented – 08/2024Review date – ?12/2024Author – Wheeler / Liz Feher (Geriatrics) / Hung Do Nguyen (General Medicine) The post Hospital in the Home (HITH) appeared first on Charlie's ED.
NRC Health
AUGUST 6, 2024
In his upcoming presentation at HUB24, Dr. Beeson will outline a tested method for systemic skill-building that targets team engagement and patient experience goals. The post A pathway to patient connection and team collaboration appeared first on NRC Health.
Emergency Live
AUGUST 9, 2024
Among the affected organs, the liver is particularly sensitive to increased body temperature The heat waves of these days, increasingly frequent and intense, risk being very harmful for our body. Besides causing the most well-known headaches, nausea and dizziness, they can have very serious consequences, especially on the liver. “Heat stroke” lethal for our body […] The post Heat stroke: a serious risk for the liver appeared first on Emergency Live.
PEMBlog
AUGUST 5, 2024
Time is testicle! Acute scrotal pain must be evaluated promptly in the ED. You’ll see swelling, extreme pain, sidling testis, and absent cremaster reflex. You’ve got 4 to 6 hours at most to get the patient to surgery. Time is testicle! Also yacht rock. Lyrics [Verse] Pain started suddenly Testicle twists freely Side lying swollen now Cremaster gone, holy cow!
PulmCCM
AUGUST 4, 2024
In the 1980s and 1990s, physicians and PhD colleagues at Vanderbilt University published papers establishing associations between patients’ complaints about feeling disrespected and their subsequent malpractice lawsuits. Further work explored the interconnections between unprofessional behavior, patient complaints, and malpractice risk.
Pediatric Education
AUGUST 4, 2024
Patient Presentation Within the span of one week, a pediatrician encountered two teenage females who had come to clinic for other problems but who had the diagnosis of thoracic outlet syndrome. One had already had surgery and the other was planned within the next month. He thought this was unusual and didn’t remember seeing anyone with this problem for several years.
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