Pediatric EM Morsels
JULY 28, 2023
Authors: Drs. Kendra Jackson and Rebecca Raffler While we’ve gotten to snack on a Morsel on this subject before , new guidelines and research surrounding DKA and cerebral edema have come to light since the first go ‘round! Thankfully, Dr. Fox wasn’t too “ salty” when we asked to rehydrate this topic. Rates of type 1 diabetes have increased since the COVID-19 pandemic.
Ken Grauer, MD
JULY 22, 2023
The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. Unlike his "usual" anginal episodes — this chest discomfort was not relieved by NTG. Some amount of time passed at home — during which his chest discomfort persisted The patient was hemodynamically stable at the time he was seen by EMS, when ECG #1 was recorded.
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Mount Sinai EM
JULY 27, 2023
Fever in the Asplenic Patient Why we care Fever in a patient with impaired splenic function = early sign of sepsis Infections in this population can develop precipitously with very minimal antecedent symptoms, and can become fulminant and fatal within hours of symptom onset DIC can occur early in the course Patient population Anatomic Asplenia (post-splenectomy, congenital asplenia) Functional Asplenia (e.g. sickle cell anemia) Hyposplenia (from atrophy, infarction, engorgement, or infiltration
The Trauma Pro
JULY 28, 2023
As a followup to my hip dislocation post on Tuesday, here is a short 5 minute video that goes through the entire process of reducing hip dislocations. There are lots of little tips and tricks. Enjoy! In the next post, a novel variant of the hip reduction technique, the Captain Morgan. Originally shown at Trauma Education: The Next Generation 2013 in St.
Emergency Live
JULY 28, 2023
More European Canadairs against fires in Mediterranean countries The increasing threat of forest fires in Mediterranean countries has prompted the European Commission to take decisive measures to protect the affected regions. The news of the purchase of 12 new Canadair aircraft, financed entirely by the European Union, has raised a ray of hope in the […] The post Fighting forest fires: EU invests in new Canadairs appeared first on Emergency Live.
RebelEM
JULY 27, 2023
Background: Current stroke guidelines recommend IV alteplase for patients with acute ischemic stroke presenting within 4.5hrs of symptom onset based on the NINDS and ECASS III publications. Both NINDS and ECASS III excluded patients with mild stroke symptoms but failed to clearly define a threshold for mild stroke. Many patients, however, will have minor strokes (defined as an NIHSS score ≤5).
Mount Sinai EM
JULY 24, 2023
This week, I wanted to touch a bit on Meconium Aspirators as apart of our GI Bleed intubation tool kit. At some point during second year, many of my fellow classmates and I started throwing these into airway boxes at Elmhurst. Especially in cardiac/resus, I think knowing to reach for one when you need one is critical, though I don’t think they need to be in every airway box.
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EM Ottawa
JULY 27, 2023
Acute scrotal pain is a common in emergency departments, comprising ~ 0.5% of all presentations. However, torsion is another very time sensitive diagnosis that is ubiquitous across all ages as seen by this Rosen’s table. Incidence / Epidemiology Unfortunately, epidemiological data is poor. Acute scrotal complaints make up approximately 0.5% of all ED visits […] The post Testicular Torsion appeared first on EMOttawa Blog.
Emergency Live
JULY 27, 2023
New Technologies in Frontline Fire Fighting With rising summer temperatures and the increasing threat of forest fires, Italy is stepping up its efforts to tackle these emergencies. A key part of firefighting involves the use of aerial means, helicopters and drones. This year, the summer firefighting campaign is well equipped with a fleet of 34 […] The post REAS 2023: Drones, aerial vehicles, helicopters against fires appeared first on Emergency Live.
Science Based Medicine
JULY 26, 2023
An opinion piece falls for all the usual acupuncture misdirection. The post Washington Post Falls For Acupuncture Pseudoscience first appeared on Science-Based Medicine.
Don't Forget the Bubbles
JULY 26, 2023
Topic Cardiology & the ECG Author Anna McCorquodale Duration 1-2 hours Facilitator Level ST4+ level used to seeing children acutely Learner level Anyone involved in initial assessment of children with cardiac symptoms; paediatric trainees, emergency trainees, foundation doctors Outline Pre-reading Basics Case 1 Case 1: Discussion Case 2 Case 2: Discussion Advanced Case 1 Advanced Case 1: Discussion Advanced Case 2 Advanced Case 2: Discussion Quiz Take Home Points Basics (15 mins) with sharin
RebelEM
JULY 26, 2023
Take Home Points Methylxanthines are a drug class that includes caffeine, theophylline, and theobromine. The three main mechanisms that account for the clinical presentation of methylxanthine toxicity are: catecholamine release, adenosine antagonism, and phosphodiesterase inhibition. Beta agonism will lead to hyperlactatemia, hypokalemia, hyperglycemia, and tachycardia.
Emergency Live
JULY 27, 2023
In the field of psychiatry and psychotherapy, sociopathy is defined by the term "antisocial personality disorder" The post Sociopathy and antisociality: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.
ECG Guru
JULY 24, 2023
This is a "classic" ECG of very good quality for you to use in a classroom setting. The Patient: A 57-year-old man who complains of a sudden onset of "sharp" chest pain while on a long bike ride. The pain does not radiate, and nothing makes it worse or better. He is pale, cool, and diaphoretic. His medical history is unknown. The ECG: This ECG could be considered "classic" for an inferior wall ST elevation M.I. caused by occlusion of the right coronary artery.
Emergency Medicine Journal
JULY 24, 2023
Background Endotracheal tube (ETT) malposition is frequent in paediatric intubation. The current recommendations for ETT insertion depths are based on formulae that hold various limitations. This study aimed to develop age-based, weight-based and height-based curve charts and tables for ETT insertion depth recommendations in children. Methods In this retrospective single-centre study, we determined the individual optimal ETT insertion depths in paediatric patients by evaluating postintubation ra
RebelEM
JULY 24, 2023
Background: Rapid Sequence Intubation (RSI) is a procedure fraught with potential complications including hypotension which, in turn, can result in cardiovascular collapse. While there are numerous potential causes of hypotension peri-RSI, induction medications represent an important, modifiable variable. Over the last decade, airway experts have advocated for reduced induction agent dosing to lessen the risk of hypotension particularly in at risk patients.
Emergency Live
JULY 28, 2023
Onychocryptosis is a disorder known as 'ingrown toenail': this condition, sometimes painful and unsightly, occurs when the corner of the toenail creeps into the skin The post Onychocryptosis: what it is and how to deal with an ingrown toenail appeared first on Emergency Live.
Don't Forget the Bubbles
JULY 24, 2023
Discitis is an inflammatory condition involving the intervertebral discs and end plates of vertebral bodies. It encompasses a spectrum of conditions that includes discitis , spondylodiscitis , and vertebral osteomyelitis. Discitis is uncommon. However, there is a bimodal peak in children, those under 6 years and adolescents. Neonates can also be affected.
SheMD
JULY 23, 2023
Disclaimer: This post was written before the COVID-19 pandemic. Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Now that it’s the heart of interview season for both medical school applicants and residency applicants, I wanted to share some tips on how to answer commonly asked interview questions.
Life in the Fast Lane
JULY 26, 2023
Pramod Chandru Network Five: Emergency Medicine Case Series Network Five Emergency Medicine Case 1 discussing an interesting case of a patient who presents with chest pain and pre-syncope.
Emergency Live
JULY 23, 2023
Pervious foramen ovale is a frequent condition in adulthood, will be encountered occasionally and some patients may present with paradoxical embolism followed by symptomatic cerebral ischaemic events The post Cerebral ischaemia: the strategy of percutaneous closure of the patent foramen ovale appeared first on Emergency Live.
Canadian EM
JULY 25, 2023
A 50-year-old female presents to your ER with a chief complaint of palpitations. A 12-lead ECG shows supraventricular tachycardia at a rate of 165 bpm, and she is put on telemetry. She is clinically stable. You attempt the modified Valsalva maneuver with no effect. You explain that you will have to give her medication to bring her heart rhythm back to normal.
ALiEM
JULY 22, 2023
You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. However, the crystalloid fluids are not flowing freely. Multiple attempts were made to place this line with the latest having a flash of blood return and a smoothly flowing saline flush. You can not seem to find your pressure infusion cuff to squeeze the IV bag and accelerate fluid administration.
Science Based Medicine
JULY 24, 2023
Dr. Peter McCullough and a number of "anti-COVID-19 vaccine" antivaxxers out there has pivoted to quackery to "detox" from the supposedly malign effects of COVID-19 vaccines. Everything old is new again, this time with nattokinase. The post “Base Spike Detox” and Signature Spike Support Formulas: Nattokinase quackery to treat COVID-19 and COVID-19 “vaccine injury” first appeared on Science-Based Medicine.
Emergency Live
JULY 26, 2023
Global fire crisis, a problem since 2019 Before the Pandemic, there were other crises that unfortunately went to be rather forgotten. In this case we have to describe the issue of fires, which in 2019 presented itself as a virtually global threat. It was undoubtedly a very busy year for the Fire Brigade and Civil […] The post Fires in 2019 and the Prolonged Consequences appeared first on Emergency Live.
Sensible Medicine
JULY 24, 2023
Last week I wrote about the COURAGE trial. At the time, in 2007, the cardiology world was stunned to learn that opening partially blocked coronary arteries—in stable patients—did not lead to fewer heart attacks or less cardiac death compared to tablets alone. I chose the verb stunned because nearly the entire focus of cardiology at the time was the search for ischemia due to these blockages—so that they could be “fixed.” Od habits are hard to break, so, post-COURAGE
Core Medical Group
JULY 28, 2023
Behind every successful venture lies a passionate individual, and Holly's story showcases just that. With a career spanning 5 years at CoreMedical Group, she has earned her place as a seasoned and revered Senior Recruiter. Her dedication to her job has allowed her rise to the top of her division, becoming one of the go-to people for nurses seeking the ultimate travel experience.
Science Based Medicine
JULY 28, 2023
Conspirituality is a must-read for anyone who seeks to understand the daunting task we face in repairing the damage done by disinformation doctors. The post Conspirituality: A Book Recommendation first appeared on Science-Based Medicine.
Emergency Live
JULY 25, 2023
Osteomyelitis is an infection of the osteoarticular system which, if not properly treated, can become chronic The post Osteomyelitis: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.
Sensible Medicine
JULY 26, 2023
We are two practicing physicians who strongly support a petition gaining traction on Change.org to eliminate the American Board of Internal Medicine’s Maintenance of Certification (MOC) requirement. From our perspective, MOC is a financial product made to enrich a professional organization that has no credible data that it ensures better physicians.
Medagadget
JULY 25, 2023
Engineers at the Federal University of Espirito Santo in Brazil have developed smart pants that can non-intrusively track physical movements and provide updates to caregivers if the people they’re taking care of are showing signs of distress. This application could be very useful for people who are monitoring elderly patients in healthcare facilities.
Science Based Medicine
JULY 25, 2023
The third installment in debunking the antivaxxer book “Turtles All the Way Down”: Chapter 3, “Deficient by Design: The Vaccine Adverse Event Reporting System (VAERS)”. The post The Grand Debunk of the antivaxxer book “Turtles All the Way Down” (part 3/10) first appeared on Science-Based Medicine.
Emergency Live
JULY 24, 2023
Fire alarm – Italy is in danger of going up in smoke Besides the alarm about floods and landslides, there is always something we have to consider and that is of course drought. This kind of very intense heat comes naturally from particular and very intense cyclones and perturbations, and all this might appear normal, […] The post Climate Change and Drought: The Fire Emergency appeared first on Emergency Live.
Sensible Medicine
JULY 28, 2023
MJ is a 24-year-old man who presents to his primary care physician on March 16, 2020 with fever, myalgia, and sore throat. He recently came home to Chicago from New York City after his college sent the students home. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber. My career has been bracketed by an epidemic and a pandemic.
Medagadget
JULY 25, 2023
Scientists at the City University of Hong Kong have developed a coating for wearable technologies that can help to dissipate heat, reducing the chances of skin burns and increasing the life of such devices. Electronic devices can generate heat, but this can be problematic for wearables that are in constant contact with the skin. The heat may be uncomfortable, may overheat the device itself, and could even cause skin burns.
Taming the SRU
JULY 26, 2023
Social EM - alcohol use disorder - The cases that haunt me - patient evaluations - neuroimaging - oral boards social em WITH drs. jarrel, pulvino and kimmel “One can view the ED (by law, the most accessible door into our healthcare system) as the social barometer of its community. Within the waiting room the emergency physicians witness the confluence of social determinants of health and their deconstruction into pathology.
Emergency Live
JULY 24, 2023
Although not much is said about them, there are also cardiac tumours: they are extremely rare, with an incidence of around 0.2% compared to other oncological cases The post Cardiac tumours, an overview of benign and malignant neoplasms appeared first on Emergency Live.
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