Sat.Jan 07, 2023 - Fri.Jan 13, 2023

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Helmet Removal

Mount Sinai EM

Why should I care about this? Ok, so it may not be that interesting, however, we should still review how to responsibly remove a helmet. In NYC, we very rarely encounter injured patients with a helmet on and that’s probably because they were never wearing one to begin with, the patient removed it, or EMS removed it. So depending on the practice setting and local EMS protocols, patients may arrive with a helmet in place and it will fall on you as the EM doc to safely remove the helmet without cau

EMS 130
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Happy HIPAA New Year!

Total Medical ComplianceHIPAA

It is a safe bet that the title of this article would come in last place for the “most popular topic” award. The start of a new year is always a good time to reflect and also look ahead and do our best to prepare. Last year, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) had its busiest year with the announcement of its 22 nd enforcement settlement on December 15, 2022.

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Congregation B’nai B’rith 2022 Mitzvah Day Activities

Medical Law

Renée Nordstrand-Black and Doug Black of NordstrandBlack PC feel truly thankful for all the good fortune in our lives. One of our greatest pleasures is living in such a beautiful community. The Santa Barbara area isn’t just a gorgeous place to live – the people here are so warm and giving that Renée and Doug can’t imagine living anywhere else. Renée and her family gladly welcome the opportunity to give back to the local community when they can.

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PREPARE II

The Bottom Line

Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation @DerekRussellMD. JAMA; 328(3):270-279. doi:10.1001/jama.2022.9792 Clinical Question In critically ill adult patients undergoing tracheal intubation and positive pressure ventilation, does intravenous infusion of a 500ml fluid bolus vs no fluid bolus, decrease the incidence of cardiovascular collapse during, or shortly after the procedure?

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The Ankle Radiograph

Mount Sinai EM

Anatomy First, we’ll refresh our bony anatomy to contextualize the radiographic images. The ankle is composed of the distal tibia and fibula and the superior talus, which is stabilized by several ligaments and the fibrous syndesmosis. Image source: Sports Medicine for the Emergency Physician A Practical Handbook The standard ankle radiographic series consists of the AP, mortise and lateral views.

Radiology 130
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Quiz post: do either or both of these patients have high lateral OMI / South African flag sign?

Dr. Smith's ECG Blog

Written by Pendell Meyers, edits by Smith Two patients presented with acute chest pain/pressure. Here are their ECGs: Patient 1: Patient 2: See below for "answers", and below that for both cases. "Answers": Patient 1 shows very subtle high lateral OMI, South African flag sign. She had an acute LAD OMI in the process of reperfusion, see case below. Patient 2 has a normal variant ECG which mimics high lateral OMI, and ruled out for MI, see case below.

EKG/ECG 52
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Protected Health Information Disclosed by Website Technology

American Medical Compliance

Certain website technologies may be at risk of sharing protected health information. The Office of Civil Rights at the U.S. Department of Health and Human Services (HHS) released a bulletin warning that certain website tracking technologies may violate the Health Insurance Portability and Accountability Act (HIPAA). Tracking technologies include but are not limited to cookies, replay software, and tracking pixels.

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Airway Ultrasound 2023 update

Core Ultrasound

Airway ultrasound is something that can be quite complex but at its most basic, it can be used to help determine if you have endotracheal versus endobronchial intubation. This is definitely not something that needs to be done all the time, but is a great adjunct in the appropriate clinical setting!

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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers A male in his teens presented with complaints of chest discomfort and dyspnea beginning while exercising but without obvious injury. He immediately stopped exercising and symptoms started to improve. Later that evening he felt recurrent central chest discomfort, shortness of breath, and vomited. Symptoms have been constant since this second episode, and are still present on arrival, which seems to have been less than 1 to 2 hours from onset of symptom

EKG/ECG 52
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159. Influenza: "did you miss me?"

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. He’s backkkkkkkkkk! If you missed seeing lots of flu, you’re in luck. In this episode, Shad Baab joins Iltifat and talks about viral testing, post-flu complications, and of course, simplifying tamiflu.

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Financial Concerns Causing Patients to Defer Care

NRC Health

It’s no secret that patient volumes in 2022 were below expectations. The post Financial Concerns Causing Patients to Defer Care appeared first on NRC Health.

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ECG of the Week 4th January 2023 – Interpretation

EMergucate

ECG of the Week 4th December 2022 – Interpretation There are P waves with an atrial rate of approximately 75.

EKG/ECG 52
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Where does your state rank in terms of life expectancy? Only Hawaii is over 80 years

CasesBlog

People in some southern states can expect to die 8 years younger than the average American, according to a data compilation that highlights the disparities in US life expectancy. While Americans lived for 79 years on average in 2020, those in Mississippi can expect to reach just 71. For comparison, people in Hawaii — which has the highest life expectancy — live to 80 on average.

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GSW Vascular Injury

EM SIM Cases

This case comes from Dr. Mark McKinney from the University of Ottawa. He completed a fellowship in simulation through the U of O Skills and Simulation Centre. His academic interests are in education, simulation, and translational simulation; including where simulation can improve hospital and emergency department preparedness. WHY IT MATTERS We recognized a gap in the opportunities and cases available for residents to work through penetrating extremity trauma algorithms acutely.

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Fouad – Managing Massive Hemoptysis

University of Maryland CC Project

Dr. Jan Fouad is a recent graduate of the Pulmonary, Critical Care, and Sleep Medicine Fellowship at the Yale School of Medicine and is currently an Interventional Pulmonology Fellow at the University of Maryland. He presents a lecture entitled "Managing Massive Hemoptysis" as part of the DC5 lecture series. Dr. Jan Fouad is a recent graduate of the Pulmonary, Critical Care, and Sleep Medicine Fellowship at the Yale School of Medicine and is currently an Interventional Pulmonology Fellow at the

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ECG of the Week 11th January 2023

EMergucate

The following ECG was obtained from a 61 year old man with coronary artery disease and previous coronary stents.

EKG/ECG 52
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New option for H pylori treatment: Voquezna

CasesBlog

The Food and Drug Administration (FDA) has approved the following new medication for the treatment of Helicobacter pylori (H. pylori) infection in adults.: - Voquezna Triple Pak (vonoprazan, amoxicillin, clarithromycin) - Voquezna Dual Pak (vonoprazan, amoxicillin) Vonoprazan, which gives the name of the medication, is an oral small molecule potassium-competitive acid blocker.

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Happy New Year! | Best of Resus 2022 | Amio Vs. Lido

JournalFeed

The JournalFeed podcast for the week of Jan 2-6, 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. Best of Resus 2022 Spoon Feed Here are the latest evidence updates on basic, advanced, and pediatric life support - and more - from this expert literature review.

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Holden – Pleural Disorders

University of Maryland CC Project

Dr. Van Holden is an Associate Professor and Program Director of the Pulmonary and Critical Care Medicine Fellowship Program at the University of Maryland, School of Medicine. She presents a lecture entitled "Pleural Disorders" as part of the DC5 lecture series. Dr. Van Holden is an Associate Professor and Program Director of the Pulmonary and Critical Care Medicine Fellowship Program at the University of Maryland, School of Medicine.

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SGEM#388: It Makes No Difference Now- Calcium Channel Blocker or Beta Blocker for Atrial Fibrillation with Rapid Ventricular Response & Heart Failure with Reduced Ejection Fraction

The Skeptics' Guide to EM

Date: January 4th, 2023 Reference: Hasbrouck et al. Acute management of atrial fibrillation in congestive heart failure with reduced ejection fraction in the emergency department. AJEM 2022 Guest Skeptics: Dr. Timlin Glaser currently a fourth-year resident in emergency medicine at Lehigh Valley Health Network and future medical toxicology fellow at the University of Arizona College of Medicine – […] The post SGEM#388: It Makes No Difference Now- Calcium Channel Blocker or Beta Blocker for Atrial

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Imaging Case of the Week 536

EMergucate

The following chest x-ray is from a 45 year old with chest pain. What can be noticed?

EMS 52
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EMCrit Shadowboxing Case 3 – Chicken or Egg – Which Organ Failed First?

EMCrit

Shadow Boxing Respiratory Failure Case EMCrit Project by Scott Weingart, MD FCCM.

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Abrams – ECMO for Respiratory Pandemics

University of Maryland CC Project

Darryl Abrams, MD is an Associate Professor of Medicine and a medical intensivist and ECMO attending at NewYork-Presbyterian/Columbia University Irving Medical Center. He is the Associate Medical Director and Director of Research of the Medical ECMO Program at the Center for Acute Respiratory Failure, as well as Medical Director of Intermediate Care and Pre-Critical Care Services.

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How to present your research in style

RCEM Learning

The post How to present your research in style appeared first on RCEMLearning.

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Imaging Case of the Week 535 Answer

EMergucate

The hand x-ray shows: evidence of impaction fracture in the distal radius.

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How point-of-care Ultrasound would change management of critically ill patients?

University of Maryland Department of Emergency Med

Title: The Impact of Thoracic Ultrasound on Clinical Management of Critically Ill Patients (UltraMan): An International Prospective Observational.

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EMCrit 341 – AVAPS (Average Volume Assured Pressure Support) NIPPV with Alex Bracey

EMCrit

Today, we speak about a mode of NIPPV that you should know about (but probably don't): AVAPS EMCrit Project by Scott Weingart, MD FCCM.

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Emergency Evidence Updates – December 2022

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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Imaging Case of the Week 534 Answer

EMergucate

The hand X-ray shows- dislocated thumb carpometacarpal joint.

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Dont act your age

University of Maryland Department of Emergency Med

Humor me and imagine that your birth certificate vanished, and your age was based on the way you feel inside. How old would you say you ar.

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Lab case 394

EMergucate

14-year-old girl, COVID day 2, presented with delirium. Her venous blood gases showed the following: Ph = 7.

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Lab case 393 interepretation

EMergucate

PH = 7.28, that is moderate acidaemia. PCO2 = 73 mmHg. This means we have respiratory acidosis.

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Critical Care Evidence Updates – December 2022

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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