Sat.Sep 23, 2023 - Fri.Sep 29, 2023

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Safety Culture in Healthcare Settings

NIOSH Science Blog

As of 2019, more than 18 million people, 11.5 % of the United States workforce, were employed in healthcare settings. Everyday healthcare workers face hazardous work conditions due to exposures to infectious agents and hazardous drugs and chemicals.

Outcomes 108
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ECG Blog #397 — An Unusually Long Cycle?

Ken Grauer, MD

You are asked to interpret the ECG in Figure-1. What is the rhythm in ECG #1 ? Figure-1: You are asked to interpret this tracing. What is the rhythm? MY Thoughts on the ECG in Figure-1: I routinely begin assessment of each 12-lead ECG I encounter — with interpretation of the rhythm. To do this — I apply the P s, Q s, 3 R Approach ( See ECG Blog #185 — for review of my system ).

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Delayed sequence intubation: An RCT

First 10 EM

Introduced to the world by our friend Scott Weingart, delayed sequence intubation (DSI) is often summarized as procedural sedation for the procedure of preoxygenation. (Weingart 2011, Weingart 2015) It is a brilliant concept, makes a ton of sense on paper, and anecdotally has seemed to help a number of my patients. However, any long time […] The post Delayed sequence intubation: An RCT appeared first on First10EM.

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STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

RebelEM

Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact. In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. In these cases, thrombolysis is recommended to improve morbidity and mortality. The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a phar

EKG/ECG 138
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Will A.I take over the World?!

Critical Care North Hampton

In this video, my great friend and fellow editor Dr Marcus Peck, talks us through the world of A.I in POCUS! Let’s face it, our kids are using it to write essays, the military uses it and you can’t seem to be able to speak to a human being on the phone as companies are.

Military 136
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Getting everyone to sing in harmony

Don't Forget the Bubbles

This talk, from Clare Skinner, on music, medicine and leadership , comes from our 2022 DFTB conference in Brisbane. [link] Years ago, before I became a medical student, I heard Professor Michael Field , Associate Dean of Medical Curriculum at the University of Sydney, nephrologist, and an accomplished flautist, being interviewed about his love of music on ABC Classic FM.

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Very fast regular tachycardia: 2 ECGs from the same patient. What is going on?

Dr. Smith's ECG Blog

This was written by Magnus Nossen, from Norway, with comments and additions by Smith A 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. An ECG was recorded immediately and is shown below. How do you interpret the ECG? ECG#1 There is a regular tachycardia with a ventricular rate of about 180 bpm.

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Journals That Ban Replications--Are They Serious Scholarly Outlets At All?

Sensible Medicine

We are living in a time of growing distrust in science and scientific institutions. According to a 2022 Pew surve y, “Trust in scientists and medical scientists, once seemingly buoyed by their central role in addressing the coronavirus outbreak, is now below pre-pandemic levels. Overall, 29% of U.S. adults say they have a great deal of confidence in medical scientists to act in the best interests of the public, down from 40% who said this in November 2020.” Subscribe now At the same

Research 128
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Let’s Natriurese not diurese!

Critical Care North Hampton

We obsess with diuresis in our critically ill patients with positive fluid balances. But are we doing a dis-service? The focus should perhaps be on natriuresis…but how? The evidence is out there suggesting a positive fluid balance is detrimental to overall outcomes in ICU.

Outcomes 128
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A man in his 40s with acute chest pain. What do you think?

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers, reviewed by Smith and Grauer A man in his 40s presented to the ED with HTN, DM, and smoking history for evaluation of acute chest pain. He was eating lunch when he had sudden onset chest pressure, 9/10, radiating to his back, with sweating and numbness in both hands. Triage ECG: What do you think? It's a very "fun" ECG, with initial ectopic atrial tachycardia (negative P waves in inferior leads conducting 1:1 with the QRSs), followed by spontaneous r

EKG/ECG 127
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Virtual Reality Headset Takes EEG Measurements

Medagadget

Researchers at the University of Texas at Austin have developed an electroencephalogram (EEG) sensor that is incorporated into a virtual reality headset. The technology can measure brain activity while someone is undergoing an immersive virtual reality experience. The device may assist in enhancing medical virtual reality interventions, such as those used to treat post-traumatic stress disorder or phobias, by revealing brain activity during different tasks or experiences that help clinicians to

Research 119
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PulmCrit Hot Take: Aggressive glycemic control is dead (TGC-Fast Trial)

EMCrit

background Today the Van de Bergh group in Belgium released a RCT investigating tight versus liberal glycemic control in the ICU. Before diving into this study, let's take a walk down memory lane. Major interest in tight glycemic control in the ICU began in 2001 with an RCT by the same group of investigators, also […] EMCrit Project by Josh Farkas.

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29 September: The World Heart Day

Emergency Live

World Heart Day: prevention is our best defence Every year, on 29 September, the world comes together to celebrate World Heart Day, an event dedicated to raising awareness of cardiovascular disease, one of the leading causes of death globally. This day aims to promote awareness of the risk factors associated with heart disease and encourage […] The post 29 September: The World Heart Day appeared first on Emergency Live.

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Proportionality and Serial ECGs Make the Diagnosis. What does the Queen say?

Dr. Smith's ECG Blog

This case comes from Jason Winter, of The Facebook Clinical Electrocardiology ECG Page. A 60-something woman called EMS for chest pain. Here is her first prehospital ECG: What do you think? There is very low voltage in the precordial leads, with a total QRS amplitude of only 3.5 mm in V2 and 4 mm in V3. In spite of this low voltage, there is ST elevation (as measured at the J-point and relative to the PQ junction, and as measured by the computer and shown on the right), of 0.54 mm in V2 and 0.65

EKG/ECG 126
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Ep 187 Crashing Anaphylaxis – AMAX4 Algorithm and The Max McKenzie Case

Emergency Medicine Cases

I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma. The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framewor

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In The Next Trauma MedEd Newsletter: Weird Stuff

The Trauma Pro

The September issue of the Trauma MedEd newsletter will be sent out soon! It’s chock full of interesting stuff! This issue will be released on September 30. If you are already a subscriber, or if you sign up any time before then, you will receive it, too. Otherwise, you’ll have to wait until it goes out to the general public a week or so later.

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Taking A Dive Into Diverticulitis

EM Ottawa

You are treating a 43-year-old male with two days of left lower quadrant abdominal pain, a documented fever of 38.4 and malaise. He has no urinary or bowel symptoms. His past medical history is unremarkable. He looks well by ED standards. After a focused history and physical examination, you narrow the differential to diverticulitis. You […] The post Taking A Dive Into Diverticulitis appeared first on EMOttawa Blog.

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Which patient has the more severe chest pain?

Dr. Smith's ECG Blog

2 middle aged males presented with chest pain. Which had the more severe chest pain at the time of the ECG? Here is the ECG of patient 1 , recorded about 2 hours after pain onset: A Massive Anterolateral STEMI/OMI Peak troponin I over 60,000 ng/L Here is the ECG of patient 2 , recorded about 2 hours after pain onset: This is OMI, but it is not STEMI Peak troponin I 440 ng/L Patient 1 at the top with the massive ST Elevation complained of 5/10 chest pain at the time the ECG was recorded.

EKG/ECG 116
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Intermittent Fasting

Sensible Medicine

I’ve been hearing a lot about intermittent fasting as an approach to weight loss lately. This comes from physicians, patients, and celebrities. I never pay attention to this kind of chatter because, as I have written , I think weight loss advice (outside of GLP-1s and bariatric surgery) arises from a data free zone. However, I’ve realized that intermittent fasting serves as a good example from which to discuss the complexities of actually practicing medicine according to evidence-bas

Research 112
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Day 1 RCEM Annual Scientific Conference: Glasgow 2023. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Day one of the RCEM annual scientific conference in Glasgow 2023. Highlights and summaries of some the talks. #FOAMed @stemlyns The post Day 1 RCEM Annual Scientific Conference: Glasgow 2023. St Emlyn’s appeared first on St.Emlyn's.

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Over 260 exhibitors from Italy and 21 other countries at REAS 2023

Emergency Live

The REAS 2023 international exhibition, the major annual event for the emergency, civil protection, first aid and firefighting sectors, is growing The 22nd edition, which will take place from 6 to 8 October at the Montichiari Exhibition Centre (Brescia), will see an increase in the participation of organisations, companies and associations from all over the […] The post Over 260 exhibitors from Italy and 21 other countries at REAS 2023 appeared first on Emergency Live.

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Refillable Device for Drug Delivery Past the Blood-Brain Barrier: Interview with Mike Maglin, CEO at CraniUS

Medagadget

CraniUS , a medtech company based in Baltimore, has developed the NeuroPASS drug delivery system. The technology is designed to deliver drugs to the brain, and it can bypass the blood-brain barrier. This layer of specialized endothelium significantly restricts which drug molecules can enter the brain, normally greatly limiting treatment options for patients with brain-based disease.

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Choosing a Control Group

Sensible Medicine

You had two choices in the lottery for senior science class. Mr. Flexner taught science in the old way. As a reductionist, he had his students learn basic physiology as that would explain human disease. If you did the work, which was hard, you got a good grade. Mrs. Onderdonk focused on the mechanics of science. Her students actually did science. They thought about questions; designed experiments to answer these questions, and assessed the results.

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Equality and global health. What I learned from being a recovering racist… 2023 update. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Stevan @codingbrown gives us insights into his experiences and journey in emergency care and the impact of institutionalised racism that exists. #FOAMed @stemlyns The post Equality and global health. What I learned from being a recovering racist… 2023 update. St Emlyn’s appeared first on St.Emlyn's.

EMS 105
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Technology and interoperability for emergency management

Emergency Live

Sinora Srl takes the field at the 2023 edition of REAS with the latest mission- and business-critical technology at the service of industry operators The 22nd International Emergency Exhibition is just around the corner. A regular appointment for Sinora Srl at the Montichiari Exhibition Centre in the province of Brescia, to show organisations, voluntary associations, […] The post Technology and interoperability for emergency management appeared first on Emergency Live.

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REBEL Core Cast 109.0 – Na Channel Blocker Poisoning

RebelEM

Take Home Points: In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. A newly “wide QRS”, especially with hemodynamic instability, should prompt consideration of sodium channel blockade and not ventricular tachycardia. Treatment is guided by administration of sodium-bicarbonate. Recall that the resultant alkalemia driven by sodium-bicarbonate will shift potassium intracellularly.

Poisoning 105
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Implantable Bioreactor for Kidney Cells

Medagadget

Researchers at the University of California San Francisco have developed an implantable bioreactor that may pave the way for artificial kidneys. Dialysis and kidney transplants both have significant disadvantages for patients with kidney failure, and so scientists are trying to develop a lab created kidney that would not require harsh immunosuppression or a donor kidney.

Research 105
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Day 2 RCEM Annual Scientific Conference: Glasgow 2023. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Chris Gray and the team review the second day of the RCEM Annual Scientific Conference in Glasgow #FOAMed @stemlyns The post Day 2 RCEM Annual Scientific Conference: Glasgow 2023. St Emlyn’s appeared first on St.Emlyn's.

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REAS 2023: Driver of the Year Trophy

Emergency Live

Celebrating Everyday Heroism: REAS 2023 Honours the Angels of the Road In the heart of autumn, in the first week of October to be precise, the emergency ecosystem in Italy will experience a moment of sharing, learning and recognition. The scene will be REAS, Salone Internazionale dell’Emergenza, which for the 2023 edition will open its […] The post REAS 2023: Driver of the Year Trophy appeared first on Emergency Live.

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Twists and Turns: Identifying Maisonneuve Fractures in the ED

Taming the SRU

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. In fact, it’s been estimated that approximately 20% of all ED visits are musculoskeletal in origin. (1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. This places a significant responsibility on the EM physician to diagnose and treat fractures.

Fractures 101
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Couldn’t Find a Catchy Title, But We Tri(fascicular)ed

Kings County Downstate EM

Co-authors: Balal Aslam MD, Esteban Davila MD Edited by: Alec Feuerbach MD Case: An 82-year-old female with a past medical history of diabetes and hypertension presented to the ED after a syncopal episode. The patient stated that she was walking to the shower when she felt weak, had a “strange […] The post Couldn’t Find a Catchy Title, But We Tri(fascicular)ed appeared first on County EM.

EMS 98
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Podcast: July/August 2023. St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Our regular round up of the best of the blog and podcast from July and August 2023. Lots to talk about this month. Trauma, burnout, prehospital care, HALO procedures, paediatric … Podcast: July/August 2023. St Emlyn’s Read More » The post Podcast: July/August 2023. St Emlyn’s appeared first on St.Emlyn's.

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Campi Flegrei earthquake: no significant damage, but concern grows

Emergency Live

Nature awakens in the supervolcano area after a series of tremors During the night of Wednesday 27 September, nature decided to break the silence with a loud roar that shook the Campi Flegrei area. At 3.35am, an earthquake of magnitude 4.2 hit the region, marking the most intense seismic event in the last forty years […] The post Campi Flegrei earthquake: no significant damage, but concern grows appeared first on Emergency Live.

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Instructors' collection ECG: Pediatric ECG: One month old infant

ECG Guru

The patient: 4 week old female infant with past medical history of meconium aspiration at birth with APGAR scores of 2,4,6. Intubated and given nitric oxide for pulmonary hypertension. Weaned in NICU over 10 days. Echocardiogram during that time showed stiff pulmonic valve. This ECG was obtained at follow up appointment. Infant is eating well, no cyanotic spells.

EKG/ECG 98
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Interview Tips for Trainees From a Program Director

SheMD

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. This post contains affiliate links. SheMD will make a commission at no extra cost to you should you click the link and make a purchase. Read our disclosure for more info. It was Malcolm Gladwell who proclaimed that practicing anything for more than 10,000 hours allows one to become an expert.

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The Job Market in Emergency Medicine: Perspectives of Graduating Residents in 2023

ACEP Now

The emergency medicine workforce is an important issue with ramifications for physicians relocating or retiring, medical students considering the specialty, and graduating residents seeking their first jobs. In August 2021, an article published in the Annals of Emergency Medicine projected a surplus of more than 7,800 emergency physicians in 2030 based on multiple scenarios, including patterns of supply and demand for emergency physicians at that time. 1 The workforce in emergency medicine is c

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PioneerLab: New Airbus Helicopters Laboratory

Emergency Live

The lab will test technologies to reduce emissions, improve autonomy and integrate eco-friendly materials Airbus Helicopters, a global leader in aviation innovation, proudly announced the unveiling of its latest breakthrough, the PioneerLab, during the German National Aviation Conference in Hamburg. PioneerLab, a technology demonstrator built upon the H145 platform, reinforces Airbus’ commitment to pioneering advancements […] The post PioneerLab: New Airbus Helicopters Laboratory app

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