Pediatric Education
AUGUST 27, 2023
Patient Presentation A resident was discussing a newborn who had been transferred from an outside facility for cyanosis. “The baby even had a snowman sign on his x-ray. I’ve only read about that because usually we get an echo so fast and already know what is happening. They think that baby was already having problems in utero so you could see the snowman so quickly after birth,” he said.
Ken Grauer, MD
AUGUST 26, 2023
The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. In view of this history — How would YOU interpret this ECG? Should the cath lab be activated? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).
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The Trauma Pro
SEPTEMBER 1, 2023
In my previous post, I reviewed a recent paper analyzing which geriatric patients were more likely to have care withdrawn after serious injury. The authors noted that those with significant limitations to daily living activities, increasing age and/or frailty, and ventilator dependence were major factors. Today’s paper was written by a multi-institutional group from several Ohio trauma centers.
Dr. Smith's ECG Blog
SEPTEMBER 1, 2023
A 50-something male had onset of chest pain 1 hour prior to ED arrival. It is constant, 9/10, left-sided CP that radiates into left arm and jaw. Endorses some associated SOB, but denies back pain, fever, cough, chills, leg swelling, or other new symptoms. Has never had this before. Takes metoprolol for HTN. Here is the triage ECG: What do you think?
Emergency Live
SEPTEMBER 1, 2023
Drones and VTOLs to the Rescue: The Future of Medical Emergencies Urban Air Mobility (UAM) is ushering in a new era in the fields of medical response, parcel delivery, and passenger transport by harnessing the potential of advanced air vehicles like drones and Vertical Take-Off and Landing (VTOL) aircraft. These innovative technologies offer faster and […] The post Urban Air Mobility (UAM): Transforming Healthcare and Beyond appeared first on Emergency Live.
Ken Grauer, MD
SEPTEMBER 1, 2023
The interesting rhythm shown in Figure-1 was obtained after Adenosine was given for a regular SVT ( S upra V entricular T achycardia ). How would YOU interpret this rhythm in Figure-1 ? Why are there so many shapes for the QRS complex in the long lead II rhythm strip? Figure-1: 12-lead ECG and long lead II rhythm strip obtained after Adenosine was given for a regular SVT rhythm.
The Trauma Pro
AUGUST 29, 2023
Traumatic injury is a continuum ranging from very minor to immediately fatal. The mortality rate along that continuum rises exponentially as the Injury Severity Score (ISS) increases. We long ago moved away from the philosophy of keeping someone alive at all costs to embracing the concept of quality of life. We have become more thoughtful about considering patient and family input in difficult cases.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Emergency Live
AUGUST 31, 2023
Rapid H2O Flood Barriers: A New and Innovative Solution to Flood Control They say that sometimes you have to fight fire with fire. But what about fighting water with water? In the realm of innovative flood control, the Rapid H2O flood barriers are making waves in the UK market. This ingenious system utilizes water as […] The post Fighting Water with Water: A Revolutionary Solution to Flooding appeared first on Emergency Live.
EM Literature of Note
SEPTEMBER 1, 2023
It’s a trick question – in the end, all of us have already lost. This is a short retrospective report evaluating, primarily, the Epic Sepsis Prediction Model, and the mode in which is deployed. The Epic SPM generates a “prediction of sepsis score”, calculated at 15 minute intervals, providing a continuous risk score for the development of sepsis.
RebelEM
AUGUST 30, 2023
Take Home Points Clinical presentation is very nonspecific; evaluate all patients presenting with back pain for infectious risk factors. Baseline labs should not guide diagnosis, but may assist in later management. MRI is key to diagnosis, obtain this imaging in all patients who raise clinical suspicion Patients with hemodynamic instability and neurologic compromise warrant empiric antibiotics.
NIOSH Science Blog
AUGUST 31, 2023
As the occupational safety and health community continues to combat very real and serious hazards, we are closing out the summer with a little fun. This summer Barbie and friends have recaptured national attention breaking box office records with movie ticket sales exceeding one billion dollars in just a few weeks. While Barbie’s first “job” in 1960 was as a fashion designer, she went on to hold over 200 jobs[1] across various industries (of course with the corresponding outfits and accessories)
Emergency Live
AUGUST 30, 2023
Takotsubo syndrome, also known as stress cardiomyopathy, is a temporary non-ischaemic cardiomyopathy that results from stressful and emotionally intense situations The post Stress cardiomyopathy: broken heart syndrome (or Takotsubo syndrome) appeared first on Emergency Live.
SheMD
AUGUST 31, 2023
When I started looking at where I wanted to spend my residency during the fourth year of medical school, I considered numerous factors, as every student does. Many of them are quite similar: location, quality or style of learning, fellowship options, benefits, personality fit, etc. However, not everyone is at the same place in life when they are matching.
ECG Guru
AUGUST 26, 2023
Does something about this ECG look "different" to you? This ECG shows a “classic” presentation of inferior-posterior M.I. when it is caused by a lesion in the right coronary artery (RCA). There are ST elevations in leads II, III, and aVF. Reciprocal ST depression is seen in Leads I and aVL. There is also reciprocal ST depression in Leads V1 – V3.
Don't Forget the Bubbles
AUGUST 28, 2023
Depending on the location of the mediastinal mass, lying a child flat or using a rapid sequence induction protocol may cause cardiorespiratory arrest. As clinicians, we need to be prepared. What causes a mediastinal mass? The mediastinum is the segment of the thorax that includes structures vital to life – the heart, major blood vessels, and the airway.
Emergency Live
AUGUST 30, 2023
The UK’s leading business event for the rotorcraft industry After the success of Helitech Expo 2022 which saw over 3,000 key buyers in attendance and 50 hours worth of unmissable content, we can now confirm the show will be returning on the 26th & 27th of September at the ExCeL London and we have some […] The post Helitech Expo 2023: Shaping the Future of Air Mobility appeared first on Emergency Live.
First 10 EM
AUGUST 28, 2023
This is a guest post by Dr. Katie Lin. Dr. Katie Lin is an Assistant Professor of Emergency Medicine at the University of Calgary, a Stroke Attending with the Calgary Stroke Program, and a critical care Flight Transport Physician with STARS Air Ambulance in Alberta. She completed her residency training and stroke fellowship in Calgary and a Masters of Public […] The post The Crashing Brain: Approach to the first 10 minutes appeared first on First10EM.
Science Based Medicine
SEPTEMBER 1, 2023
Has the first case of complete congenital Qi deficiency been diagnosed in Massachusetts? Is it possible to run a successful landscaping business without any meridians? Where can you get acupuncture and your car detailed at the same time? All these questions and more will be answered in today's post, which I completely made up. The post Science-Based Satire: TCM Experts Baffled by Man Born Without Meridians first appeared on Science-Based Medicine.
Taming the SRU
SEPTEMBER 1, 2023
IN-Flight Emergencies - utility of trauma pan-scans - Sepsis operations - bites and stings - Intro to reliability science In-Flight Emergencies WITH Dr. Urbanowicz Approximately 1 in 40 flights are affected by a medical emergency, yet <2% planes get diverted Most commonly due to syncope, headache, dizziness, and/or nausea/vomiting As a physician, you are not legally obligated to intervene on an in-flight medical emergencies in the US This does vary for international flights Aviation Medical
Emergency Live
AUGUST 29, 2023
Emergency Response Driver Simulator: A Safe and Effective Way to Train for Intersection Dangers Intersections contain several potential hazards and risks for an emergency driver. The driver must assess and negotiate an intersection without risking an accident. Potential hazards, which may be pedestrians or other road users hiding behind vehicles, can stress drivers when an […] The post Intersection Dangers – Emergency Response Drive Training With A Simulator appeared first on Emergency Liv
Sensible Medicine
AUGUST 30, 2023
Last week a friend sent me a link to an article in The Financial Times titled, MRI scan more accurate than blood test at diagnosing prostate cancer, UK study finds. I read the article, skeptically, thinking MRI as a screening test, come on. I thought it was a piece of churnalism until I read the study itself from BMJ oncology and realized that the real story was research article.
Core Medical Group
SEPTEMBER 1, 2023
In the heart of healthcare recruitment at CoreMedical Group, there's Michael - a Long-Term Care recruiter in the Travel Nursing division with a passion for the outdoors and a heart devoted to healthcare. As he navigates the intricate world of matching nurses with their dream assignments, his unique approach of personal experiences and professional drive shines through.
Science Based Medicine
AUGUST 28, 2023
Brave maverick doctors (i.e., quacks) have long tried to portray themselves as "innovators" challenging an ossified medical consensus for the good of patients. This tradition continues among COVID-19 quacks, in particular the Frontline COVID-19 Critical Care Alliance and its founders. The post Quoth quacks, “The medical consensus has changed before, making my quackery science!
Emergency Live
AUGUST 28, 2023
Renewing Air Rescue in Ireland: Bristow and the New Era of Search and Rescue for the Coastguard On 22 August 2023, Bristow Ireland officially signed a contract with the Irish government to provide search and rescue (SAR) services using helicopters and turboprop aircraft to serve the Irish Coast Guard. Starting in the fourth quarter of […] The post Bristow signs search and rescue contract in Ireland appeared first on Emergency Live.
Sensible Medicine
AUGUST 29, 2023
Listen now | An introduction to a podcast series comparing US and Danish public policy, with a focus on the many differences in COVID-19 response and vaccination policies
Taming the SRU
AUGUST 30, 2023
As the name would suggest, inflammatory markers are biological markers of, well, inflammation. They are used clinically to detect pathological inflammation or measure response to treatment [1-2]. Colloquially, “inflammatory markers” typically refer to laboratory tests that measure specific acute phase proteins (also known as “acute phase reactants”) [1-5]; however, this term is vaguely defined and can encompass any so-called “marker of inflammation,” including the test we commonly describe to pa
St. Emlyn
AUGUST 30, 2023
St.Emlyn's - Emergency Medicine #FOAMed Journal Club review of the ARREST trial showing that bypass to a cardiac arrest centre in London does not improve outcomes. #FOAMed #cardiology @stemlyns The post JC: The ARREST trial. Does bypass to cardiac arrest centres save lives? St Emlyn’s appeared first on St.Emlyn's.
Emergency Live
AUGUST 28, 2023
Wolff Parkinson White syndrome is a cardiac pathology due to an abnormal transmission of the electrical impulse between the atria and ventricles which can cause tachyarrhythmias and palpitations The post Abnormalities in the transmission of electrical impulses: Wolff Parkinson White Syndrome appeared first on Emergency Live.
Sensible Medicine
AUGUST 28, 2023
This weekend at the European Society of Cardiology, I watched Professor Paulus Kirchhof present results of the NOAH AFNET 6 trial, which is also published in the New England Journal of Medicine. I describe it here for two reasons: it is an example of well-conducted unbiased study, and it deals with an increasingly common problem of short-duration episodes of atrial fibrillation.
Science Based Medicine
AUGUST 30, 2023
COVID is still here, happily mutating, and we need to adapt to this new reality. The post Summer COVID Wave first appeared on Science-Based Medicine.
St. Emlyn
AUGUST 29, 2023
St.Emlyn's - Emergency Medicine #FOAMed Part 2 of our introduction to ultrasound use in the paediatric emergency department with @Dr_Pete_EmMed #USS @FOAMed #paediatrics The post Paediatric Point of care ultrasound: Big Kids playing with toys or the future of Paediatric emergency medicine? Part II appeared first on St.Emlyn's.
Emergency Live
AUGUST 27, 2023
The peritoneum is a thin, almost transparent, mesothelial serous membrane found in the abdomen that forms the lining of the abdominal cavity and part of the pelvic cavity (parietal peritoneum), and also covers a large part of the viscera contained within it (visceral peritoneum), while at the same time attaching them to the walls of the cavity (viscera ligaments) The post What is the peritoneum?
Dr. Smith's ECG Blog
AUGUST 30, 2023
Case sent by Logan Stark MD, written by Pendell Meyers A woman in her 70s presented with acute chest pain. It started 10 hours prior to arrival, then had improved, then recently returned. No prior ECG was available. Here is her triage ECG: What do you think? The ECG was sent to me with no information, and I replied "OMI". I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: V1 and V2 have abnormal STE, and V2 has a hyperacute T wave.
EMCrit
AUGUST 29, 2023
A deeper dive on accidental hypothermia in anticipation of my much awaited winter EMCrit Project by Scott Weingart, MD FCCM.
EMDocs
AUGUST 28, 2023
Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.
Emergency Live
AUGUST 26, 2023
Leriche syndrome is caused by chronic obstruction of the aortic bifurcation and characteristic symptoms include intermittent claudication or symptoms of chronic ischemia, reduced or absent peripheral pulses, and erectile dysfunction The post Aortic obstruction: overview of Leriche syndrome appeared first on Emergency Live.
ALiEM
SEPTEMBER 1, 2023
A 65-year-old male presented with chest and abdominal pain for three weeks. He endorsed a poor appetite and a weight loss of 16 kilograms in the last month. He denied fever, vomiting, diarrhea, and tarry stools and described having his usual bowel movements. Additional Images Physical Exam Vitals : BP 172/71; HR 127; T 35.9°C; O2 Sat 100% General : In acute distress Cardiovascular : Regular rate and rhythm; no murmur; bilateral upper extremity and lower extremity pulses palpable Gastrointestin
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