The Trauma Pro

DECEMBER 6, 2024

The debate over incidental appendectomy has waxed and waned over the years. And for the most part, it has nearly permanently waned in general surgical cases for now. But every once in a while, I am asked about incidental appendectomy during trauma laparotomy. Is it a good idea? What reasons could there possibly be for doing it? In the old days, we would frequently do an incidental appendectomy because… well, just because we were there.

Operations 147

Operations Administration Wellness 147

Ken Grauer, MD

DECEMBER 6, 2024

EKG/ECG 326

EKG/ECG 326

EMCrit

DECEMBER 1, 2024

John Holcomb, author of the PROPPR trial, on massive transfusion in 2024 EMCrit Project by Scott Weingart, MD FCCM.

Resuscitation 127

Resuscitation 127

Science Based Medicine

DECEMBER 6, 2024

Doctors who gushed over RFK Jr. made their bed, and they'll lie in it. The post Dr. Vinay Prasad Sabotaging RFK Jrs Confirmation Will Increase Vaccine Hesitancy & Doctors Criticizing RFK Jr. Paved the Way for His Ascendancy first appeared on Science-Based Medicine.

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The Trauma Pro

DECEMBER 3, 2024

In my last post, I described the Pediatric Readiness Score and its components. Today, I’ll explain why maintaining a high score may benefit your trauma center and what it costs to do so. Research groups at the Oregon Health Sciences University and the University of Utah combined multiple data sources to estimate current levels of ED pediatric readiness, the cost to achieve it, the number of pediatric deaths in emergency departments, and the number of potential lives saved if readiness is m

Pediatrics 113

Pediatrics Emergency Department Research Hospitals 113

Dr. Smith's ECG Blog

DECEMBER 3, 2024

This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He had recently returned from overseas travel where these symptoms had been intermittently bothersome over the preceding weeks and had been attributed to heartburn.

EKG/ECG 96

EKG/ECG Burns Wellness Shock 96

EM Literature of Note

DECEMBER 4, 2024

The emergency department is a place of risk and errors. Those who work in the ED are acutely aware of this, and it conjures up tremendous cognitive pressures on staff every shift. Every ED clinician knows the most benign-appearing triage complaint may obfuscate lurking catastrophe. The vision changes that are actually an acute aortic dissection. A sore shoulder that is necrotizing fasciitis.

Emergency Department 92

Emergency Department Stroke Patient Safety Research 92

St. Emlyn

DECEMBER 2, 2024

St.Emlyn's - Emergency Medicine #FOAMed Uncover the truth about alcohol poisoning. Find out how toxic alcohols can be ingested accidentally or intentionally and the serious consequences they can have with a focus on Emergency medicine management. #FOAMed @stemlyns The post Toxic alcohol poisoning: What do we know about fomepizole, methanol and ethylene glycol?

Poisoning 91

Poisoning 91

Dr. Smith's ECG Blog

DECEMBER 6, 2024

A 50-something man presented with worsening severe exertional chest pain which was just resolving as he had an ECG recorded in triage. Time zero. Are the T-waves in leads I and II hyperacute? Hard to tell. How can we know? By the evolution of the ECG! Watch what happends as the heart recovers from its episode of ischemia. The T-waves deflate, demonstrating that the first one was indeed hyperacute. 2 hours T-waves in lead II are significant smaller In lead I not much difference Troponins returned

EKG/ECG 101

EKG/ECG 101

Science Based Medicine

DECEMBER 3, 2024

Yesterday, Dr. David Gorksi invited us to come up with questions for Senators to ask our future public health leaders. Here are mine. The post Questions For Senators to Ask Drs. Marty Makary and Jay Bhattacharya first appeared on Science-Based Medicine.

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EMDocs

DECEMBER 6, 2024

Authors: Haley Dusek, MD (Emergency Medicine Resident, Carolinas Medical Center ); Erik Fisher, MD (Emergency Medicine Attending/Medical Toxicologist, Carolinas Medical Center) // Reviewed by: Anthony Spadaro, MD (@TSpadaro91, Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK); and Brit Long, MD (@long_brit) Case: A 27-

Poisoning 74

Poisoning Fluid Resuscitation Seizures Resuscitation 74

The Skeptics' Guide to EM

NOVEMBER 30, 2024

Date: November 10, 2024 Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington's MEDEX program.

Administration 86

Administration CPR Airway Management Outcomes 86

Emergency Medicine Cases

DECEMBER 3, 2024

On this month's EM Quick Hits podcast: Ross Prager on TEE in cardiac arrest, Justin Morgenstern on nebulized ketamine for analgesia in the ED, Hans Rosenberg & Krishin Yadav on standardizing cellulitis management, Mathew McArther on latest studies on subcutaneous insulin protocols in DKA, Jennifer C. Tang on documenting differential diagnoses medicolegal tips.

Documentation/Coding 81

Documentation/Coding EMS Resuscitation 81

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

91

91

RebelEM

DECEMBER 4, 2024

Take Home points : If the patient is low risk with CHA 2 DS 2 -VASc (men < 2, women < 3), cardioversion is safe up to 48 hours from onset. In higher risk patients, we should reserve cardioversion unless there is clear onset less than 12 hours or the patient has been anticoagulated for 3 weeks. Consider anticoagulation in every patient with atrial fibrillation whether they are cardioverted or referred.

Emergency Department 103

Emergency Department Stroke EMS Shock 103

Core Medical Group

DECEMBER 3, 2024

This year's Core Cares Wrapped is here! See how our team has given back in 2024 and how we practiced this fundamental value this year.

78

78

First 10 EM

DECEMBER 2, 2024

Despite being widely talked about in glowing terms, the original WOMAN trial was clearly negative, with no benefit in their primary outcome, and no change in all cause mortality, and therefore no hint of benefit. (There is a lot of confusion about what disease specific mortality means when this paper is discussed, but it only […] The post WOMAN-2: TXA has no role in postpartum hemorrhage appeared first on First10EM.

Outcomes 74

Outcomes EMS 74

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

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81

Emergency Medicine Cases

DECEMBER 3, 2024

In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more.

EKG/ECG 86

EKG/ECG EMS 86

ALiEM

DECEMBER 3, 2024

A 26-year-old male with a past medical history of eczema presented to the Emergency Department with a rash for two days. The patient stated he first noticed a rash on his right arm that rapidly spread to his face, chest, and left arm. He reported having similar rashes before but never to this extent. The patient stated he was given Bactrim and amoxicillin about one month ago for another rash, though he was unsure of the diagnosis.

Academics 60

Academics Emergency Department Infectious Diseases 60

PEMBlog

DECEMBER 4, 2024

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast , we explore pertussis, also known as whooping cough – a disease that remains a public health challenge despite widespread vaccination efforts. We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates.

Pediatrics 52

Pediatrics PPE Wellness Infectious Diseases 52

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

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81

EM Ottawa

DECEMBER 5, 2024

Quantitative End-Tidal CO2 (ETCO2) was in vogue for a while, and seemingly some centres adopted it as standard of care, while others found that it did not make a significant clinical impact so it fell out of style and left to ‘practitioner preference’ With increasing experience and use, we have mounting evidence to do a […] The post Quantitative End-Tidal CO2 – the New Scoop appeared first on EMOttawa Blog.

Resuscitation 62

Resuscitation 62

ACEP Now

DECEMBER 6, 2024

By some definitions, you could call former Maryland state legislator Dan Morhaim, MD, FACEP, a retired emergency physician. He thinks of it as re-deployed. Dr. Morhaim spent more than two decades in the Maryland House of Delegates, fighting for legislation to protect health care workers and patients before his final legislative term ended in 2019. His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of

Emergency Department 52

Emergency Department Hospitals Wellness 52

Mind The Bleep

DECEMBER 6, 2024

Introduction The acute scrotum is a constellation of new-onset pain, swelling and/or tenderness of intra-scrotal contents (1). In this article, we will review the limited number of differentials. Please note that a single clinical feature is not the confirmatory to a particular differential but the whole clinical picture will need to be considered when making a diagnosis.

Documentation/Coding 52

Documentation/Coding Operations Ultrasounds Hospitals 52

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

Resuscitation 80

Resuscitation 80

St. Emlyn

DECEMBER 3, 2024

St.Emlyn's - Emergency Medicine #FOAMed In this podcast, Liz Crowe discusses the effect bad behaviour has on teams and ultimately patient safety. The post Podcast – ECMO in Trauma with Chris Bishop at Tactical Trauma 24 appeared first on St.Emlyn's.

Patient Safety 76

Patient Safety Shock Resuscitation 76

ACEP Now

DECEMBER 6, 2024

What does your program offer that residents cant get anywhere else? We see a high volume of critically ill patients within our department (approximately 210,000 visits per year). Our catchment area is extensive, including all of Delaware and portions of Maryland, New Jersey, and Pennsylvania. Our three campuses that we work at are within 35 minutes of each other and provide a diverse patient population.

EMS 52

EMS Wellness Hospitals 52

EMergucate

DECEMBER 3, 2024

The x-ray is from a toddler with fever and abdominal pain. What can be seen? Answer will be posted later.

EMS 52

EMS 52

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

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60

Sensible Medicine

DECEMBER 6, 2024

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48

ACEP Now

DECEMBER 6, 2024

A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. During initial assessment, an ECG was obtained and revealed ST-segment elevation (STE) in the inferior leads with ST depression anteriorly. FIGURE 1. Initial ECG demonstrating inferolateral ST segment elevation and anteroseptal depression, just prior to cardiac arrest.

Resuscitation 52

Resuscitation EKG/ECG Documentation/Coding COPD 52

Don't Forget the Bubbles

DECEMBER 2, 2024

Merry Christmas and Season’s Greetings! With millions of journal articles published yearly, it is impossible to keep up. An international team joining DFTB Bubble Wrap from Aghia Sophia Childrens Hospital ED , Athens, Greece, tell us what is new in thepaediatric literature Led by Spyridon Karageorgos, a Paediatrician enthusiastic about Paediatric Emergency Medicine, reducing antibiotic use in paediatric patients, and Medical Education.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Fractures 52

Life in the Fast Lane

DECEMBER 2, 2024

Chris Nickson ICM Clinical Refresher Course Returning to the clinical coalface after a prolonged absence is inherently challenging. The good thing is there are courses that can help you get back in the swing of things.

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52

Emergency Medicine News

DECEMBER 1, 2024

No abstract available

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49

ACEP Now

DECEMBER 6, 2024

A 46-year-old female with a prior medical history of asthma presented to the emergency department with shortness of breath and wheezing. After three DuoNeb treatments and 16 mg of dexamethasone, her wheezing improved; however, she continued to report shortness of breath on exertion. Given the persistent symptoms, a cardiac point-of-care ultrasound was obtained.

Emergency Department 52

Emergency Department Ultrasounds Hospitals Research 52

Thinking Critical Care

NOVEMBER 30, 2024

So over the years I’ve learnt invaluable stuff from each and every one of the colleagues I’ve managed to build a network with, and certainly I have learnt – and unlearnt – a lot from this guy. Here, Rory and I discuss the concept of interfaces that a group of us painstakingly crafted over the last year. So I hope this starts to spark some interest.

Shock 53

Shock Sepsis Resuscitation 53