The Trauma Pro
JUNE 21, 2024
The VIP syndrome occurs in healthcare when a celebrity or other well-connected “important” person receives a level of care that the average person does not. This situation was first documented in a paper published in the 1960s, which noted that VIP patients have worse outcomes. Who is a VIP? It may be a celebrity. A family member. Or even a colleague.
Pediatric EM Morsels
JUNE 21, 2024
The management of pediatric thermal burns always seems to be a hot topic , whether we are caring for a little future chef who splashed a scalding microwaved noodle cup on himself, or a toddling youngster who pulled a pot of boiling water on herself. Or maybe you have the adventurous adolescent who was a little too aggressive with the lighter fluid before igniting the campfire.
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Dr. Smith's ECG Blog
JUNE 17, 2024
Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. What do you think? If this EKG were handed to you to screen from triage without any clinical information, what would you think?
Sensible Medicine
JUNE 15, 2024
In prior posts, I was critical of the culture among trainees. One essay described the phenomenon of calling in fake sick. Another asked what the balance is between accommodation and the rigors of the job. These essays were about the effort, dedication and professionalism of trainees. Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.
Science Based Medicine
JUNE 16, 2024
When conference organizers told me not to make my talk "political", they were really saying there were certain people and ideas I wasn't allowed to criticize. I didn't get it at the time. I get it now. The post I’ve Been Silenced, Censored, and Cancelled. The Reason Why Matters. first appeared on Science-Based Medicine.
Don't Forget the Bubbles
JUNE 19, 2024
Why is this study needed? Cervical spine injuries are a rare but serious finding following blunt trauma, affecting around 1-2% of presentations. In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR).
EMCrit
JUNE 17, 2024
introduction Bilevel Sequence Intubation (BSI) refers to initiation of noninvasive bilevel positive pressure ventilation with a backup rate prior to intubation (either using a BiPAP machine or a full-featured mechanical ventilator). BSI is distinct from traditional rapid sequence intubation (RSI), since BSI involves the delivery of machine-initiated, pressure-controlled breaths following administration of sedation and paralytics. […] EMCrit Project by Josh Farkas.
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Science Based Medicine
JUNE 17, 2024
A few months ago, I wrote about how antivaxxers misrepresent vaccine safety studies to portray vaccines as dangerous, using a large study of outcomes in adults as an example. They're doing it again, but this time it's a large study of COVID-19 vaccines in children. The post How antivaxxers weaponize vaccine safety studies to falsely portray vaccines as dangerous, part 2: The children first appeared on Science-Based Medicine.
Emergency Medicine Cases
JUNE 18, 2024
Dr. Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg. acute Q waves or loss of R waves, hyperacute T waves, or reciprocal STD/TWI) and if the ECG is nondiagnostic, consider other OMI signs including clinical (refractory isc
The Trauma Pro
JUNE 18, 2024
Early resuscitation, particularly with blood products in patients with hemorrhage, is literally a lifesaver. As each minute ticks by, survival slowly diminishes. To facilitate this, massive transfusion protocols (MTP) have been designed to rapidly deliver sizable quantities of blood products to the trauma resuscitation bay. One of the recurring issues I see at trauma centers is the lack of a reliable way of activating the MTP.
St. Emlyn
JUNE 18, 2024
St.Emlyn's - Emergency Medicine #FOAMed Does the use of non invasive ventilation prior to intubation of critically ill patients improve outcomes? The post Noninvasive Ventilation for Preoxygenation during Emergency Intubation appeared first on St.Emlyn's.
Science Based Medicine
JUNE 18, 2024
The Ancient Egyptian Book of the Dead depicts a scene in which a bowel of golden rice is weighed against the feather of truth. The post Save the Whales, Blind the Children first appeared on Science-Based Medicine.
Don't Forget the Bubbles
JUNE 17, 2024
The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU.
Emergency Live
JUNE 20, 2024
A Critical Situation India has been struck by a wave of extreme heat, reaching record temperatures in several cities, including New Delhi, which recorded 52.3°C, surpassing the historic measurement of 50°C. This phenomenon is just one of the symptoms of the climate crisis gripping the subcontinent, influenced by the global phenomenon of El Niño. The […] The post Extreme Heat in India: Climate Crisis Hits Hard appeared first on Emergency Live.
St. Emlyn
JUNE 20, 2024
St.Emlyn's - Emergency Medicine #FOAMed Learn about Sudden Arrthymic Death Syndrome in children. Listen to the podcast recorded live at the Premier Conference 2024. The post Podcast – Sudden Cardiac Death Syndrome appeared first on St.Emlyn's.
Science Based Medicine
JUNE 21, 2024
Do tattoos cause lymphoma? A new study that says "maybe?" is making the rounds but I wouldn't worry too much. The post Will Your Tattoo Give You Cancer: Probably Not…but Maybe? first appeared on Science-Based Medicine.
American Medical Compliance
JUNE 21, 2024
The Department of Health and Human Services (HHS) estimated that improper payments in the Medicare and Medicaid programs exceeded $100 billion from 2016 to 2023. Fraud, waste, and abuse (FWA) in healthcare present significant challenges, causing substantial financial losses, eroding public trust, and compromising the quality of patient care. Moreover, as frontline defenders of the healthcare system, healthcare providers play a crucial role in preventing these issues.
Emergency Live
JUNE 19, 2024
Practical Tips for a Beach Vacation Without Risks Summer vacations are the perfect time to enjoy the sea and sun, but it’s important to prioritize water safety. Whether you’re an experienced swimmer or a beginner, following a few simple rules can make the difference between a carefree day and a potentially dangerous incident. In this […] The post Safety at sea: how to protect yourself while on vacation appeared first on Emergency Live.
EMCrit
JUNE 18, 2024
REVISE is the latest multicenter RCT on the use of PPIs for GI prophylaxis in critical illness. I would view this as the triquel following SUP-ICU and PEPTIC. In order to understand REVISE in context, let's briefly review SUP-ICU and PEPTIC trials, before discussing REVISE. Part I: SUP-ICU (2018) This was a large multicenter RCT […] EMCrit Project by Josh Farkas.
Science Based Medicine
JUNE 19, 2024
We can add decaffeinated (decaf) products to the list of things you probably shouldn’t worry about but someone wants to make you worry anyway. You may have read recently that some decaf coffee and tea brands have “chemicals” in them that may be a health risk. The real story, as you might imagine, is more complicated. The cause of the recent headlines […] The post The Decaf Wars first appeared on Science-Based Medicine.
The Skeptics' Guide to EM
JUNE 15, 2024
Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program.
Emergency Live
JUNE 19, 2024
The increase of ticks in Europe Ticks pose a growing public health problem in Europe, with a significant rise in their prevalence in recent years. This phenomenon is mainly due to climate change, which is altering the habitats and habits of these parasites. Reports and health consequences Ticks are particularly active during the warm months, […] The post Rise of ticks in Europe: the risks and how to prevent them appeared first on Emergency Live.
EMCrit
JUNE 18, 2024
All the literature goodness for June 2024 EMCrit Project by Scott Weingart, MD FCCM.
Science Based Medicine
JUNE 20, 2024
Amazon has implemented new quality standards for some dietary supplements. The post Amazon goes where the FDA does not first appeared on Science-Based Medicine.
ACEP Now
JUNE 18, 2024
ACEP Now is looking for its next resident to join our editorial team. The position is open to any emergency medicine resident physician in an ACGME-accredited program who will be PGY2–4 during the July 2024–July 2025 Resident Fellow term. Responsibilities include: Regularly promote ACEP Now articles via social media, including Twitter and Facebook. Author or curate 4 Resident Voice columns during the 12-month position.
Emergency Live
JUNE 19, 2024
Hynaero leverages ONERA’s expertise in developing the Fregate-F100, a Franco-European amphibious water bomber aircraft HYNAERO, the Bordeaux-based start-up, and ONERA (Office national d’études et de recherches aérospatiales) have signed a memorandum of understanding (MoU) to collaborate on the development of the new generation amphibious water bomber aircraft, the Fregate-F100.
EMCrit
JUNE 15, 2024
more on PREOXI EMCrit Project by Scott Weingart, MD FCCM.
Sensible Medicine
JUNE 21, 2024
This is the fourth and final of our essays on power. The first three are here and here. I’ve been thrilled to feature some of our readers. We hope you have enjoyed these. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber. “I’m nervous. I don’t know what will happen.” I, then a 50-year-old associate professor of medicine, said those words over the phone to a friend late one night in
First 10 EM
JUNE 17, 2024
Maximizing your productivity and impact is hard. The A.D.D. framework: Automate, Deprecate, and Delegate, identifies strategies that can be implemented to scale your impact in research and beyond. This is a guest post by Dr. Ross Prager, which was also posted on his blog at resub.app, but that I should would be useful to readers […] The post Improving Productivity: Implementing the A.D.D. framework appeared first on First10EM.
Emergency Live
JUNE 18, 2024
Airbus Helicopters Introduces the H160: Innovation and Versatility in the Aviation Landscape On June 14, 2024, Airbus Helicopters unveiled the first H160 helicopter delivered in Italy at its headquarters in Trento. The buyer, Air Corporate – the launch customer for the H160 in Italy – further bolsters its fleet with this delivery. This helicopter, the […] The post Airbus presents first H160 delivered to Italy in Trento, Italy appeared first on Emergency Live.
Dr. Smith's ECG Blog
JUNE 21, 2024
A patient in the ICU with significant underlying cardiac disease [HFrEF 30%, non-ischemic cardiomyopathy, LBBB s/p CRT-D (biventricular pacer), AVNRT s/p ablation a few yrs ago, hx sinus tachycardia while on max tolerated BB therapy] went into a regular wide-complex tachycardia after intubation for severe COPD exacerbation. Here is the ECG: Regular Wide Complex Tachycardia at a rate of 166 bpm.
Sensible Medicine
JUNE 16, 2024
David Cohen is one of the smartest docs on Twitter. I learned a bunch talking with him. The procedure called transcatheter aortic valve implantation or TAVR is a damn miracle. In days of old, a heart surgeon would have to saw open the chest and cut out the heavily calcified immobile aortic valve and sew in a new one. I watched a case as a young doctor and came away shocked that patients survive this surgery.
EMDocs
JUNE 15, 2024
We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: PREOXI RCT – Preoxygenation with Noninvasive Ventilation vs. Non-rebreather Mask Spoon Feed Noninvasive ventilation (NIV) was superior to a standard non-rebreather (NRB) oxygen mask for preoxygenation of critically
Emergency Live
JUNE 21, 2024
Medical Facilities and Specialized Personnel On Board Cruise ships are like floating cities equipped with state-of-the-art medical facilities to handle any health emergency. Each ship has a medical center with hospital beds, diagnostic equipment such as ECG and X-ray machines, and a well-stocked pharmacy. On board, there is always a team of healthcare professionals, including […] The post How Cruise Ships Handle Medical Emergencies appeared first on Emergency Live.
Emergency Medicine Journal
JUNE 20, 2024
Introduction With the rising use of immune checkpoint inhibitors ( ICIs ) in oncology, emergency physicians are increasingly confronted with their immune-related adverse events ( irAEs ). We described the types of irAEs presenting to the ED of a Belgian cancer centre and determined associations with the development of an irAE and other patient’s characteristics.
Emergency Medicine Cases
JUNE 18, 2024
In this month's EM Quick Hits podcast: Megan Landes on the importance of diagnosing HIV in the ED, Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion, Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient, Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis, Matt Pointer on the most lucrative side-gig, DIY investing.
EM Ottawa
JUNE 20, 2024
This case report demonstrates the utility of point-of-care ultrasound (POCUS) to identify complicated gallbladder disease. In this case, the patient presented with abdominal pain and a known history of cholelithiasis. POCUS demonstrated signs of small bowel obstruction and subsequently guided the decision to pursue radiology-performed imaging. Subsequently, the rare complication of Bouveret syndrome was identified. […] The post A Rolling Stone Without a Home: Bouveret Syndrome on PoCUS ap
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