Ken Grauer, MD

SEPTEMBER 6, 2024

You are shown the ECG in Figure-1 — told only that the patient had a “continuous" tachycardia. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? What is the differential diagnosis? — Treatment? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Thoughts on the ECG in Figure-1: The rhythm in Figure-1 — is a regular SVT ( S upra V entricular T achycardia ) at a rate just under 150/minute , without clear sign of sinus

EKG/ECG 248

EKG/ECG Administration Wellness Operations 248

The Trauma Pro

SEPTEMBER 6, 2024

Trauma professionals don’t always know everything. Sometimes we have to engage a specialist in the care of our patient. And unfortunately, we don’t always know which conditions demand immediate attention and which can wait. This can lead to overuse of our consultant colleagues and calls at inappropriate times. So what if we diagnose an injury in their area of expertise at 2 am?

Operations 257

Operations Hospitals Wellness 257

Science Based Medicine

AUGUST 31, 2024

I trust you'll have the intellectual integrity to play videos of these speakers. Anything less, would be misinformation and censorship. The post An Open Letter to the President of Stanford, Jonathan Levin: Don’t Censor Drs. Scott Atlas, John Ioannidis, Sunetra Gupta, Marty Marky, Monica Gandhi, Jay Bhattacharya, and Vinay Prasad. Amplify Their Voices. first appeared on Science-Based Medicine.

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Sensible Medicine

SEPTEMBER 5, 2024

The lay media is abuzz with stories about Elle Macpherson, who admits in a new memoir to declining chemotherapy seven years ago. Although precise details are not provided, it sounds like Ms. Macpherson had localized or regional breast cancer and underwent surgery. We learned something about the risks of commenting on the health of celebrities over a decade ago when an OpEd we published in Washington Post about former president George W.

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Outcomes Wellness 116

RebelEM

SEPTEMBER 2, 2024

Background: Emergency intubations present a unique set of challenges, particularly when dealing with heavily contaminated airways. Anesthesiologist, Dr. James DuCanto, developed the DuCanto catheter to enhance airway management in these high-stakes situations. The commonly used 14 Fr Yankauer catheter, with its smaller bore, may struggle to clear heavily contaminated airways effectively.

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Airway Management Outcomes EMS Research 116

Broome Docs

SEPTEMBER 3, 2024

Welcome to another month of nerdy journal jam goodness. This month Justin has served up an eclectic collection of evidence, ethics and educational excellence. As always – we have the full PDFs liked below and you can read more deep thoughts over at First10EM where Justin likes to inconvenience a lot of electrons in his pursuit of educational elegance.

Sepsis 109

Sepsis Emergency Department Outcomes Hospitals 109

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Written by Magnus Nossen — with edits by Grauer. The patient in today’s case is a 30-something female. She has no known previous medical history. Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. The ECG below was recorded by EMS. What is your assessment? ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm.

Seizures 106

Seizures EKG/ECG EMS Stroke 106

Science Based Medicine

SEPTEMBER 6, 2024

I suppose it's my turn to be called a fraudster, liar, perjurer, felon, grifter, stooge, imbecile, and maybe even murderer. What I won't get is a reasonable explanation as to why supposedly releasing a deadly virus was mass murder, but intentionally spreading it was a forgivable "policy position". The post Biosafety Now: Releasing The Virus Was Mass Murder.

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ACEP Now

SEPTEMBER 5, 2024

Jennifer J. Casaleto, MD, FACEP (North Carolina) Current Professional Positions: Emergency Medicine Physician, CirrusMD and Mid-Atlantic Emergency Medical Associates (MEMA); Adjunct Clinical Faculty Physician, Atrium Health’s Carolinas Medical Center Internships and Residency: Emergency Medicine Residency, Carolinas Medical Center (2003) Medical Degree: MD, Vanderbilt University School of Medicine (2000) Response Similar to most member organizations, ACEP experienced membership decline associate

Leadership 98

Leadership PPE EMS Wellness 98

Dr. Smith's ECG Blog

SEPTEMBER 5, 2024

Written by Magnus Nossen - Edits by Grauer and Smith The patient in today’s case is a woman in her 70s with a previous medical history of HTN and hyperlipidemia. She presented to an outside hospital after several days of malaise and feeling unwell. At the time of admission, her vital signs were normal. Heart rate was in the 80s. She had a very elevated troponin T at 12,335 ng/L at the time of presentation. ( This is a value typical for a large subacute MI, n ormal value 48 hours after myocardial

Shock 105

Shock EKG/ECG Hospitals Wellness 105

Sensible Medicine

SEPTEMBER 1, 2024

As seems to be the norm on Sensible Medicine these days, whenever John, Vinay, or I publicly disagree with one another, one of our readers chimes in to explain how all of us are off the mark. Today I am happy to post the latest comeuppance, this one by Dr. Thomas Huddle. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.

Academics 111

Academics Operations Hospitals Wellness 111

St. Emlyn

SEPTEMBER 3, 2024

St.Emlyn's - Emergency Medicine #FOAMed @LizCrowe2 gives us a fantastic critical appraisal of an EMJ paper discussing the patient experience in the emergency department. A qualitative study gives real insight into the patient experience. #FOAMed @stemlyns The post JC: The patient experience in the Emergency Department. appeared first on St.Emlyn's.

Emergency Department 95

Emergency Department 95

PulmCCM

SEPTEMBER 4, 2024

Jon-Emile S. Kenny MD [ @heart_lung ] Since its first description [1], the Venous Excess Ultrasound Score [VExUS] has received much research attention. Very simply, VExUS combines the size of the inferior cava [IVC] with Doppler patterns from the hepatic, portal and intrarenal veins. From these measures a score from 0 to 3 is given as a marker of increasing ‘venous congestion [VC].’ But what exactly does VC mean?

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

EMDocs

SEPTEMBER 4, 2024

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. This podcast on health equity and the impact of standardized clinical care pathways and decision support tools embedded in the electronic health record (EHR).

Pediatrics 82

Pediatrics Outcomes Operations Hospitals 82

EMCrit

SEPTEMBER 6, 2024

Learn about how to use ultrasound during cardiac arrest EMCrit Project by Scott Weingart, MD FCCM.

Ultrasounds 111

Ultrasounds 111

Science Based Medicine

SEPTEMBER 3, 2024

Myrna Mattaring, a retired scientist who worked in diagnostic labs, claims that COVID-19 vaccines caused a 1432% increase in cancer cases, a clearly impossible claim. Here I make a plea for examining such claims, including a much more famous and accepted one, with basic math. The post Quoth Myrna Mantaring: “US government data” confirms a “143,233% increase in cancer cases due to COVID vaccination”?

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First 10 EM

SEPTEMBER 2, 2024

The First10EM monthly (or I guess seasonal this time) wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the format means the focus is mostly on content […] The post The First10EM monthly wrap-up for summer 2024 appeared first on First10EM.

Academics 74

Academics 74

EMDocs

SEPTEMBER 3, 2024

Welcome to the emDOCs Videocast – please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today we focus on Andexanet versus 4F-PCC for reversal of DOAC-associated intracerebral hemorrhage (ICH). EBM Update: ANNEXA-1 and DOAC Reversal in ICH Article: Connolly SJ, Sharma M, Cohen AT, et al; ANNEXA-I Investigators.

Stroke 77

Stroke Outcomes Hospitals 77

EMCrit

SEPTEMBER 3, 2024

All the Resuscitation and Acute Critical Care goodness in the literature for September 2024 EMCrit Project by Scott Weingart, MD FCCM.

Resuscitation 86

Resuscitation 86

Science Based Medicine

SEPTEMBER 4, 2024

In our increasingly technological we are constantly exposed to radio frequency electromagnetic waves (RF-EMF). It would certainly be inconvenient, to say the least, if this ubiquitous and essential technology had negative health effects. But of course we would need to know if this were the case so that steps could be taken to fix it. Fortunately, a recent systematic review conducted by […] The post WHO Systematic Review of RF and Cancer first appeared on Science-Based Medicine.

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ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. Of that total, 120 million dollars were new loans taken out against the assets of the hospitals with interest rates around 10 percent. 1 Immediately after the purchase, the real estate holdings of the hospitals were spun off into a separate company owned by Paladin a

Hospitals 69

Hospitals Radiology Radiology Administration 69

NRC Health

SEPTEMBER 5, 2024

Brooke Howard, Vice President of Operations at Tidelands Health shares how the system's patient connections team embarked on a transformative journey to enhance the patient experience. The post Transforming patient experience through an innovative engagement center appeared first on NRC Health.

Operations 64

Operations 64

Sensible Medicine

SEPTEMBER 3, 2024

It is well-recognized that our commercial drug development process, a process that has led to so many nearly miraculous advancements, serves people with rare diseases poorly. Kate Edwards’ experiences are ones that I could not have guessed were possible. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.

Pediatrics 63

Pediatrics Poisoning Research Military 63

Science Based Medicine

SEPTEMBER 2, 2024

Using LLM tools to tackle AI-driven science misinformation head-on The post LLMs: Fighting Fire with Fire first appeared on Science-Based Medicine.

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Emergency Live

SEPTEMBER 6, 2024

Cagliari March 29, 2024 Nearly 40 years have passed since the 1985 experience with the three PMAs around the Basilica of Bonaria, on the occasion of Pope Wojtyla’s visit. In the meantime, after 14 years since Oct. 20, 1985, on March 29, 1999, Cagliari’s 118 service began. The occasional fact On the morning of March […] The post Happy Birthday One Hundred Eighteen of Cagliari appeared first on Emergency Live.

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Don't Forget the Bubbles

SEPTEMBER 5, 2024

With millions of journal articles published yearly, it is impossible to keep up. This time, Doctors from ‘The Bridge ‘ tell us what is new in the world of paediatric literature… The Bridge: Is a Post Graduate Doctor in Training (PGDiT) -led paediatric research forum in Yorkshire and Humber, UK, with the aim of bridging the gap in research access amongst PGDiT.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Life in the Fast Lane

SEPTEMBER 4, 2024

Mike Cadogan UCEM says No to Softness The Utopian College of Emergency for Medicine (UCEM) is proud to announce a new policy pertaining to the discipline of peri-departmental medicine. Until now, the softest admissions - such as the Patient Without Discernible Pathology (PWDP) - have been the toughest dispositions.

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ACEP Now

SEPTEMBER 4, 2024

ACEP state advocacy impacts the lives and careers of every emergency physician, every day. ACEP chapters continue to tally state legislative and policy wins by sharing their experience with public officials, and organizing bold campaigns on the issues that matter most. The ACEP advantage is unmistakable. Chapters across the country are seeing success when they leverage the relationships and expertise that only ACEP can provide.

Leadership 52

Leadership Emergency Department Teamwork Hospitals 52

Emergency Live

SEPTEMBER 5, 2024

The flames spread rapidly over rough terrain, defying any attempt to contain Mount Cimadors, once a lush green lung of Friuli, is now marked by deep scars. A fire, which was set off by lightning on 19 August, has devastated over 100 hectares of forest, leaving behind a lunar landscape and a community in distress. […] The post Fire on Mount Cimadors: 100 hectares burned appeared first on Emergency Live.

Burns 52

Burns 52

PHARM

SEPTEMBER 4, 2024

What happened to Max McKenzie Years ago I somehow got involved in a project called the Vortex Approach. A cognitive aid concept created by Melbourne anaesthetist Dr Nicholas Chrimes that aimed to improve doctors recognition and management of DIFFICULT AIRWAYS & in particular the Cannot Intubate Cannot Oxygenate scenario. A group of us pooled money to create a phone app whilst Nick created a website and designs out of his own money.

Anaphylaxis 52

Anaphylaxis Hospitals 52

Canadian EM

SEPTEMBER 3, 2024

Introduction Test result follow-up can be especially challenging in the Emergency Department (ED) due to its multiplicity of moving parts. ED physicians are under increasing pressure when treating patients due to the challenges of high volumes of patients, pressure for quick discharges in the face of space constraints, and complexities surrounding patient handover.

Emergency Department 52

Emergency Department 52

Board Bombs

SEPTEMBER 2, 2024

There are at least 2 can’t-miss-conditions here on this multiple choice question. The Dog Days of summer ended on Labor Day, so let’s start fall with a scary differential diagnosis of naming that can’t-miss neuro emergency! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here.

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Emergency Live

SEPTEMBER 5, 2024

An unmissable appointment for professional updating, from 4 to 6 October in Montichiari (Brescia) The summer that is coming to an end has reminded us how crucial it is to be prepared for emergencies. Forest fires have become an increasingly frequent and devastating threat, putting a strain on our territory and communities. To meet this […] The post REAS 2024: Your mission starts here!

Operations 52

Operations 52

ACEP Now

SEPTEMBER 2, 2024

I appreciate this article , and this is by no means meant to be a personal attack or discrediting the validity of the information contained in the article. I consult for a pharma company and disclose it whenever I speak or write about something related to that work. In this case, the Open Payments website shows that one of the authors has received over 128,000 dollars from Ceribell, a company that makes a POC EEG system.

Seizures 52

Seizures 52

PEMBlog

SEPTEMBER 2, 2024

In honor of the return of football season I decided to post this tune… Concussions are nothing to mess around about – and sometimes you don’t know you have one until a bit later. So a conservative plan involves resting until symptoms improve and following up with your doctor. No one knows if listening to “bro country” worsens symptoms.

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Mind The Bleep

SEPTEMBER 1, 2024

This article has been written with final year medical students in mind, deciding where to go for foundation training. As an FY2, it is one of the questions I get asked most by medical students. You might already have a clear idea of where they want to be, but if you don’t (or just want some advice/reassurance) then keep reading! Context: I have spent both years of my foundation training in a district general hospital (DGH) in the North East of England after studying at the University of Gl

Academics 52

Academics Hospitals Research 52

Emergency Live

SEPTEMBER 5, 2024

Despite warnings from meteorological and hydrological agencies, thousands of victims were hit The devastating floods that have hit Nigeria in recent months have highlighted serious shortcomings in the country’s emergency management system. Despite the warnings of meteorological and hydrological agencies, thousands of people have been left homeless and dozens have lost their lives.

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