Sat.Jul 13, 2024 - Fri.Jul 19, 2024

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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.

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ECG Blog #439 — How Many Possibilities?

Ken Grauer, MD

How would YOU interpret the rhythm in Figure-1 — if you were sent this tracing without the benefit of any history? Figure-1: How would YOU interpret this rhythm? The "Quick" Answer: My initial thoughts on the rhythm in Figure-1 : The rhythm in Figure-1 is not completely regular. That said — the R-R interval for the first 5 beats looks regular. The R-R interval for the last few beats is shorter than this — but also regular.

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How Often Should My Trauma Multidisciplinary Performance Improvement Committee Meet?

The Trauma Pro

Every trauma center is required to have two specific committees: a multidisciplinary trauma performance improvement committee (PI) and a trauma operations committee (ops). However, a common question is, “How often do my committees need to meet?” Let’s start with your PI committee. The answer, of course, is “it depends.” There is no cookie-cutter, one-size-fits-all answer.

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JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Background – What do we already know about REBOA? In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.

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PREOXI Trial – Noninvasive Ventilation for Preoxygenation

The Bottom Line

In critically ill patients undergoing tracheal intubation does pre-oxygenation with non-invasive ventilation compared with pre-oxygenation with an oxygen mask reduce the incidence of hypoxemia during intubation?

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Infective Endocarditis

Don't Forget the Bubbles

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How Often Should My Trauma Operations Committee Meet?

The Trauma Pro

In my last post, I discussed how often your multidisciplinary trauma performance improvement committee (PI) should meet. As you know, one other mandatory committee is required of all trauma centers, the Trauma Operations Committee (Ops). In this post, I will: describe how often your operations committee should meet help you determine whether your two committees should meet on the same day or separately How Often?

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Providing Clarity Regarding the Regulation of Respirators Used in Health Care Settings

NIOSH Science Blog

A Discussion Paper, Streamlining Regulatory Oversight of Respirators Used in Health Care Settings will Improve Worker Protection, was recently published in the National Academy of Medicine’s NAM Perspectives journal by respiratory experts outside of the federal government. This paper highlights continued confusion amongst interested parties including health care organizations and manufacturers seeking approval regarding federal regulations and guidance on the use of air-purifying respirators (AP

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Two firefighters die in Matera: they were saving a family from flames

Emergency Live

In Nova Siri, Matera province, where two firefighters lost their lives while fighting a vegetation fire Yesterday afternoon in Nova Siri, Matera province, two firefighters lost their lives while engaged in extinguishing a vegetation fire. The victims, Nicola Lasalata and Giuseppe Martino, both 45 and originally from Matera, were part of the Policoro detachment.

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Vagal Maneuvers Simplified

Northwestern EM Blog

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Thinking in probabilities: eCPR edition

Critical Care Now

Reading Time: 3 minutes Extracorporeal cardiopulmonary resuscitation (eCPR) has been somewhat of a controversial topic in the intensive care community over the years, with observational and randomized controlled trials (RCTs) swinging the pendulum of scientific consensus back and forth from “hugely beneficial” to “expensive, without significant benefit”.

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Navigating Nerve Blocks: US-Guided Nerve Blocks Vs. Sub-Dissociative Ketamine

RebelEM

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Citizen-centered Disaster Preparedness - How B-prepared Empowers You!

Emergency Live

The new B-prepared, supported by the European Commission, promotes mutual assistance and cooperation through team-based gameplay Disasters, whether natural or human-made, pose significant challenges to communities worldwide. Educating and empowering citizens is crucial for mitigating impacts and ensuring safety and resilience. Supported by the European Commission, freshly started B-prepared is aiming to make a difference!

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Initial Resuscitation in ARDS

Northwestern EM Blog

Written by: Hart Edmonson, MD (NUEM ‘27) Edited by: David Adler, MD (NUEM ‘25) Expert Commentary by : Anthony J. Esposito, MD Expert Commentary Thank you to Drs. Edmonson and Adler for this infographic that concisely emphasizes key concepts for the recognition and initial management of acute respiratory distress syndrome (ARDS) in the Emergency Department.

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EMCrit ShadowBoxing – Casey Parker Rural Medicine Critical Care Case

EMCrit

A great rural medicine critical care cards case EMCrit Project by Scott Weingart, MD FCCM.

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But the INR is 3.2! Markers of Coagulation Status in Cirrhotics

Taming the SRU

Rout G, Shalimar, Gunjan D, et al. Thromboelastography-guided Blood Product Transfusion in Cirrhosis Patients With Variceal Bleeding. J Clin Gastroenterol 2019;54(3):255–62. This study was a single-center, prospective, open-label, randomized controlled trial of patients with cirrhosis and acute variceal bleeding. Patients were randomized to blood product resuscitation guided by either TEG parameters or conventional coagulation tests (INR, platelet count, and fibrinogen).

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Vacation first aid kit: your personal pharmacy on the road

Emergency Live

In order to have the best vacation and a well-deserved rest, you need to be prepared for anything. A well-stocked first aid kit can make the difference After a long period of work, a nice trip and a well-deserved vacation are ideal for relaxing and recharging. But in order to fully enjoy your vacation, it […] The post Vacation first aid kit: your personal pharmacy on the road appeared first on Emergency Live.

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Magnesium oil: Not so magical

Science Based Medicine

Despite the hype, there is no evidence to show magnesium oil is effective for any purpose. The post Magnesium oil: Not so magical first appeared on Science-Based Medicine.

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Which of these, if either, is OMI? Which of these underwent emergent angiography and PCI? Which should have?

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers Case 1: A man in his 50s presented with acute chest pain. Normal vital signs. Here is his ECG at triage: What do you think? Here's what Version 1 QOH thinks: It is diagnostic of acute LAD OMI, with the precordial swirl pattern. See this post if you dont know that pattern yet: Precordial Swirl -- 20 cases of Swirl or Look-Alikes Here was a repeat ECG done within 20 minutes (still with ongoing pain): It still looks like active OMI to me, but perhaps sli

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ToxCard – Novel Phenethylamines: 2-C and N-BOME

EMDocs

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Killer heat hits Mecca: how to cope with high temperatures

Emergency Live

Nearly 1,000 pilgrims have died in Saudi Arabia due to extreme temperatures. Once again, high temperatures are having a dramatic impact on human health Mecca: The carnage of high temperatures During the annual Hajj pilgrimage to Mecca, a tragic heat wave hit Saudi Arabia killing nearly 1,000 people. The extreme temperatures, which exceeded 50 degrees, […] The post Killer heat hits Mecca: how to cope with high temperatures appeared first on Emergency Live.

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Conspiracy Medicine

Science Based Medicine

Was COVID cooked up in a lab? Do “they” have a cure for cancer and are hiding it from the public? Do pharmaceutical companies make up diseases to market otherwise failed drugs? Did insurance companies scheme with infectious disease professional organizations to suppress treatments for chronic Lyme disease? Did the supplement industry lobby congress to weaken regulations of their own products?

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Research Roundup (July 2024)

First 10 EM

Some big and potentially practice changing articles this month. (I tend to read ridiculous articles in my free time, which I have had very little of, and so there are no intubation in outer space or highly philosophical papers about the language this month. Don’t worry, there is still a very bad joke.) BiPAP for […] The post Research Roundup (July 2024) appeared first on First10EM.

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Cerebral malaria: ED presentation, evaluation, and management

EMDocs

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EMCrit Follow-Up and Q&A – July 2024

EMCrit

Q&A for July 2024 EMCrit Project by Scott Weingart, MD FCCM.

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Aaron Siri vs. Stanley Plotkin on post-licensure safety monitoring of vaccines

Science Based Medicine

Vaccine scientist Stanley Plotkin coauthored a commentary on vaccine postlicensure studies. Antivax lawyer Aaron Siri tries to spin it as an "admission" that vaccines aren't safe. Predictable. The post Aaron Siri vs. Stanley Plotkin on post-licensure safety monitoring of vaccines first appeared on Science-Based Medicine.

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Invasive Group A Strep (iGAS). It’s Backkkkk (Part 2)

EM Ottawa

In case you missed it, in part 1 of this series, Dr. Zworth discussed the increasing prevalence of invasive Group A Strep (iGAS), the mounting public health concern, recognition, and diagnosis. In this post, we focus on management, the treatment of (strep) pharyngitis, and post-exposure prophylaxis. Take home #5: The four pillars of iGAS management […] The post Invasive Group A Strep (iGAS).

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A Useful Tool for Massive Airway Decontamination

PHARM

James DuCanto, MD, walks us through the essential steps of SALAD (suction-assisted laryngoscopy and airway decontamination) at the protected airway course. — Read on www.anesthesiologynews.

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The Cardiology Seminal Trial's series is well underway

Stop and Think

With age, I have come to appreciate the value of reading and knowing the evidence underpinning what we do in cardiology. The thing is that cardiology requires a lot of technical learning. To read images or perform procedures, you have to master specific tasks. Forging these neural pathways takes a lot of effort and time, especially for new learners.

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Drowning Deaths Continue Post-Pandemic Rise

Science Based Medicine

More people, mostly kids, are drowning these days, in no small part because of the pandemic. The post Drowning Deaths Continue Post-Pandemic Rise first appeared on Science-Based Medicine.

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Emergency Evidence Updates – June 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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"Toxic" quizzing: Is the attending mean or is the resident sensitive?

Sensible Medicine

Recently, I read an article on “toxic” quizzing. It’s was about attendings asking trainees questions in a mean way. Does it happen? Yes, of course. When I was a medical student, there was only one drug approved for HER-2 positive breast cancer. It was traztuzumab (this was before lapatinib). A breast surgeon, known for pimping, asked me about it in the OR.

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Fracture Fridays: Monkey Bars and Elbow Scars

PEMBlog

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Global healthcare leader and lifestyle expert Doctor Mike announced as HUB24 keynote

NRC Health

Seize the opportunity to be motivated by Doctor Mike’s insights and forward-thinking vision to revolutionize healthcare one viewer at a time. Join us on this journey toward improved health, powered by data-driven solutions and collaborative efforts. The post Global healthcare leader and lifestyle expert Doctor Mike announced as HUB24 keynote appeared first on NRC Health.

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Critical Care Evidence Updates – June 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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ACMT Toxicology Visual Pearl: Skin Lesions

ALiEM

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EM@3AM: Endometritis

EMDocs

Authors: Haley Sinatro, MD (EM Resident Physician, UTSW EM); Alan John, MD (Assistant Professor, UTSW EM) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

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