The Trauma Pro

JUNE 23, 2023

What are common sources of malpractice complaints against nurses? The most common event is medication error. Most people worry about common errors like wrong dose, wrong drug, and wrong route of administration. But one less commonly considered drug-related responsibility is assessment for side effects and toxicity of medications administered. Other common reasons include failure to adequately monitor and assess the patient, and failure to supervise a patient that results in harm.

Documentation/Coding 245

Documentation/Coding Administration 245

RebelEM

JUNE 22, 2023

Background: The COVID-19 pandemic has been the focus of massive research efforts over the last three years. Our understanding of the disease and effective treatments to reduce mortality have progressed rapidly during this time. However, the medical community is only just starting to understand long-COVID (WHO Definition: the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation).

Outcomes 145

Outcomes Research Documentation/Coding Wellness 145

The Bottom Line

JUNE 19, 2023

In adult patients with major trauma, who are at risk for trauma-induced coagulopathy does early administration of 1g of tranexamic acid (TXA) followed by an infusion of 1g over 8 hours, compared with placebo, increase survival with a favourable functional outcome at 6 months?

Administration 145

Administration Outcomes Shock 145

Don't Forget the Bubbles

JUNE 19, 2023

You are asked to see a baby boy in the labour ward. He was born at 38 weeks and 5 days gestational age and weighs 2600 grams. His mother is healthy, but she does mention that her first-born daughter was also small. She weighed 2570 grams at 39 weeks and is now perfectly healthy. The parents are of South-Asian descent. There were no issues during the pregnancy, and estimated fetal growth by ultrasound was constant.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

The Trauma Pro

JUNE 20, 2023

Back in the old, old days, there was really no such thing as nursing malpractice. Nurses had little true responsibility, and liability largely fell to the treating physicians. But as nursing responsibilities have grown, they have become an integral part of the assessment, planning, and management of their patients. As all trauma professionals know, our work is very complex.

Documentation/Coding 130

Documentation/Coding Operations Hospitals 130

First 10 EM

JUNE 19, 2023

The internet is alive with rumors of a simple, cheap, low-risk cure for long COVID. Sound too good to be true? That’s because it almost certainly is. Let’s talk about this COVIT-OUT trial and what it says about metformin. The paper Bramante CT, Buse JB, Liebovitz DM, et al. Outpatient treatment of COVID-19 and incidence […] The post No, metformin is probably not the cure for long COVID appeared first on First10EM.

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EMS 136

Broome Docs

JUNE 20, 2023

Hi All, we are back with another instalment of the Journal Club with Justin Morgenstern. Big news this month is that Justin has just been invited to visit my home shop as the honorary WG Smith Fellow and deliver a series of EBM lectures to the local teams in Western Australia. So we are planning to take this show on th eraod and do some live sessions later in 2023.

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Emergency Department Sepsis Best Practices 132

SheMD

JUNE 18, 2023

It's that time of the year. July 1st is almost here and hospitals around the country will welcome in their new interns. To those starting on the wards as interns, this series is for YOU! We're sharing advice from SheMD authors on how to not only SURVIVE but THRIVE during your intern year. Wishing you all the best next week. You CAN do this! January 1st may be the start of the New Year, but for everyone in the medical field we all know that the year really begins on July 1st.

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Research Hospitals 124

Science Based Medicine

JUNE 18, 2023

Though calls for "debates" are made by unserious people, unserious people can do serious damage when they are willing to spread disinformation about vaccines, all because a doctor with principles isn't willing to play his part in their absurd theater. The post The Pandemic As Spectacle first appeared on Science-Based Medicine.

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ACEP Now

JUNE 21, 2023

U.S. emergency medicine (EM) residency training length has been a decades-long dilemma: four vs. three years. Two important questions befall educators and residents. First, is three years enough time to become an EM physician? Second, does an additional year add sufficient value to justify the time and expense? To date, the debate has been lively yet largely conceptual.

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EMS Academics Telemedicine Operations 114

Emergency Live

JUNE 21, 2023

Long QT syndrome is a cardiac pathology, attributable to the family of heart arrhythmias When the patient has a long QT, it means that his normal ventricular contraction is impaired and he lengthens. Since the pathology is rather rare, it is still today the subject of careful medical research that can establish in an increasingly […] The post Cardiac arrhythmias: long QT cardiac syndrome appeared first on Emergency Live.

Research 122

Research 122

RebelEM

JUNE 19, 2023

Background: Injuries are a major cause of death worldwide. Hemorrhage accounts for about 1/3 of all trauma deaths and as such, it should be our goal to find treatments to decrease death from hemorrhage. Our bodies have a finely tuned system that allows blood to flow freely and not clot too easily while also allowing the body to form clots when needed.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

Emergency Medicine Journal

JUNE 22, 2023

Background Tools proposed to triage ED acuity in suspected COVID-19 were derived and validated in higher income settings during early waves of the pandemic. We estimated the accuracy of seven risk-stratification tools recommended to predict severe illness in the Western Cape, South Africa. Methods An observational cohort study using routinely collected data from EDs across the Western Cape, from 27 August 2020 to 11 March 2022, was conducted to assess the performance of the PRIEST (Pandemic Resp

Outcomes 98

Outcomes 98

Greater Sydney Area HEMS

JUNE 17, 2023

In the second episode in this series, HEMS physician and podcast host Dr Samuel Bulford interviews staff specialist Dr Natalie May about a case which has fundamentally influenced her approach as a clinician, educator and mentor.

Leadership 98

Leadership 98

Emergency Live

JUNE 20, 2023

Angina is chest pain or a feeling of pressure that is felt when the heart is not getting the right amount of oxygen The post A feeling of tightness in the chest? Could be angina pectoris appeared first on Emergency Live.

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PHARM

JUNE 23, 2023

St.Emlyn’s – Emergency Medicine #FOAMed Critical Appraisal of the The PATCH trial of TXA Tranexamic Acid in major trauma patients. TXA saves lives, … JC: The PATCH trial. TXA in major trauma.

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Dr. Smith's ECG Blog

JUNE 21, 2023

Sent by Magnus Nossen MD, written by Pendell Meyers A man in his 50s, previously healthy, developed acute chest pain. EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? Below is the version standardized by PM Cardio app Meyers interpretation: Findings are specific for posterior (and also likely inferior) wall transmural acute infarction, most likely due to acute coronary occlusion (OMI).

Urgent Care 98

Urgent Care EKG/ECG EMS Emergency Department 98

Sensible Medicine

JUNE 19, 2023

The specific story includes yet another failure of oseltamivir (Tamiflu) to provide benefit in the treatment of influenza. The larger story is why some therapies persist in the absence of any evidence of benefit. Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.

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Hospitals Outcomes Research 97

Emergency Live

JUNE 19, 2023

Kleptomania is included in the Manual of Mental Disorders (DSM-IV TR) under Impulse Control Disorders and is characterised by "the recurrent inability to resist the impulse to steal objects that have no personal utility or commercial value" The post Kleptomania: causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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EMDocs

JUNE 22, 2023

Author: Taylor Webb, MD (Emergency Medicine Resident, University of Mississippi Medical Center) // Reviewed by: Brit Long, MD (@long_brit) I am a third year Emergency Medicine chief resident at the University of Mississippi Medical Center (UMMC) and want to share one of my experiences to all medical residents and providers. Remember that while mistakes in resuscitation are often dissected and analyzed, it is equally crucial to acknowledge and celebrate the moments of impeccable execution, where

Resuscitation 97

Resuscitation Ultrasounds Critical Access Documentation/Coding 97

The Bottom Line

JUNE 19, 2023

In patients resuscitated from out-of-hospital cardiac arrest (OOHCA) does targeted mild hypercapnia compared to targeted normocapnia improve 6-month neurological outcomes?

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Resuscitation Outcomes Hospitals 98

EM Ottawa

JUNE 19, 2023

Methodology: 4/5 Usefulness: 3.5/5 Bouzat P, et al. JAMA. 2023 Mar 21:e234080. doi: 10.1001/jama.2023.4080. Question and Methods: This double-blind, randomized, placebo-controlled superiority trial aimed to assess whether 4F-PCC decreases 24hr blood product consumption for trauma patients at risk of massive transfusion. Findings: There was no statistically significant difference in median total 24hr blood product […] The post Efficacy and Safety of Early Administration of 4-Factor Pro

Administration 95

Administration 95

Emergency Live

JUNE 23, 2023

Pericarditis is the inflammation of the pericardium, the membrane that surrounds the heart, itself formed by two layers, an outer one called the fibrous pericardium and an inner one called the serous pericardium The post Inflammations of the heart: pericarditis appeared first on Emergency Live.

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Science Based Medicine

JUNE 22, 2023

USA Track & Field is endorsing a kinesiology tape that is claimed to improve cell oxygenation. The post Can Kinesiology Tape Increase Oxygen Delivery and Improve Sports Performance? first appeared on Science-Based Medicine.

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Medagadget

JUNE 19, 2023

Researchers at Rockefeller University have developed a cell culture platform in which to grow ‘lung buds’ from human embryonic stem cells. The tiny structures are similar to the lung buds that form during fetal development, and they contain tiny airways and alveoli. The researchers create the structures in a bio-reactor style device that is furnished with microfluidic chips in which the lung buds grow.

Research 89

Research 89

University of Maryland Department of Emergency Med

JUNE 18, 2023

It is difficult to diagnosis a ruptured AAA with POCUS. However, based on one systematic review and meta-analysis, POCUS has a sensitivity of.

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Emergency Live

JUNE 22, 2023

The medical term spondylolisthesis refers to a pathological condition characterised by a slow but progressive and constant displacement of a vertebra with respect to the vertebra underneath The post Spondylolisthesis: what is it? appeared first on Emergency Live.

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Science Based Medicine

JUNE 21, 2023

Thirty years on, there is even more evidence that GMO food are safe. The post Update on GMOs and Health first appeared on Science-Based Medicine.

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St. Emlyn

JUNE 23, 2023

St.Emlyn's - Emergency Medicine #FOAMed Critical Appraisal of the The PATCH trial of TXA Tranexamic Acid in major trauma patients. TXA saves lives, but functional outcomes vary. #FOAMed @stemlyns The post JC: The PATCH trial. TXA in major trauma. St Emlyn’s appeared first on St.Emlyn's.

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Outcomes EMS 79

Medagadget

JUNE 19, 2023

Researchers at the University of Pennsylvania have developed nanorobots that can travel to the site of a fungal infection under the influence of an external magnetic field, bind to the fungal cells, and then release reactive oxygen species to completely destroy the fungus. The tiny particles are an example of catalytic nanoparticles, which the researchers have dubbed ‘nanozymes’.

Research 78

Research 78

Emergency Live

JUNE 21, 2023

Lumbar stenosis is a narrowing of the vertebral canal in the lumbosacral spine. This disorder can lead to changes in the spine that can generate excessive pressure on the nerve roots, causing intense pain The post Lumbar stenosis: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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EMDocs

JUNE 17, 2023

Author: Jackie Nguyen, MD (EM Resident Physician, UTSW – Dallas, TX); Joshua Kern, MD (Assistant Professor of EM/Attending Physician, UTSW – Dal las, TX) // Reviewed by: Sophia Görgens, MD (EM Resident Physician, Zucker-Northwell NS/LIJ, 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 re

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EMS Infectious Diseases Pediatrics Emergency Department 72

Emergency Medicine Journal

JUNE 22, 2023

Clinical introduction A 67-year-old woman presented to the ED with a 1-week history of dyspnoea on exertion. She did not report fever or cough. Her medical history only included hyperlipidaemia. She was a never-smoker. Physical examination revealed the following findings: BP, 148/98 mm Hg; HR, 112/min; body temperature, 35.8℃; RR, 20/min; and oxygen saturation, 94% on ambient air.

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Science Based Medicine

JUNE 23, 2023

Do humans spontaneously burst into flames? Can these mysterious cases be predicted and kept at bay by homeopathic remedies? No. They don't and they can't. I made it all up. Is it just me, or is getting really hot in here. The post Science-Based Satire: Could Spontaneous Human Combustion Become a Chronic, Treatable Disease? Maybe. Yeah, I think so. first appeared on Science-Based Medicine.

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Emergency Live

JUNE 21, 2023

Haemospermia or haematospermia - the presence of blood in semen - is an event that occurs as a result of the rupture of certain blood vessels along the tract that semen travels during ejaculatory phenomenon The post Haemospermia or haematospermia: what does it mean if you find blood in your sperm? appeared first on Emergency Live.

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The Skeptics' Guide to EM

JUNE 17, 2023

Date: June 15, 2023 Reference: Rees CA et al. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. American Journal of Hematology Jan 2023 Guest Skeptic: Dr. Amy Drendel is a pediatric emergency medicine physician and physician scientist at Children’s Wisconsin. […] The post SGEM#406: Homeward Bound…after a dose of Intranasal Fentanyl for Sickle Cell Vaso-occlusive

Emergency Department 73

Emergency Department Pediatrics Administration Head Injuries 73

Emergency Medicine Journal

JUNE 22, 2023

While emergency departments are open to anyone without appointment, the need for prioritisation results in periods of waiting that are both wasteful and frustrating. However, value can be added to patient care by (1) engaging the waiting patient, (2) empowering the waiting patient and (3) educating the waiting patient. If these principles are implemented, they will benefit both the patient and the healthcare system.

Emergency Department 74

Emergency Department 74