Sensible Medicine

MARCH 14, 2025

“Don’t worry about reading – you won’t be able to keep your eyes open. The only thing you need to learn this year is how to differentiate sick people from not sick people.” So said my program director during my internship. This comment might be one of the reasons I’ve been skeptical of sepsis screening. If there is one thing a medicine resident or hospitalist should be able to do well is identify the patients who are sick and need attention.

Sepsis 95

Sepsis Wellness Documentation/Coding Fluid Resuscitation 95

The Trauma Pro

MARCH 10, 2025

All trauma professionals need to keep up with the current thinking in their field. There are a variety of ways to do this, including lectures, courses, online curricula, meetings, and reading journal articles. The last method requires a bit of skill and patience. Many research papers are dry, long, and hard to read. Quite a few people do not have the patience to wade through them and get lost in all the details.

Research 175

Research 175

Don't Forget the Bubbles

MARCH 10, 2025

Challenging working conditions in health services, especially in emergency departments (ED), lead to high levels of stress and burnout. This contributes to the staff retention problem recognised by professional associations such as RCEM and ACEM. As well as being a practice and policy priority, there have been repeated calls for research to better understand the problem.

Emergency Department 104

Emergency Department Research EMS Academics 104

EM Ottawa

MARCH 10, 2025

Methodology: 4/5 Usefulness: 3.5/5 Gibbs KW, et al. N Engl J Med. 2024 Jun 20;390(23):2165-2177. Question and Methods:The PREOXI trial aimed to determine whether noninvasive ventilation (NIV) via BiPAP reduces hypoxemia compared to standard oxygen masks for preoxygenation in critically ill adults undergoing emergency intubation through a multicenter, randomized controlled trial.

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Sensible Medicine

MARCH 12, 2025

As of Aug 30, 2024, the US FDA has granted approval for Comirnaty (Pfizer) and Spikevax (Moderna) and emergency use authorization for Novavax for use in fall 2024 COVID-19 vaccine programs. 1,2 Moderna and Pfizer have manufactured mRNA vaccines targeting the KP.2 SARS-CoV-2 variant, a descendent of the JN.1 strain, whereas the Novavax recombinant protein platform targets the JN.1 variant.

Administration 99

Administration CDC Research 99

The Trauma Pro

MARCH 12, 2025

Okay, heres another one! But it’s a doozy. Its the most important one I live by. It ensures that you dont get bogged down by habit, custom, dogma, ignorance, or just plain laziness. Question everything! If someone ever says, but thats the way I/we always do it, or thats what the policy says, or even I read a good paper/chapter on this, take it with a really big grain of salt.

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The Skeptics' Guide to EM

MARCH 8, 2025

Reference: Pessano S, et al. Positioning for lumbar puncture in newborn infants. Cochrane Database Syst Rev. December 2023 Date: February 7, 2025 Dr. Lauren Rosenfeld Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. She is also a new podcast host for Emergency Medicine Residents Association (EMRA) Cast Series.

Outcomes 71

Outcomes Emergency Department Wellness 71

Sensible Medicine

MARCH 10, 2025

The Journal of the American Medical Association published an actual randomized controlled trial for coronary artery calcium (CAC). As a skeptic of this imaging test, I saw the headline and thought: finally, we will learn whether patients who have their chest radiated have better outcomes. Better outcomes, such as fewer heart attacks or strokes, or longer life, is why we interact with healthcare.

Stroke 83

Stroke Outcomes Hospitals 83

PulmCCM

MARCH 10, 2025

This is part of a series of articles on the duration of CPR for in-hospital cardiac arrest. An index to all posts in the series can be found here: Introduction Although cardiopulmonary resuscitation (CPR) is performed on more than 250,000 people in U.S. hospitals each year, physicians receive no formal guidance or training on how, when, or why it should be made.

CPR 52

CPR Hospitals Hyperthermia / Hypothermia Resuscitation 52

ACEP Now

MARCH 11, 2025

The treatment of patients with pulmonary embolism (PE) has evolved substantially over the past few decades. Many patients with PE can be discharged directly from the emergency department (ED). Advanced therapies such as catheter-directed treatments (CDT) are now available in many centers, and anticoagulants such as low-molecularweight heparins (LMWH) and direct oral anticoagulants (DOACs) have been developed, which obviate the need for frequent laboratory monitoring and dose titration in many pa

Hospitals 52

Hospitals Administration Outcomes Stroke 52

St. Emlyn

MARCH 11, 2025

St.Emlyn's - Emergency Medicine #FOAMed This epiode of the St Emlyns Podcast features Dr. Dan Dworkis discussing high-performance teams, excellence in crisis, and how emergency clinicians can continuously improve under pressure. The post Podcast – High Performing Teams with Dan Dworkis at Tactical Trauma 24 appeared first on St.Emlyn's.

Resuscitation 53

Resuscitation 53

EB Medicine

MARCH 12, 2025

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2025 Emergency Medicine Practice article, Emergency Department Management of Knee Pain Common Etiologies of Knee Pain Risk Factors and Statistics Infectious Causes of Knee Pain Pre-Hospital Care and EMS History and Physical Exam Imaging Guidelines Ottawa Knee Rule and X-Ray Necessity Imaging Modalities for Knee Effusion Ultrasound for Tendon Injury and Arthrocentesis CT and MRI in Knee Injury Diagnosis Lab Tests for Septic Knee

Emergency Department 61

Emergency Department Ultrasounds EMS Hospitals 61

EMDocs

MARCH 9, 2025

Authors: Zac Crenshaw, DO (EM Resident Physician, Mizzou Columbia, MO); Jessica Pelletier, DO, MHPE (Assistant Professor of EM/Assistant Residency Director, Mizzou Columbia, MO) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); 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 revie

Pediatrics 52

Pediatrics EMS Infectious Diseases Fractures 52

ACEP Now

MARCH 10, 2025

You work as the medical director at a suburban, community emergency department (ED). At your monthly meeting with the chief medical officer (CMO) and chief nursing officer (CNO), they inform you of the hospitals plan to start a Sexual Assault Nurse Examiner (SANE) Program. They ask you if you would be willing to serve as the teams medical director. As expected, you have several questions.

Sexual Assault 52

Sexual Assault Forensics Leadership Pediatrics 52

Dr. Smith's ECG Blog

MARCH 10, 2025

Written by Jesse McLaren A 50 year old presented to triage with one hour of chest pain, and the following ECG labeled normal by the computer (GE Marquette SL) algorithm. What do you think? Theres normal sinus rhythm, first degree AV block, early R wave, normal voltages. Theres hyperacute T waves in I/aVL with reciprocal inferior ST depression, diagnostic of high lateral occlusion MI.

EKG/ECG 89

EKG/ECG Outcomes Documentation/Coding Emergency Department 89

Science Based Medicine

MARCH 11, 2025

Stored blood quickly loses its effectiveness, so how can we improve the situation? The post Innovations in Blood Transfusions Will Save Lives first appeared on Science-Based Medicine.

Blood Transfusions 77

Blood Transfusions 77

American Medical Compliance

MARCH 12, 2025

This Tuberculosis, Hepatitis, and HIV Awareness and Prevention Training educates healthcare providers on how these diseases spread, their symptoms, and effective prevention methods. Providers will learn infection control measures tailored to each disease and standard techniques to reduce transmission risks in healthcare settings. Understanding these practices helps them protect themselves, their patients, and colleagues, ensuring a safer healthcare environment.

Infectious Diseases 52

Infectious Diseases PPE CDC Documentation/Coding 52

ACEP Now

MARCH 10, 2025

A 28-year-old man presented with agitation. He was brought in by police and was restrained because of threats of biting and hitting police. The patient refused any additional medical care and stated, I know my rights! You cant hold me against my will. When the emergency physician recommended vital signs, a history, and physical examination, the patient began hitting and biting staff, yelling obscenities, and threatening legal action.

Documentation/Coding 52

Documentation/Coding Emergency Department Psychiatric Risk Management 52

Ken Grauer, MD

MARCH 14, 2025

You are shown the ECG in Figure-1 without the benefit of any history. QUESTION: This tracing was interpreted as sinus tachycardia with some kind of BBB ( B undle B ranch B lock ). What kind of BBB is this? Figure-1: The initial ECG in today's case. What kind of BBB is this? ( To improve visualization I've digitized the original ECG using PMcardio ).

EKG/ECG 245

EKG/ECG Hospitals 245

Science Based Medicine

MARCH 13, 2025

When Islamic Medicine Kills the Ayatollah! The post Islamic Medicine and the Biopolitics of Antiscience in Iran first appeared on Science-Based Medicine.

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PEMBlog

MARCH 10, 2025

Measles is dancing yet again and I think we all know why. With an attack rate of 90%+ if you are not vaccinated you are at risk. Lyrics [Verse] Fevers high, eyes are red, runny nose, stuck in bed. inside cheeks, tiny spots Koplik’s calling all the shots. Rash spreads fast, head to toemeasles, no, dont say it’s so! Too late now, the virus stayscomplications on the way.

Infectious Diseases 52

Infectious Diseases 52

ACEP Now

MARCH 10, 2025

Satonofuji Hisashi has been a career sumo wrestler since 1996. He is no champion wrestlerin fact, he is far from it. His highest attained rank was in the Makushita division in 2005, the third highest of six sumo divisions. Traditionally, the most elite wrestlers sat in a curtained area at the arenamakushita did not and the name thus translates to below the curtain.

Academics 52

Academics Wellness CPR Hospitals 52

Ken Grauer, MD

MARCH 8, 2025

The ECG in Figure-1 was obtained from a middle-aged man who presents to the ED ( E mergency D epartment ) with 6 hours of chest pain. He is hemodynamically stable. QUESTION: As per the title of this blog post How many important findings can you identify? Figure-1: The initial ECG in today's case obtained from a middle-aged man with 6 hours of chest pain. ( To improve visualization I've digitized the original ECG using PMcardio ).

EKG/ECG 262

EKG/ECG Wellness Administration 262

The Trauma Pro

MARCH 14, 2025

Several years ago, I ran a series of posts on my Laws of Trauma. I assembled them into newsletter that contained all nine that existed at the time. If you’d like to download it, just click this link. I’ve been struck by another pattern, and I think it’s about time to add the tenth law. Weirdly enough, it was inspired by Dancing With The Stars.

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Dr. Smith's ECG Blog

MARCH 14, 2025

Written by Magnus Nossen, with edits by Smith The patient in today's case is a 70-year-old farmer. He has a history of coronary artery disease and a STEMI two years prior that was treated with primary PCI. He contacted EMS due to acute onset chest pain and feeling unwell and fatigued. He was given ASA and sublingual NTG and taken to the ED. At the time of this initial ED ECG, his symptoms were improving ECG #1 on admission to the ED The patient was not seen quickly in the ED as it was a busy shi

EKG/ECG 108

EKG/ECG EMS Outcomes Academics 108

ACEP Now

MARCH 9, 2025

As hospital boarding, increased emergency department (ED) volumes, and complexity of patients have increased, so have wait times. Some physicians now coin themselves waiting room medicine specialists as departments schedule a physician in triage or attempt to evaluate patients in whatever spaces might be available. After years of training to fully undress a patient for an exam at ABEM General Hospital, patients may now routinely be treated in street clothes sitting in a hallway chair.

Emergency Department 90

Emergency Department Point-of-Care Testing Documentation/Coding Hospitals 90

PulmCCM

MARCH 13, 2025

Patients in septic shock are under extreme stress and have high levels of circulating catecholamines. Catecholamine toxicity has been postulated to worsen the organ failure associated with severe sepsis. Vasopressor infusions with norepinephrine and epinephrine could theoretically add to catecholamine toxicity. Infusions of ultra-short acting beta blockers such as esmolol and landiolol have been investigated as adjunctive therapies for patients with septic shock who have persistent tachycardia a

Shock 98

Shock Sepsis Stroke Wellness 98

Emergency Medicine Cases

MARCH 11, 2025

On this month's EM Quick Hits podcast: Stephen Freedman on pediatric bloody diarrhea, S-TEC and hemolytic uremic syndrome, Justin Morgenstern on the evidence for IM epinephrine in out of hospital cardiac arrest, Matthew McArther on recognition and ED management of dengue fever, Andrew Petrosoniak on imaging decision making in trauma in older patients, Brit Long & Michael Gotlieb on recognition and management of TTP.Please consider a donation to EM Cases to help ensure continued Free Open Acc

EMS 74

EMS Pediatrics Hospitals Resuscitation 74

Dr. Smith's ECG Blog

MARCH 9, 2025

Written by Hans Helseth Hans is an EKG tech who is applying to medical school. EKG interpretation skills have little to do with one's level of education. In fact, much of what passes for EKG education can actually harm one's interpretation skills. A 62 year old man with hyperlipidemia presented to a rural emergency department with 7 hours of 3/10 chest pain.

EKG/ECG 89

EKG/ECG Emergency Department 89

ACEP Now

MARCH 11, 2025

A 16-year-old male presents to the emergency department (ED) with his mother with the chief complaint of intermittent abdominal pain and constipation for several weeks. There are no red flag symptoms for an underlying surgical cause and review of systems is otherwise unremarkable. Vital signs include a heart rate of 50, blood pressure 85/40, temperature of 35.9 C (96.6 F).

Emergency Department 52

Emergency Department Psychiatric Dehydration Pediatrics 52

Sensible Medicine

MARCH 13, 2025

I am thrilled to welcome Dr. Todd Stern to Sensible Medicine. Todd and I have worked together for years. He had the office next to me when I arrived at The University of Chicago in 1997. At the end of each day, I would run the decisions I had made by him, and he would tell which sounded good and which I might want to reconsider. He has supported me with not only deep knowledge of medicine but with the humor he brings to the occasional drudgery of our work.

Hospitals 66

Hospitals 66

Total Medical ComplianceHIPAA

MARCH 14, 2025

In todays digital healthcare environment, protecting patient information is not just the responsibility of IT or compliance officersit is a shared duty among all employees. Data breaches can occur anywhere, from large hospitals to small clinics, and human error is often the primary cause. A single mistake, such as sending an email to the wrong recipient or leaving a workstation unlocked, can expose sensitive information.

Best Practices 52

Best Practices Hospitals 52

Dr. Smith's ECG Blog

MARCH 8, 2025

Written by Willy Frick Disclaimer at the outset: Some aspects of this case are not completely clear to me, and approach being unknowable. I've presented the case as best I understand it, but I can see good arguments for other interpretations. A woman in her late 60s presented after a car crash. Her husband was driving and she was a passenger. They were hit at high speed.

EKG/ECG 77

EKG/ECG CPR Resuscitation Wellness 77

American Medical Compliance

MARCH 14, 2025

The Protecting Patient Privacy in Texas (HB 300) Training helps healthcare providers understand their responsibilities under Texas law. Providers learn what defines a covered entity, as well as patients’ rights to access, amend, and restrict their health information. Additionally, they explore the required safeguards to protect PHI. By mastering these regulations, providers can ensure compliance, strengthen patient trust, and avoid legal and financial penalties.

Documentation/Coding 52

Documentation/Coding Administration Wellness Outcomes 52

ACEP Now

MARCH 10, 2025

Youre working the night shift in a rural critical access hospital in the Midwest when a 36-year-old, 31-week primigravida patient with no known prior medical history presents with a mild headache. Initial vitals show a blood pressure (BP) of 170/115 mm Hg, which remains elevated 15 minutes later. You follow the recommended emergency department (ED) lab workup for hypertensive disorders of pregnancy, including urine protein/creatinine ratio, serum creatinine, platelet count, complete blood count,

OB/GYN 52

OB/GYN Seizures Stroke Hospitals 52

JournalFeed

MARCH 8, 2025

New! Download the JournalFeed iPhone app ! The JournalFeed podcast for the week of March 3-7, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Monday Spoon Feed : Guidelines recommended low molecular weight heparin (LMWH) for most patients with acute pulmonary embolism (PE), but we often choose unfractionated heparin (UFH).

Outcomes 52

Outcomes Hospitals 52

Core Ultrasound

MARCH 13, 2025

Carpal tunnel syndrome can cause significant pain and disability, and in some cases, a rapid ultrasound-guided release can provide immediate relief in the emergency department. In this video, we walk you through a step-by-step approach to performing ultrasound-guided carpal tunnel release. Carpal Tunnel Exam Wrist Effusion Courses The post 5 Minute Sono Carpal Tunnel Release (2025) first appeared on Core Ultrasound.

Ultrasounds 40

Ultrasounds Emergency Department 40