Sensible Medicine

NOVEMBER 23, 2024

It is my pleasure to introduce this article by Joseph Marine, MD. Mr. Marine has 10 sensible suggestions for reform at the NIH. I love them all, but particularly #3, 6, and 8, which I have railed about for years. Vinay Prasad, MD MPH The NIH needs reform The recent news that Dr. Jayanta Bhattacharya is being considered for the post of Director of the National Institutes of Health (NIH) was received with enthusiasm by many of us who opposed the US pandemic response.

Infectious Diseases 128

Infectious Diseases Research Leadership Academics 128

Dr. Smith's ECG Blog

NOVEMBER 27, 2024

Pendell and I and the geniuses at Powerful Medical (Producers of the PMCardio Queen of Hearts OMI AI app ) are working on an objective, mathematical definition of hyperacute T-waves , based on real OMI outcomes and hyperacute T-wave annotation that has excellent interrater agreement (between me and Pendell), and it will end up being a logistic regression using these 3 variables: 1) area under the curve (AUC) relative to the QRS size 2) increased symmetry , as defined by time from T-wave onset to

EKG/ECG 110

EKG/ECG Research Outcomes Wellness 110

Science Based Medicine

NOVEMBER 29, 2024

Dr. Zubin Damania praised and promoted RFK Jr.-loving doctors. We criticized these doctors and corrected their factual errors. See the difference? The post ZDoggMD on RFK Jr.’s Rise: “I’m Talking About Like These Science Based Medicine Guys” first appeared on Science-Based Medicine.

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EM Ottawa

NOVEMBER 28, 2024

What do you do when expert nurses tell you they can’t obtain IV access? Do you spend 20 minutes performing an invasive central line? Does your resident finally get two IO EPAs? Or do you save the day with a slick, ultrasound guided IV? Obtaining peripheral ultrasound guided IV access is not only a core […] The post Ultrasound Guided Peripheral IVs appeared first on EMOttawa Blog.

Ultrasounds 123

Ultrasounds 123

EMCrit

NOVEMBER 28, 2024

I discussed the reasons for migrating to BlueSky here. I've received positive feedback from several FOAMed expats who migrated to Bluesky and enjoy it there. I've also received some questions about getting started on BlueSky, so here is a brief guide to moving into MedSky. [1] Set up your account & profile This is essentially […] EMCrit Project by Josh Farkas.

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St. Emlyn

NOVEMBER 26, 2024

St.Emlyn's - Emergency Medicine #FOAMed In this podcast, Liz Crowe discusses the effect bad behaviour has on teams and ultimately patient safety. The post Podcast – Bad Behaviour in Teams with Liz Crowe at Tactical Trauma 2024 appeared first on St.Emlyn's.

Patient Safety 106

Patient Safety 106

Science Based Medicine

NOVEMBER 23, 2024

If you associate yourself with Sensible Medicine, you are anti-vaccine no matter how you describe yourself. The post Any Doctor Who Enabled RFK Jr. In Any Way Is Anti-Vaccine No Matter How They Describe Themselves first appeared on Science-Based Medicine.

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Dr. Smith's ECG Blog

NOVEMBER 25, 2024

Introductory Angiography Guide To find the guide later, go to the banner at the top of the blog: This blog is dedicated to improving understanding of ECGs in the context of emergency medicine. A substantial proportion of cases discussed include diagnostic angiography. Attaining expertise in angiography requires dedication and practice. What follows is an introduction to angiography -- a guide meant for people with no prior experience interpreting angiograms.

Documentation/Coding 102

Documentation/Coding EKG/ECG 102

St. Emlyn

NOVEMBER 24, 2024

St.Emlyn's - Emergency Medicine #FOAMed GLP-1A toxicity: What do emergency clinicians need to know about drugs like Ozempic® and Wegovy®? #FOAMed @stemlyns Greg Yates takes through a paper reporting overdoses in US practice. The post GLP-1A toxicity: What do emergency clinicians need to know about drugs like Ozempic® and Wegovy®? appeared first on St.Emlyn's.

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Don't Forget the Bubbles

NOVEMBER 29, 2024

It’s a busy day in the paediatric ED. A worried parent rushes in carrying a toddler who’s just had a gulp from an unlabelled bottle in the garage. The child looks unsettled but otherwise fine—for now. “It was just a bit of the stuff we use for cleaning the car windscreen,” the parent says. You smell the faint odour of alcohol on the child’s breath A quick mental note: methanol poisoning?

Poisoning 64

Poisoning Forensics Seizures Outcomes 64

EM Literature of Note

NOVEMBER 25, 2024

Following on the success of Toy Story 2, Inside Out 2, and Avatar 2, we have WOMAN-2, yet another trial featuring emergency medicine’s third-favorite medication: tranexamic acid. However, where those sequels succeeded, WOMAN-2 is more like Miss Congeniality 2 – the one we’re not going to talk about again. But, don’t take it from me – take it from the ChatGPT Agent I created!

Research 79

Research Outcomes Administration Wellness 79

American Medical Compliance

NOVEMBER 29, 2024

Continuous Glucose Monitoring (CGM) technology is transforming the approach to diabetes care for healthcare providers, including endocrinologists, diabetes educators, and nurses, as well as for the patients they support. Unlike traditional methods that rely on periodic fingerstick tests, CGM offers real-time insights into glucose levels, trends, and fluctuations, empowering proactive management and improving patient outcomes.

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Outcomes Wellness Operations Pediatrics 77

EMDocs

NOVEMBER 23, 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: Could Paralyzing Before Sedatives Increase First Pass Success? Spoon Feed This study utilized Bayesian analysis and found that when paralytic medications were administered before sedatives during ED intubation, the

Administration 72

Administration 72

Don't Forget the Bubbles

NOVEMBER 27, 2024

Imagine this – a six-week-old infant with a fever of 38.3⁰C presents to your emergency department. They look well and, apart from fever, have no other symptoms. There are no sick contacts at home. Although they look well, you don’t want to miss a serious diagnosis, so what do you do? You’ve so many questions. Which of the many febrile infant clinical decision tools should you use?

Outcomes 81

Outcomes Wellness Hospitals Emergency Department 81

AED Leader

NOVEMBER 25, 2024

California is leading the way in public safety with a new law that could save countless lives during cardiac emergencies. Effective January 1, 2017, the state’s Health and Safety Code 19300 mandates that certain high-occupancy buildings must install Automated External Defibrillators (AEDs). This legislation reflects a growing recognition of how crucial AEDs are in improving survival rates for sudden cardiac arrest (SCA).

CPR 52

CPR Documentation/Coding Shock Hospitals 52

Board Bombs

NOVEMBER 29, 2024

You've survived Thanksgiving, now survive managing a pediatric airway obstruction by foreign body. This case will make you wish your in-laws came back to visit for Christmas. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 241.

Pediatrics 52

Pediatrics 52

EMergucate

NOVEMBER 26, 2024

The following ECG is from a 62-year-old man who presented following an MVA.

EKG/ECG 52

EKG/ECG 52

Don't Forget the Bubbles

NOVEMBER 25, 2024

A 7-week-old baby presents to the Emergency Department (ED) with a one-day history of coryza and cough. Parents have recorded a temperature of 38°C at home. In triage, she is noted to be alert and feeding well. Her initial observations show a temperature of 38.2°C, HR 152 bpm, RR 45/min, and oxygen saturation 97% in room air. You perform a viral swab test at ED which comes back positive for SARS-CoV-2.

Point-of-Care Testing 69

Point-of-Care Testing Outcomes Wellness Emergency Department 69

AED Leader

NOVEMBER 27, 2024

Stryker Corporation Announces Discontinuation of LIFEPAK CR Plus and EXPRESS AED Models Stryker Corporation , makers of the widely recognized LIFEPAK line of automated external defibrillators (AEDs), has officially announced the discontinuation of U.S. production of the LIFEPAK CR Plus and LIFEPAK EXPRESS models. According to the companys official press release, this decision comes as part of a strategic move to phase out these older AED models and shift their focus toward newer, more advanced s

CPR 52

CPR Pediatrics Operations Outcomes 52

The Evolution & Medicine Review

NOVEMBER 26, 2024

Ongoing selection for adaptation to high altitude Ye, S., Sun, J., Craig, S. R., Di Rienzo, A., Witonsky, D., Yu, J. J., Moya, E. A., Simonson, T. S., Powell, F. L., Basnyat, B., Strohl, K. P., Hoit, B. D., & Beall, C. M. (2024).

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EMergucate

NOVEMBER 25, 2024

Question 1: PH = 7.30, that is mild acidaemia. HCO3 = 18, that is low (less than 24), So we have metabolic acidosis.

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Greater Sydney Area HEMS

NOVEMBER 24, 2024

Visit the post for more.

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JournalFeed

NOVEMBER 23, 2024

The JournalFeed podcast for the week of Nov 18-22, 2024. 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 : Most of the time, targeting a hemoglobin threshold of 7 – 8 g/dL in critically-ill patients is recommended, with acute coronary syndrome as the exception to the rule.

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Stop and Think

NOVEMBER 28, 2024

Just a short note to say thank you to those who follow this Substack. I am grateful to have readers. It’s Thanksgiving here and it is nice that my brain gets a holiday. Peace be with you all. JMM Stop and Think is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

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EMergucate

NOVEMBER 25, 2024

72 year-year-old man with history of type II DM and has a single kidney. Presented with 2 weeks of diarrhoea. He has been in bed for 2 weeks. Unresponsive. Last proper meal was 2 weeks ago.

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Board Bombs

NOVEMBER 23, 2024

We have a short attention span in the ED….so it’s okay to defer hyponatremia to the real nerds (psst internal medicine). But there are a few indications when we need to jump into action to save the day. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake. 240.

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PHARM

NOVEMBER 23, 2024

Management of critically ill patients in austere environments: good clinical practice by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

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Resuscitation 40

Core Ultrasound

NOVEMBER 29, 2024

In this video tutorial, we provide a detailed guide to operating the Sonosite LX ultrasound machine. Designed for both beginners and those familiar with ultrasound technology, this demonstration will walk you through the essential features and functions of this device. You’ll learn how to power it on, optimize image quality, navigate the user interface, save and review images, and utilize its advanced settings to improve your workflow. > The post 5 Minute Sono – Sonosite LX Machine Basics

Ultrasounds 40

Ultrasounds Operations 40

EMergucate

NOVEMBER 24, 2024

There is a sliver of air under the right hemi-diaphragm.

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EMS 52

PulmCCM

NOVEMBER 25, 2024

More than half a million bloodstream infections occur annually in the U.S. and are estimated to cause nearly 100,000 deaths, with worldwide totals many times higher. Treatment courses for many severe infections have been reduced in length with no apparent detriment, but most trials testing antibiotic durations have excluded patients with bacteremia.

Infectious Diseases 40

Infectious Diseases Research Hospitals Outcomes 40

EMDocs

NOVEMBER 25, 2024

Authors: Kamoga Dickson, MD (EM Resident Physician, Makerere College of Health Sciences, Kampala, Uganda); Jessica Pelletier, DO, MHPE (APD/Assistant Professor of EM/Attending Physician, University of Missouri-Columbia) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 42-year-old male from a rural area in northeastern Uganda presents to the tertiary care emergency department with severe itching, skin changes on his legs, and episodes of blurred vision, describing &

Infectious Diseases 53

Infectious Diseases Emergency Department EMS Administration 53

Ken Grauer, MD

NOVEMBER 23, 2024

I was sent the ECG shown in Figure-1 — told only that that it was from an acutely ill patient on a ventilator, who was being evaluated for bradycardia. His providers thought this rhythm was complete AV block. QUESTIONS: How would you interpret the ECG in Figure-1 ? Is the rhythm complete AV block? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).

EKG/ECG 407

EKG/ECG Documentation/Coding 407

EMergucate

NOVEMBER 24, 2024

The chest x-ray reveals sail sign.

EMS 52

EMS 52

Core Ultrasound

NOVEMBER 27, 2024

In part two of this interview, Dr. Longino, a hospitalist researcher, and Dr. Riscinti, an emergency medicine physician—both from Denver Health—explore the future of the VExUS (Venous Excess UltraSound) exam. We discuss ongoing and future research, emerging applications, and strategies to expand the accessibility and adoption of this important tool.

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Ultrasounds Research 40

Sensible Medicine

NOVEMBER 24, 2024

Marty Makary, an editorial board member of Sensible Medicine, is up for FDA commissioner. In honor of that, we reprint one of his essays. Elsewhere I have a short piece on how the media coverage of him has been biased, and why I support his nomination. In the piece below Marty was correct that there is no data to support year over year COVID boosters, and I, like most Americans, don’t get them.

CDC 111

CDC Research 111

The Skeptics' Guide to EM

NOVEMBER 23, 2024

Date: November 13, 2024 Reference: Lee WH, et al. Study of Pediatric Appendicitis Scores and Management Strategies: A Prospective Observational Feasibility Study. Academic Emergency Medicine. Dec 2024 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC. He’s also the host of SGEMPeds.

Pediatrics 74

Pediatrics Sepsis Academics Emergency Department 74

EMergucate

NOVEMBER 24, 2024

The lateral view of ankle demonstrates an avulsion fracture above the posterior calcaneus.

Fractures 52

Fractures EMS 52