Sat.Jul 08, 2023 - Fri.Jul 14, 2023

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ECG Blog #385 — This Patient Arrested Soon After

Ken Grauer, MD

The ECG in Figure-1 was obtained from a 60-year old woman — who presented to the ED ( E mergency D epartment ) for “palpitations”. Her vital signs were normal at the time this triage ECG was recorded. Blood was drawn , and the patient was promptly placed in a room to be seen — but on entering, the ED physician found her unresponsive in cardiac arrest.

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Molluscum contagiosum: definition, causes, symptoms, diagnosis and treatment

Emergency Live

Molluscum contagiosum is a viral skin infection that causes lesions of the skin and, more rarely, the mucous membranes. Molluscum contagiosum presents itself with skin lesions with a typical dome shape called papule with a hollow in the centre, called umbilication The post Molluscum contagiosum: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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SGEM#409: Same as it Ever Was – Tamiflu for Influenza?

The Skeptics' Guide to EM

Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM.

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"I just want to work on my car"

Sensible Medicine

I always tell junior faculty that your contract means little, and, indeed, I found that to be the case, when a mid-career faculty departed and I inherited a third of his lung cancer patients. Yet, like most unexpected clinical changes in my career, I ended up learning unexpected truths. One man taught me about lung cancer screening. He was the most improbable 74 year old.

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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The Electronic Trauma Flow Sheet: What Does(n’t) Work – Part 2

The Trauma Pro

In my last post, I wrote about how the electronic trauma flow sheet (eTFS) practically assures a garbage in situation. Today, I’ll dig into what happens on the back end, and how it also creates a garbage out situation. There are two ways to view the eTFS on the back end (abstraction phase): read a paper report (timeline), or view it live in the electronic health record (EHR).

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Sudden Shortness of Breath - Pulmonary Embolism

ECG Guru

ECG 1 is from a 57-year-old male with no prior cardiac disease. He reports acute shortness of breath for 2 days. We see a sinus rhythm with left anterior fascicular block (LAFB) and conspicuous T-wave inversions in the inferior leads and in V1-V6. These are typical ECG changes that may indicate a pulmonary embolism. ECG 2 was taken from the same patient 1 year earlier.

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G6PD Deficiency

Don't Forget the Bubbles

4-year-old Mark presents with lethargy, jaundice, and abdominal pain after eating one portion (40g) of broad beans. Could he have G6PD deficiency? G6PD , short for glucose-6-phosphate dehydrogenase, is an enzyme active in all cell types and is key to protecting red blood cells from oxidative damage and early destruction. A child with reduced G6PD enzyme activity has increased red blood cell breakdown – haemolysis – when exposed to specific triggers.

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The Electronic Trauma Flow Sheet: What Does(n’t) Work – Part 1

The Trauma Pro

There are two major problem areas using an electronic trauma flow sheet (eTFS): the front end and the back end. Today, I’ll discuss the front-end data entry problems. Trauma activations are very data-intensive events. Before the patient arrives, there are registration activities so the electronic health record (EHR) can begin accepting other information about the patient.

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The Study of the Week Looks Back and Asks One Question

Sensible Medicine

I am worried about the state of medical science and our journals. At the risk of sounding naive, I want to believe that people who choose academic medicine do so to answer important scientific questions. I’ve traveled the world and met academics. Many of them impress me as serious people trying to advance the field. But that observation is hard to square with some of the studies that make it into big journals—and then into the lay press.

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Focaccia Group acquires NCT factory

Emergency Live

Focaccia Group: a new chapter of growth Focaccia Group, a company specialising in the outfitting of vehicles, recently announced the acquisition of the historic NCT – Nuova Carrozzeria Torinese factory, marking a significant advance in its path of growth and consolidation. This plant, a former Lancia and Abarth factory, is at the centre of a […] The post Focaccia Group acquires NCT factory appeared first on Emergency Live.

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By the Numbers: the Emergency Medicine Blogs and Podcasts Rankings

ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

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A 40-something presented after attempted prehospital resuscitation with persistent Ventricular Fibrillation

Dr. Smith's ECG Blog

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated w

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Fracture Fridays: Keeping up with the Joneses

PEMBlog

The case A self-proclaimed dance team superstar presents after injuring her foot at a regional competition. She tried to finish the routine after landing awkwardly. But was having difficulty bearing weight. She applied ice overnight and despite ibuprofen is still in pain, and presents to the ED the next day.On her exam the neruovascular exam is normal, and she has pain along the proximal edge of the 5th metatarsal.

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Skin fungi: mycosis of the foot

Emergency Live

Mycosis of the foot: suspicious spots, flaking skin, nails that change colour and texture: if the feet begin to show these characteristics, it could be a fungal infection The post Skin fungi: mycosis of the foot appeared first on Emergency Live.

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Friday Reflection 25: The Advice I’d Like to Give a Student Entering Medical School

Sensible Medicine

EJ was a 32-year-old man with risk factors for HIV infection who presented to the emergency room with two weeks of worsening shortness of breath. When he arrived, he was tachycardic, tachypneic, hypoxic, and his chest x-ray revealed diffuse parenchymal infiltrates consistent with pneumonia. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.

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The Business of Medicine and the Harm It Does

Emergency Medicine News

An abstract is unavailable.

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I was reading ECGs on the system when I came across this one, called "normal" by the conventional computer algorithm

Dr. Smith's ECG Blog

I come in early for every shift to read the ECGs on the system that have not yet been "confirmed". I came across this one: The computer calls is: "SINUS RHYTHM. NORMAL ECG" What do you think? Be VERY careful when the computer calls the ECG "Normal". I saw the inferior ST depression (which is reciprocal to subtle STE in aVL) and the subtle ST depression in precordial leads and thought: "If this patient came in with chest pain, then it is an acute OMI.

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Dependent Personality Disorder: Definition, Causes, Symptoms, Diagnosis, and Treatment

Emergency Live

The essential characteristic of individuals with Dependent Personality Disorder is dependent and submissive behavior aimed at seeking someone to protect and care for them The post Dependent Personality Disorder: Definition, Causes, Symptoms, Diagnosis, and Treatment appeared first on Emergency Live.

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Liz Crowe: Is burn out burning us out? St Emlyn’s

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed @LizCrowe2 explains how the term burnout is being inappropriately used and as a result may obscure and excuse some of the work related stressors we experience. @stemlyns #FOAMed The post Liz Crowe: Is burn out burning us out? St Emlyn’s appeared first on St.Emlyn's.

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Journal Feed Weekly Wrap-Up

EMDocs

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: DEVICE RCT – VL vs DL for Critically Ill Adults Spoon Feed Video laryngoscopy (VL) was associated with higher rates of first attempt intubation success compared to direct laryngoscopy (DL) for critically ill patient

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Annals of B Pod: Acute Globe Subluxation

Taming the SRU

HISTORY OF PRESENT ILLNESS A middle aged male presented with right eye pain. Patient stated that upon waking up from a nap his right eye spontaneously “popped out.” He was able to self-reduce the eye via relaxation and gentle pressure. He reported residual redness and soreness of the right eye. He denied any visual changes or difficulty with eye movements.

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Inflammations of the heart muscle: myocarditis

Emergency Live

Myocarditis is an inflammation that affects the heart muscle. The name comes from the myocardium, the muscular component of the heart that makes up its walls and enables it to perform its pumping function The post Inflammations of the heart muscle: myocarditis appeared first on Emergency Live.

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Exploring the World of Healthcare Recruitment with Roger

Core Medical Group

Have you ever wondered what it takes to find the perfect match between healthcare candidates and their dream roles? In the world of healthcare recruitment, there are professionals who go above and beyond to find the perfect match between candidates and their respective roles.

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PATCH-trauma: Another negative (but complicated) TXA trial

First 10 EM

I have spent a lot of time reading and talking about the TXA literature. The more literature I see, the less valuable TXA seems. However, trauma remains the one area of practice with a clearly positive trial, with the CRASH2 trial that started it all. Despite its size, the CRASH2 trial was imperfect, and replication […] The post PATCH-trauma: Another negative (but complicated) TXA trial appeared first on First10EM.

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Grand Rounds Recap 6.28.23

Taming the SRU

Admit/Transfer/Discharge - Breakng bad News - History of EM Admit-Transfer-Discharge WITH Dr. Paulsen There are many factors that influence disposition, including independence of the patient and family/friend support, access to follow up, resources at your hospital, and transfer environment Why Transfer? Regionalized certified care centers, specialty procedural interventions, higher level of care Why Consult?

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Magnetic resonance imaging of the heart: the relevance in diagnosing heart disease

Emergency Live

Health of our heart: magnetic resonance imaging is a diagnostic method based on the application of a high-intensity magnetic field directed at the area of interest The post Magnetic resonance imaging of the heart: the relevance in diagnosing heart disease appeared first on Emergency Live.

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EMCrit 353 – Massive Hemorrhage Protocol, the Trauma Anesthesiologist’s Perspective with Roman Dudaryk

EMCrit

Massive Hemorrhage Protocol--The Trauma Anesthesiologist Perspective. EMCrit Project by Scott Weingart, MD FCCM.

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A Listener Criticizes Our Conversation on Medical Journals

Sensible Medicine

In our last podcast , Vinay and I discussed the problem with medical journals. This was in response to a column I wrote about four fatally flawed studies that appeared in the most prominent journals. The commenter is an established academic who will remain nameless because his success depends on journals publishing his work. Was disappointed that in the most recent sensible med podcast — you guys didn't mention what I think is the biggest conflict of all and reason we don't get fair judgin

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Pelvic Fractures

University of Maryland Department of Emergency Med

Pelvic fractures can be a major source of life threatening hemorrhage. Suspect fracture with significant force/mechanism. Signs are pelvic tendern.

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Mastitis, the difference between puerperal and non-puerperal

Emergency Live

Mastitis is a very frequent inflammatory pathology after childbirth, during breastfeeding, and is usually due to an infection of bacterial origin The post Mastitis, the difference between puerperal and non-puerperal appeared first on Emergency Live.

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EMCrit Wee – Case of Failure of Pulse Ox to Confirm Transcutaneous Pacemaker (TCP) Capture with Mathieu Brunet

EMCrit

Today I am joined by Mathieu Brunet, MD; a EM Doc and Trauma Team Leader. He recently wrote me with a case of Transcutaneous Pacing in which he thought he had mechanical capture due to a perfect matched pulse ox waveform. Well it turned out that was erroneous. Why??? Listen to this episode. EMCrit Project by Scott Weingart, MD FCCM.

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emDOCs Podcast – Episode 81: Hemophilia

EMDocs

Today on the emDOCs cast, Brit Long, MD ( @long_brit) covers hemophilia, including background, severity, evaluation, and management. Episode 81: Hemophilia What is hemophilia? Bleeding disorder due to a deficiency in one or more of the proteins (factors) involved in the coagulation pathway. Interruption of the coagulation cascade → ↓ fibrin clot formation → Several types : Hemophilia A – deficiency in factor VIII, 80-85% of cases Hemophilia B – deficiency in factor IX Hemophilia C – deficiency

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MISHA Knee Shock Absorber: Interview with Anton Clifford, CEO of Moximed

Medagadget

Moximed , a medtech company based in California, has developed the MISHA knee system, an implantable shock absorber for use in patients with knee osteoarthritis. The system is designed as an alternative to total knee replacement, and can help to reduce pain and discomfort for patients when performing daily activities, such as walking. The system is implanted on the outside of the knee, beneath the skin, and there is no need to remove bone, muscle, or ligament, resulting in a much faster patient

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Renault: more than 5000 firefighters trained in 19 countries

Emergency Live

Time Fighters: Renault and the Fire Brigade united for Road Safety For more than a decade, a unique partnership has revolutionised the way road accidents are dealt with: that between Renault, the well-known car manufacturer, and the firefighters. Started in 2010, this exclusive collaboration, called ‘Time Fighters’, has a clear and defined objective: to make […] The post Renault: more than 5000 firefighters trained in 19 countries appeared first on Emergency Live.

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Speaking with One Voice on Cancer Screening

Sensible Medicine

As a general internist, cancer screening is part of my job. However, it is a part of my job that can torture me. I know we save hundreds of thousands of people each year with screening tests but I also know that we: we falsely reassure some people by telling them that they do not have disease when they do; we chase down false positive screening tests to prove that people don’t have disease we didn’t think they had until we screened them; and, in some people, we diagnosis and treat di

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Tme to Access: IO vs IV

University of Maryland Department of Emergency Med

This study found that time to intraosseous was faster than time to peripheral IV. This lead to quicker resuscitation time. This was particularly tr.