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The ECG in Figure-1 — was obtained from a middle-aged man who presented to the ED ( E mergency D epartment ) in cardiac arrest. ROSC ( R eturn O f S pontaneous C irculation ) was obtained — and ECG #1 was recorded. In view of this history — How would YOU interpret the ECG in Figure-1 ? Should you activate the cath lab? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).
A bucket-handle injury is a relatively uncommon complication of blunt trauma to the abdomen. It only occurs in a few percent of patients, but is much more likely if they have a seat belt sign. The basic pathology is that the bowel mesentery (small bowel of sigmoid colon) gets pulled away from the intestinal wall. This injury is problematic because it may take a few days for the bowel itself to die and perforate.
Reference: Kruse et al. Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People Recommendations for Immediate Action to Improve Care. WJEM December 2023 Date: May 30, 2024 Guest Skeptic: Dr. Kay Dingwell is a rural emergency physician working in Prince County, PEI with a special interest in gender-affirming care and improving the care of trans and gender-diverse patients.
Ooooo the infamous chief complaint of “ weakness ” ……. We just love those don’t we? Although neurological complaints may not be a crowd’s favorite, it is one we must become comfortable with. Timely recognition and treatment can be life-improving and life-saving! So, with that goal in mind, let us digest another delicious morsel on weakness – Acute Transverse Myelitis in Children : Acute Transverse Myelitis in Children: Basics Rare, non-compressive, inflammatory condition of the spinal cord
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!
St.Emlyn's - Emergency Medicine #FOAMed Presentation skills - what are they and why do we need to have them? This post covers the things to consider before you even open any presentation software. The post Ten Tips for Better Presentations – Part 1 appeared first on St.Emlyn's.
the PREOXI trial validates what I have been saying for 15 years about preoxygenation for the critically ill patient EMCrit Project by Scott Weingart, MD FCCM.
Recently I heard the story about a residency program where it is a cultural norm to call out “fake sick.” In other words, if a resident has a particularly long or rough day, if they feel they need some rest— even in the absence of fever, chills, drenching night-sweats and propulsive vomiting— they will call out “sick” Covering residents remark how interesting it is that fake sick days are usually on weekends or adjacent to weekends (Mon-Fri), and that this is
Recently I heard the story about a residency program where it is a cultural norm to call out “fake sick.” In other words, if a resident has a particularly long or rough day, if they feel they need some rest— even in the absence of fever, chills, drenching night-sweats and propulsive vomiting— they will call out “sick” Covering residents remark how interesting it is that fake sick days are usually on weekends or adjacent to weekends (Mon-Fri), and that this is
Preparation for intubation, appropriate preoxygenation, and preventing peri-intubation arrests has been one of my core topics for conference talks. My initial airway series emphasized “optimizing the basics” and carefully considering “is this patient ready for intubation?”. My “RSI and then they die” lecture is by far my most watched video on YouTube.
For years, adult literature has provided clear guidelines for cervical spine imaging through the NEXUS and Canadian C-spine Rule (CCR) tools. These have been invaluable in helping clinicians decide when to image the neck in trauma patients. Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children.
St.Emlyn's - Emergency Medicine #FOAMed Discover the highlights of Day 1 at the Premier conference on Paediatric Emergency Medicine. The post Paediatric Emergency Medicine – Premier Conference – Day 1 appeared first on St.Emlyn's.
This is a story about placebo effects. I raise the issue because the prominent journal JAMA-Psychiatry published a paper purporting to show that placebos have great effects in many psychiatric conditions. The erroneous conclusion provides excellent teaching points. First a Thought Experiment Say I gave 100 cyclists a red supplement designed to increase muscle contraction and increase pedal power.
Written by Pendell Meyers with edits by Smith. Sent by anonymous A man in his 40s with no previous heart disease presented within 30 minutes of onset of acute chest pain that started while exercising. There was associated shortness of breath and left arm radiation. This Triage ECG (ECG #1) was recorded on a chest pain patient at triage at 1906 (top highest quality image, bottom photo including computer algorithm interpretation): "Sinus rhythm, normal ECG" (This was performed on a Mortara machine
As we have covered multiple times before, the evidence for paxlovid is heavily conflicted and mostly negative. There is very little reason to be using this agent clinically. However, despite an utter lack of evidence, many people have held out hope that paxlovid might be the miracle cure for the nebulous long COVID syndrome (referred […] The post Paxlovid doesn’t work for long COVID either (The STOP-PASC trial) appeared first on First10EM.
St.Emlyn's - Emergency Medicine #FOAMed This secondary analysis of the DOSE VF trial highlights double sequential external defibrillation (DSED) as a superior strategy over standard and vector change defibrillation for refractory ventricular fibrillation (RVF) in out-of-hospital cardiac arrest, improving survival rates and neurological outcomes significantly.
Recently, Aaron Goodman, a hematologist at UCSD, tweeted: It generated a backlash, particularly among doctors who run research labs, some e.g.s The dialog raises several adjacent questions Are physician scientists — people who mostly run labs and see patients 1/2 a day a week in clinic and 2-4 weeks a year in the hospital — good doctors ?
Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we look at hypocalcemia in trauma and the diamond of death. Episode 102: Hypocalcemia in Trauma and the Diamond of Death Why is hypocalcemia in trauma something we should know about? Previous triad of death = hypothermia, acidosis, and coagulopathy. All are associated with critical illness and severe hemorrhage.
A patient presented with hypotension and altered mental status and presumption of DKA. As the medics arrived, they handed me this ECG: What medication did I call for IMMEDIATELY when I saw this? This is obviously severe hyperkalemia and the patient is near cardiac arrest. The medics had no idea. I called for 2 grams of Calcium Chloride. There was no IV access, so we obtained intraosseous (IO) access, but she arrested before we could give her all the calcium.
Origins of the 911 Number The emergency number 911, known in the United States as the universal number for emergencies, has its origins in the 1960s. Before 911, there wasn’t a single number that anyone in distress could call, which led people to often dial direct numbers of local police stations, fire departments, or hospitals, […] The post The History of the 911 Emergency Number appeared first on Emergency Live.
Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.
Perelman VS, Francis GJ, Rutledge T, Foote J, Martino F, Dranitsaris G. Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department A randomized controlled trial. Ann Emerg Med 2004;43(3):362–70. 10.1016/j.annemergmed.2003.09.008 This was a multicenter, prospective, and single blinded randomized control trial designed to determine whether rates of infection after repair of uncomplicated lacerations in immunocompetent patients is comparable using clean non
This case was posted by Eric Funk ( [link] ) , editor of the Expert Witness Newsletter , on his site. Here is the case on his site. He has graciously allowed me to repost it here. It is a case he presented several years ago, but then want to re-visit in light of the Queen of Hearts AI system. Don't miss his analysis and assessment of the Queen of Hearts AI OMI ECG bot -- that assessment is at the very bottom of the post.
An Intricate World of Adenomatous Polyps Adenomatosis occurs when numerous adenomatous polyps form within the body. Adenomatous polyps are benign glandular tumors. They can arise in various organs, but are most common in the colon. These polyps vary greatly in shape and size and, although benign in the early stages, can become neoplastic cells if […] The post Adenomatosis: Understanding a Complex Condition appeared first on Emergency Live.
Authors: Eliza Szybka, DO (EM Resident Physician, Department of Emergency Medicine, Advocate Christ Medical Center, Oak Lawn IL); Michael Cirone, MD (@mcironeMD, Assistant Program Director, Advocate Christ Medical Center, Oak Lawn IL) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge
I was hopeful that our series on churnalism would change the world of healthcare and biomedical research journalism. I thought that journalists would never again commit one of the seven deadly sins of churnalism. Sensible Medicine is a reader-supported publication. I you appreciate our work, consider becoming a free or paid subscriber. They would never assume causation when a study only showed an association (1).
In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Corey Hazekamp, MD, MS, one of authors of the June 2024 Emergency Medicine Practice article, Managing Emergency Department Patients With Opioid Use Disorder Current State of Opioid Epidemic Overview of overdose deaths and trends. Data and statistics about opioid overdose mortality rates.
Advanced Training for Security and Civil Protection Professionals: Registrations Open Until November 8, 2024 The Università Cattolica del Sacro Cuore is launching a new Master’s program in Crisis & Disaster Management, led by Professor Marco Lombardi. This interdisciplinary program aims to provide qualifications and professional recognition in the field of Civil Protection, healthcare, and specific […] The post Master in Crisis & Disaster Management: Enrolment open appeared
Written by Willy Frick A 57 year old man with was admitted to the hospital with chest pain. He underwent coronary angiography which showed severe multivessel disease, and he agreed to proceed with workup for CABG. Overnight, his cardiac telemetry showed the following: Telemetry Sample 1 What do you think? The rhythm terminated before it could be captured on 12-lead.
In today's rapidly evolving technological landscape, innovation is challenging human adaptability such that we are barely able to predict which technology will exist within the next six months. One of the most striking examples of this acceleration is the release of Large Language Models (LLMs). In November 2022, OpenAI launched ChatGPT-3.5. Over the following 18 months, not only were two upgrades released for ChatGPT but users also got the ability to create their own GPTs through more specific
In the rapidly evolving landscape of healthcare technology, the integration of clinicians into product development teams has emerged as a crucial element for success. As a panelist on "Clinicians who VC," I had the opportunity to discuss the multifaceted roles clinicians play in product development and the unique value they bring to the table.
At the center of attention will be climate change, civil protection, artificial intelligence, and sustainability. We are halfway through the journey leading up to INTERSCHUTZ, scheduled in Hannover from June 1st to June 6th, 2026. The next edition of the world’s leading trade fair for fire and rescue services, civil protection, and security is exactly […] The post Four focal themes for Interschutz appeared first on Emergency Live.
Methodology: 3.5/5 Usefulness: 2.5/5 Montini G, et al. Pediatrics. 2024 Jan 1;153(1):e2023062598. Question and Methods: This multicenter, parallel-group randomized controlled trial intended to determine the non-inferiority of a 5-day versus 10-day course of oral clavulin for treating of febrile urinary tract infections (fUTI) in children. Findings: The primary outcome of recurrence of UTI within 30 […] The post Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections:
You won’t want to miss an exceptional keynote to kick off our event, featuring Geeta Nayyar, M.D., M.B.A., a globally recognized chief medical officer, technologist, and bestselling author who helps leaders leverage a human approach to innovation, including rapid advances in AI, to achieve better health and business outcomes. The post What does the real patient experience scale look like?
The complexity of rescue operations Rescue operations following mining accidents represent some of the most dangerous and complex rescue challenges. Coordination, advanced technologies, and specialized skills are essential to overcome obstacles such as collapses, floods, and critical weather conditions. Preparation and initial response Preparation is key in this process.
St.Emlyn's - Emergency Medicine #FOAMed This secondary analysis of the DOSE VF trial highlights double sequential external defibrillation (DSED) as a superior strategy over standard and vector change defibrillation for refractory ventricular fibrillation (RVF) The post Does the outcome from refractory VF differ from recurrent VF in DOSE-VF patients?
Aware of growing discourse among emergency physicians about physician unionization, the ACEP Board of directors spent some time at its April meeting discussing what role—if any—ACEP could play. Although not committed to implementation of either, the Board discussed possible options including providing support to members who want to unionize themselves and considering partnership with one or more established unions.
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