The Trauma Pro

OCTOBER 31, 2023

Consultants provide very important services to trauma patients in the ED and inpatient settings. The trauma professionals managing those patients can’t know everything (although we sometimes think we do). But occasionally our patients present issues that require evaluation by other experts in order to guarantee excellent care. Sometimes our consultants want to do too much, or make recommendations that are not really in their area of expertise (e.g. a cardiologist evaluating a cardiac contu

Risk Management 113

Risk Management Documentation/Coding Fractures Hospitals 113

Pediatric EM Morsels

NOVEMBER 3, 2023

Imported Malaria , like all imported tropical illnesses, is a Tale of Two Cities. The infection was unknowingly obtained while enjoying a delightful holiday and then brought back in transit to a country where it is not endemic. In these non-endemic countries, we need to always be attentive to patient’s history of recent travel to correctly identify any concerns related to their recent travel.

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

Ken Grauer, MD

OCTOBER 29, 2023

= NOTE: These are my "slides" for November 2, 2023 — for my M edALL p resentation. The talk will be recorded and posted on-line. Based on ECG Blog #351 ( www.tinyurl.com/KG-Blog-351 ) LINK to this Page — www. tinyurl.com/KG-MedAll-351 — = = ECG Blog #205 = The Systematic Approach I favor. The "formula" = [link] LINK for Blog #205 = [link] - = Figure: The Systematic Approach that I favor.

EKG/ECG 195

EKG/ECG 195

Sensible Medicine

NOVEMBER 2, 2023

Doctors and ‘experts’ who got COVID policy wrong are asking for forgiveness. Their errors hurt children— resulting in massive learning losses— and caused broader destabilization to the economy, work life, social communities and more. Do they deserve forgiveness? And, why did they err in the first place? Recently Scott Galloway, the NYU professor, appeared on Bill Maher.

Documentation/Coding 145

Documentation/Coding Pediatrics 145

Don't Forget the Bubbles

OCTOBER 30, 2023

Read between the lines. No matter where we are or what type of medicine we practice, it is likely that we all were told at one point that we were expected to be lifelong learners. This is important as medical knowledge is constantly evolving. Dr. David Sackett, the father of evidence-based medicine, once said: I The traditional way to stay current is by reading the relevant scientific literature.

Research 144

Research Outcomes 144

The Trauma Pro

NOVEMBER 3, 2023

I know this has happened to most of you at one point or another: One of your trauma patients sustains an injury outside of your area of expertise. You engage a consultant to evaluate that condition and manage it. They do so, and it requires some type of invasive procedure. They return from the procedure, and as you are rounding on the patient, you find the consultant has ordered a medication that you have not seen ordered for that procedure before.

Poisoning 147

Poisoning Wellness 147

RebelEM

OCTOBER 30, 2023

Background: Hemorrhage is the leading cause of trauma related mortality. The initial injury is often complicated by multifactorial coagulopathy that can exacerbate bleeding. Fibrinogen is the precursor to fibrin and a major component of stable clot formation. Fibrinogen and fibrin are often depleted during major trauma as a result of consumption, breakdown, and dilution.

Administration 128

Administration Blood Transfusions Outcomes Hospitals 128

EM Ottawa

NOVEMBER 2, 2023

Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1) These injuries can be debilitating requiring surgical intervention, debridement or amputation in the most severe cases.

Emergency Department 118

Emergency Department Wellness Hospitals Resuscitation 118

Dr. Smith's ECG Blog

OCTOBER 30, 2023

A 60 yo with 2 previous inferior (RCA) STEMIs, stented, called 911 for one hour of chest pain. He had no h/o heart failure. Here is the first prehospital ECG (time 0, after one hour of pain): I do not see evidence of OMI, and neither did the Queen of Hearts Here is the 2nd prehospital ECG (time 10 minutes, after 70 minutes of pain): No change On arrival, the first ED ECG was recorded 20 minutes after the last one (90 minutes after pain onset): What do you think?

EKG/ECG 112

EKG/ECG 112

Life in the Fast Lane

OCTOBER 29, 2023

Kane Guthrie Haemorrhage Control Haemorrhage Control: Principles and Cognitive Aid with Cliff Reid. Don't Let Your Patient Bleed to Death!

Resuscitation 127

Resuscitation 127

ACEP Now

OCTOBER 30, 2023

What does your program offer that residents can’t get anywhere else? We are the first community emergency medicine program in the country. Residents train at an academic Level I trauma center and several freestanding emergency departments (EDs). We offer innovative ultrasound training, which includes nerve blocks in the ED, and annually participate in SAEM Sonograms.

Ultrasounds 111

Ultrasounds Academics Emergency Department 111

EM Ottawa

OCTOBER 30, 2023

Methodology: 1.5/5 Usefulness: 1.5/5 Loke DE, et al. CJEM. 2022 Mar;24(2):206-213. Question and Methods: Trying to quantify gender disparities in CT turnaround time and ED LOS and determine if intervention in the form of protocolized point-of -care pregnancy testing would eliminate the disparity. Findings: Pre intervention women of childbearing age had 18 min longer CT […] The post Implementation of a standardized pregnancy screening process to address gender disparities in radiology turn-

Radiology 108

Radiology Radiology 108

Medagadget

NOVEMBER 1, 2023

Researchers at the Wyss Institute at Harvard University have developed a microfluidic chip that can recreate some of the features of radiation-induced lung injury. The lungs are very sensitive to radiation, and this can limit the application of radiotherapy to treat cancer. Accurately modeling radiation-induced lung injury could assist in developing new methods to prevent and treat the phenomenon, but it has been difficult to study this before the advent of advanced organ-on-a-chip models.

Research 106

Research Wellness 106

Emergency Live

OCTOBER 30, 2023

Hero of the Sky: How the 85th SAR Centre at Pratica di Mare (Italy) Performed a Complex Rescue At first light, the Italian Air Force completed an extraordinary rescue mission, once again demonstrating the value and effectiveness of its operations in critical situations. With an HH-139B helicopter from the 85th SAR (Search and Rescue) Centre […] The post Air Force Rescue: Rescue of a Hiker on Mount Miletto (Italy) appeared first on Emergency Live.

Operations 105

Operations 105

Sensible Medicine

NOVEMBER 3, 2023

When I look back on these reflections, it is surprising to me how much I’ve written about death. I am not a palliative care physician or even a geriatrician. Even though my practice is made up of about 750, overwhelmingly older people, mostly with chronic medical conditions, I only attend to the death of a patient a few times a month. Let’s contrast that to the thirty or so cases of hypertension I manage each week.

Hospice 109

Hospice Head Injuries Academics Hospitals 109

EM Ottawa

OCTOBER 30, 2023

Methodology: 4/5 Usefulness: 3.5/5 Prekker ME et al. N Engl J Med. 2023 Aug 3;389(5):418-429. Question and Methods: Authors aimed to determine if video laryngoscopy improves rates of first pass success compared to direct laryngoscopy. They performed a pragmatic, multicenter, unblinded randomized parallel-group trial. Findings: 85.1% first pass success with video laryngoscopy and 70.8% with direct […] The post Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Ad

108

108

Life in the Fast Lane

NOVEMBER 1, 2023

James Miers and John Mackenzie Ocular foreign body removal Emergency Procedure: Ocular foreign body removal.

131

131

Emergency Live

OCTOBER 30, 2023

Rescue Teams Intervene Massively After Collision Between Two Trains in Southeast India A serious train accident sowed death and destruction last night in southeastern India, specifically between the towns of Alamanda and Kantakapalle in the state of Andhra Pradesh. Two trains collided under circumstances yet to be clarified, leaving behind a devastating toll of 13 […] The post India: Train Accident in Andhra Pradesh, Balance Sheet Very Severe appeared first on Emergency Live.

105

105

ACEP Now

OCTOBER 30, 2023

A disability is any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them. 1 This includes impairments or difficulty with: vision; movement, processing, or thinking and remembering; verbal or non-verbal communication; mental health; hearing; or relationships.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

Kings County Downstate EM

OCTOBER 30, 2023

Co-Authors: Esteban Davila, Hemil Chauhan This is part 2 of a 2-part series focusing on BRASH. Part 1 can be found here. Patient Presentation A 70-year-old male with a past medical history of diabetes, hypertension, and chronic kidney disease (baseline creatinine 2-3 mg/dL) is brought in by EMS after being […] The post BRASH Part 2: A BRASH with Death appeared first on County EM.

EMS 98

EMS 98

Taming the SRU

NOVEMBER 3, 2023

Kring, R. M. et al. Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. J. Ultrasound Med. 41, 2695–2701 (2022). Broad strokes In this prospective, non-randomized study published by Kring et al in January 2022 out of Maine Medical Center, researchers compared mean pain scores at rest and during incentive spirometry before, at 15 minutes after, and then 60 minutes after treatment with a serratus anterior plane block.

Fractures 98

Fractures Ultrasounds Outcomes Research 98

Emergency Live

OCTOBER 30, 2023

San Diego Introduces Regulations for the Safety and Disposal of Lithium Batteries: Pioneering Initiative for Responsible and Safe Use In a bid to address safety concerns and promote responsible disposal practices, San Diego is set to become the first city in the county to introduce comprehensive regulations governing the storage and disposal of lithium-ion batteries. […] The post San Diego regulates lithium-ion batteries appeared first on Emergency Live.

105

105

Medagadget

OCTOBER 31, 2023

A team at Columbia University School of Engineering and Applied Science has developed a technique to enhance chimeric antigen receptor (CAR) T cell therapy in solid tumors. The technique involves engineering E. coli bacteria, that naturally tend to accumulate in the immune privileged core of solid tumors. The bacteria have been engineered to interact with tumor cells and deposit a synthetic antigen on the cells that can then be targeted by CAR T cells.

Research 96

Research Wellness 96

Science Based Medicine

NOVEMBER 1, 2023

The evidence continues to support that low levels of fluoride in drinking water are safe. The post Fluoride and IQ first appeared on Science-Based Medicine.

101

101

RebelEM

NOVEMBER 1, 2023

What is Flow? Simply put, flow is the peak of human performance, maximum focus with maximum responsiveness, an optimal state of consciousness. This state of mind is accessible to anyone under the right circumstances and has huge implications to how we live, work and train. REBEL Cast Book Club Episode 4 — The Rise of Superman: Decoding the Science of Ultimate Human Performance Click here for Direct Download of the Podcast In “The Rise of Superman,” Steven Kotler details the flow state throug

EMS 90

EMS Hospitals 90

Emergency Live

OCTOBER 31, 2023

160th Anniversary of the Red Cross Emblem: a conference to celebrate and learn more about the symbol of humanitarianism On 28 October, Italian Red Cross President Rosario Valastro kicked off the CRI Conference dedicated to the 160th Anniversary of the Red Cross Emblem. The event was a unique opportunity to celebrate the iconic symbol that […] The post CRI Conference: Celebrating the 160th Anniversary of the Red Cross Emblem appeared first on Emergency Live.

105

105

Medagadget

NOVEMBER 1, 2023

Researchers at Rice University have developed a magnetoelectric material that converts a magnetic field into an electric field. The material can be formulated such that it can be injected into the body, near a neuron, and then an alternating magnetic field can be applied to the area from outside the body. Magnetic fields are very useful in this context, as they can easily penetrate tissue without causing any damage.

Research 91

Research 91

Science Based Medicine

OCTOBER 30, 2023

Antivaxxers don't like it when one of their crappy studies that they somehow managed to sneak into a decent peer-reviewed journal is deservedly retracted, as happened to Mark Skidmore's paper that estimated that 278K people might have died from COVID-19 vaccines. Fortunately for Skidmore and others, there exist fake journals that will launder their study by republishing it so that antivaxxers can continue to claim the work has been published in a "peer-reviewed journal.

94

94

Core Medical Group

NOVEMBER 3, 2023

In the world of healthcare recruitment, Chelsea's journey has been very influential. For the past six months, she's worked as a Recruiter within CoreMedical Group's Allied Healthcare Division, finding inspiration in her work and her team's collaborative spirit. Beyond her professional role, Chelsea is a culinary enthusiast, crafting new recipes in the kitchen.

89

89

Emergency Live

OCTOBER 31, 2023

Theoretical and practical emergency-urgency congress in Bari (Italy): a unique opportunity for professionals and practitioners A not-to-be-missed event is the one promoted and conceived by Dr. Fausto D’Agostino, medical director Anesthesiologist Resuscitation at the Campus Bio-Medico in Rome, which will be held in Bari at the Hi Hotel on Nov. 24-25 entitled “Theoretical-Practical EMERGENCY-URGENCY Congress“ […] The post Bari: Practical Emergency-Urgency Congress With Top

Resuscitation 105

Resuscitation 105

Medagadget

OCTOBER 31, 2023

Arriving in two boxes reminiscent of Apple product packaging – one for the chest piece (the part that contacts the body), and another for the detachable earpiece (tubes + ear tips) – the CORE 500 is clearly an upgrade from the Eko DUO stethoscope. Similar to its predecessor, the CORE 500 can be used with your own headphones, smart phone, and just the chest piece, making it free of any hassle with the earpiece tubes.

EKG/ECG 90

EKG/ECG Burns Wellness Telemedicine 90

Science Based Medicine

NOVEMBER 3, 2023

Part 1 is available here. “There is No COVID Heart” On May 14, 2021, three “medical conservatives,” Drs. John Mandrola, Andrew Foy and Vinay Prasad, published an article titled “Setting the Record Straight: There is No ‘Covid Heart’” In it, they argued that “The issue of Covid-19 induced cardiac problems was massively overblown.” Though the virus had existed for barely over year, they were very […] The post Part 2: Is an Abnormal Lab Val

89

89

EB Medicine

NOVEMBER 1, 2023

In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the November 2023 Pediatric Emergency Medicine Practice article, Pediatric Diabetes: Management of Acute Complications in the Emergency Department and some of the highlights from the other EB Medicine articles published in November. Epidemiology Differential diagnosis Prehospital care ED history and physical exam Diagnostic studies Point of care testing Labs Imaging Treatment IV fluids, the 2-bag system Mild DKA Moderate to severe DKA

Pediatrics 90

Pediatrics Point-of-Care Testing Urgent Care Emergency Department 90

Emergency Live

NOVEMBER 3, 2023

Guido Crosetto and Civil Defense Coordinate Search and Assistance Efforts in Weather Devastated Areas in Tuscany The weather emergency has hit Italy with unprecedented force, and in the last few hours, the heart of Tuscany, straining the resilience of infrastructure and the safety of local populations. At a time when nature is demonstrating all its […] The post Bad Weather in Tuscany (Italy): Defense Mobilizes for Relief Operations appeared first on Emergency Live.

Operations 104

Operations 104

ALiEM

NOVEMBER 3, 2023

Welcome to the AIR Trauma Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to trauma in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board.

Blood Transfusions 84

Blood Transfusions EMS Emergency Department Resuscitation 84

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

Written by Nathanael Franks MD, reviewed by Meyers, Smith, Grauer, etc. A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest.

EKG/ECG 82

EKG/ECG Shock Documentation/Coding Academics 82

The Skeptics' Guide to EM

OCTOBER 28, 2023

Date: October 26, 2023 Reference: Jones et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial placebo-controlled trial. Lancet July 2023 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers […] The post SGEM#419: Welcome Back – To Another Episode on Back Pain first appeared on The Skeptics Guide

Emergency Department 88

Emergency Department Research 88