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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
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.
= 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.
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!
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.
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.
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.
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.
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.
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?
Let’s start with a picture: This is the Kaplan-Meier curve, from an RCT, published in JAMA , of an oral medication vs a placebo given to patients after a myocardial infarction (MI). The group on the drug sustained a 36% reduction in the occurrence a major adverse cardiac or brain event vs placebo. Outcomes included cardiac death, MI, emergency coronary revascularization or stroke.
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.
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-
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.
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
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
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.
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.
Authors: Saran S. Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. Belcher, MD (EM Attending Physician, University of Kentucky, Department of Emergency Medicine) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) “What do you call an IV contrast shortage?
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.
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.
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.
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.
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.
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.
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.
Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! This series provides evidence-based updates to previous posts so you can stay current with what you need to know.
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.
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
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: How Useful Is Lactate Clearance Anyway? Spoon Feed Don’t hang your hat on lactate clearance to assess therapeutic response to resuscitation in sepsis; there are too many confounders, and initial clearance does not n
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