Sat.Oct 28, 2023 - Fri.Nov 03, 2023

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Help! My Consultant Won’t Come In To See A Patient!

The Trauma Pro

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

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Imported Malaria

Pediatric EM Morsels

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
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MEDALL Lecture Slides — Blog #351 — Posterior Leads.

Ken Grauer, MD

= 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.

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Doctors and 'experts' who got it wrong during the COVID-19 pandemic

Sensible Medicine

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.

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Guidelines Merge STEMI and non-STE ACS: ECS emphasizes that ACS is a spectrum of disease, not only a STEMI-NSTEMI dichotomy

Emergency Medicine News

An abstract is unavailable.

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How To Read a Scientific Paper

Don't Forget the Bubbles

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
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Ocular foreign body removal

Life in the Fast Lane

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

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More Trending

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Fluoride and IQ

Science Based Medicine

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.

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"Non-STEMI" is a worthless term.

Dr. Smith's ECG Blog

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 121
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Haemorrhage Control

Life in the Fast Lane

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

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The Deep Freeze: A Review of Frostbite Management

EM Ottawa

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.

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If only critical appraisal was this good for *all* studies

Stop and 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.

Stroke 120
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Study laundering: IPAK, antivax “scientists,” and the return of living dead antivax studies

Science Based Medicine

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.

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Friday Reflection 32: The Trauma of Not Dying Alone

Sensible Medicine

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.

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Not All EDs Are Created Equal: PCPs must make sure they specify which ED when they tell patients to ‘go to the ER’

Emergency Medicine News

An abstract is unavailable.

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Consultant Gives An Unusual Recommendation: What Would You Do?

The Trauma Pro

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 113
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Residency Spotlight: Cleveland Clinic Akron General

ACEP Now

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.

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Haemorrhage Control Part 2

Life in the Fast Lane

Kane Guthrie Haemorrhage Control Part 2 Haemorrhage Control: Principles and Cognitive Aid Part 2.

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Nurses Called ‘Doctor’: How do patients distinguish between DNPs and MDs/DOs when both call themselves doctor?

Emergency Medicine News

An abstract is unavailable.

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Implementation of a standardized pregnancy screening process to address gender disparities in radiology turn-around-time and ED length of stay

EM Ottawa

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-

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Part 2: Is an Abnormal Lab Value After Vaccination More Concerning Than Death From COVID?

Science Based Medicine

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

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Lung Chip Mimics Radiation Injury

Medagadget

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.

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Air Force Rescue: Rescue of a Hiker on Mount Miletto (Italy)

Emergency Live

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.

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Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults

EM Ottawa

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

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PATCH-Trauma Trial's Mixed Results: No improved functional outcome was seen, though mortality from hemorrhage declined

Emergency Medicine News

An abstract is unavailable.

Outcomes 101
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EQUAL: a Straightforward Approach To Caring for Disabled Patients

ACEP Now

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.

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India: Train Accident in Andhra Pradesh, Balance Sheet Very Severe

Emergency Live

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.

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BRASH Part 2: A BRASH with Death

Kings County Downstate EM

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.

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Phenylephrine is Worthless? No Surprise: The drug is found in 261 different OTC products, and is completely ineffective as a decongestant

Emergency Medicine News

An abstract is unavailable.

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Serratus Anterior Plane Blocks for Rib Fractures in the ED

Taming the SRU

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.

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San Diego regulates lithium-ion batteries

Emergency Live

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.

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Bacteria Tag Team Tumors with T Cells

Medagadget

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.

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Chelsea's Path: Balancing Healthcare Recruitment and Parenthood

Core Medical Group

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.

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Pediatric DKA and HHS

EB Medicine

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

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CRI Conference: Celebrating the 160th Anniversary of the Red Cross Emblem

Emergency Live

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.

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Magnetoelectric Material Stimulates Neurons Minimally Invasively

Medagadget

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.

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See this "NSTEMI" go unrecognized for what it really is, how it progresses, and what happens

Dr. Smith's ECG Blog

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.

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