Sensible Medicine

JANUARY 23, 2025

Two health obsessions that I’ve never really understood are the supposed benefits of vitamin D (for every imaginable ill) and harm of seed oils. Dr. Bobby Dubois thinks a lot about the evidence behind health recommendations on his podcast. His research has led him to a pretty clear opinion about the role of seed oils in health and disease. Attentive Sensible Medicine readers will note that his take is a bit different from that expressed in a recent post.

Wellness 97

Wellness Stroke Research 97

Emergency Medicine Journal

JANUARY 21, 2025

This month’s update is by the Emergency Department of the University Hospital of Heraklion, Crete, Greece. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlighted each paper’s main findings, key limitations and clinical bottom line.

Emergency Department 98

Emergency Department Hospitals Outcomes 98

Dr. Smith's ECG Blog

JANUARY 23, 2025

This was written by Hans Helseth. He just graduated from college. He has no medical training, but he has read this blog for years. He is an ECG tech who hopes to go to medical school. He has never been poisoned by the STEMI/NSTEMI paradigm because he has never been to medical school. Lucky Hans. You don't need to have medical training to recognize OMI on the ECG.

EKG/ECG 85

EKG/ECG Poisoning Wellness 85

Science Based Medicine

JANUARY 24, 2025

In 2017, Dr. Vinay Prasad said an anti-vaccine doctor was a "quack". What changed? The post Dr. Vinay Prasad 2025 = Dr. Kelly Brogan 2015 first appeared on Science-Based Medicine.

68

68

PEMBlog

JANUARY 21, 2025

The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. Differentiating these pathogens based on clinical presentation is crucial for targeted management, minimizing unnecessary diagnostic tests, and optimizing healthcare resources.

Pediatrics 52

Pediatrics Rapid Diagnostic Testing Dehydration Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

A short systematic review was undertaken to assess whether intradermal sterile water injections (ISWI) provide effective pain relief in adult patients presenting to the Emergency Department (ED) with renal colic. MEDLINE, Embase, Cochrane and Google Scholar databases were searched, identifying seven relevant studies. Study information, patient characteristics, key results and methodological weaknesses were tabulated.

Emergency Department 52

Emergency Department Research 52

Dr. Smith's ECG Blog

JANUARY 21, 2025

I was reading ECGs on the system and saw all of these, from one patient. I read them without clinical context and looked at the clinical context later. A 70-something dialysis patient presented and coronary disease had missed dialysis and then presented with acute onset of shortness of breath. He denied chest pain. There was mild hypoxia prehospital, lowest saturation 90%, On arrival, BP was 140/84, pulse 122, O2sat 100% and the patient had increased work of breathing.

EKG/ECG 63

EKG/ECG Hospitals Wellness 63

The Evolution & Medicine Review

JANUARY 24, 2025

The abstract deadline is February 3 for the 10th annual meeting of the International Society for Evolution, Medicine, and Public Health will be at Vanderbilt University in Nashville this year, just before a big symposium to celebrate the centenary of the Scopes trial.

52

52

Emergency Medicine Journal

JANUARY 21, 2025

Background Extreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.

Emergency Department 52

Emergency Department Wellness 52

Life in the Fast Lane

JANUARY 23, 2025

Mark Corden Funtabulously Frivolous Friday Five 362 Funtabulously Frivolous Friday Five 362 - Just when you thought your brain could unwind, enter the medical trivia of FFFF.

Fractures 52

Fractures 52

Greater Sydney Area HEMS

JANUARY 23, 2025

Visit the post for more.

52

52

Core Medical Group

JANUARY 23, 2025

Meet traveling physical therapist, Mark Zajac! Get to know Mark and how he found CoreMedical Group as well as his favorite things about traveling with us.

Wellness 52

Wellness 52

Emergency Medicine Journal

JANUARY 21, 2025

Background Growing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences in the utilisation of low-acuity ED visits between culturally and linguistically diverse (CaLD) migrants and English-speaking background (ESB) population.

Emergency Department 52

Emergency Department 52

PulmCCM

JANUARY 23, 2025

Various new “sepsis tests” have come to market or will soon, claiming to solve the problem of diagnostic imprecision in the early management of suspected sepsis. Could they? The lack of a reliable diagnostic test or universally accepted criteria to diagnose sepsis leads to significant challenges in clinical practice and research. Overly general case definitions and sloppy EMR algorithms result in a high rate of overtreatment with antibiotics due to false positives, as well as delayed

Sepsis 45

Sepsis Wellness Emergency Department Research 45

EMergucate

JANUARY 21, 2025

The following ECG is from a young male who has presented with intermittent palpitations. He has no significant medical history.

EKG/ECG 52

EKG/ECG 52

RebelEM

JANUARY 21, 2025

Background: The current standard care for evaluating pulmonary embolism (PE) advises against D-dimer testing in patients with a high clinical probability. European and American guidelines emphasize a sequential diagnostic approach based on pretest probability assessment using either a formal clinical decision instrument (e.g., Wells’ , Revised Geneva ) or clinical gestalt.

EMS 45

EMS Research Wellness Outcomes 45

Emergency Medicine Journal

JANUARY 21, 2025

Background Evidence regarding high-dose inhaled corticosteroids (HDICS) in asthma exacerbations in adults is insufficient. This study compares the treatment outcomes of HDICS as add-on therapy to the outcomes of standard treatment in adult patients with acute asthma exacerbation in the ED. Methods This was a single-centre, triple-blind, randomised controlled trial conducted in the ED in Thailand between March 2022 and April 2023.

Hospitals 52

Hospitals Outcomes 52

The Skeptics' Guide to EM

JANUARY 18, 2025

Date: January 7, 2025 Dr. Dara Kass Guest Skeptics: Dr. Dara Kass is an emergency medicine physician, public health leader, and advocate passionate about equity and healthcare reform. She founded FemInEM, promoting gender equity in emergency medicine, and champions organ donation reform after donating part of her liver to her youngest son. Dr. Kass is dedicated to expanding reproductive healthcare access and educating the public on healthcare policy.

Academics 45

Academics Emergency Department EMS Outcomes 45

Board Bombs

JANUARY 19, 2025

Live from New Orleans! We're telling you the ultimate secret to managing back pain in the ED. You'll never guess what works the best to treat acute low back pain (and you might be disappointed to hear it- let's be real!). Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here.

52

52

EM Literature of Note

JANUARY 21, 2025

The last decade or so featured a rather notable increase in palatability for the conservative management of appendicitis. Why undergo surgery for a condition antibiotics can cure? You wouldn’t take out your bladder for a urinary tract infection, would you? This latest randomized trial adds to the evidence surrounding the “antibiotics first” strategy for appendicitis by expanding it to children.

Operations 91

Operations Hospitals 91

Emergency Medicine Journal

JANUARY 21, 2025

Trauma remains a significant cause of mortality and morbidity. Non-compressible torso haemorrhage is one of the key drives of these mortality data. Our contemporary management has focused on damage control resuscitation, with a focus on haemorrhage control, haemostatic resuscitation and permissive hypotension. The evidence for permissive hypotension lacks the robustness as other treatments, such as tranexamic acid.

Resuscitation 52

Resuscitation 52

St. Emlyn

JANUARY 21, 2025

St.Emlyn's - Emergency Medicine #FOAMed Learn more about the Ten Second Triage tool in this interview recorded at Tactical Trauma 24. The post Podcast – Ten Second Triage with Sean Brayford Harris at Tactical Trauma 24 appeared first on St.Emlyn's.

108

108

Sensible Medicine

JANUARY 21, 2025

Sensible Medicine is spoiled with great submissions. A challenge we face is needing to pass on articles which are interesting, thoughtful, and well-argued but which fall outside our lane – articles that are not even “medicine adjacent” This article, the second we have published by Charles Silver, pushes the edge of the envelope. I think there is enough of the intersection of medicine and society for us to publish this, especially as public health and politics seems to be gettin

Shock 79

Shock Wellness 79

Ken Grauer, MD

JANUARY 24, 2025

I was sent the ECG in Figure-1 without clinical information. I interpreted the rhythm as AFib ( A trial F ibrillation ). QUESTION: Do you see anything else? Figure-1: The initial ECG in today's case. Take another LOOK. To facilitate description I've numbered the beats in Figure-2. Figure-2: I've numbered the beats from Figure-1. Confession: I initially looked at this tracing too quickly.

EKG/ECG 236

EKG/ECG Stroke 236

Emergency Medicine Journal

JANUARY 21, 2025

Background Rapid identification of individuals with acute respiratory infections is crucial for preventing nosocomial infections. For rapid diagnosis, especially in EDs, lateral flow devices (LFDs) are a convenient, inexpensive option with a rapid turnaround. Several ‘multiplex’ LFDs (M-LFDs) now exist, testing for multiple pathogens from a single swab sample.

Emergency Department 52

Emergency Department Hospitals 52

Dr. Smith's ECG Blog

JANUARY 24, 2025

Written by Willy Frick A 52 year old man with hypertension, dyslipidemia, and seropositive rheumatoid arthritis (a risk factor for CAD) presented with acute substernal chest pressure with diaphoresis which woke him from sleep just after midnight. He said it felt like "someone ripped [his] heart out." Ominous. While walking into the ED, the patient had an episode of "dizziness" causing him to fall onto his stomach.

EKG/ECG 108

EKG/ECG Hospitals Wellness 108

Science Based Medicine

JANUARY 22, 2025

The FDA recently removed FD&C Red No. 3 from the list of approved food additives. This was not based on any new data or interpretation of the data, but rather was a response to a petition from food safety and environmental groups. Their argument was in turn based on the Delaney Clause, a 1960 law saying that the FDA must ban any […] The post Why Did the FDA Ban Red Dye #3 first appeared on Science-Based Medicine.

109

109

Ken Grauer, MD

JANUARY 18, 2025

The ECG in Figure-1 was obtained from an older woman who presented to the ED ( E mergency D epartment ) because of a syncopal episode. She was asymptomatic at the time this ECG was recorded. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? Is there AV block? If so What kind? Figure-1: The initial ECG in today's case. ( To improve visualization I've digitized the original ECG using PMcardio ).

EKG/ECG 254

EKG/ECG Wellness 254

Emergency Medicine Journal

JANUARY 21, 2025

The need to isolate patients with influenza and COVID-19 in emergency departments (ED) requires quick screening tests for these infections. 1 Given mutations and newer variants of these diseases, vaccines and varying incidence, we assessed the diagnostic accuracy of two rapid screening tests in our ED in Spain during periods of higher and lower prevalence according to the Acute Respiratory Infection Surveillance System data. 2 A retrospective cross-sectional observational study was carried out i

Emergency Department 52

Emergency Department Hospitals 52

Dr. Smith's ECG Blog

JANUARY 18, 2025

I was texted this case by Ankur Kalra , an interventional cardiologist at the University of Indiana. He also did his cardiology fellowship at my institution, Hennepin County Medical Center. He runs the Parallax podcast, and he inteviewed me on that Podcast this year. He says the podcast had over 3000 downloads and "It's our season 6 topper" Here it is: Ep 121: OMI/NOMI: A Paradigm Shift in Myocardial Infarction Diagnosis With Dr Stephen Smith By the way, also don't miss this new OMI review artic

EKG/ECG 115

EKG/ECG Wellness 115

Sensible Medicine

JANUARY 24, 2025

I frequently get asked whether learning critical appraisal is still important. The argument is that with the complex ways that industry – pharma and device makers — manipulates trials, appraising trials is hopeless unless you have at least an MPH. I totally disagree with this sentiment. A little bit of common sense, an understanding of study design, and some basic stats can carry you a very long way.

Research 101

Research Hospitals Outcomes Wellness 101

Mind The Bleep

JANUARY 24, 2025

A brief guide to help you distinguish between inflammatory and non-inflammatory arthritis in UKLME MCQs. Inflammatory Arthritis Inflammatory arthritis will present with: Joints which have pain, stiffness and swelling. Symptoms worse at rest Symptoms get better with activity Symptoms worst in the morning Stiffness which lasts over 30 mins There are many different types of inflammatory arthritis, these include but are not limited to rheumatoid arthritis, psoriatic arthritis and reactive arthritis.

96

96

Emergency Medicine Journal

JANUARY 21, 2025

Case presentation A 29-year-old man presents to the ED with a foreign body (FB) in his right leg. He was impaled by an organic thorn while doing yard work in his backyard roughly 3 hours prior to presentation. A sample of the type of plant that was inserted into his lower extremity is shown in figure 1. He reports pain with movement of the limb, but no numbness or tingling.

Ultrasounds 52

Ultrasounds Wellness 52

The Bottom Line

JANUARY 24, 2025

ADAPT-Sepsis: PCT or CRP-guided Antibiotic Duration for Patients with suspected Sepsis Dark et al. JAMA Dec 9 2024. doi:10.1001/jama.2024.26458 Clinical Question For critically ill adults with suspected sepsis, does a procalcitonin (PCT) guided or C-reactive protein (CRP) guided antibiotic discontinuation prompt, compared with usual care, reduce the total duration of antibiotics without increasing all-cause 28-day mortality?

Sepsis 91

Sepsis 91

American Medical Compliance

JANUARY 23, 2025

A recent Joint Accreditation Data Report shows that healthcare continuing education is expanding to meet the growing needs of the industry. In 2022, the number of organizations providing healthcare training increased from 132 to 146, marking a 10% rise from the previous year. Additionally, learning opportunities saw significant growth, with a 31% increase in training programs and a 13% rise in participation among healthcare professionals.

Best Practices 81

Best Practices Teamwork Patient Safety Wellness 81

EMDocs

JANUARY 18, 2025

We always work hard, but we may not have time to read through a bunch of journals. Its 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: When to Start Norepinephrine for Septic Shock? Spoon Feed In a meta-analysis of patients with septic shock, starting norepinephrine earlier had no mortality benefit, though heterogeneity and bias limit clinically rel

Shock 82

Shock Administration 82

Emergency Medicine Journal

JANUARY 21, 2025

We congratulate Xu et al on developing a machine learning-derived triage tool for major incidents. 1 The use of this technology, together with artificial intelligence, is likely to increase rapidly, and a triage tool that relies on binary questions, rather than quantitative measures or calculations, is intuitively advantageous. However, the proposed tool, while statistically sound, suffers from a lack of face-validity.

Research 52

Research 52