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There have been many times I have encountered a triage note which states “ patient recently returned from … (insert awesome foreign country) … ” Not only does this leave me daydreaming about my future travel adventures, but has often caused me to take pause. Thoughts of what endemic illnesses could this child potentially have been exposed to in their travels?
Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. These are Osborn waves usually associated with hypothermia. There is also large T wave inversion and long QT.
Background: Massive pulmonary embolism defined as sustained hypotension (SBP <90mmHg) has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) [1]. However, full-dose thrombolytic therapy (Alteplase 100mg (IV) is associated with an increase in bleeding [2]. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety
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!
I got the idea of this story from our project over at Cardiology Trials , where we are cataloging the seminal trials in cardiology. Gosh, I am learning a ton about medical evidence. Please do head over there and join the learning. When I rounded in the coronary care units back at Indiana University in the early 1990s, there was momentum to use IV-magnesium (Mg) in patients after myocardial infarction.
Reference: Wilkinson-Stokes M, Betson J, Sawyer S. Adverse events from nitrate administration during right ventricular myocardial infarction: a systematic review and meta-analysis. Emerg Med J. February 2023 Date: January 24, 2024 Guest Skeptic: Dr. Rupinder Sahsi is a fellow EBM enthusiast with academic appointments at McMaster University and Wright State University who works as an emergency physician […] The post SGEM#428: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in R
Reference: Wilkinson-Stokes M, Betson J, Sawyer S. Adverse events from nitrate administration during right ventricular myocardial infarction: a systematic review and meta-analysis. Emerg Med J. February 2023 Date: January 24, 2024 Guest Skeptic: Dr. Rupinder Sahsi is a fellow EBM enthusiast with academic appointments at McMaster University and Wright State University who works as an emergency physician […] The post SGEM#428: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in R
Background : Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. Tenecteplase, a modified version of alteplase, is being increasingly utilized for AIS due to its favorable pharmacological profile, ease of administration, and cost effectiveness.
Recently, I came across a tweet that lavished praise on an unremarkable article. The article contained, as my friend Bapu Jena likes to say, no new ideas. It merely restated things that had been said before. Immediately, the tweet jumped out at me — there was a disconnect between the flattery and the content. I happen to know the doctor who tweeted this and consider him a straight shooter.
A UK-based study found that 4% of admissions to a tertiary paediatric intensive care unit (PICU) over a 10-year period were due to refractory status epilepticus (RSE) – seizures which fail to terminate despite appropriate first and second-line treatments. Of those patients admitted with RSE, a subset will go on to develop super-refractory status epilepticus (SRSE).
Written by Jesse McLaren, comments by Smith A 55 year old with a history of NSTEMI presented with two hours of exertional chest pain, with normal vitals. Below is the triage ECG, with a computer interpretation (Marquette 12 SL) of “normal” which was confirmed by the over-reading cardiologist. What do you think? Should this patient continue to stay in the waiting room, without interruption of the physician to interpret the ECG, because the computer interpretation is normal?
At a Thanksgiving gathering, a middle-aged doctor talks to an older relative. While enjoying a pre-feast cocktail, the relative asks, “Why is it that doctors don’t want to see patients?” The doctor bumbles through a reply. Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a paid subscriber.
AHA Updates its Cardiac Arrest Guidelines In December 2023, the American Heart Association published a “focused update” to its landmark guidelines for the management of cardiac arrest. PulmCCM is not affiliated with the American Heart Association. Read the document for all the details (it’s not long). Here’s PulmCCM’s take on the new changes.
You’re running a trauma activation, and everything is going great! Primary survey – passed. Resuscitation – lines in, fluid going. You are well into the exam in the secondary survey. Then it happens. The automated blood pressure cuff shows a pressure of 72/44. But the patient looks so good! You recycle the cuff. A minute passes and another low pressure is noted, 80/52.
A 60-something male presented stating that he had had chest pain that morning which awoke him from sleep but then resolved after several minutes. He has had similar pain in the past which he attributed to acid reflux. He has a history of untreated hypertension. He is pain free now. His systolic BP was 200. The patient is pain free at the time of this ECG: What do you think?
Methodology: 4/5 Usefulness: 3.5/5 Thiele H, et al. N Engl J Med. 2023 Oct 5;389(14):1286-1297. Editorial: Routine Early ECLS in Infarct-Related Cardiogenic Shock? Question: Does early ECLS therapy confer a mortality benefit in patients with MI complicated by cardiogenic shock? Methods: Open label RCT with 417 patients comparing 30-day all-cause mortality between ECLS versus standard […] The post Extracorporeal Life Support in Infarct-Related Cardiogenic Shock appeared first on EMOttawa B
In this episode, Sam Ashoo, MD, and T.R. Eckler MD interview Nick Harrison, MD and Daniel Brenner, MD, two of the authors of the February 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Right Heart Failure Pathophysiology Presenting Symptoms Differential Diagnosis Specific Acute Causes PE Sepsis RVMI PPV ARDS COVID-19 Specific Chronic Causes CTEPH Left Heart Failure Congenital Heart Disease LVAD Lung Disease Group 3 Pulmonary Hypertension Pulmonary A
Polypharmacy is technically defined as taking five or more medications on a daily basis. Polypharmacy is increasingly becoming the norm among adults, due to several factors (an aging population, increasing numbers of medical problems, and increasingly complex regimens available to treat chronic disorders such as heart failure). Indeed, the term “polypharmacy” is arguably antiquated now […] EMCrit Project by Josh Farkas.
Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. Louis); Marina Boushra, MD (EM-CCM Attending Physician, Cleveland Clinic Foundation); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case: A 39-year-old male is brought in by EMS with a sudden-onset severe headache
A Leap Forward in the Air Rescue Sector Thanks to Innovative Technologies of Airbus H145 Helicopters Innovations and Versatility of the Airbus H145 The Airbus H145 helicopter stands out in the field of air rescue due to its unique features, making it a benchmark model in the industry. With its new Helionix avionics suite, this […] The post The new faces of helicopter rescue: the success of Airbus' H145s appeared first on Emergency Live.
In this episode, we explore consumer & caregiver perspectives on artificial intelligence, from in-room patient monitoring to AI-powered care searches. The post The Impacts of AI on Patient Experience and Patient Care appeared first on NRC Health.
Sheralyn Guilleminot and Mike Cadogan Using Artificial Intelligence in the Medical Field Full interview with critical care clinician and AI enthusiast, Dr Sameer Shaikh, on the many ways to use AI to save time and increase efficiency in healthcare
Female Health Awareness at the Center of European Strategies The New Era of Women’s Healthcare Prevention in Europe Female healthcare prevention has taken on new importance in Europe, particularly through the EU4Health 2021-2027 program. This program, representing the largest ever undertaken by the EU in the healthcare sector, places a particular emphasis on promoting health […] The post Revolution in women's health: a modern and proactive vision appeared first on Emergency Live
This was sent by Sam Ghali @EM_RESUS A 44 year old man presented with chest pain The tech came running with the ECG as the computer called "STEMI!" What do you think? Sam sent this to me and asked: "What do you think, Steve?" My answer: --Tough one! --But I'm going to stick my neck out and say "Not OMI" --STE in V2 has a near "saddleback" configuration, and that is a sign of false positive STE.
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: Do Febrile Neonates with COVID-19 Need a Full Workup? Spoon Feed This systematic review and meta-analysis of almost 4,000 febrile infants ≤ 90 days old diagnosed with COVID-19 indicated that these patients have a lo
An Integrated Approach to Addressing Alcohol Consumption and its Effects in Europe Informational-Educational Campaigns in Italy In Italy, various initiatives have been launched to raise awareness among young people about the dangers of alcohol. Campaigns such as “Io non sbando” and “Non perderti in un bicchiere” have reached students in schools to disseminate information about […] The post Alcoholism: new awareness strategies in Europe appeared first on Emergency Li
A brief post collating a few bits of my various work published across the interwebs … The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Apple Podcasts Google Podcasts Soundcloud Naturally, there are continuing Journal Club features, covering the following articles: Zone 1 endovascular balloon occlusion of the aorta vs resuscitative thoracotomy for patient resuscitation after severe hemorrha
Chris Nickson Critical Care Reviews… Down Under! Expressions of interest are open to attend the "Critical Care Reviews Down Under" meeting in Melbourne, December 10th & 11th 2024.
Understanding the Symptoms, Causes, and Treatment Options for Rheumatoid Arthritis What is Rheumatoid Arthritis? Rheumatoid arthritis is a chronic autoimmune disease that primarily affects the joints, causing inflammation, pain, swelling, and, in some cases, loss of function. Contrary to what one might think, rheumatoid arthritis is not just a joint disease; it can also have […] The post Rheumatoid arthritis: what it is and how it manifests itself appeared first on Emergency Live.
HISTORY OF PRESENT ILLNESS The patient is a female in her late 60’s presenting with acute onset of left arm pain and swelling. She initially noticed pain in her left arm with movement while helping her family move earlier on the day of presentation. While changing, she noticed that her arm was swollen to the mid humerus. She feels that this swelling came on over several hours.
REBOA (resuscitative endovascular balloon occlusion of the aorta) has been discussed in the emergency medicine world for quite some time now, but always with very limited data. There have been some observational studies that suggested REBOA was associated with worse outcomes, but the outcomes were largely assumed to be the result of confounders. (Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM.
St.Emlyn's - Emergency Medicine #FOAMed Iain and Simon review the best of the blog and the state of UK emergency care in this podcast round up from January 2024. The post Podcast round up: December 2024. St Emlyn’s appeared first on St.Emlyn's.
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