Sensible Medicine

NOVEMBER 18, 2023

This week, a viewpoint appeared in JAMA Health forum. It argues that patients, particularly disabled and immunocompromised patients, should be able to request health care providers wear masks, and providers should not be permitted to decline that request. Doctors have a duty not to harm their patients, and ergo, should wear masks when requested. It then discusses ways state medical boards and other groups can police this policy.

Blood Transfusions 141

Blood Transfusions Hospitals Wellness 141

Ken Grauer, MD

NOVEMBER 18, 2023

== — CLICK HERE — for a V ideo presentation of this case! ( 15 minutes ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #344 — == How would YOU interpret the lead II rhythm strip shown in Figure-1 ? Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? Or — Is it “ something else ”? Figure-1: How would YOU interpret this lead II rhythm strip?

EKG/ECG 248

EKG/ECG 248

Science Based Medicine

NOVEMBER 20, 2023

The BMJ, once a bastion of evidence-based medicine, has become disturbingly susceptible to publishing biased "investigations" that feed antivax narratives. Its latest report on VAERS by Jennifer Block, who in the past has defended Gwyneth Paltrow and Goop and whose history is not one of supporting science, is just another example of this deterioration.

CDC 134

CDC 134

Stop and Think

NOVEMBER 19, 2023

I had thoughts. Maybe you did too. There were just so many media reports of cardiac arrest in athletes. This is a column about two things—a medical problem (cardiac arrest) and the way our brains work. During the pandemic we learned that the vaccine against SARS-CoV-2 could cause myocarditis—or inflammation of the heart. Young males had the highest risk of this adverse effect.

Documentation/Coding 128

Documentation/Coding Wellness Resuscitation 128

Sensible Medicine

NOVEMBER 23, 2023

I want to begin this post by saying: I wish the nothing but the best to the patient, Carol, who has a diagnosis of lung cancer. I hope that our medicines are able to give her a long and rich life, and that a new discovery can eliminate this disease. This is a post about her doctors at Vanderbilt. I also want to say that I am confident insurers can behave poorly, peer to peer is an insult, and prior auth is a broken system, but medicine has to be careful not to offer unproven and costly things to

Operations 130

Operations Research Wellness 130

Don't Forget the Bubbles

NOVEMBER 22, 2023

One-liner… Although commonly used, Propofol can have severe adverse effects. Propofol Infusion Syndrome (PRIS) can lead to significant morbidity and mortality in children. What is Propofol? Commonly referred to as “the milk of amnesia”, propofol is a drug used for induction and maintenance of general anaesthesia and for procedural sedation. Propofol is prepared in a lipid emulsion, giving it a characteristic milky white appearance, and due to its ability to dissolve in fats, it is rapidly redist

Pediatrics 126

Pediatrics Research EKG/ECG Operations 126

First 10 EM

NOVEMBER 20, 2023

When caring for pregnant women, I frequently find myself searching for information on radiation risks from diagnostic imaging, to help guide our shared decision making process, so I decided to create a summary in a spot I would always know where to find it. I have ranted in the past about the many problems with […] The post Diagnostic imaging during pregnancy and lactation appeared first on First10EM.

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Sensible Medicine

NOVEMBER 21, 2023

A few years ago, Dr. Richard T. Bosshardt waded into a minefield. He had been a Fellow of the American College of Surgeons (ACS) for over thirty years when he expressed his opinion that the ACS’s diversity, equity, and inclusion initiatives were threatening their dedication to excellence. Dr. Bosshardt has garnered support for his objections and has published his opinions in The Wall Street Journal, City Journal, and National Review.

Leadership 116

Leadership Fractures Wellness 116

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Thorough history taking and detailed examination can aid in diagnosis. Causes of paediatric neck lumps can be broadly divided into three categories – congenital , inflammatory and neoplastic.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Hospitals 124

St. Emlyn

NOVEMBER 24, 2023

St.Emlyn's - Emergency Medicine #FOAMed Emergency care practitioners are known for creating order from chaos, being pragmatic amidst difficult circumstances and advocating for patients when others cannot. The post The Emergency Care Voice Rescued from a Sea of Politics appeared first on St.Emlyn's.

EMS 115

EMS 115

Life in the Fast Lane

NOVEMBER 21, 2023

Chris Nickson Come join the 2024 Clinician Educator Incubator! If you want to develop as a Clinician Educator and help lead 21st century critical care education, join the 2024 Clinician Educator Incubator!

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ALiEM

NOVEMBER 22, 2023

The toxin from the golden poison dart frog most resembles which of the following in its mechanism of action? Botulinum toxin Bufotoxin Grayanotoxin Palytoxin Tetrodotoxin Photo adapted from Wilfried Berns (Wikimedia Commons) Reveal the Answer 3. Grayanotoxin – a sodium channel opener Background The golden poison dart frog ( Phyllobates terribilis ), often considered one of the most poisonous animals on the planet, secretes onto its skin the lipophilic alkaloid batrachotoxin , which irreversibly

Poisoning 113

Poisoning 113

The Trauma Pro

NOVEMBER 21, 2023

The veracity of medical research conclusions, specifically trauma research, has always fascinated me. I see so many people who are content to jump to conclusions based on a paper’s title or the conclusions listed in its abstract. However, having read thousands of research papers over the years, I am no longer surprised when these easy-to-digest blurbs don’t entirely match up with the actual details embedded within the manuscript.

Research 113

Research Outcomes Wellness 113

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

To learn more about Occlusion MI, join us in this Free Webinar on November 27 12 noon US Central Time: Sign up at this link: [link] Infection and DKA, then sudden dyspnea while in the ED A 63 year old male with a PMH of CAD and peripheral vascular disease from type 1 DM presented to clinic and was found to have a very high blood sugar and so was sent to the emergency department.

EKG/ECG 111

EKG/ECG Emergency Department Wellness Hospitals 111

Sensible Medicine

NOVEMBER 20, 2023

I received a text message from a colleague last night during dinner that a trial we were part of, called OCEANIC AF , was being terminated early by the data safety monitoring board. This morning, the makers of asundexian had a press release up on its site. This is huge news in cardiology. But it is also worthy of a column here because we at Sensible Medicine are interested in how new therapies are tested.

Stroke 110

Stroke Outcomes Wellness 110

Emergency Live

NOVEMBER 22, 2023

Advancing European CBRN-E Preparedness and Response through Standardisation The National Standards Authority of Ireland (NSAI) and the PracticE Ecosystem for StandaRdS (PEERS) project are collaboratively hosting a webinar on December 12, 2023, titled ‘Enhancing CBRN-E Preparedness and Response Capabilities through Standardisation.’ The webinar aims to showcase ongoing European CBRN-E research and standardisation efforts, specifically focusing […] The post PEERS and NSAI Webinar

Research 110

Research 110

Science Based Medicine

NOVEMBER 22, 2023

The first CRISPR-based therapy approval is a milestone worthy of noting. The post First CRISPR Treatment Approval first appeared on Science-Based Medicine.

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Trigger Lab

NOVEMBER 23, 2023

Ventilare un neonato prematuro ricercando la migliore strategia di sincronizzazione rappresenta una sfida quotidiana in neonatologia.

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RebelEM

NOVEMBER 20, 2023

Background: Hemmorhage is a major cause of preventable death in trauma patients. Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Theoretically, the use of REBOA with aortic occlusion should help limit hemorrhage, maintain cerebral/myocardial perfusion, and allow more time for interventional and surgical pro

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Emergency Live

NOVEMBER 23, 2023

Emotional Management During Resuscitation: A Crucial Aspect for Operators and Rescuers A Different Perspective on Cardiopulmonary Resuscitation Cardiopulmonary resuscitation (CPR) is a vital skill for emergency workers and lay rescuers. However, Marco Squicciarini, BLSD Training Coordinating Physician at the Ministry of Health and BLSD Instructor Trainer since 2004, highlights an aspect often overlooked in training […] The post Understanding Traumatic Dissociation in Cardiopulmonary Resusc

Resuscitation 105

Resuscitation CPR Operations 105

Taming the SRU

NOVEMBER 21, 2023

airway grand rounds - r1 clinical knowledge: heavy metals - consultant corner: acute leukemia - pediatric sim - pediatric cases airway grand rounds WITH dr. carleton Difficult airway algorithm: when should we RSI? When you are forced to act immediately When reoxygenation and intubation is likely to be successful and a patient is able to tolerate a period of apnea (is not likely to become profoundly hypoxic nor hypercarbic) How to perform a successful awake look intubation when RSI not indicated:

Pediatrics 91

Pediatrics EKG/ECG Resuscitation Dehydration 91

Life in the Fast Lane

NOVEMBER 19, 2023

Casey Parker and James Rippey Ultrasound Case 111 A 45 year old woman with chronic alcoholic liver disease presents to the ED with exertional dyspnoea and is noted to have a SpO2 of 90% at rest despite having a normal chest examination and CXR.

Ultrasounds 85

Ultrasounds 85

EMDocs

NOVEMBER 20, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American College of Gastroenterology recently released updated guidelines for managing patients with lower GI bleeding (LGIB). This post will provide the major takeaways for emergency clinicians. Background Acute LGIB results in over 100,000 admissions in the U.S. annually, and the incidence appears to be increasing based on current literature.

Resuscitation 80

Resuscitation Fluid Resuscitation Hospitals Research 80

Emergency Live

NOVEMBER 20, 2023

Specialized Solutions for the Safety of Small Passengers During Emergency Transport Transporting children by ambulance requires special care and precautions. In emergency situations, ensuring the safety of young patients is a top priority. This article explores international regulations and technological innovations that help make pediatric ambulance transport safe and effective.

Pediatrics 105

Pediatrics 105

Science Based Medicine

NOVEMBER 21, 2023

When a placebo is called 'powerful', what is meant? Nothing. The post Adjectives first appeared on Science-Based Medicine.

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University of Maryland Department of Emergency Med

NOVEMBER 19, 2023

Acute bronchiolitis (AB) is a common cause of respiratory tract infections in infants. A recent study looked at the application of Point-of-Car.

Ultrasounds 74

Ultrasounds Pediatrics 74

Core Medical Group

NOVEMBER 21, 2023

As the holiday season approaches, it's time to express gratitude and appreciation for the clinicians who have been on the frontlines of healthcare throughout the year. In the spirit of giving back, many retailers are offering exclusive Black Friday and Cyber Monday deals for healthcare workers. This is the perfect opportunity to indulge in some well-deserved self-care or find thoughtful gifts for loved ones.

Wellness 74

Wellness 74

Emergency Live

NOVEMBER 20, 2023

Cervical Cancer Elimination Day of Action: A Renewed Commitment to Overcoming Global Health Inequalities Nov. 17 marks the third “Cervical Cancer Elimination Day of Action,” a pivotal moment for the international community as world leaders, cervical cancer survivors, advocates and civil society come together to celebrate progress and recognize persistent challenges.

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Science Based Medicine

NOVEMBER 23, 2023

A new survey shows use of melatonin in children is widespread despite modest efficacy and an unknown long-term safety profile. The post Despite safety and quality questions, melatonin use growing in children first appeared on Science-Based Medicine.

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University of Maryland Department of Emergency Med

NOVEMBER 22, 2023

This retrospective study looked at trauma patients over age 65 and divided them into age ranges 65-80 (geriatric) and 80 plus (super-geriatric). Th.

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EMDocs

NOVEMBER 18, 2023

Author: Jacob Kirkland, MD (EM Resident Physician, UTSW – Dallas, TX); Stephen Field, DO (Assistant Professor of EM/Attending Physician, UTSW – Dallas, TX) // Reviewed by: Sophia Görgens, MD (EM Resident Physician, Zucker-Northwell NS/LIJ, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

Emergency Live

NOVEMBER 21, 2023

From Buses to Tracked Vehicles: Fermignano Puts Civil Defense Vehicles on Sale A Rare Opportunity to Acquire Rescue Vehicles The City of Fermignano, in an unprecedented move, has put up for sale an entire fleet of vehicles, many previously used by the local civil defense. This sale offers a unique opportunity for rescue entities, organizations […] The post Unique Bargains for Rescue Vehicles: Special Sale in Fermignano (IT) appeared first on Emergency Live.

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EMCrit

NOVEMBER 23, 2023

A pulm-crit shadowboxing case EMCrit Project by Scott Weingart, MD FCCM.

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University of Maryland Department of Emergency Med

NOVEMBER 21, 2023

A recently published study of ED APPs, residents, attendings, and nurses attempted to assess clinician's perspectives on how ED boarding im.

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EMDocs

NOVEMBER 21, 2023

Today on the emDOCs cast with Jess Pelletier and Brit Long, we discuss a case of hypokalemic periodic paralysis. Episode 90: Hypokalemic Periodic Paralysis Case: 20-year-old Caucasian male presents with severe pain and weakness in both of his thighs with inability to walk independently that started when he woke up that morning. Normal state of health prior to this.

Administration 69

Administration 69

Emergency Live

NOVEMBER 24, 2023

Coping with Floods and Blackouts in Florida: Useful Safety Tips Torrential Rains and Flooding in Florida Florida is facing a wave of severe weather characterized by heavy rains and intense winds, which has already caused flooding and power outages in several areas of the state. The situation is particularly severe along the southeast coast, where […] The post Florida Floods: A Guide to Safety and Prevention appeared first on Emergency Live.

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EM Ottawa

NOVEMBER 23, 2023

As you’ve gleaned from the title of this blog post, today we are focusing our conversation on CHANGE; with a particular emphasis on its implications in healthcare. However, before we get deep in the weeds, it’s important that we acknowledge the elephant in the room; CHANGE is HARD. I suspect that most of you reading this […] The post Change: Why Healthcare Reform is More Important Than Ever appeared first on EMOttawa Blog.

Administration 66

Administration Wellness 66