EMDocs
OCTOBER 3, 2023
Today on the emDOCs cast, we have a guest piece by Rob Orman, MD. Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus Podcast Learn more at roborman.com If you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it’s here. Episode 87: Conquering Mid-Shift Overwhelm Mid-shift in an emergency department is a special beast.
Ken Grauer, MD
OCTOBER 6, 2023
The ECG in Figure-1 was obtained from a middle-aged woman who presented with "palpitations". Of note — she has a history of untreated hyperthyroidism. QUESTIONS: How would YOU interpret the rhythm in Figure-1 ? Can you explain the atrial activity in this rhythm strip? Figure-1: The initial long lead II rhythm strip in today's case. MY Approach to the Rhythm in Figure-1: As per ECG Blog #185 — I favor the P s, Q s, 3 R Approach for interpretation of the cardiac rhythm — beginning with whichever o
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Mount Sinai EM
OCTOBER 2, 2023
Let’s talk about large bore/central vascular access! We’ll review different kinds, their different names, and when to use them! Of note outside the scope of this review: how to insert each of these – I think this is better learned by watching videos, watching others, & doing with guidance. This is also by no means a comprehensive vascular access guide – this is a framework to highlight three commonly used types of central lines in the ED.
The Trauma Pro
OCTOBER 3, 2023
Back braces have always confused me. There are so many types: TLSO, LSO, backpack, extension, and even the lowly abdominal binder can function as a brace. And I have never been able to predict which brace my spine colleagues accurately would prescribe for a specific condition or injury. Many vertebral fractures can be treated non-operatively. And it seems intuitive that there would be some benefit from splinting the spine to limit the range of motion to enhance healing.
Pediatric EM Morsels
OCTOBER 6, 2023
Post-COVID everyone seems to be posting the perfect picture of their travels to the far reaches of the world. While this is an exciting change, it allows transmission of illness to countries where they are not endemic. Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. In addition to my passion for PEM, I also share a passion for global health.
Sensible Medicine
OCTOBER 3, 2023
In the United States, Covid vaccine policy continues to be out of step with the world and out of touch with the people. If the CDC wishes to regain trust, they should make honesty, not simplicity their guiding principle. Subscribe now Once again, a new Covid vaccine has debuted, and once again, the Center for Disease Control (CDC) has issued a recommendation that baffles me.
Mount Sinai EM
OCTOBER 5, 2023
Let’s talk about mandible dislocations & how we can reduce them. First, we need to take a look at the mandible anatomy – can refer back to this as we discuss mandible dislocation: So how does the mandible dislocate (also called temporomandibular joint dislocation)? Causes: Lateral dislocation Anterior dislocation Often due to trauma – direct blow Can break condylar neck w/ dislocation Lateral dislocations often w/ fracture Check for loose or missing teeth!
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Dr. Smith's ECG Blog
OCTOBER 1, 2023
This is a re-post of an excellent case from 2021. See it again now, along with our new Queen of Hearts functionality. We've come a long way in 2 years! And the pace only quickens. A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. He called EMS who brought him to the ED.
EM Ottawa
OCTOBER 5, 2023
Do you remember when every newborn under 30 days with a fever needed an LP/admission/blood cultures? Well. times are a little different but its nuanced. The goal of this update is to provide a practical update in pediatric emergency medicine to the average Canadian adult or community emergency clinician. We will review the following three […] The post Little People, Big Updates: Updates in Pediatric Emergency Medicine appeared first on EMOttawa Blog.
Science Based Medicine
OCTOBER 1, 2023
Overselling the vaccine in 2021 was not being pro-vaccine. It was pro-stop-worrying-about-the pandemic, from the doctors who assured us herd immunity was imminent. The post Overhyping Vaccines Wasn’t Pro-Vaccine. It Was Pro-Stop-Worrying-About-COVID. first appeared on Science-Based Medicine.
Emergency Live
OCTOBER 3, 2023
Rescue Drones Network OdV presents its new technologies at REAS 2023 Also in this 2023 Rescue Drones Network OdV will be present at the REAS International Exhibition, one of the most important events in the emergency sector. A delegation of 12 associates will be actively present in its own exhibition space with a novelty compared […] The post Rescue Drones Network: drones and technology for civil protection appeared first on Emergency Live.
First 10 EM
OCTOBER 2, 2023
Although I think we all now recognize the fundamental importance of social determinants of health, I don’t think emergency medicine has found a way to adequately integrate this into our care. That is a shame, considering the huge amount of effort we put into things like tetanus shots or TXA therapy that have tiny (or […] The post Unconditional cash transfers to reduce homelessness?
Total Medical ComplianceHIPAA
OCTOBER 6, 2023
Modern healthcare has evolved dramatically with the integration of technology. While digitization has indeed elevated patient care and broadened its accessibility, it has also brought along challenges, primarily concerning privacy and security. A significant part of this conversation involves the use of communication tools like video conferencing and their compliance with HIPAA.
Science Based Medicine
OCTOBER 2, 2023
A prominent oncologist and cancer biologist, Wafik El-Deiry, recently amplified claims that COVID-19 vaccines cause "turbo cancer," wanting a "civil discourse about science and actual answers that are missing." Unfortunately, calls for "civil discourse" by an eminent oncologist about unfounded claims only lends undeserved credibility to them. So, once more into the fray.
Emergency Live
OCTOBER 5, 2023
Olmedo presents several innovations for the safety of rescuers at REAS 2023 The company from Reggio Emilia, with its seventy-two years of experience in the production of ambulances and special vehicles, marked by continuous growth, both group and technological, presents itself at REAS 2023, with a surprise waiting to be discovered, an innovative project, created, […] The post Olmedo, a new chapter in a story of growth and innovation at REAS 2023 appeared first on Emergency Live.
ACEP Now
OCTOBER 4, 2023
Exploring Unique Careers in Emergency Medicine Dr. Liz Clayborne didn’t set out to become an entrepreneur. She had her mind set on academic emergency medicine, with specific interests in health policy, medical ethics, and health disparities. The spark that ignited her entrepreneurial journey was a common problem when she was an EM resident at George Washington University: nosebleeds.
RebelEM
OCTOBER 2, 2023
Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. However, it is unclear if all degrees (mild, moderate, severe) of DKA require the same intensive treatment. Mild to moderate DKA represents a subgroup of patients that often require admission to the ICU due to hospital policies not allowing insulin infusions outside of this clinical setting.
Sensible Medicine
OCTOBER 2, 2023
This is a story about a common practice that bothers me. The example I will use involves the treatment of patients who have multiple coronary lesions. The two choices are placing multiple stents or having coronary bypass surgery. More on the specifics in a moment. The general concept is how trials measure, report and interpret outcomes. Before any experiment, choices have to be made about which outcome(s) to measure.
Emergency Live
OCTOBER 5, 2023
Mariani Fratelli, the SMART AMBULANCE, at REAS 2023 with a new technical gem The Pistoia-based company, a historic brand in the Italian market, always known for excellence in technical thinking and craftsmanship, presents the latest engineering masterpiece by Mauro Massai (CEO) and his team at the Montichiari exhibition: the SMART AMBULANCE The always gracious Eng. […] The post Mariani Fratelli presents the SMART AMBULANCE, the ambulance of the future appeared first on Emergency Live.
Dr. Smith's ECG Blog
OCTOBER 3, 2023
By Magnus Nossen, from Norway I was shown this print out of a rhythm strip from a patient on telemetry. I was asked what's going on? There are four leads shown (II, dV2, V1 and V5). The three images beneath one and other are consecutive rhythm strips each 10 seconds long. The patient was on telemetry due to acute MI. Can you correctly describe what's going on in this interesting rhythm strip?
Science Based Medicine
OCTOBER 4, 2023
The work of Katalin Karikó and Drew Weissman made possible the mRNA vaccines, with implications that go beyond this one application. The post Nobel for Medicine Goes To mRNA Vaccine Science first appeared on Science-Based Medicine.
ACEP Now
OCTOBER 3, 2023
In April 2023, the third edition of the Brain Trauma Foundation’s evidence-based guidelines for the prehospital management of traumatic brain injury (TBI) was published in Prehospital Emergency Care. 1 The practice guidelines were written by a multi-disciplinary group of experts and went through an extensive peer review process. This document is an update of guidelines first published in 2000, and then updated in 2007.
Emergency Live
OCTOBER 4, 2023
Croce Verde Pinerolo: a party to celebrate more than a century of solidarity On Sunday 1 October, in Piazza San Donato, in front of Pinerolo Cathedral, the Pinerolo Green Cross celebrated its 110th anniversary of foundation with great enthusiasm and solemnity. The celebration was a moment of great significance not only for the association itself […] The post Croce Verde of Pinerolo Celebrates 110 Years of Impeccable Service appeared first on Emergency Live.
Sensible Medicine
OCTOBER 6, 2023
SS was a 78-year-old man whose chief concern was simply, “I am dying.” During three visits to his home, I was unable to find anything concerning, or to reassure him that his health was good, or to convince him to come to the office for a more traditional evaluation. Four weeks after our last visit, his wife called me to let me know that he had died in his sleep.
Taming the SRU
OCTOBER 1, 2023
There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Institutional resources and specialty services may further dictate the management of PTX.
RebelEM
OCTOBER 5, 2023
Background: Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. Corticosteroids have excellent anti-inflammatory and immunomodulatory effects that could mitigate some of the inflammation caused by pneumonia. There have been several randomized trials that have shown glucocorticoids have positive effects in patients with CAP.
Emergency Live
OCTOBER 4, 2023
GIARO: water rescue equipment for quick and safe operations The company GIARO was founded in 1991 by two brothers, Gianluca and Roberto Guida, from whose initials the company takes its name. The office is located in Rome and deals with nautical assistance at 360° referring to mechanical and pneumatic repairs of SUPs and dinghies. It […] The post Boating at 360°: from boating to the evolution of water rescue appeared first on Emergency Live.
Core Medical Group
OCTOBER 6, 2023
This week, we're thrilled to introduce Danielle, a seasoned travel nurse recruiter with over five and a half years of experience in Core's travel nurse division. When she's not hard at work, you can find her at the barn, horseback riding with her cherished companion, Chauncey! She also loves cherishing valuable moments with her family and two adorable pups, Sadie and Stanley.
EM Updates
OCTOBER 1, 2023
Alcohol withdrawal syndrome is unpredictable so managing AWS with scheduled meds invariably leads to under or over-treatment. CIWA-Ar is the best known severity scale but is lengthy and sometimes challenging to use so many alternatives have been developed. It probably doesn’t matter which scale is used–the benefit of symptom-based treatment over scheduled treatment arises not from the scoring tool but from the frequent reassessments.
Taming the SRU
OCTOBER 5, 2023
morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS Diagnosis requires findings on U/S and EKG +/- troponin w/o significant obstructive CAD and the absence of other mimicking diagnoses Treatment is su
Emergency Live
OCTOBER 4, 2023
ProAcqua Group: emergency solutions, safe and sustainable water and food ProAcqua Group produces systems for the purification and distribution of water in emergency situations, also with a totally independent photovoltaic system. It distributes NRG5 EMERGENCY FOOD in Italy, ready-to-eat food for emergency situations with a 20-year shelf life, and many other foods with different weight, […] The post ProAcqua Group: Water and Food in Emergency Situations appeared first on Emergency Live.
EM Literature of Note
OCTOBER 1, 2023
And, most importantly, if you put the symptoms related to your fever into ChatGPT, it will generate a reasonable differential diagnosis. “So?” This brief report in Annals describes a retrospective experiment in which 30 written case summaries lifted from the electronic documentation system were fed to either clinician teams or ChatGPT. The clinician teams (either an internal medicine or emergency medicine resident, plus a supervising specialist) and ChatGPT were asked to generate a &
AENJ: Current Issue
SEPTEMBER 30, 2023
This article reviews the results of a randomized controlled trial, “Rapid Agitation Control with Ketamine in the Emergency Department: A Blinded, Randomized Controlled Trial” by D. Barbic et al. (2021), comparing time to sedation, level of sedation, and adverse outcomes between intramuscular ketamine versus intramuscular midazolam and haloperidol among acutely agitated patients presenting to the emergency department (ED).
Sensible Medicine
SEPTEMBER 30, 2023
I recently got back from Copenhagen, where, in a series of 3 talks, I explored the themes of the book Malignant: How Bad Policy and Bad Evidence Harm People with Cancer. What are those lessons, and why do they matter? (Pictured with Marco Donia, MD Herlev Hospital Copenhagen) We need cancer that drugs that extend survival, and not merely change the appearance of tumors on CT scans Images on CT scans (e.g.
Emergency Live
OCTOBER 3, 2023
Conscious Driving, Love for the Environment and Helping People: The Mission of the UISP Motorsports Instructors at REAS 2023 The world of off-roading is often associated with rough tracks, high-adrenaline adventures and, above all, a deep affinity and respect for nature and the surrounding environment. UISP Motorsports Instructors, a central figure in this universe of […] The post UISP: Responsible and Sustainable Driving for the Off-Roaders of the Future appeared first on Emergency Live.
Science Based Medicine
OCTOBER 6, 2023
One thing I've learned during the past few years, is how quickly scenes of mass death fade from the collective memory. Denial is powerful. Everyone just wants to forget. There's no national day of mourning or any memorial to the countless victims of previous vaccine-mandates. It seems that humanity's sad fate is that every generation is doomed to repeat the mistakes of the past.
AENJ: Current Issue
SEPTEMBER 30, 2023
Tick-borne diseases occur throughout the United States, with a disease burden that ranges from mild to severe. As temperatures rise with climate change, the active season for ticks increases, and more tick-borne illness is seen (Centers for Disease Control and Prevention, 2022a). Many patients present to the ED for suspected tick bites, rashes, and generalized medical complaints that may be related to a tick-borne disease, so it is important for the emergency nurse practitioner (ENP) to accurate
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