American Medical Compliance

OCTOBER 14, 2024

Assisted living facilities are a lifeline for elderly and vulnerable individuals who need care and support in a safe, nurturing environment. Yet, even in these compassionate settings, caregivers often face the challenge of managing aggressive behaviors among residents. Imagine the case of Mrs. Stevens, a once gentle and kind woman who, after the onset of dementia, began exhibiting sudden outbursts of anger.

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Wellness Operations Outcomes 95

The Trauma Pro

OCTOBER 18, 2024

All trauma centers admit some of their patients to nonsurgical services. This usually occurs when patients have medical comorbidities that overshadow their injuries. Unfortunately, the decision-making that goes into balancing the medical versus trauma issues is not always straightforward. The fear is that if trauma patients are inappropriately placed on a nonsurgical service, mortality and morbidity may be higher because their injuries may not receive adequate attention.

Documentation/Coding 147

Documentation/Coding Emergency Department Hospitals 147

Sensible Medicine

OCTOBER 15, 2024

It is my pleasure to introduce this article by Joseph Marine, MD in response to mandatory masking policies in a number of California hospitals. There is simply no randomized evidence to support these policies, and they make little sense in 2024. I worry about the mental abilities of the public health officers who instituted these policies, and that their actions will further erode trust in public health.

Hospitals 126

Hospitals Wellness 126

Science Based Medicine

OCTOBER 18, 2024

WWTI doctors' cared only about infecting unvaccinated children with SAR-CoV-2, and they were willing to blatantly contradict themselves and make things up achieve this goal. The post Dr. Sunetra Gupta Versus Dr. Sunetra Gupta first appeared on Science-Based Medicine.

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Dr. Smith's ECG Blog

OCTOBER 15, 2024

This was sent to me by an undergraduate name Hans Helseth, who is an EKG tech, but who is an expert OMI ECG reader. He wrote most of it and I (Smith) edited. A prehospital “STEMI” activation was called on a 75 year old male ( Patient 1 ) with a history of hyperlipidemia and LAD and Cx OMI with stent placement. He arrived to the ED by helicopter at 1507, about three hours after the start of his chest pain while chopping wood around noon.

EKG/ECG 101

EKG/ECG Hospitals Wellness 101

St. Emlyn

OCTOBER 18, 2024

St.Emlyn's - Emergency Medicine #FOAMed Kevin Cyr, the commander of a SWAT-like unit within the Royal Canadian Mounted Police, shared his insights at the Tactical Trauma 24 conference in Sundsvall, Sweden, in conversation with Iain Beardsell and Liz Crowe and offers essential takeaways for anyone working in high-pressure environments, including healthcare professionals.

Leadership 83

Leadership 83

Sensible Medicine

OCTOBER 16, 2024

Dr. Satel is a bit of a regular here on Sensible Medicine. Today she returns to a topic that she wrote about in January 2023 , changing our organ donation laws to increase organ availability. Adam Cifu Sensible Medicine is a reader-supported publication. If you support our work, consider becoming a free or paid subscriber. What if we could solve the organ donor shortage with a simple tax credit?

Operations 107

Operations Research 107

Dr. Smith's ECG Blog

OCTOBER 12, 2024

Written by Bobby Nicholson What do you think of this “STEMI”? A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. With EMS, patient had a GCS of 3 and was saturating 60% on room air. He improved to 100% with the addition of non-rebreather, however remained altered and was intubated by EMS with ketamine and succinylcholine.

EKG/ECG 93

EKG/ECG Documentation/Coding Emergency Department COPD 93

First 10 EM

OCTOBER 14, 2024

Another month, another set of articles. Some clinically relevant. Some just thought provoking. One is more than 100 years old. Yes, I look everywhere for these papers. The BroomeDocs podcast version can be found here: [link] Clinically but not statistically significant: what do you do? Turgeon AF, Fergusson DA, Clayton L,et al. Liberal or Restrictive […] The post The October 2024 Research Roundup appeared first on First10EM.

Research 89

Research EMS 89

Sensible Medicine

OCTOBER 14, 2024

Last Monday I wrote about one of the most positive drug trials in all of cardiology. In the RALES trial, the mineralocorticoid receptor antagonist (MRA) spironolactone substantially reduced death rates in patients with heart failure due to a weak heart. There were two big limitations to the RALES story. One was that the most common kind of heart failure now is heart failure with preserved heart function.

Outcomes 88

Outcomes Hospitals Wellness 88

St. Emlyn

OCTOBER 12, 2024

St.Emlyn's - Emergency Medicine #FOAMed The final day of the RCEM Annual Scientific Conference with papers on chest pain, trauma, psychosocial, diagnostics and more. #rcemasc #FOAMed @stemlyns The post RCEM Annual Scientific Conference. Day 3. appeared first on St.Emlyn's.

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Dr. Smith's ECG Blog

OCTOBER 17, 2024

Written by Jesse McLaren Two patients in their 70s presented to the ED with chest pain and RBBB. Do either, both, or neither have occlusion MI? Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. Past medical history included RBBB without other cardiac history, but old ECG was not available.

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EKG/ECG EMS Shock Ultrasounds 73

EMDocs

OCTOBER 14, 2024

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.

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EKG/ECG EMS Resuscitation Emergency Department 78

Sensible Medicine

OCTOBER 18, 2024

Let’s start with some definitions – or at least my definitions. Conventional medicine is what licensed MDs and DOs should be practicing: the skilled use of the diagnostic sciences, treatments based on the principles of evidence-based medicine, and the provision of prognoses to patients who request them. All this should be done in a caring and empathic manner.

Research 69

Research Wellness 69

The Skeptics' Guide to EM

OCTOBER 12, 2024

Reference: Ma K et al. A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments. PLoS One. June 2024 Date: Oct 1, 2024 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. He is the co-founder of website lead of Don’t Forget the Bubbles (DFTB).

Emergency Department 85

Emergency Department Pediatrics Outcomes EMS 85

Don't Forget the Bubbles

OCTOBER 18, 2024

What are midline catheters? There are three types of peripheral venous catheters: 1. Midline Catheter 2. PICC line 3. Long peripheral catheters. Midline catheters (MCs) are peripheral intravenous lines that are longer (usually 6-20 cm) than routine peripheral IV cannulas. However, the tip of the catheter does not extend into a central vein. The final position of the tip should be in the axillary vein, ideally in the infraclavicular segment.

Administration 59

Administration Pediatrics Ultrasounds Burns 59

EMDocs

OCTOBER 12, 2024

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: LR or NS for Sickle Cell Pain Crisis? Spoon Feed For sickle cell patients (particularly Hgb SS) with a vaso-occlusive episode (VOE), large volume resuscitation (>2L) with lactated ringers (LR) has been shown to

Resuscitation 81

Resuscitation Outcomes Hospitals 81

The Bottom Line

OCTOBER 13, 2024

Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery: The TIGHT K Randomized Clinical Trial O’Brien. JAMA 2024; 332:979 – 988. doi:10.1001/jama.2024.17888 Clinical Question In adult patients undergoing coronary artery bypass surgery (CABG) is supplementing potassium when serum concentration is ≤ 3.5 mEq/L non-inferior to supplementation when serum concentration is ≤ 4.

Operations 68

Operations 68

EM Ottawa

OCTOBER 17, 2024

We remain amid an opioid crisis in Canada, with over 8000 deaths (or 22/day) in 2023. The harms of opioid use in society are devastating and cannot be understated – but so too are the harms from stimulant and other substance use. In 2023 there were 3479 apparent stimulant toxicity deaths, which is approximately 10/day. […] The post S’now Problem: Keep your Cool when Stimulants turn up the Speed appeared first on EMOttawa Blog.

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Resuscitation EMS 61

Taming the SRU

OCTOBER 16, 2024

research grand rounds - r1 core content: thromboembolic disease in pregnancy - r4 discharge/transfer/treat: hand injuries - ed discharge after trauma - pediatric respiratory emergencies and airway management Research Grand Rounds WITH dr. Freiermuth Peer Review Not common practice until the 1970s Intent was to ensure scientific integrity Equity The Process Read, summarize manuscript, comment on strengths and weaknesses, determine whether article fits with the priorities of the journal Recommend

Airway Management 62

Airway Management Fractures CDC Pediatrics 62

RebelEM

OCTOBER 16, 2024

Take Home Points Orogastric lavage may still play an important role in treatment of the overdose patient. Do not perform lavage if the ingestion has limited toxicity at any dose or the ingested dose is unlikely to cause significant toxicity. Strongly consider orogastric lavage in a patient who has taken an overdose of drugs that are particularly toxic, suspected extreme doses associated with high morbidity/mortality and do not have easily available and effective antidotes.

EMS 57

EMS 57

Don't Forget the Bubbles

OCTOBER 14, 2024

Some definitions Asylum seeker: A person who has fled their country and applied to another country to be recognised as a refugee but has not yet been granted this status. Refugee: Someone whose asylum application has been successful. The government recognizes they cannot return to their country of origin owing to a well-founded fear of being persecuted for the reasons provided for in the United Nations Refugee Convention or European Convention on Human Rights (such as persecution due to race, se

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

EM Ottawa

OCTOBER 15, 2024

Methodology: 3/5 Usefulness: 4/5 Essat M, et al. Ann Emerg Med. 2024 Jun 18:S0196-0644(24)00260-9 Question and Methods: Using systematic review methodology, the authors aimed to determine sensitivity and specificity in the use of D-Dimer in the work-up for Acute Aortic Syndrome. Findings: A total of 25 studies were included in the primary meta-analysis; summary sensitivity […] The post Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis appeared

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Mind The Bleep

OCTOBER 17, 2024

What my elective entailed I undertook a four-week Pre-Hospital Emergency Medicine (PHEM) elective with the Midlands Air Ambulance Charity. This entailed two day shifts on the helicopter and one night shift on the critical care car each week. Through this role, as an observer, I was able to experience various pre-hospital emergencies; the most common scenarios I attended were cardiac arrests, but I also attended trauma patients at the scene of road traffic accidents, fractures in a wilderness med

Ambulance Services 52

Ambulance Services Hospitals Anaphylaxis Airway Management 52

EMergucate

OCTOBER 15, 2024

An 80yr male presents with 2 weeks increasing shortness of breath, he has a history of CABG. What can be seen on the ECG: If these were new findings what might you be concerned about?

EKG/ECG 52

EKG/ECG EMS 52

Don't Forget the Bubbles

OCTOBER 16, 2024

You’re embarking on your first paediatric registrar rotation – welcome to this exciting next stage of your career, and congratulations on getting here! This article is not intended to be a set of step-by-step instructions but to give you some ideas to consider and some tips and tricks from first-time registrars who have recently gone through this transition.

Teamwork 52

Teamwork Documentation/Coding Leadership Burns 52

Science Based Medicine

OCTOBER 14, 2024

Hangovers: a problem with only one solution. The post Hungover first appeared on Science-Based Medicine.

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Mind The Bleep

OCTOBER 17, 2024

I am a GP at a large practice based in a town in southwest Scotland, and I also work as a doctor in the Emergency Department in our local district general hospital. But it doesn’t stop there. Like dozens of other doctors, nurses, and paramedics across Scotland, I have the privilege of being a responder with BASICS Scotland. What is a BASICS responder and who can do it?

Ambulance Services 52

Ambulance Services Hospitals Anaphylaxis Outcomes 52

Emergency Live

OCTOBER 15, 2024

MUM-T Technology Aims to Enable Faster, More Efficient Crisis Response Worldwide Collaboration between drones and helicopters is poised to revolutionize emergency and rescue operations. Airbus Helicopters and its European partners recently completed a large-scale demonstration to test the interoperability between piloted and unmanned aerial systems (MUM-T).

Operations 52

Operations 52

Sensible Medicine

OCTOBER 13, 2024

Last week was different from a usual work week for me and my reading reflected that. I was privileged to be invited to The University of Colorado Anschutz Medical Campus as the Meiklejohn Visiting Professor. I got to spend a couple of days there, gave two talks, and met with slew of wonderful members of the faculty. Like the best of these visits (at least from my point of view) I felt like I learned more than I taught.

Research 54

Research 54

Board Bombs

OCTOBER 14, 2024

These 5 high yield pearls all share a common thread: helping you ACE the upcoming boards! If you are premium member you get access to the next 5. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at [link] Cite this podcast as: Briggs, Blake; Husain, Iltifat. 236. Potpourri Board Blitz October 14th, 2024.

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Mind The Bleep

OCTOBER 17, 2024

You may have seen Mountain Rescue teams (MRTs) if you’ve been out in the hills or mountains, seen them on the television (a few series have recently been on air), or perhaps you’ve seen them at Emergency Services open days. What is it all about, from the viewpoint of a doctor? I offer my viewpoint as a doctor having been involved in MRTs for over 11 years.

Soft Tissue Injuries 52

Soft Tissue Injuries Seizures Ambulance Services Teamwork 52

Life in the Fast Lane

OCTOBER 14, 2024

Pramod Chandru Network Five: Practice Changes In Paediatric Wheeze Management Network Five Emergency Medicine Journal Club Episode 30 reviewing updates on paediatric wheeze management with paediatric respiratory and sleep specialist Dr Chetan Pandit!

Pediatrics 52

Pediatrics 52

Emergency Medicine Ireland

OCTOBER 14, 2024

Welcome back to the tasty morsels of critical care podcast. Following on from our initial post in this entirely accidental series on “things you don’t want to find in the chest drain” we turn our eyes (if not our noses) to empyema. Many penumonias will develope a parapneumonic effusion. This is largely reactive and inflammatory but by no means does it mean there is infection.

Wellness 52

Wellness Ultrasounds 52

Taming the SRU

OCTOBER 14, 2024

THE CASE A female in her 60’s with a remote history of bilateral cataract surgery presented to the emergency department (ED) with a two-week history of right eye swelling. Six days prior, the patient was evaluated at an urgent care and prescribed doxycycline and prednisone. She was re-evaluated over the following days and was transitioned from doxycycline to cephalexin.

Ultrasounds 52

Ultrasounds Urgent Care Emergency Department Documentation/Coding 52

PulmCCM

OCTOBER 14, 2024

Albumin is a protein produced by the liver whose molecular weight and negative charge attract sodium cations, and with them water molecules. In this way albumin produces most of the vascular system’s oncotic pressure—the force tending to retain fluid in blood vessels without its leaking into the extravascular space. This increases mean arterial pressure.

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Resuscitation Shock Wellness 52

PEMBlog

OCTOBER 14, 2024

Did you know that pancreatitis is mostly caused by viruses in kids? They don’t drink alcohol or get gallstones like grown ups. Also, scorpion bites apparently cause it. But that’s silly and only something you see in board review books. Anyway, this would be a better Broadway musical than most retreads of 1980s & 90s movies. Lyrics [Verse] Pancreatitis calls out my name The pain the intensity, I cannot explain My mom said I ate too many wings My dad told me to focus on more pleasa

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