Ken Grauer, MD
APRIL 23, 2023
The 12-lead ECG and long lead rhythm strip in Figure-1 — was obtained from a previously healthy 15-year old male , who presented with fever and diarrhea. He was hemodynamically stable. No chest pain. How would YOU interpret the ECG in Figure-1 ? What is the cardiac rhythm? What do you suspect as the clinical diagnosis? Figure-1: The initial ECG in today’s case — obtained from a 15-year old male with fever and diarrhea.
EMCrit
APRIL 27, 2023
The precise utilization of ABG, VBG, and pulse oximetry remains controversial. Unfortunately, there is little high-level evidence investigating whether these interventions affect patient outcomes (for example, there is precious little evidence to support most of the target values that we're chasing after). This chapter attempts to explore the strengths, weaknesses, and indications for various techniques. […] EMCrit Project by Josh Farkas.
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RebelEM
APRIL 26, 2023
Take Home Points Alcoholic Ketoacidosis (AKA) can present with significant acidemia (pH < 7.00). Despite the significant acidemia, patients with AKA can remain alert and lucid despite their severe metabolic derangement. Relying on urine ketones for diagnosis can be misleading, as acetoacetate is the primary ketone detected in the urine but not the most common ketone generated in AKA.
Pediatric EM Morsels
APRIL 28, 2023
Pediatric x-rays are challenging. Of course, we want children to grow, but those darn growth plates really make interpretation of their films difficult !! We have previously discussed how the surrounding ligaments and tendon are often stronger than the weakest part of the child’s bone necessitating our vigilance when addressing the pediatric extremity complaint (ex, Ankle Pain , Elbow Injury , Supracondylar Fractures ).
Science Based Medicine
APRIL 25, 2023
In 2019, Drs. John Mandrola, Adam Cifu, Vinay Prasad, and Andrew Foy wrote an article titled The Case for Being a Medical Conservative. They wrote that the “choice of the term ‘medical conservative’ does not imply a political philosophy.” Instead, they recognized “that many developments promoted as medical advances offer, at best, marginal benefits”.
EMCrit
APRIL 26, 2023
Is there an easier way to mix up push-dose epinephrine that is still as safe? EMCrit Project by Scott Weingart, MD FCCM.
SheMD
APRIL 24, 2023
As Editor of SheMD, I'm sharing my story of #PhysicianInfertility, because we have to start the conversation. We have to talk about the fact that we, female physicians, have INCREASED rates of infertility. Physician infertility isn't something we learn about in medical school. We learn about physician infertility when we become the patient, when it may be too late.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
PHARM
APRIL 28, 2023
Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1.
EMCrit
APRIL 25, 2023
CAR-T cell therapy is rapidly expanding as a miraculous therapy for numerous malignancies. However, it also causes a variety of unique and severe side-effects, which frequently cause ICU admission. This chapter explores current approaches to complications including CRS (cytokine release syndrome), HLH (hemophagocytic lymphohistiocytosis), and ICANS (immune effector cell-associated neurotoxicity syndrome).
SheMD
APRIL 28, 2023
I want to have kids young and I want to get married young. This is a strange thing to hear from a twenty-two year old in 2019. “Don’t you want to live your life and not be tied down?”, “You have to be established in your career first.”. Other women look at me as if I am telling them I want to be a housewife and I’m setting the feminist movement back sixty years.
PEMBlog
APRIL 28, 2023
This is my one annual non-medical post – every year since our third anniversary I’ve been making a music video. Here is the one for anniversary number 16. Enjoy! Something tells me that I will eventually have to buy an anniversary card from Hallmark for my wife Kerri. Hallmark stores are still open right? Maybe that’s my excuse. Maybe I’ll wait until they all close down because nobody wants to buy a card anymore and then I’m in the clear.
PHARM
APRIL 28, 2023
Some joker on Twitter called Chrimes took this at Aspen, Colorado It is an oft quoted maxim of trauma resuscitation that shock is haemorrhagic until proven otherwise. Certainly for penetrating trauma this is all often 100% accurate but for blunt trauma it becomes less and less a reliable rule. Cardiac causes of shock in trauma? Why yes dear reader. Classically the car driver who suffers a myocardial infarction then crashes the car.
EMCrit
APRIL 23, 2023
Resistant SCAPE can be scary but you can handle it! EMCrit Project by Scott Weingart, MD FCCM.
SheMD
APRIL 28, 2023
As medical students, residents, fellows and newly minted attending physicians, we pride ourselves in practicing evidence-based, data driven medicine. Statistics, randomized-controlled trials, level 1 evidence and highly powered studies are what contribute to our armory of data that we use to diagnose and treat medical issues. Well, infertility is no exception and recent and current data is clearly showing that this is a growing global health issue that affects men and women regardless of ethnici
Science Based Medicine
APRIL 27, 2023
A new study shows most melatonin products are inaccurately labelled. The post Melatonin quality varies widely first appeared on Science-Based Medicine.
PHEM Cast
APRIL 27, 2023
Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition Vasopressors in Trauma: A Never Event?
AED Leader
APRIL 27, 2023
Heart palpitations when exercising, or right before or after exercise, usually occur because the normal electrical rhythm of the heart has been disrupted (by exercise). You may be especially susceptible to exercise-related heart palpitations if you smoke, have high blood pressure, or follow a poor diet. In very rare cases, heart palpitations after exercise could Read More "Should You Worry About Heart Palpitations When Exercising?
NRC Health
APRIL 27, 2023
The post Life-work balance: What we get right and wrong in the workplace appeared first on NRC Health.
Science Based Medicine
APRIL 26, 2023
Ashwagandha is another dubious herbal products marketing with inadequate evidence and poor logic. The post Ashwagandha – An Herbal TikTok Sensation first appeared on Science-Based Medicine.
SheMD
APRIL 26, 2023
This post contains affiliate links. SheMD will make a commission at no extra cost to you should you click the link and make a purchase. Read , our disclosure for more info. In medicine, there is an added pressure among female physicians to be “strong.” To work extra hard as a physician (while also being a perfect “mom,” “wife,” or “daughter” outside the hospital), and to exhibit resiliency when faced with micro aggressions and inequality in the workplace.
PEMBlog
APRIL 26, 2023
Dr. Kit Carney and Dr. Kristen Humphrey discuss gun violence, its impact on our patients and their families, as well as practical tips on advocating for safe storage of firearms, and how we can support victims of violence. Listen Gun Violence and Safety (2023) – Brad Sobolewski, MD, MEd – featuring Kit Carney, MD & Kristen Humphrey, MD – PEM Currents: The Pediatric Emergency Medicine Podcast [link] Subscribe Advocacy and education resources Be SMART Campaign Be SMART emphas
Greater Sydney Area HEMS
APRIL 26, 2023
By Raphael Dworkin, HEMS registrar. Every morning our team discusses cases over coffee. Here is a useful snippet… Fictional Vignette – 52M rally car driver accidentally clips a tyre wall causing his car to flip upside down at low speed. It takes approx. 30 mins for scene to be cleared and ambulance teams to arrive. Patient is suspended vertically by safety harness throughout this time. – Prior to extraction, he was GCS 15 and talking.
EMergucate
APRIL 25, 2023
Facial x-ray view is from an adult patient who has been punched in the face. What can be noticed?
Emergency Medicine Cases
APRIL 25, 2023
In this month's EM Quick Hits: Heather Cary on the use and misuse of abdominal FAST in pediatric trauma, Hans Rosenberg and Arleigh McCurdy on the diagnosis and management of Multiple Myeloma in the ED, David Jerome on practice tips for managing the drowning patient, Brit Long and Michael Gottlieb on the diagnosis and management of Alcohol-Induced Ketoacidosis, Navpreet Sahsi on his journey to becoming a humanitarian and global EM doctor.
Dr. Smith's ECG Blog
APRIL 25, 2023
This was sent to me by a partner: "Curious what you think of this one we had overnight. Healthy male under 25 years old with a pretty good story for acute onset crushing chest pain relieved with nitro. He had another episode the day before after exerting himself. No pericardial effusion on ultrasound." What do you think? First, many on Twitter said "Pericarditis".
NRC Health
APRIL 25, 2023
The post NRC Health stands out as Best in KLAS at HIMSS Conference appeared first on NRC Health.
Ultrasound Gel
APRIL 24, 2023
Hold onto your hats - the latest episode discusses an application for ultrasound that you have probably never even thought about doing! Ultrasound-guided trigger point injections - do they work?! Hold onto your hats - the latest episode discusses an application for ultrasound that you have probably never even thought about doing! Ultrasound-guided trigger point injections - do they work?!
SheMD
APRIL 24, 2023
Are you pre-med or in medical school and trying to figure out when to start a family? Wondering when the best time is? There is NO BEST TIME, but this article discusses some of the risks of #physicianinfertility as well as highlighting the utility of egg freezing to preserve fertility for women in medicine (or any career). As women in medicine, we are always focused on the next goal we need to achieve to advance our career.
First 10 EM
APRIL 24, 2023
I’ve gone in depth into the topic of steroids for pneumonia previously. (Also covered on the EM Cases Journal Jam.) At the time, despite some promising point estimates, I thought that the evidence was too weak to suggest regular use of steroids for community acquired pneumonia. In that write up, I did mention a number […] The post Steroids for pneumonia (CAPE COD and ESCAPe) appeared first on First10EM.
Emergency Medicine Cases
APRIL 24, 2023
Does the addition of dexamethasone to ketorolac improve pain scores in patients suffering from renal colic? Find out through this critical appraisal of a recent RCT on this EMC Journal Club. The post Journal Club 3 – Dexamethasone and Ketorolac in Acute Renal Colic appeared first on Emergency Medicine Cases.
Cook County EM Blog
APRIL 24, 2023
The Case: A 15-year-old presented with right index finger pain. He states he was catching a football and it hit the tip of his right index finger and forcibly flexed it causing pain at his DIP joint. He was initially seen in triage and right hand radiographs were obtained and read by the radiology resident as negative (Figure 1). On examination, the patient had tenderness over the dorsal aspect of the DIP joint with weak extension.
Board Bombs
APRIL 23, 2023
Ovarian Cysts. Do you admit? Discharge? Neither? Let’s cover what you need to know on this rapid bomb preview. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Cite this podcast as: Briggs, Blake. Episode 173. Ovarian Cysts. April 23rd, 2023. [link] Accessed [date] Ovarian Cysts.
Taming the SRU
APRIL 22, 2023
Background Atrial fibrillation is a prevalent disease entity that affects over 500,000 new people annually. A subset of these patients develop an accelerated rate either primarily or due to other factors known as rapid ventricular response. If untreated, atrial fibrillation can increase clot formation and lead to an increased risk for heart attack and stroke as well as development of congestive heart failure.
The Skeptics' Guide to EM
APRIL 22, 2023
Date: April 20, 2023 Reference: Franklin D, et al. Effect of early high-flow nasal oxygen vs standard oxygen therapy on length of hospital stay in hospitalized children with acute hypoxemic respiratory failure: the PARIS-2 randomized clinical trial. JAMA 2023 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine attending at Mount Sinai Medical Center […] The post SGEM #401: Hey Ho!
Science Based Medicine
APRIL 28, 2023
After three solid years of the pandemic, here is an admittedly incomplete rundown of how it has affected children in the United States. The post Children and COVID-19: A Few Facts and Figures from the Pandemic’s First Three Years first appeared on Science-Based Medicine.
PHARM
APRIL 28, 2023
How I personalize fluid therapy in septic shock? – PMC — Read on www.ncbi.nlm.nih.
Dr. Wes
APRIL 27, 2023
This piece first appeared on Sensible Med on 4/26/2023. If you’re a board-certified internist, you’re probably quite familiar with the controversy surrounding the American Board of Internal Medicine (ABIM) that began when lifelong board certification mysteriously became time-limited in 1990.
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