Ken Grauer, MD
MARCH 29, 2023
The ECG in Figure-1 is from a man in his 30s — who overall has been healthy, except for a history of "intermittent palpitations" that he has had since childhood. Episodes typically last less than 2 minutes — but this time, he presented to the ED ( E mergency D epartment ) because of ongoing symptoms lasting a number of hours. The patient consumed alcohol at a party the night before.
Pediatric EM Morsels
MARCH 31, 2023
Children love to trick us! Sometimes it is all in good fun and other times it is quite serious! They like to pretend to be well when they are truly sick ( remember to check that Cap Refill and to never trust a Neonate! ) and they often show us “odd” findings that are really normal (ex, Growth Plates, Primitive Reflexes ). They like to keep us on our toes so much, that even their cervical bones can deceive us.
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RebelEM
MARCH 30, 2023
Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. The TOMAHAWK (Desch 2021), COACT (Abella 2019), and PEARL (Lemkes 2019) trials examined patients with OHCA without ST elevation with a shockable rhythm, and investigators found no difference in delayed versus emergency angiogram.
NRC Health
MARCH 29, 2023
In this episode we are joined by Toya Gorley, Improvement Advisor at NRC Health and Dr. Elizabeth Paskas, Senior Vice President, Chief Patient Experience Officer at Hackensack Meridian Health as they discuss the Fundamentals First mentality and how it has impacted health systems. The post Hackensack Meridian Health & NRC Health: Fundamentals First appeared first on NRC Health.
EMCrit
MARCH 25, 2023
Hayden Richards is a communications maven. EMCrit Project by Scott Weingart, MD FCCM.
The Skeptics' Guide to EM
MARCH 31, 2023
Date: March 28, 2023 Reference: Fowler et al. Objective assessment of sleep and fatigue risk in emergency medicine physicians. AEM March 2023 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You arrive at 7am to relieve your colleague after a night shift. You find her at […] The post SGEM#399: I’m So Tired – Emergency Medicine and Fatigue first appeared on The Skeptics Guide to Emergency Medicine.
Dr. Smith's ECG Blog
MARCH 31, 2023
This was sent to me by a friend. It is from a 50-something with chest pain: What do you think? This was marked as "Not a STEMI" by the physicians. It is not a STEMI, but it is diagnostic of an LAD OMI (Occlusion MI). There is subtle ST Elevation in V1-V4 and hyperacute T-waves in V2-V6. There is also subtle but diagnostic INFERIOR ST Elevation, with reciprocal ST Depression in aVL.
Emergency Care Today brings together the best content for emergency care practitioners from the widest variety of industry thought leaders.
Dr. Mike Sevilla
MARCH 30, 2023
A cheeseburger really is not healthy, right? Well, in a recent news report , a survey claimed that the food chain Whataburger (we have no restaurants around here) has the “healthiest” cheeseburger in America. The wildly popular food website called Mashed (they have 25 monthly readers worldwide) reached out for my comment on this. You can probably guess what I said about it.
American Medical Compliance
MARCH 30, 2023
After the COVID-19 pandemic, there has been a greater importance in implementing proper infection control protocols, such as identifying cases of infections and supplying proper personal protective equipment (PPE) to emergency medical workers. All medical facilities must establish and follow proper infection control guidelines due to the high potential of exposure to infectious materials and patients that healthcare personnel face.
Dr. Smith's ECG Blog
MARCH 30, 2023
= My Comment by K EN G RAUER, MD ( 3/30 /2023 ): = The ECG in Figure-1 was sent to me without the benefit of any history. I thought the rhythm illustrated a number of essential concepts for clinicians dedicated to Emergency Care. Do YOU know what the rhythm is? IF this arrhythmia is puzzling to you — READ ON! I illustrate how to make the diagnosis within less than 15 seconds.
NRC Health
MARCH 30, 2023
Compliment Sharing is a new digital solution to address burnout and boost morale among frontline care teams. The post NRC Health energizes healthcare organizations with digital solution to ease burnout for care teams appeared first on NRC Health.
Dr. Mike Sevilla
MARCH 30, 2023
Over the past three years, we have learned a lot about getting COVID infections, and being re-infected with the COVID virus. Looking back, there is a lot that we know now that we did not know previously. Thanks to CNET for reaching out to me to comment on this for their story “ What to know about getting COVID again (and again) in 2023.” I encourage you to click on the article and to check out my comments.
American Medical Compliance
MARCH 30, 2023
OSHA (Occupation Safety and Health Administration) views workplace violence as a major occupational risk. In response to this risk, OSHA may install additional safety standards to combat workplace violence. Over the last decade, the number of workplace violence instances has grown significantly. These instances have continued to increase as a result of the COVID-19 pandemic.
Stop and Think
MARCH 28, 2023
There is this idea that one of the main problems with US healthcare is that our system is set up to profit from sick care. This comment from my friend Dr. David Albert captures the idea: Martha, as you well know, we have a sick care system not a well care system that doesn't make $ from wellness but from caring for the sick. Not sure it will change (Trillions of dollars at stake).
Emergency Medicine Cases
MARCH 28, 2023
Dr. Nav Sahsi gives us a quick primer on Doctors Without Borders, explains the difference between humanitarian work and development work and describes the motivation, personal skills, education, time commitment and flexibility required for humanitarian work for all those with an interest in Global EM. The post Global EM 3 So you want to be a humanitarian doctor?
Cook County EM Blog
MARCH 28, 2023
The Case: The patient is a 61-year-old male with non-insulin dependent diabetes, hypertension, coronary artery disease status post CABG in 2019 who presented with blurry vision of the left eye after being hit on the face with a blunt object by his roommate approximately ten days prior to presentation. The patient reports that over the past year his roommate had been abusing him physically.
NRC Health
MARCH 28, 2023
Check out the latest spring highlights on how we put Human Understanding® into practice The post Partnering for progress: Our spring highlights in healthcare innovation appeared first on NRC Health.
Ultrasound Gel
MARCH 27, 2023
Virtual reality ultrasound?! It is here, and it might be a valuable educational tool. Special host Shawn Sethi, usual but still somewhat special host Mike, and definitely special guest ultrasound educator Suean Pascoe discuss the available evidence and their own perspectives on this innovative technology. [link] Virtual reality ultrasound?! It is here, and it might be a valuable educational tool.
Emergency Medicine Cases
MARCH 28, 2023
In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UN
Emergency Medicine Ireland
MARCH 27, 2023
Welcome back to the tasty morsels of critical care podcast. Oh Chapter 37 is dedicated to NIV in the ICU and is probably worth some time given that this is a common respiratory support both in the ICU and throughout the hospital. Many of the benefits of NIV are similar to those seen with ventilation with the blue plastic tube through the vocal cords.For example you still get: positive airway pressure which recruits alveoli and improves oxygenation improved alveolar ventilation which improves min
Dr. Smith's ECG Blog
MARCH 27, 2023
I was reading ECGs on the system, and saw this one: What do you think? I knew that, if the patient had presented with chest discomfort, that this ECG is diagnostic of inferior posterior OMI, even though it is not a STEMI. However, it is difficult to recognize for an interpreter who is does not have special expertise in OMI ECG diagnosis. We taught an AI system from PM Cardio to recognize patterns of subtle OMI (beware: this version of the app is not available to the public yet).
AED Leader
MARCH 27, 2023
Heart palpitations may come on after eating certain foods or you may have heart palpitations for another reason, such as dehydration, low electrolyte levels, pregnancy, anxiety, anemia, thyroid issues, or an underlying heart disease or arrhythmia like atrial fibrillation. While experiencing heart palpitations after eating is fairly common and is usually not dangerous, an irregular Read More "10 Foods You Should Avoid if You Have Heart Palpitations" The post 10 Foods You Should Avoid if You Have
RebelEM
MARCH 27, 2023
Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Traditionally patients were managed on the ventilator with lung volumes of 10 – 15 ml/kg. However, that practice is long-outdated and patients managed on lower tidal volumes (6 ml/kg) were found to have decreased mortality. 1 This practice of lower tidal volumes has been termed “lung protective ventilation” (LPV) and is now the standard of care for
NRC Health
MARCH 27, 2023
NRC Health is proud to host and participate in several special events you won’t want to miss this spring! The post Spring’s healthcare events you don’t want to miss—come see us! appeared first on NRC Health.
JournalFeed
MARCH 25, 2023
The JournalFeed podcast for the week of March 20-24, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Cochrane Anti-Maskers Spoon Feed In this Cochrane review, hand-hygiene programs reduce the incidence of clinical acute respiratory illness (ARI), while masking probably does not provide additional benefit.
The Skeptics' Guide to EM
MARCH 25, 2023
Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. He is also now a fully-fledged “sonologist”.
Life in the Fast Lane
MARCH 31, 2023
Michael Gibbs MD Implantable Device Imaging 003 March 2023 Implantable device imaging and interpretation.
EMergucate
MARCH 26, 2023
The following pelvic x-ray is from a 10-year-old with pain in the left pelvis after a trampoline injury.
Taming the SRU
MARCH 31, 2023
massive bee envenomation - R4 Capstone - Hydrocephalus - cpc: brain tumor - hyperviscosity syndromes - the language of being well & embracing fear in emergency medicine tamingthesru: Massive bee envenomation WITH dr. Yates Anaphylaxis Pathophysiology Type 1 Hypersensitivity Reaction IgE-mediated Mast-cell degranulation of vasoactive materials Reaction occurs in minutes Clinical Definition: Acute onset of illness with involvement of the skin, mucosal tissue or both + one of the following Resp
Emergency Medicine Education
MARCH 30, 2023
JAMA published a retrospective cohort study among septic patients who received vasopressor (norepinephrine) and hydrocortisone to show if adding fludrocortisone was more effective to this regimen compare with only giving hydrocortisone. 88275 patients reviewed and in hospital mortality and discharge to hospice as a primary outcome measured. Patients treated with combination of hydrocortisone-fludrocortisone (47.2%) had lower adjusted absolute risk difference 3.7% compare with hydrocortsone group
University of Maryland Department of Emergency Med
MARCH 27, 2023
A retrospective review of patients over age 13 presenting to one urban level one trauma center and one urban community hospital looked at traumat.
EMergucate
MARCH 27, 2023
Question 1: PH = 6.9, that is severe acidaemia HCO3 = 22 mmol/L. So, we have metabolic acidosis. Next, we need to calculate the Anion gap and the compensation.
The Bottom Line
MARCH 31, 2023
What’s new in the Critical Care literature – monthly updates
University of Maryland Department of Emergency Med
MARCH 27, 2023
This is a review of the literature surrounding using mechanical compression devices for in-hospital cardiac arrest. The bottom line is there is.
University of Maryland Department of Emergency Med
MARCH 31, 2023
Myasthenia gravis is an autoimmune disease of the neuromuscular junction, most commonly due to antibodies attacking acetylcholine receptors in.
University of Maryland Department of Emergency Med
MARCH 27, 2023
In a systematic review looking at patients over age 65 who sustained a cervical spine injury from a low-level fall, there was a 3.8% preval.
University of Maryland Department of Emergency Med
MARCH 25, 2023
This study is a secondary analysis of another studying looking at hypertonic saline in traumatic brain injury (TBI) making it not the most.
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