Sat.Jan 04, 2025 - Fri.Jan 10, 2025

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The EM Expert Mindset – A Female Perspective

Emergency Medicine Cases

Dr. Patricia Lee is an EM physician in Calgary, Alberta and an Assistant Professor at the University of Calgary in the Department of Emergency Medicine. She reached out to me after listening to Episode 200 How EM Experts Think Part 1 as a longtime supporter of EM Cases, to highlight the importance of recognizing challenges that female-identifying EM physicians may face before, during and after ED shifts.

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Defenders of the Great Barrington Declaration Neither Know Nor Care What it Proposed. The Deliberate Erasure of the We Want Them Infected Movement Has Succeeded.

Science Based Medicine

Defenders of the GBD won't tell you what it actually said. I will. The post Defenders of the Great Barrington Declaration Neither Know Nor Care What it Proposed. The Deliberate Erasure of the We Want Them Infected Movement Has Succeeded. first appeared on Science-Based Medicine.

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The Death of Critical Thinking in Emergency Medicine

ACEP Now

In recent years, emergency medicine, once the bastion of quick decision making, clinical acumen, and patient-centered care, has been quietly succumbing to a different forcethe slow but steady erosion of critical thinking. The culprit is the increasing reliance on protocolization and the diminishing autonomy of emergency physicians. This shift, intended to standardize care and mitigate error, is paradoxically undermining the very heart of medicinethe doctors ability to think critically, adapt to

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Online QT calculator for wide QRS (LBBB, RBBB, etc.)

Dr. Smith's ECG Blog

(This was created by Arron Pearce ( [link] ) Online QT calculator for wide QRS (LBBB, RBBB, etc.

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These are the ‘Roids you are looking for – Steroids in the ED

EM Ottawa

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED). However, their use is far from straightforwardbalancing […] The post These are the ‘Roids you are looking for – Steroids in the ED appeared first on EMOttawa

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The Semmelweis gambit: A red flag for defending bad science and quackery

Science Based Medicine

A proponent of the Great Barrington Declaration is comparing rejection of its "natural herd immunity" approach to the pandemic to the rejection of Ignaz Semmelweis and his findings. It's a deceptive comparison beloved of all manner of scientific cranks. The post The Semmelweis gambit: A red flag for defending bad science and quackery first appeared on Science-Based Medicine.

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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.

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EM Innovation Collaborative - An interview with Nicholas Stark, MD, MBA & Zaid Altawil, MD

EB Medicine

In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1. Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. Growth of EMIC - Expansion from three members to over 500 - Focus areas: Education, mentorship, opportunity 3.

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ECG Pointers: A Dynamic Approach to Tachydysrhythmias Part 4

EMDocs

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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EMCrit 392 – All Things Defibrillation with Sheldon Cheskes

EMCrit

Nitty Gritty of All Things Defibrillation EMCrit Project by Scott Weingart, MD FCCM.

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Podcast – Likelihood Ratios: Critical Appraisal Nugget 12

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Mastering likelihood ratios can transform your diagnostic skills. In this podcast with Rick and Greg, discover how likelihood ratios can enhance decision-making and improve patient care. The post Podcast – Likelihood Ratios: Critical Appraisal Nugget 12 appeared first on St.Emlyn's.

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Neonatal Resuscitation Algorithms:

SCGH ED

Australian Resuscitation Council (ARC) Flowchart KEMH Neonatal Resuscitation Algorithm: The post Neonatal Resuscitation Algorithms: appeared first on Charlie's ED.

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Ep 201 How EM Experts Think Part 2: Data Gathering, Diagnostic and Treatment Decision Making, Test Ordering and Interpretation, Documentation, Emotional Resilience

Emergency Medicine Cases

In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine? How can we best streamline thorough data gathering for each case so that we don't miss key data points?

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Come join the 2025 Clinician Educator Incubator!

Life in the Fast Lane

Chris Nickson Come join the 2025 Clinician Educator Incubator! Expressions of interest are now open for the sixth Clinician Educator Incubator - EOIs close Feb 10th 2025.

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Prehospital Emergency Anaesthesia (PHEA) vs. Emergency Department RSI: A Comparative Study on Trauma Care Timelines and Outcomes

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). The post Prehospital Emergency Anaesthesia (PHEA) vs. Emergency Department RSI: A Comparative Study on Trauma Care Timelines and Outcomes appeared first on St.Emlyn's.

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SAEM Clinical Images Series: A Curious Case of Anisocoria

ALiEM

A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. The infant appeared to be asymptomatic per parents, without any behavior changes or associated symptoms noted. The patients mother noticed her sons left pupil was dilated and unresponsive to light the morning of presentation.

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Dr. Elsburgh Clarke Was Among First to Specialize in Emergency Medicine

ACEP Now

Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr.

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Mobile Stroke Unit Propaganda Writ Large

EM Literature of Note

This is yet another one of those “Get With The Guidelines” stroke analyses, a retrospective dredge with massive imbalances between groups followed by statistical adjustments capable of turning out whichever result suits an author list with a full, dense printed page of pharma and stroke technology conflicts of interest. In that respect, the study is unremarkable.

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Acute Diverticulitis for the Emergency Medicine Provider

Northwestern EM Blog

Written by: Ashley Segobiano, MD (NUEM 28). Edited by: Nicholas Maurer, MD, MPH (NUEM 26). Expert Review by : Molly Estes, MD Molly Estes, MD Emergency Medicine Physician, Assistant Professor at Feinberg School of Medicine Northwestern Memorial Hospital, Feinberg School of Medicine How To Cite This Post: [Peer-Reviewed, Web Publication] Segobiano, A.

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Sepsis alerts work! Just not in the patients who fire the alerts

PulmCCM

In the past decade, so-called “sepsis alerts” came out of nowhere to become a ubiquitous and resource-intensive component of inpatient medical care. The trouble is, no one checked first to see if they work. “Sepsis alerts” are automated notifications that flag patients who meet certain criteria compatible with severe infection discernible from the electronic medical record.

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Talking Trauma – London Trauma Conference 2024 Day 2

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Day 2 of the London Trauma Conference delivered impactful discussions on trauma care innovations, including advanced resuscitation strategies, rib fracture management, and prehospital interventions. The post Talking Trauma – London Trauma Conference 2024 Day 2 appeared first on St.Emlyn's.

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Clinical Governance Day – Wednesday, 15th January

Greater Sydney Area HEMS

Visit the post for more.

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SAEM Clinical Images Series: Xylazine Wounds

ALiEM

A 32 year-old male with PMH significant for opioid use disorder, a prior admission in 2021 for left-sided empyema s/p thoracotomy and decortication, gas bacteremia, and tricuspid endocarditis presented for a left leg wound. The patient reported a wound to his left leg that had become larger over the past 5 months. The pain worsened today, prompting him to come to the emergency department for evaluation.

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Transcatheter Tricuspid Valve Replacement for Severe Tricuspid Regurgitation (TRISCEND II trial)

PulmCCM

Transcatheter aortic-valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (M-TEER) have emerged as lower-morbidity options for selected patients with severe aortic stenosis or mitral regurgitation. Transcatheter tricuspid valve replacement has proved to be more challenging.

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Peds Collab Preview | Join NRC Health experts for an interactive workshop

NRC Health

The NRC Health 2025 Pediatric Collaborative is truly a cant-miss experience, with exceptional presentations that will stir innovative ideas. Check out a preview of one of the sessions! The post Peds Collab Preview | Join NRC Health experts for an interactive workshop appeared first on NRC Health.

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Lab case 455

EMergucate

80 year old man presented with shortness of breath. This patient had history of CHF and COPD. His venous blood gases showed the following PH = 7.

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ASTER – Acetaminophen in Sepsis

The Bottom Line

Acetaminophen for Prevention and Treatment of Organ Dysfunction in Critically Ill Patients With Sepsis Ware. JAMA 2024. doi:10.1001/jama.2024.8772 Clinical Question In critically ill adult patients with sepsis does the administration of acetaminophen compared to placebo increase the number of days alive and free of organ support to day 28?

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Work Place Violence | JournalFeed Top 10!

JournalFeed

The JournalFeed podcast for the week of Dec 30 Jan 3, 2024. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Tuesday Spoon Feed : Workplace violence (WPV) occurs in one out of every 3.7 shifts among healthcare workers (HCWs) in emergency departments, with nurses and younger HCWs being at higher risk.

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A Fungus Among Us?

Pediatric Education

Patient Presentation An 8-year-old male came to clinic with his parents because of uncontrolled asthma symptoms. They had moved into a rented home that was about 50 years old in August, when they moved to the area from another country. Since that time he had increased runny nose and coughing and used his albuterol only intermittently. He was coughing several times per day and his parents said he “coughed all night” but it didn’t wake up the patient.

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2024 Emergency Medicine Research Highlights: Forced Air, Sepsis, and More

ACEP Now

Every year, the hopeless task of keeping up with the medical literature grows even more unattainable. Will our Sisyphean burden be replaced with AI? ( Read this months Skeptics Guide to Emergency Medicine for that answer.) Will we be microchipped with peripheral PubMed brains? Will we finally wake up from the Matrix and be freed? Not yet! So, in the meantime, heres a host of articles of more than just passing interest from the past year, not already covered in ACEP Now.

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A conversation with Margaret McCartney, MD, PhD regarding evidence-based medicine and conflicts of interest

Sensible Medicine

I have long followed the work of Dr. Margaret McCartney. She is a general practitioner in Glasgow, Scotland, writer, public speaker, and now PhD. She is a fierce advocate for evidence-based medicine. She holds highly skeptical views of screening for disease—which, to my surprise is quite common in the UK. Her recently finished PhD sought empirical evidence regarding declaration of conflicts of interest in the UK.

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CONCEALED CONDUCTION AND VENTRICULOPHASIC SINUS ARRHYTHMIA

ECG Guru

Sometimes in a simple 1-lead ECG strip, various interesting ECG phenomena can be recognized, such as here. One could briefly look over the ECG, make the diagnosis of ventricular bigeminus and then be satisfied. On closer inspection, however, 3 questions arise: 1. Is the P wave behind the PVC a sinus node P or an atrial extrasystole? 2. + 3. after one comes to the conclusion that it is a sinus node P: why is it not conducted and why is the PP distance smaller when there is a QRS complex in betwee

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Syncope, chest pain, and inferior ST Elevation with Reciprocal ST depression in aVL

Dr. Smith's ECG Blog

A 26 year old male presented with syncope and chest pain. Syncope was sudden and without prodrome, and resulted in head trauma with a scalp laceration. Here is his ECG: There is significant ST Elevation in inferior leads, with reciprocal ST depression in aVL. This appears to be an inferior OMI What do you think? Smith : I recognize this as a STEMI mimic.

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Navigating Strict State Abortion Laws

ACEP Now

On June 24, 2022, Roe v. Wade was overturned by the U.S. Supreme Court, leaving regulation of abortion to the discretion of the states. Since then, many states have enacted laws to strictly regulate abortion, resulting in complex legal considerations for medical professionals. 1,2 This article reviews key statutes in the states with the strongest prohibitions against abortion and offers documentation principles for treating patients with ectopic pregnancies, spontaneous miscarriages, and other p

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Surgeon General Alcohol Warning

Science Based Medicine

In 1964 the US Surgeon General released its first report on the health risks of smoking and tobacco use. This turned out to be a landmark move, paving the way for the following decades of progressively more restrictive regulation of public tobacco use and marketing. In 1964 smoking was at its peak in the US, when 42% of Americans smoked. Today the […] The post Surgeon General Alcohol Warning first appeared on Science-Based Medicine.

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Friday Reflection 47: Patients Make the Hardest Decisions

Sensible Medicine

MM is a 55-year-old man with recurrent pneumonia. He initially presented with a fever, chills and a lobar infiltrate. Symptoms resolved with antibiotics but recurred a week later. During his second course of treatment, further evaluation with a CT scan showed the infection to be post-obstructive, occurring distal to compression of a secondary bronchus by severe scoliosis.

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The AI Will Literally See You Now

EM Literature of Note

This AI study is a fun experiment claiming to replicate the clinical gestalt generated by a physician’s initial synthesis of visual information. The ability to rapidly assess the stability and acuity of a patient is part of every experienced clinician’s refined skills and used as a pre-test anchor for application of further diagnostic and management reasoning.