This Podcast Will Kill You

JULY 23, 2024

2014): 6-7. Official journal of the American College of Gastroenterology| ACG , 118 (1), pp.59-76. Annals of internal medicine , 172 (1), pp.ITC1-ITC16. Caio, Giacomo, et al. ” BMC medicine 17 (2019): 1-20. Cenit, María Carmen, et al. Gastroenterology , 160 (1), pp.63-75. Al-Dulaimi, D.,

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REBEL EM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 1, 4, 6 The overall incidence of VAP is somewhere around 5%-40% of all intubated patients, depending on the study and country from which it is reported. 4, 8 Paper: Dahyot-Fizelier, C.,

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Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Here is lead I from ECGs 1 and 2 shown side-by-side to highlight the change in axis from borderline right to completely normal. Consider the following: We become attuned to looking for acute coronary occlusion in patients who present with acute symptoms to the ED ( E mergency D epartment ).

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Pediatric EM Morsels

AUGUST 18, 2023

Rose 2014) They are the most frequently prescribed class of medications in adults; however, in children they are the least frequently prescribed class , <2% of antibiotics. Hersh 2014) Fluoroquinolone Use in Children: Indications for use Let’s keep this simple, Pseudomonas ! Which is a risk of 1 event for 62.5 Pediatrics.

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This Podcast Will Kill You

JANUARY 16, 2024

” PLoS pathogens 10.11 (2014): e1004475. Manaresi, E. Hoelzer, Karin, et al. Pt 9 (2008): 2280. History Biology Allison, Andrew B., “Role of multiple hosts in the cross-species transmission and emergence of a pandemic parvovirus.” ” Journal of virology 86.2 2012): 865-872. Heegaard, E.D.

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REBEL EM

AUGUST 30, 2023

Epidemiology 1 to 2.4 cases per 100,000 people ( Zimmerli 2010 ) More common in males with M:F of 3:1 Rate is also increasing due to increased number of spinal procedures Typically affects adults, with most cases occurring in patients over 50 years old. Other pathogens include: E. PMID: 26316526 Boody B, et al.

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Don't Forget the Bubbles

JUNE 30, 2023

He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. She calls out her findings: A – OK B – 1 puncture mark to the anterior left chest wall, covered with a three-sided dressing. Actively oozing.

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Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. ECG 1 What do you think? Grines, C.

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REBEL EM

JANUARY 25, 2024

Article: Arvig MD, Lassen AT, Gæde PH, et al. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. The first evaluation of the patient was to be done within 1 hour of arrival to ED (Including the first POCUS). Emerg Med J.

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Broome Docs

DECEMBER 22, 2024

2024 Oct 9. There were no differences in survival (12% with IO vs 10% with IV) or neurologically intact survival (9% vs 8%). 2024 Nov 1. 2018 Nov 22;379(21):2002-2014. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. doi: 10.1001/jama.2024.20424.

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FOAMfrat

MAY 19, 2024

While transporting to the emergency department, the patient’s mother informed me that PDCD affects less than 1 in 50,000 individuals and is more common in males than females. The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. 2014 Feb.

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Dr. Smith's ECG Blog

JULY 22, 2023

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year incidence of SCD in this cohort [1].

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Don't Forget the Bubbles

MAY 29, 2023

A study of teams over a 1-year period highlights that people witnessing incivility are also affected, which could lead to individuals feeling unsupported in their teams. 2021:36:1–2, NP448–NP473 Available at. Review of Cultivating Communities of Practice: A Guide to Managing Knowledge, by Wenger E, McDermott R, Snyder WM].

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Don't Forget the Bubbles

JUNE 30, 2023

E – Temp 37.2 Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7% Last year, Kornelson et al. A retrospective cohort study in Japan by Maeda et al.

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EMDocs

SEPTEMBER 7, 2023

1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity? Metabolism of DEG adapted from Bessenhofer, et al. Toxicity typically evolves through three phases: 2,3,7,8,9 Phase 1: Gastrointestinal symptoms (e.g., References: Abubukar et al. Nelson, et al. Schier, Capt.

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Don't Forget the Bubbles

JUNE 17, 2024

Here are ten things to think about: 1. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J. 2014 Jun 26;23(12):653-9. Frich JC, Brewster AL, Cherlin EJ, Bradley EH. 2020 Jan 1;35(1):70-6. 2023 Oct 31;21(1):403. Roche E, Jones A, Plunkett A. 2020 Aug 20.

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REBEL EM

FEBRUARY 5, 2024

Article: Marx T, Joly LM, Parmentier AL, et al. Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Recurrence of pneumothorax within 1 year. Panacek, E. Cochrane Database of Systematic Reviews 2017, Issue 9.

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EMDocs

AUGUST 7, 2023

1 A D-dimer level can, therefore, be used as a non-specific and indirect biomarker for the presence of intravascular clotting, which may be useful in the diagnosis of VTE. 1-3 In this patient population, the NPV of a negative D-dimer level is high, such that a negative test makes further evaluation for VTE unnecessary.

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EMDocs

AUGUST 3, 2023

2014 Sep-Oct;52(8):856-67. Epub 2014 Aug 18. PMID: 25133498 Ghannoum M, Kazim S, Grunbaum AM, Villeneuve E, Gosselin S. Bebarta VS, Kao L, Froberg B, et al. 2004;20(9):649-650. Extracorporeal treatment for acetaminophen poisoning: recommendations from the EXTRIP workgroup. Clin Toxicol (Phila). Epub 2016 Apr 27.

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This Podcast Will Kill You

JANUARY 2, 2024

2002): 1-7. Nature Reviews Endocrinology , 7 (9), pp.540-557. Devogelaer, Jean-Pierre, et al. Endocrine reviews , 43 (1), pp.61-90. Molecular and Cellular Pediatrics , 7 (1), pp.1-9. Academic Press, 2014. Sochett, E. Annual review of biochemistry , 78 , pp.929-958. and Glorieux, F.H., Bickel, Ralph K.

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This Podcast Will Kill You

NOVEMBER 27, 2023

” Cambridge: Cambridge University Press 197 (1993): 9-23. Parasites & Vectors , 15 (1), pp.1-9. Brown, Amanda MV, et al. The Lancet Global Health , 8 (9), pp.e1186-e1194. Ferri, Emanuele, et al. Gerth, Michael, et al. 2014): 5117. Kaur, Rupinder, et al. and Nutman, T.B., Addiss, D.

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This Podcast Will Kill You

OCTOBER 24, 2023

2005): 1-6. Bulletin of Science, Technology & Society , 25 (1), pp.37-45. “Insecticide toxicology, mammalian toxicity of 1-naphthyl-N-methylcarbamate (Sevin insecticide).” Stewart, Nelson E., “Acute toxicity of the insecticide Sevin® and its hydrolytic product 1-naphthol to some marine organisms.”

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Don't Forget the Bubbles

MARCH 18, 2024

The Royal Children’s Hospital in Melbourne summarises them in an easy-to-follow flow diagram (figure 1). Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. Blood tests Urine Stool Full blood count with blood film Urinalysis Stool MC&S Coagulation Urine MC&S E.

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This Podcast Will Kill You

SEPTEMBER 10, 2024

Perantoni, E., Kaimakamis, E., Longtin, Yves, et al. Elsevier, 2014. JMIR Medical Informatics, 9(1), p.e22753. . “Laennec, the Man—1781–1826.” ” The Boston Medical and Surgical Journal 195.5 1926): 208-211. Lung sounds recordings: Rocha, B.M., Vogiatzis, I., Natsiavas, P., Oliveira, A.,

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Don't Forget the Bubbles

JANUARY 10, 2024

Maitland K, Olupot-Olupot P, Kiguli S, et al. doi:10.1056/NEJMoa1900100 Maitland K, Kiguli S, Olupot-Olupot P, et al. The study asked TWO questions: 1. 3,950 children were recruited between September 2014 to May 2017. Transfusion Volume for Children with Severe Anemia in Africa. N Engl J Med. 2019;381(5):420-431.

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NAEMSP

APRIL 19, 2023

However, evidence emerged in the 1980’s demonstrating that calcium chloride had no effect on return of spontaneous circulation (ROSC) rates, and in fact could be detrimental (Landry, Foran, & Koyfman, 2014). Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al.,

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ECG & Echo Learning

OCTOBER 2, 2022

Most agents exhibit both vasopressor and inotropic effects (Figure 1). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 mg (max 1 mg) Safe for peripheral use ++ + N/A Beta-effect more pronounced at low doses. References Overgaard, Dzavik et al. Jentzer et al. Circulation 2011.

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This Podcast Will Kill You

NOVEMBER 7, 2023

New England Journal of Medicine, 355(1), pp.51-65. 2014): 415-435. Nature reviews Disease primers, 1(1), pp.1-20. Lee, Carrie, et al. Craythorne, E. and Al-Niami, F., International journal of dermatology, 49(9), pp.978-986. Public Health Research & Practice, 32(1). Miller, A.J.

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Dr. Smith's ECG Blog

APRIL 22, 2022

But these cases show the potential dangers of delayed recognition and treatment of inferior reperfusion Take away 1. ECG’s can be labeled as ‘normal’ by the computer (and confirmed by cardiology) even with diagnostic signs of occlusion or reperfusion References 1. Backus BE, Six AJ, Kelder JC, et al. Case Rep Emerg Med 2014 7.

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AAEM RSA

APRIL 1, 2021

1 The American College of Surgeons’ (ACS) Trauma Quality Improvement Program (TQIP) Massive Transfusion in Trauma Guidelines leave a good amount of flexibility for hospitals regarding transfusion protocols, focusing more on systems-level aspects of designing and implementing MTPs.2,3 Holcomb JB, Tilley BC, Baraniuk S, et al.

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ACEP Now

NOVEMBER 7, 2023

1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). References Go AS, Mozaffarian D, Roger VL, et al. Larribau R, Deham H, Niquille M, et al. 2018;13(9):e0204169.

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AAEM RSA

AUGUST 27, 2020

1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Nielsen N, Wetterslev J, Cronberg T et al. By the time of the study by Nielsen et al. Kirkegaard et al.

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REBEL EM

JULY 18, 2022

Paper: Zahed R, Moharamzadeh P, Alizadeharasi S et al. 2013 Sep;31(9):1389-92. The NoPAC trial, which was published in 2021,(1) compared TXA to placebo in a large multicenter randomized control trial in the UK which looked at data from 26 emergency departments. Am J Emerg Med. Epub 2013 Jul 30. PMID: 23911102. Ann Emerg Med.

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AAEM RSA

NOVEMBER 23, 2020

Shollen et al. 6 Jolly et al. 9 While these flexible tracks may help women remain in the workforce during the demanding child-rearing years, getting off track can be detrimental to career advancement and promotion, especially in comparison to men who usually start and remain in full-time service. Wahington, DC: 2014.

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Dr. Smith's ECG Blog

OCTOBER 24, 2018

A 40-something male presented with dyspnea and left arm numbness, and perhaps some chest tightness, for 1 1/2 hours. Thelin et al. Mokhtari et al. Note baseline wander in lead aVL of ECG #1. Here is his triage ECG: There is massive STE in V3-V6, and also STE in II, III, aVF. Why is this important?

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REBEL EM

MARCH 13, 2023

Article : Vianen NJ et al. The search contained terms for (1) prehospital cardiac arrest or prehospital advanced life support, and (2) injuries and trauma. References: Grasner JT, et al. 2008 Apr 22;178(9):1141-52. PMID: 16128477 Tran A, et al. PMID: 32531405 Further Reading: Beck B, et al. Epub 2022 Mar 25.

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EM Didactic

DECEMBER 19, 2018

Ketamine undergoes extensive hepatic metabolism (via cytochrome P450 enzymes) with norketamine being an active metabolite with 1/3 of the potency of ketamine. Galinski M, Dolveck F, et al. 2007 May;25(4):385- 90 Ahern TL, Herring AA, Anderson ES, Madia VA, et al. 2015 Jul;16(7):1402-9. Scand J Trauma Resusc Emerg Med.

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