EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? 2022 Jul 5;328(1):57-68. 2020 Feb 12;10(1):2470.

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Pediatric EM Morsels

FEBRUARY 2, 2024

2021 May; 8:1-16. While there is no “right” work up for these patients, hopefully this morsel will help illuminate your evaluation of Travel-Related Illness in Children: Travel-related Illness: Basics International travel has been significantly increasing since commercial airlines made travel much easier. References Abdel-Haq N, Asmar BI.

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Dr. Smith's ECG Blog

JUNE 17, 2024

Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. C Examination notable for diaphoresis, 1+ bilateral lower extremity edema, regular heart rate and rhythm, and no signs of respiratory distress with normal breath sounds. Accessed May 28, 2024. What do you think? Stein et al.

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ACEP Now

FEBRUARY 13, 2024

A radiograph is shown (see figure 1). LEARN MORE The most common nerve blocks in this study are shown in Table 1. 1–4 Emergency physicians commonly prescribe opioid pain medications, and there is significant variability among prescribing patterns. 2023 Sep 2;15(9):e44583. 2024 Jan;83(1):14-21. N Engl J Med.

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EMDocs

FEBRUARY 15, 2024

1 These plants contain tropane alkaloids such as atropine (mixture of d-hyoscyamine and l-hyoscyamine) and scopolamine which are muscarinic receptor antagonists. 2 Jimson weed ( Datura stramonium, Figure 1) is one of several anticholinergic plants that if ingested can cause anticholinergic toxicity. 3 Figure 1. 3 Figure 1.

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Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures Without Pyuria. 2024;24(1):111-118. 2024 Feb 28:fetalneonatal-2023-326501. Giannoni, E., 2024 Jan 27;403(10424):355-64. Acad Pediatr. PMID: 38418208.

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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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ACEP Now

JULY 7, 2024

9 By speaking out, I hope to once again find my calling in medicine. Accessed May 19, 2024. Accessed May 19, 2024. 2024;15(1):3-16. Muir-Cochrane E, Oster C. 2020;55(3 Suppl 1):7-16. 2024;46(1):1,21. The “hidden curriculum” of our training teaches us not to challenge the hierarchy. Use of restraints.

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First Responders Childrens' Foundation

DECEMBER 8, 2023

Each VIP experience is available for bidding online at charitystars.com/umg through January 12, 2024. Select packages also benefit the Country Music Hall of Fame, The Store, and C.A.T.S. Foundation.

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Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Learning Point: 1. The Queen of Hearts AI app will hopefully be FDA approved in Q1 of 2024. For examples of such exceptions — See My Comment in the January 9, 2019 — August 22, 2020 — and June 30, 2023 posts in Dr. Smith's ECG Blog ). Figure-1: Comparison between the first 3 ECGs in today's case.

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Don't Forget the Bubbles

JANUARY 17, 2024

Around 80% of those reported pass spontaneously, with another 10-20% requiring endoscopic removal and only 1% requiring surgical intervention. BMC Pediatrics , 21 (1), Jackson, J., Journal of The Korean Society of Emergency Medicine , 33 (1), pp.134-138. 2012 Jan;3(1):6. 2012;47(9):E19-E22. Metro, D.C., Alharbi, N.

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EMDocs

FEBRUARY 7, 2024

Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. January 23, 2024. 2023 October 9. 2012 Feb 1;4(1):127-57. Essex R, Weldon SM, Thompson T, Kalocsányiová E, McCrone P, Deb S. 2013 Dec;14:1-0. 2022 Nov 9. October 16, 2023. Retrieved from: [link].

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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. 2002 Oct 9.

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Don't Forget the Bubbles

MARCH 11, 2024

New York, USA: The International Society for Pediatric Neurosurgery, 2024 (Accessed January 9, 2024). link] Mitchell, E. Pediatric Annals, 52(1), e10–e17. References The ISPN Guide to Pediatric Neurosurgery (USA): Positional Plagiocephaly in Children Homepage. Bialocerkowski, A. Vladusic, S. L., & Wei Ng, C.

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EMDocs

JUNE 25, 2024

Estimate TBSA: may use Lund-Browder chart (most accurate assessment in children and adults), Rule of Nines, or palm method (measure the burn by using patient’s entire palmar surface and fingers as 1% TBSA). Cartotto R, Johnson LS, Savetamal A, Greenhalgh D, Kubasiak JC, Pham TN, Rizzo JA, Sen S, Main E. 2024 May 6;45(3):565-589.

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Don't Forget the Bubbles

AUGUST 4, 2024

You will find the list is broken down into four sections: 1.Reviews 2024 Jul 9:e2023064794. 2024 Jul 8. 2024 Jul 21. Beaulieu E, Beno S. 2024 Jul 22;29(4):255-269. 2024 Jul 29. 2024 Jul 20;404(10449):277-293. 2024 Jul 11. 2024 Jul 11. Vassilopoulou E, et al.

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Broome Docs

MAY 31, 2024

Welcome to the June edition of the Journal Club for 2024. 2013 Sep;24(9):1848-53. 2023 Nov 28;27(1):465. 2024 Apr 1:e240167. 2023 Sep 8;9(1):73. 117(1) 36–41 DOI: 10.1177/01410768231207260 This is a fascinating read about the history of the humble placebo in science. Psychol Sci. Epub 2013 Jul 17.

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Broome Docs

MARCH 28, 2024

2024 Jan 22;41(2):96-102. PMID: 34890894 Myth 1: Kayexalate is safe and useful. 2024 Jan 2;53(1):afad255. Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A. Casey wrote a protocol for peripheral noradrenaline 9 years ago… in 2015! Emerg Med J.

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Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. For clarity in Figure-1 — I've reproduced the initial ECG in today's case.

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Don't Forget the Bubbles

JULY 22, 2024

study from 200 9. 2024 Mar 22 [cited 2024 Mar 25];0(0) Methods – What is an IPD meta-analysis? A large proportion of the trials come from Finland (3) and The UK (2) and also from Australia (1) and the US (1), but only a small number took place in the ED. Castro-Rodriguez JA, Beckhaus AA, Forno E.

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ACEP Now

SEPTEMBER 3, 2024

1 Immediately after the purchase, the real estate holdings of the hospitals were spun off into a separate company owned by Paladin and other PE investors. 7-9 The PE model then aims to sell acquired businesses for a profit within three to six years. Accessed August 25, 2024. Appelbaum E, Batt R. Accessed August, 2024.

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Pediatric EM Morsels

MAY 10, 2024

Chest Pain in Children: Hysteria vs Vigilance Diverse pathology can present as chest pain in children Cardiac 1-9% GI 2-10% Musculoskeletal – 2-20% No Identifiable cause – 21-45% of the time! Pediatr Rev September 2020; 41 (9): 469–480. 2021;13(1):2. Pediatrics. 2013 Oct;132(4):e1010-7. 2011;140(4):859-866.

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Dr. Smith's ECG Blog

AUGUST 14, 2024

R waves 6 through 9 have no preceding P waves and are suspiciously regularly spaced. Impulses E, F, G, H, and I were blocked. Progress in Biophysics and Molecular Biology , 120 (1–3), 164–178. Science Translational Medicine , 9 (400). Figure-1: I've labeled the initial ECG in today's case to illustrate my theory.

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Dr. Smith's ECG Blog

JULY 24, 2024

Easy LINK — [link] — My New E CG P odcasts ( 5/28/2024 ): These podcasts are part of the Mayo Clinic Cardiovascular CME Podcasts Series ( "Making Waves" ) — hosted by Dr. Anthony Kashou. 2:25 — Dr. Grauer: The 1st Error : Too many clinicians in 2024 are still stuck in the outdated millimeter-based STEMI Paradigm”.

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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. 2020 Jan 1;35(1):70-6. InHealthcare 2024 Jan 22 (Vol. 2023 Oct 31;21(1):403. cognitive rehearsal techniques ). Organizational dynamics. 2020 Aug 20.

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REBEL EM

MAY 27, 2024

No significant differences in heart rate 1 minute after cardioversion were observed between the three groups. 2010;17(1):44-49. Qiu, S., & Zhang, Q. Combined modified Valsalva maneuver with adenosine supraventricular tachycardia: A comparative study. The American Journal of Emergency Medicine, 78, 157–162. seconds (range: 22.5,

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EMDocs

JULY 13, 2024

1997 Mar;11(1):203-22. 2024, [link] Accessed 7 February 2024. 1985 Dec 1;153(7):737-9. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. 2024, [link] Mackeen AD, Packard RE, Ota E, Speer L. Infect Dis Obstet Gynecol. 2000;8(2):77-82. doi: 10.1002/(SICI)1098-0997(2000)8:2<77::AID-IDOG3>3.0.CO;2-6.

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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. Mimoz (2024). 4, 8 Paper: Dahyot-Fizelier, C.,

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Dr. Smith's ECG Blog

JANUARY 13, 2024

Spikes 2, 3, 4, 5, 7, 8, and 9 all occur either during or immediately after P waves which should never happen. He had routine follow up for the mitral valve clip approximately 1 month after the procedure, and the note indicated recognition of atrial lead dislodgement on the CT scan from the hospitalization a few weeks prior.

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FOAMfrat

APRIL 22, 2024

This kid had sticks go through his cheek from running with a lollipop, hit by a car, almost kidnapped, attacked by a dog, and almost burnt his house down by throwing a 9-volt battery in the trash. 2024 Mar 15:1-9. Robichaud L, Ross D, Proulx MH, Légaré S, Vacon C, Xue X, Segal E. 2016;20(1):76-81.

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This Podcast Will Kill You

MAY 21, 2024

” Neurol Asia 9 (2004): 59-63. and De Wit, E., Bertherat, E., Epidemiology and Infection 147, e95, 1–6. Animals , 13 (1), p.159. Rota, and Pierre E. Last updated 2024-03-22 [link] Wong, Kum Thong, et al. and Wang, L., Nipah virus infection. Journal of clinical microbiology , 56 (6), pp.10-1128.

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ACEP Now

APRIL 5, 2024

Accessed March 26, 2024. Accessed March 26, 2024. Accessed March 26, 2024. Accessed March 26, 2024. Accessed March 26, 2024. Accessed March 26, 2024. Accessed March 26, 2024. Published May 1, 2023. Accessed March 26, 2024. Accessed March 26, 2024. France E, Bourn S, et al.

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EMDocs

MARCH 14, 2024

1 Medicaid expansion seeks to increase insurance coverage by closing the ‘coverage gap’ for individuals who are unable to afford health insurance but are otherwise ineligible to qualify for traditional Medicaid. Published February 29, 2024. Accessed March 5, 2024. link] Williams E, Rudowitz R, Burns A. Mississippi Today.

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