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First10EM Journal Club: August 2024

Broome Docs

In a surprise to no one who reads First10EM, clinical judgment is better than all decision tools for sepsis Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. 2024 Mar 25:S0196-0644(24)00099-4. 2024 Jun;26(6):381-385. Epub 2024 Apr 9. 2024 Jul;81:75-81.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

1 Risk Factors: 1-4 Spontaneous Anticoagulants (Apixaban, Rivaroxaban, etc.) Older Age (median age of 70 years) 1 Abnormal vasculature/neoplasm of the kidney (e.g., 5 Clinical Presentation: 1-3 Variable presentation but may present with dropping hemoglobin/hematocrit without other findings in spontaneous cases.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

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? C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

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. The patient was upgraded to the ICU for closer monitoring.

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First10EM Journal Club: June 2024

Broome Docs

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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First10EM Journal Club: March 2024

Broome Docs

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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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

REBEL EM

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. Mimoz (2024). Lasocki, T.

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