The Skeptics' Guide to EM

SEPTEMBER 1, 2018

[display_podcast] Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. display_podcast] Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. A better option is to try kindness as outlined in the excellent book by Dr. Brian Goldman. Reference: Riskin A, Erez A, Foulk TA, et al. Pediatrics.

ALS 130

ALS Emergency Department OR EMS 130

Critical Care Scenarios

MAY 31, 2020

The book Buy the new textbook (Bryan edited, Brandon authored a chapter) here or on Amazon: Concepts in Surgical Critical Care, First Edition ed. Figure 1 from Srour et al (vide infra). Resources The SAVIOR algorithm. References * Srour H, Shy J, Klinger Z, Kolodziej A, Hatton KW.

Critical Care 100

Critical Care Epinephrine ED ALS 100

EMDocs

AUGUST 8, 2023

However, patients remain concerned about losing a testicle, and there is high medicolegal risk. Pain can be intermittent. 84-90% have testicular pain. May start within a few hours of a minor trauma or wake them from sleep. Abdominal/flank pain – 20% ONLY have this complaint (check this testicles in a male patient with abdominal/flank pain).

ALS 67

ALS OR Emergency Department 67

This Podcast Will Kill You

JANUARY 2, 2024

Natalie is a New York Times bestselling author of novels for young readers, whose recently published award-winning book Hummingbird tells the story of a young girl with OI. Heartwarming, magical, and brilliant, this wonderful book is a must-read. Devogelaer, Jean-Pierre, et al. Tsimicalis, Argerie, et al. Tune in today!

E-9-1-1 52

E-9-1-1 ALS OR 52

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. and two cohort studies, one performed in Australia by O’Leary et al. and one in the US by Bonafide et al. and two cohort studies, one performed in Australia by O’Leary et al.

Life Support 98

Life Support Advanced Life Support ALS Emergency Department 98

The Skeptics' Guide to EM

MARCH 13, 2021

Reference: Post et al. Reference: Post et al. The guest skeptic for SGEM#201 was Dr. Chris Carpenter, who literally wrote the book on diagnostic accuracy of clinical decision instruments in the ED with Dr. Jesse Pines. Robert Edmonds is an emergency physician in the US Air Force in Ohio.

ALS 100

ALS Emergency Department ED OR 100

FOAMfrat

AUGUST 28, 2024

Basic Physiology Cellular respiration - please keep reading, I promise I will not talk about the Krebs cycle - is at the core of all life-sustaining biologic processes. It produces energy for the body and can be completed with (aerobic) or without (anaerobic) oxygen. In healthy patients, this mechanism maintains blood pH between 7.35

Critical Care 98

Critical Care Overdose OR ALS 98

Dr. Smith's ECG Blog

AUGUST 2, 2024

118.007305) from Heitner et al. , PEARL #1: The important paper cited by Dr. Frick in his discussion above ( Heitner et al — Cardiovasc Interven 12(5), 2019 ) — highlights the fact that learning to predict the probable "culprit" artery from interpretation of the initial ECG is more than simply an academic exercise.

STEMI 109

STEMI ALS OR 109

AAEM RSA

NOVEMBER 23, 2020

3 Sheryl Sandberg’s recent book, Lean In , focused attention on the individual factors that hinder the advancement of women and has challenged women to overcome their own low expectations and self-defeating behaviors. Shollen et al. 6 Jolly et al. link] Shollen SL, Bland CJ, Finstad DA, Taylor AL. Soc Forces.

OR 52

OR E-9-1-1 ALS 52

EMS 12-Lead

APRIL 2, 2022

So, when I first began teaching ECGs and writing my books (in the early 1980s) — I decided to synthesize my impressions of the literature into what I felt (e.g. Upon arrival he was found alert and oriented, and without gross distress. He denied difficulty breathing, epigastric pain, or chest discomfort. Figure 1-2. Is it LBBB, or LAFB?

ALS 130

ALS STEMI Coronary OR 130

ACEP Now

AUGUST 15, 2023

The next shift you may feel inadequate as you realize the antibiotics you prescribe will never be picked up by your patient. You may alleviate pain and anxiety for a dying great-grandfather and his family or listen to an underserved veteran recount their service and struggles. 6 What’s Your Pre-Shift Ritual? That’s okay.

ALS 90

ALS Emergency Department OR CPR 90

The Skeptics' Guide to EM

JUNE 29, 2018

[display_podcast] Date: June 20th, 2018 Reference: Fox LM et al. display_podcast] Date: June 20th, 2018 Reference: Fox LM et al. The first time was with Dr. Al Sacchetti. Al was brought back for a second time looking at using electro-acupuncture for migraine prophylaxis. Reference: Fox LM et al.

Emergency Department 100

Emergency Department ALS ED EMS 100

This Podcast Will Kill You

FEBRUARY 13, 2024

Granta Books, 2011. Ellis, Samuel, et al. “That time of the month”, “Aunt Flo”, “the red wave”, “period”, the list goes on. But what about euphemisms for menopause? We’ve got “the change” or “change of life”, “climacteric”, and… that’s it? There may be more out there, but the comparison is revealing. History Biology Foxcroft, Louise.

ALS 98

ALS OR 98

FOAMfrat

OCTOBER 28, 2023

What is Sweep? You may have heard this term in reference to medicine, or you may just be familiar with what your parents had you doing to help around the house when you were younger. I hope you enjoy the content, and please reach out with any questions or if there are any topics you'd like to see in the future. Okay, easy enough.

Life Support 52

Life Support Paramedic CPR OR 52

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. A definitive trial was needed to help establish the best transfusion practices to prevent child mortality in LMICs. Transfusion Volume for Children with Severe Anemia in Africa. N Engl J Med. 2019;381(5):420-431.

E-9-1-1 78

E-9-1-1 ALS OR Critical Care 78

FOAMfrat

MAY 17, 2024

ECMO is somewhat similar. The basic components must remain the same to achieve the therapeutic goal. At its most basic form, ECMO or Extracorporeal Membrane Oxygenation is a way to artificially support the patient’s heart and or lungs by removing the blood from the body, oxygenating it, and returning it to the patient in real-time.

Life Support 98

Life Support OR ALS EMS 98

This Podcast Will Kill You

DECEMBER 19, 2023

Banerjee, Rajashree, et al. McDonald, Claire, et al. Parkinson’s is a disease of many dimensions. The choices seem limitless and maybe a tad overwhelming. But that’s where we come in. “Levodopa: the story so far.” ” Nature 466.7310 (2010): S6-S7. Kalia, L.V. and Lang, A.E., Parkinson’s disease. 2022): 27-37. .”

ALS 52

ALS OR 52

The Overrun Podcast

MARCH 4, 2020

The book that defines the thought process behind gestalt: [link] The HEART score for cardiac risk stratification: [link] 1st 10EM does a really great job breaking studies down for us in the FOAMed world; check them out explaining the Oliver paper: [link] Wang, et. It's been termed a hunch, a gut instinct; but it's much more than that.

EMS 52

EMS ALS OR 52

REBEL EM

NOVEMBER 30, 2022

Perform manual detorsion after diagnosis Read More: Video: The New Testicular Torsion Traction Technique Ben-Israel T et al. PMID: 20837255 Sidler D et al. PMID: 22217895 Ban KM, Easter JS: Selected Urologic Problems; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8.

ALS 52

ALS ED OR EMS 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

Lemkes et al. I believe that I was the first to represent Wellens as a reperfusion syndrome, in my book , The ECG in Acute MI , pages 22-23 and 51, and in chapter 27 on Reperfusion and Reocclusion. There are also subtly hyperacute T-wave in I, aVL, and V2-V6. The S-wave is reconstituted. The inferior findings are much less pronounced.

STEMI 113

STEMI ACS Critical Care OR 113

ACEP Now

SEPTEMBER 3, 2024

From 200 billion dollars that year, the firms that make up the Healthcare Private Equity Association now have over 2 trillion dollars in assets under management. 5 Private equity follows a fundamentally different business model from other forms of investment, such as publicly-traded or privately-owned companies.

E-9-1-1 69

E-9-1-1 ALS OR Emergency Department 69

REBEL EM

SEPTEMBER 29, 2022

Article: de-Madaria E et al. PMID: 36103415 Buxbaum JL et al. PMID: 28266591 Ramirez-Maldonado E et al. There are also potential harms to large volume fluid resuscitation including progression of pancreatitis and fluid overload with or without respiratory failure. NEJM 2022; 387: 989-1000. Am J Gastroenterol 2017.

ICU 52

ICU ALS Critical Care Emergency Department 52

ACEP Now

JULY 6, 2023

Brian Zink captured a wonderful initial vision statement for our specialty with the title of his book, “Anyone, Anything, Anytime,” which documented the history of our specialty. Gulati M, et al. Stiell IG, et al. After convincing ourselves that we save our systems large sums of money, we need to educate our critics.

ALS 52

ALS Emergency Department STEMI ED 52

FOAMfrat

JUNE 25, 2024

Since then, I’ve developed a habit for outdoor recreation and light versions of mountaineering, which led me to realize that altitude illness can occur in much less extreme conditions than I’d previously thought and that these pathophysiologies might actually be relevant to those of us not living in Nepal.

OR 86

OR Coronary ALS 86

EMDocs

JUNE 3, 2023

Figure 2: Open book pelvic fracture. Introduction The pelvic ring is made up of the bony ilium, ischium, pubis, and sacrum, which are held together with ligaments. Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. External clues are not often present, with one study finding only 7.6%

ED 54

ED Operating Room ALS Frozen Plasma 54

Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

Here is an example of isolated RV infarction, from Dr. Smith's book : Learning points: 1) OMI can be very subtle and RV infarction may manifest poorly on the standard ECG. Any cause of pulmonary hypertension. There is normal axis, normal R-wave progression in the precordial leads and no intraventricular conduction abnormalities.

STEMI 96

STEMI OR ACS ALS 96

EMDocs

APRIL 22, 2024

Alerhand et al described ten individual echocardiographic findings of RV strain that suggest PE. Time was of the essence, the patient was intubated, ACLS measures were continued, and POCUS was performed. Consultants were rapidly mobilized, and therapy was administered confidently within minutes of arrival. 10,11 Vid 1. TAPSE motion normal.

ED 81

ED NARCAN ALS OR 81

Emergency Medicine Ireland

MAY 27, 2024

Is the IVS becoming less flattened, is the RV less distended, is the TAPSE improving etc… Echo early, echo often in my book. We’ve been talking about pulmonary hypertension, last time we had a pretty broad overview with a focus on group 1 or pulmonary arterial hypertension. In terms of monitoring should we be reaching for a PAC?

Critical Care 52

Critical Care ICU OR ALS 52

Dr. Smith's ECG Blog

APRIL 22, 2022

Backus BE, Six AJ, Kelder JC, et al. Moumneh T, Sun BC, Baecker A, et al. Shah ASV, Anand A, Sandoval Y, et al. Patel J, Alattar F, Koneru J, et al. Gulati M, Levy P, Mukherjee D, et al. Greenslade J, Cho E, Van Hise C, et al. Specifying the level is more accurate, evidence-based and safe 3. Am J Med 2021 5.

E-9-1-1 52

E-9-1-1 STEMI ALS ED 52

Dr. Smith's ECG Blog

MARCH 11, 2016

Raitt MH, et al. There is a body of literature from the thrombolytic era showing that high ST score correlates with high mortality (see annotated bibliography below, from my book The ECG in Acute MI ). This comes from chapter 28 of my book The ECG in Acute MI ). Methods: Oliva et al. (94) 0 0 1 36 207 MMRF 1 1 242 14.0

ALS 52

ALS STEMI OR ED 52

ALiEM

OCTOBER 30, 2024

The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Along the same time, a veterinary sedative, xylazine , became popular in Puerto Rico in individuals who used injection drugs [3]. We treat with wound care and reserve surgical management only for limbs that are no longer viable.

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E-9-1-1 Naloxone Emergency Department ALS 161

FOAMfrat

JULY 1, 2023

Their recommendation, as I can tell, appears to come from two things: A paper by Levin NM et al. I also find the following information useful: Succinylcholine has an onset of approximately 45 seconds, whereas Rocuronium has an approximate onset of 60 to 90 seconds -- Depending on what book you read. mg/kg of Rocuronium was used [4].

E-9-1-1 52

E-9-1-1 Emergency Department OR ALS 52

Dr. Smith's ECG Blog

DECEMBER 29, 2015

The criteria of Armstrong et al. LVH usually has concave-upwards ST segments, but conVEX-upwards can also be seen, e.g. in these cases from Dr Smith’s book: The ECG in Acute MI : Case 22-1. One retrospective analysis by Armstrong et al. The T-waves in those leads have also significantly increased. 3 Is the STE concave or convex?

STEMI 52

STEMI Coronary ALS CAD 52

FOAMfrat

SEPTEMBER 19, 2024

Background and Epidemiology In the United States, roughly 9,000 snake bites are reported annually, with approximately 3,000 being attributed to venomous species and less than 10 resulting in death. Many bites are associated with (human) consumption of alcohol. Fortunately, overall prognosis for snake envenomation within the U.S. Neither will the ER.

Emergency Department 90

Emergency Department Epinephrine OR Plasma 90

Dr. Smith's ECG Blog

JUNE 28, 2018

de Zwaan C et al. I believe that I was the first to represent Wellens as a reperfusion syndrome, in my book , The ECG in Acute MI , pages 22-23 and 51, and in chapter 27 on Reperfusion and Reocclusion. Am Heart J. 1982 Apr;103(4 Pt 2):730-6. Am Ht J 117(3): 657-665; March 1989. Wehrens XH, Doevendans PA, Ophuis TJ, Wellens HJ.

STEMI 52

STEMI Coronary OR ALS 52

The Skeptics' Guide to EM

MAY 5, 2018

[display_podcast] Date: March 6th, 2018 Reference: White et al. display_podcast] Date: March 6th, 2018 Reference: White et al. There are comic book super heroes that are physicians. Thor the god of thunder was transformed into a physician named Donald Blake in the earlier comic book series? Reference: White et al.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

FEBRUARY 29, 2020

Date: February 28th, 2020 Reference: Rajendran et al. Date: February 28th, 2020 Reference: Rajendran et al. Anxiety disorders are the most common ( Marchesi et al EMJ 2004 ). Reference: Rajendran et al. AEM February 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 100

Emergency Department ALS ED OR 100