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Date: February 7, 2023 Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. NEJM 2022 Guest Skeptic: Dr. Sean Moore is an emergency physician working in Kenora Ontario, where he is Chief of Staff at Lake of the Woods District Hospital, Northern Medical Director for the Ornge air medical transport program and associate medical director with CritiCall […] The post SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular F
ED recognition and management of some commonly missed or mismanaged hand inuries including finger tip avulsions and amputations, nailbed injuries, PIP dislocations, metacarpal fractures, hand tendon lacerations, Stener lesions, Seymour fractures, mallet fingers, jersey fingers, skier's thumb, Bennet fractures and Rolando fractures with masters Dr. Arun Sayal and Dr.
In this intro video, we demonstrate the use of ultrasound imaging to identify fractures. Ultrasound-guided fracture identification is a minimally invasive technique that allows for quick and accurate diagnosis of fractures, without the need for radiation or contrast agents. Additionally, it can be used during reductions to assist in identification of adequate alignment without the need for a C-arm!
Engineers at the University of California San Diego have developed a wearable ultrasound system for cardiac imaging. The postage stamp-sized patch can be worn on the skin of the chest and uses AI and ultrasound waves to perform advanced imaging of the heart. The technology can even be worn to perform cardiac ultrasound imaging during exercise. Each patch can be worn for up to 24 hours, and provides information on how much blood the heart is pumping, a key metric in detecting and appraising a var
A review of the basics of blood donation, storage, typing, screening, matching, and transfusion. Transfusion medicine series at Critical Concepts Find us on Patreon here! Buy your merch here! A review of the basics of blood donation, storage, typing, screening, matching, and transfusion. Transfusion medicine series at Critical Concepts Find us on Patreon here!
Reference: Cashen K, Reeder RW, Ahmed T, et al. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center.
Dr. Jesse McLaren on when to consider Spontaneous Coronary Artery Dissection (SCAD), which patients are at risk for reocclusion, and the challenges of diagnosing SCAD in patients who have nonischemic ECGs despite silent occlusion, occlusions perfused by collaterals, or from non-occlusive MI on this ECG Cases. The post ECG Cases 40 – Approach to Spontaneous Coronary Artery Dissection (SCAD) appeared first on Emergency Medicine Cases.
Joint pain is a fairly common complaint and accurately identifying fluid (or lack thereof) can be difficult and frustrating without POCUS! In this video I show you how to identify joint effusions (including shoulder, knee and hip effusions) and how to use ultrasound to accurately stick a needle in it to either drain that fluid or to aspirate it.
Researchers at Columbia University’s Irving Medical Center have developed a method to create three-dimensional bioengineered skin grafts. To date, bioengineered skin is typically created in flat sheets. However, these are difficult to fit to complex anatomy, such as the hand, and so these researchers have designed a more sophisticated technique that combines laser scanning, 3D printing, and cell culture to create seamless three dimensional skin grafts.
A candid discussion of our flaws, mistakes, weaknesses, and errors, and a look at why it’s important to reflect on these things in medicine, acknowledge them, and try to improve. Find us on Patreon here! Buy your merch here! A candid discussion of our flaws, mistakes, weaknesses, and errors, and a look at why it’s important to reflect on these things in medicine, acknowledge them, and try to improve.
Date: February 17, 2023 Reference: Gettel et al. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. AEM Feb 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.
Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With … Continue reading →
Is low dose diltiazem as effective and safer than standard dose diltiazem for rate control in patients with atrial fibrillation with rapid ventricular response? Dr. Rohit Mohindra and Dr. Shelley McLeod critically appraise the latest study on diltiazem dosing and deliver a research methodology hot take on this month's EM Cases Journal Club. The post Journal Club 2 – Diltiazem Dosing in Atrial Fibrillation with Rapid Ventricular Response appeared first on Emergency Medicine Cases.
Researchers at MIT have developed an ingestible sensor that can reveal gastrointestinal motility issues, such as gastroparesis and gastroesophageal reflux disease. The technology is intended for use as an easy at-home method to diagnose such issues, which typically require more invasive and inconvenient procedures, such as endoscopy or X-ray imaging.
A review of the methods of PEEP setting, including stress index, PV loops, esophageal manometry, and PEEP tables, and finally my preferred method of driving pressure trials. Find us on Patreon here! Buy your merch here! A review of the methods of PEEP setting, including stress index, PV loops, esophageal manometry, and PEEP tables, and finally my preferred method of driving pressure trials.
Date: February 1, 2023 Reference: Wolfrum et al. Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. Circulation. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital.
Question 1: PH = 7.43 that is with in normal range, more toward alkalotic spectrum HCO3 = 39.9, that is elevated so we have metabolic alkalosis. Next we need to check the compensation process.
In this Part 3 of our 3-part podcast series on management of lacerations Dr. Haley Cochrane joins Anton and Justin to explore laceration aftercare and the evidence for keeping wounds dry or wet, wound dressings, topical antibiotics, prophylactic oral antibiotics, Vitamin E oil, aloe vera cream and UV protection with regards to cosmetic outcomes and infection rates.
All things Sleep--you will add years to your life if you sleep well, so the time investment to listen to this podcast may be well worth it EMCrit Project by Scott Weingart, MD FCCM.
Researchers at Northwestern University have developed a wearable that can detect when someone is talking or singing, and tallies this information up to provide a warning when the wearer might be at risk of vocal fatigue. Overusing your voice in a short space of time can lead to vocal fatigue and even injury. This technology is useful for patients with vocal disorders, but also for people who rely on their voices a lot, such as singers, politicians, and teachers.
Discussing the psychology of emergency response, team dynamics, and debriefing with Dan Dworkis, MD, PhD, FACEP. He’s the Chief Medical Officer at the Mission Critical Team Institute, a board-certified emergency physician, and an assistant professor of emergency medicine at the Keck School of Medicine of USC where he works at LAC+USC. He performed his emergency … Continue reading "Episode 56: Resuscitation psychology with Dan Dworkis" Discussing the psychology of emergency response, team dynamic
In patients with refractory out-of-hospital cardiac arrest (OHCA) and an initial ventricular arrhythmia, does extracorporeal cardiopulmonary resuscitation (ECPR), as compared with conventional CPR (CCPR), improve survival with a favourable neurologic outcome
In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing. The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on
A team at Rice University has developed an automated feeding platform for mosquitoes that allows researchers to test different types of repellent and investigate mosquito-borne disease transmission. Traditionally, such mosquito research would require human volunteers or animal subjects for the mosquitos to feed on, but this is obviously inconvenient and a little distasteful.
Hello PEC Podcast listeners! In this episode of the PEC podcast, we cover the Prehospital Emergency Care Journal Volume 26 Number 5 with our original PEC Podcast crew; Phil Moy, Scott Goldberg, Jeremiah Escajeda, and Joelle Donofrio-Odmann! We discuss such articles as: Secondary Traumatic Stress in Emergency Services Systems (STRESS) Project: Quantifying and Predicting Compassion Fatigue in Emergency Medical Services Personnel & EMS Experience Caring and Communicating with Patients and Fam
I was reading EKGs on the system and came across this one: What do you think? This is diagnostic of hyperkalemia. HyperK can result in all sorts of pseudoSTEMI or pseudoOMI patterns, including ST elevation, ST depression, and large T-waves. These T-waves are tall but have a narrow base and a corresponding flat ST segment (see lead V4). Also, there are no definite P-waves and this is another result of hyperkalemia.
If you missed The EM Cases Summit '23, no worries, we've got you covered! All the main stage talks of both the 2023 and 2021 Summits are now available for video streaming, on your own time, for a limited time only thru emcasessummit.com. Plus you get the 2023 and 2021 eBooks summarizing the talks as a bonus. New EM Cases swag too. The post EM Cases Summit Video Streaming Package Now Available appeared first on Emergency Medicine Cases.
A proper EMT knife is much more than a blade with a star of life on it. Rescue tools help a first responder gain quick access or assess a patient during trauma or medical emergencies. A proper EMT knife is also a rescue tool. This article has put together a list of such items. These items range from a battery-operated pulse oximeter to a monster multi-tool with 16 instruments in 1.
Researchers at the Korea Institute of Materials Science (KIMS) creaetd a Raman-spectroscopy-based urine test that can detect metabolic compounds that are produced by pancreatic and prostate cancers, potentially allowing for rapid and convenient cancer screening. The technology consists of a paper strip onto which a urine sample can be added. The paper contains ‘coral-shaped’ structures that assist in amplifying the optical signal of cancer metabolites in the urine when the paper strip is illumin
Case submitted by Magnus Nossen MD, written by Pendell Meyers A previously healthy man in his 40s presented to the ED with epigastric abdominal pain off and on for several days. Vitals were within normal limits. It is unclear whether he had active pain at the time of the first ECG: What do you think? Here is PM Cardio's Queen of Hearts interpretation (AI ECG interpretation trained by Meyers, Smith, and PM Cardio team using thousands of cases and their outcomes): The output number ranges from 0 t
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