The Skeptics' Guide to EM

MARCH 31, 2023

Date: March 28, 2023 Reference: Fowler et al. Objective assessment of sleep and fatigue risk in emergency medicine physicians. AEM March 2023 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You arrive at 7am to relieve your colleague after a night shift. You find her at […] The post SGEM#399: I’m So Tired – Emergency Medicine and Fatigue first appeared on The Skeptics Guide to Emergency Medicine.

ALS 130

ALS Emergency Department 130

Pediatric EM Morsels

MARCH 31, 2023

Children love to trick us! Sometimes it is all in good fun and other times it is quite serious! They like to pretend to be well when they are truly sick ( remember to check that Cap Refill and to never trust a Neonate! ) and they often show us “odd” findings that are really normal (ex, Growth Plates, Primitive Reflexes ). They like to keep us on our toes so much, that even their cervical bones can deceive us.

OR 130

OR EMS Critical Care 130

Emergency Medicine Cases

MARCH 28, 2023

Dr. Nav Sahsi gives us a quick primer on Doctors Without Borders, explains the difference between humanitarian work and development work and describes the motivation, personal skills, education, time commitment and flexibility required for humanitarian work for all those with an interest in Global EM. The post Global EM 3 So you want to be a humanitarian doctor?

EMS 130

EMS 130

Core Ultrasound

MARCH 24, 2023

Examining the Utility of Cardiac Ultrasound During Cardiac Arrest Peer reviewed by Ben Smith, MD 3/23/23 RWMA R Heart TEE Cardiac POCUS can be dramatically useful and life-saving in cardiac arrest. I like to think about it in three different broad categories: Procedural, identifying reversible causes, and guiding therapy. This video isn’t a discussion regarding its utility for procedures or diagnosing reversible causes, but it is talking about how maybe the echo pulse check is not the best way t

OR 130

OR 130

EMS 12-Lead

MARCH 19, 2023

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. Fire/EMS crews found him clammy and uncomfortable. Vital signs were noted to be unremarkable with respect to any hypo-hypertensive crisis, hypoxia, etc.

Coronary 130

Coronary STEMI Paramedic Defibrillator 130

EMergucate

MARCH 11, 2023

The elbow x-ray shows Small irregular densities suggestive of avulsion fractures posterior to the elbow associated with soft tissue swelling.

EMS 130

EMS 130

The Skeptics' Guide to EM

MARCH 25, 2023

Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. He is also now a fully-fledged “sonologist”.

ED 130

ED Critical Care Emergency Department ALS 130

Emergency Medicine Cases

MARCH 28, 2023

In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UN

EMS 130

EMS 130

EMCrit Project

MARCH 21, 2023

Steroid is worthless for pneumonia! Wait, a new study shows it's beneficial! Hang on, a fresh meta-analysis shows that steroid it's useless! And wait, here's a fresh NEJM study showing mortality benefit!! This feels like a roller coaster. What's going on here? Several factors may explain this: Steroid is beneficial, but only in a subset […] EMCrit Project by Josh Farkas.

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Medgadget

MARCH 17, 2023

Researchers at Linköping University in Sweden have developed a method whereby the body can ‘grow its own’ electrodes. The minimally invasive technique involves injecting a hydrogel that is laden with enzymes into target tissues. The enzymes interact with molecules that are present in the tissue to change the structure of the gel and allow it to become electrically conductive.

OR 128

OR 128

EMergucate

MARCH 26, 2023

The following pelvic x-ray is from a 10-year-old with pain in the left pelvis after a trampoline injury.

EMS 130

EMS 130

The Skeptics' Guide to EM

MARCH 11, 2023

Date: March 8, 2023 Reference: Smida et al. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital Emergency Care 2023 Guest Skeptic: Dr. Chris Root is a third-year resident physician in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM. […] The post SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking f

CPR 130

CPR Defibrillator BLS Paramedic 130

Critical Care Scenarios

MARCH 29, 2023

We look at evaluating the patient with encephalopathy and unexplained anion gap, including the workup and treatment of toxic alcohol poisoning, with guest Dr. Jerry Snow (@ToxicSnowEM), medical toxicologist and director of the toxicology fellowship at Banner University Medical Center in Phoenix. Find us on Patreon here! Buy your merch here! Click here to claim … Continue reading "Episode 58: Toxic alcohols with Jerry Snow" We look at evaluating the patient with encephalopathy and unexplained ani

Overdose 100

Overdose OR EMS 100

Emergency Medicine Cases

MARCH 14, 2023

In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes?

Overdose 130

Overdose EMS 130

REBEL EM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. The TOMAHAWK (Desch 2021), COACT (Abella 2019), and PEARL (Lemkes 2019) trials examined patients with OHCA without ST elevation with a shockable rhythm, and investigators found no difference in delayed versus emergency angiogram.

Coronary 83

Coronary CPR OR ICU 83

Medgadget

MARCH 9, 2023

Researchers at University College London and at the University of Ghana have developed a smartphone-based system that can detect anemia through simple photos taken using the phone’s camera. The technology is intended for use in low- and middle-income countries where access to routine medical diagnostics may be unreliable. The process involves obtaining images of areas of the body which are least pigmented, including the white of the eye, the lower eyelid, and the lip.

OR 107

OR 107

EMergucate

MARCH 7, 2023

Chest x-ray from an adult female with dry retching. What can be seen? Answer will be posted later.

EMS 130

EMS 130

The Skeptics' Guide to EM

MARCH 18, 2023

Date: February 27, 2023 Reference: Walsh PS, Schnadower D, Zhang Y, Ramgopal S, Shah SS, Wilson PM. Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. JAMA Pediatr. 2022. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC.

ICU 101

ICU Emergency Department OR 101

Critical Care Scenarios

MARCH 22, 2023

Some basic tactics for keeping attention in your live talks, presentations, and lectures. Find us on Patreon here! Buy your merch here! Some basic tactics for keeping attention in your live talks, presentations, and lectures. Find us on Patreon here! Buy your merch here!

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100

EMCrit Project

MARCH 17, 2023

A new format of ED Critical Care perfectly suited to rural environments EMCrit Project by Scott Weingart, MD FCCM.

Critical Care 89

Critical Care ED 89

Prehospital Emergency Care Podcast

MARCH 31, 2023

Happy Women's day PEC Podcast listeners! In this Deep Dive episode of the PEC podcast, Dr. Maia Dorsett discusses the Prehospital Emergency Care Manuscript titled Characteristics and Experiences of Women Physicians and Professionals in NAEMSP with the authors: Kathy Staats MD FACEP kstaats@ucsd.edu Anurhada Luke MD Luke.Anuradha@mayo.edu Click here to download it today!

EMS 52

EMS 52

Medgadget

MARCH 27, 2023

Researchers at the Georgia Institute of Technology have developed a nanotechnological solution for lymphedema, a failure of the lymphatic system that results in uncomfortable and irreversible fluid retention. Previous research efforts have focused on trying to grow new lymphatic vessels, but these researchers have taken a different approach, and instead engineered a drug delivery technology that can directly target sluggish lymphatic vessels and kickstart their pumping action.

OR 100

OR 100

EMergucate

MARCH 18, 2023

The following chest x-ray is from a 42-year-old with asthma exacerbation. What can be noticed?

EMS 130

EMS 130

The Skeptics' Guide to EM

MARCH 4, 2023

Date: March 3, 2023 Reference: Hosseinialhashemi et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Ann Emerg Med. 2022 Guest Skeptic: Dr. Dominique Trudel is a CCFP-EM resident in Ottawa, Ontario. Her interest is serving French minority communities delivering care at the Montfort Hospital in Ottawa.

ALS 100

ALS Emergency Department EMS 100

Critical Care Scenarios

MARCH 15, 2023

We discuss our approach to keeping up with research, learn about new studies, interpret them, and some general thoughts on how to apply new literature to our practice. Find us on Patreon here! Buy your merch here! We discuss our approach to keeping up with research, learn about new studies, interpret them, and some general thoughts on how to apply new literature to our practice.

100

100

EMCrit Project

MARCH 25, 2023

Hayden Richards is a communications maven. EMCrit Project by Scott Weingart, MD FCCM.

83

83

Ingenious

MARCH 31, 2023

The INGENIOUS coordinator, the Institute of Communication and Computer Systems (ICCS) will organise the PSCE Conference in Lavrion, Greece on 10-11 May 2023 in collaboration with the National Technical University of Athens (NTUA) and the Public Safety Communication Europe (PSCE). The Conference will focus on Security threat posed by fake-based technologies, Military Cooperation for crisis management, New Technologies for Search and Rescue Operations and Horizon scanning in public safety.

Public Safety 52

Public Safety 52

Medgadget

MARCH 9, 2023

Researchers at Columbia University Irving Medical Center and the Université de Paris, France, have tested an ultrasound denervation catheter in its potential to treat hypertension. The technology is called the Paradise ultrasound denervation device and it has been developed by ReCor Medical , a medtech company with offices in California and the UK. The concept is based on the phenomenon whereby overactive neural activity in the kidney can lead to increases in sodium and water retention, underlyi

95

95

EMergucate

MARCH 27, 2023

Question 1: PH = 6.9, that is severe acidaemia HCO3 = 22 mmol/L. So, we have metabolic acidosis. Next, we need to calculate the Anion gap and the compensation.

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Dr. Smith's ECG Blog

MARCH 31, 2023

This was sent to me by a friend. It is from a 50-something with chest pain: What do you think? This was marked as "Not a STEMI" by the physicians. It is not a STEMI, but it is diagnostic of an LAD OMI (Occlusion MI). There is subtle ST Elevation in V1-V4 and hyperacute T-waves in V2-V6. There is also subtle but diagnostic INFERIOR ST Elevation, with reciprocal ST Depression in aVL.

STEMI 52

STEMI Coronary OR ED 52

Critical Care Scenarios

MARCH 8, 2023

When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here! When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here!

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100

FOAMcast

MARCH 27, 2023

Apple Podcasts , Spotify , Listen Here The role of steroids in pneumonia is controversial. Steroids were found to reduce mortality in COVID-19 patients requiring at least supplemental oxygen but are not associated with a mortality benefit in influenza. In 2019, the Infectious Disease Society of America recommended against the routine use of steroids in hospitalized patients with community-acquired pneumonia (CAP) while the Society for Critical Care Medicine recommends steroids in these patients.

Critical Care 52

Critical Care ACS ALS 52

First Responder Wellness

MARCH 27, 2023

A first responder’s work can be rewarding, but over time, it can also take its toll on an individual and lead to emotional exhaustion. This exhaustion can result from high emotional involvement, such as working with traumatized individuals in the community without adequate support. In the emergency services community, compassion fatigue can often be thought of as the emotional exhaustion manifesting itself as the reduced ability of a responder to engage with empathy or compassion toward t

First Responder 52

First Responder Mental Health Services Public Safety OR 52

Medgadget

MARCH 30, 2023

Researchers at the California Institute of Technology have developed a smart bandage for chronic wounds, such as those sometimes experienced by patients with diabetes. The bandage is flexible and stretchy, but contains electronic components that can monitor the wound for signs of infection, including abnormal temperature, increased uric acid levels, and changes in pH.

OR 92

OR 92

EMergucate

MARCH 20, 2023

21-year-old man brought for ED for impaired mental state, he was extremely agitated and needed 6 staff members to restrain … Continue reading →

ED 100

ED 100

Dr. Smith's ECG Blog

MARCH 30, 2023

= My Comment by K EN G RAUER, MD ( 3/30 /2023 ): = The ECG in Figure-1 was sent to me without the benefit of any history. I thought the rhythm illustrated a number of essential concepts for clinicians dedicated to Emergency Care. Do YOU know what the rhythm is? IF this arrhythmia is puzzling to you — READ ON! I illustrate how to make the diagnosis within less than 15 seconds.

Coronary 52

Coronary OR ED 52

Critical Care Scenarios

MARCH 1, 2023

We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky.

OR 100

OR 100