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Reference: Punches et al. Patient Perceptions of Microaggressions and Discrimination Towards Patients During Emergency Department Care. AEM Dec 2023 Date: December 14, 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.
In this part 1 or our 2-part podcast series on wrist injuries Dr. Arun Sayal and Dr. Matt DiStefano answer such questions as:when should we suspect a DRUJ injury, why is it important to pick up DRUJ injuries in the ED, and how does it change our management? Why is the lateral x-ray view so important in picking up commonly missed wrist injuries? When it comes to distal radius fractures, how are Colles vs Barton's vs Smith's fractures managed differently in the ED?
A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. Two days prior to presentation she began to experience fevers with a Tmax of 103°F. One day before presentation she developed a rash that began on her face and slowly spread down her body, now involving her palms. The patient endorsed associated pruritus and cervical lymphadenopathy with the rash.
Within the past year, two major societies have released guidelines on ARDS: the ATS (American Thoracic Society) and the ESICM (European Society of Intensive Care Medicine). Don’t be fooled by their names – both of these organizations are fundamentally international in scope. Some authors on the ATS document were from Europe, and similarly some authors […] EMCrit Project by Josh Farkas.
“Okay team, we’ve been following the APLS algorithm for 30 minutes and have considered all reversible causes. This child has been in cardiac arrest for at least an hour and none of the interventions we have carried out have made a difference. The blood gas is incompatible with life. I think we should stop resuscitation. Does anyone have any objections?
Date: November 20, 2023 Reference: Jones et al. Time to reflect on open-label placebos and their value for clinical practice. PAIN October 2023 Guest Skeptic: Dr. Caitlin Jones is a Postdoctoral Research Associate at Sydney University’s institute for Musculoskeletal Health. Her research evaluates the benefits and harms of treatments for musculoskeletal conditions with a particular […] The post SGEM Xtra: Open Label Placebo first appeared on The Skeptics Guide to Emergency Medicine.
In this ECG Cases Dr. Jesse McLaren delves into ECG interpretation in toxicology and the poisoned patient using his HEARTS approach in 7 case examples. Heart rate/rhythm: consider antidotes for brady/tachy-arrhythmias, and for sinus tachycardia consider fluids for vasodilation and benzodiazepines for agitation. Electrical conduction and axis: consider sodium bicarb for QRS > 100 especially if RBBB or terminal rightward shift, and magnesium for QTc> 500.
In this ECG Cases Dr. Jesse McLaren delves into ECG interpretation in toxicology and the poisoned patient using his HEARTS approach in 7 case examples. Heart rate/rhythm: consider antidotes for brady/tachy-arrhythmias, and for sinus tachycardia consider fluids for vasodilation and benzodiazepines for agitation. Electrical conduction and axis: consider sodium bicarb for QRS > 100 especially if RBBB or terminal rightward shift, and magnesium for QTc> 500.
An 84-year-old female presented with a chief complaint of right hip pain after a fall 12 hours prior to presentation. The patient reported a history of falls resulting in shoulder, rib, and left hip fractures in the past. The patient stated that upon getting out of bed, she took 4-5 steps, lost her balance, and fell backward onto the bedroom floor. She denied loss of consciousness.
This content is for AAA members only. Please either Log In or Join! The post VA Issues Notice on Delay of Special Modes of Transportation Final Rule appeared first on American Ambulance Association.
Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. He described it as severe, sharp, and substernal with associated nausea, vomiting, chills, and diaphoresis.
Improvement of your deployment operations requires that you understand where your services will be needed and how to get the available units into the most suitable positions. Then, once you are prepared to respond, it is also critical that only the most appropriate assignments are made for each request to preserve your ability to respond to the next call as well.
Discussing the new 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline, with the joint first authors: Dr. Ariane Lewis, neurointensivist, professor of neurology and neurosurgery at NYU Langone, director of neurocritical care, and chair of the Langone ethics committee, and Dr. Matthew Kirschen, pediatric neurointensivist and associate director of pediatric … Continue reading "Lightning rounds #35: Brain death updates, with Ariane Lewis a
A 45-year-old male status-post right nephrectomy secondary to a renal mass presented to the emergency department with right-sided flank pain. He endorsed low-grade intermittent right-sided flank pain since the nephrectomy one year prior, associated with an increasingly enlarging mass extending laterally from his right abdomen. Over the course of the past several days, the mass had become larger and more painful.
This content is for AAA members only. Please either Log In or Join! The post 2023 Year-End Government Affairs Update appeared first on American Ambulance Association.
We go over the treatment of rapid atrial fibrillation (afib with RVR). Hosts: Brian Gilberti, MD Jonathan Kobles, MD [link] Download Leave a Comment Tags: Cardiology Show Notes Understanding AF with RVR Categories General AF with RVR: Definition and basic understanding. Rapid AF with Pre-excitation: Characteristics and complications. Chronic AF in Critical Illness: Identification and special considerations.
This is written by Willy Frick, an amazing cardiology fellow in St. Louis. [link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. He described it as "10/10" intensity, radiating across his chest from right to left. EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49.
We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, the peri-operative course, and important post-op complications. Find us on Patreon here! Buy your merch here! Takeaway lessons We learn about liver transplant with Dr.
A 49-year-old male presented to the emergency department of an academic hospital with the chief concern of penile pain. Prior medical history is notable for end-stage renal disease on hemodialysis three times per week, but the patient has not been dialyzed in the past four days, hypertension, insulin-dependent diabetes mellitus, heart failure with reduced ejection fraction (59% two months prior), seizure disorder, prior pulmonary embolism (eight months prior), a left nephrectomy seven months ago
Michele Bracken Training Officer Wendover Ambulance West Wendover, NV Share on: Facebook | Instagram | X | LinkedIn How did you come to be in EMS? I had a good […] The post EMS Profiles | Meet Michele Bracken appeared first on American Ambulance Association.
Written by Pendell Meyers A woman in her 20s with connective tissue disorder and history of aortic root and valve repair presented with palpitations. Here is her triage ECG: What do you think? Atrial flutter with 2:1 conduction. The atrial flutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm.
Neil Long Button Battery Update 3.0 Want to know the latest on button battery management, prevention and immediate care? Look no further than our latest tox offering.
St.Emlyn's - Emergency Medicine #FOAMed We generally try and review studies that are close to use in practice. but occasionally we spot something that is just interesting and which might give us a clue as … JC: Selective aortic arch perfusion. St Emlyn’s Read More » The post JC: Selective aortic arch perfusion. St Emlyn’s appeared first on St.Emlyn's.
Private Health Insurance: Roll out of Independent Dispute Resolution Process for Out-Of-Network Claims Has Been Challenging GAO-24-106335Published: Dec 12, 2023. Publicly Released: Dec 12, 2023. Jump To […] The post GAO | Roll Out of IDR Process for Out-of-Network Claims Has Been Challenging appeared first on American Ambulance Association.
Authors: Genevieve Pentecost, MD (@genpentecost, Emergency Medicine Resident, Washington University School of Medicine in St Louis) and Aaron Lacy, MD (@AaronLacyMD, Assistant Professor of Emergency Medicine, Washington University School of Medicine in St Louis) // Reviewed by: Jamie Santistevan, MD (EM Physician, Presbyterian Hospital, Albuquerque, NM); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Introduction Welcome back to ECG Pointers from emDOCS.
Written by Willy Frick The OMI paradigm has taught me that any diagnosis of NSTEMI is cause for immediate evaluation. "A patient just arrived as a transfer for NSTEMI." I quickly reviewed the patient’s records and saw that she was a 53 year old woman with a history of BMI 40, but no other identifiable risk factors for coronary artery disease. Her first hsTnI at the referring facility was undetectable.
Sheralyn Guilleminot and Mike Cadogan AI Prompting Techniques 4 AI Prompting Techniques to Help You Stay Ahead in Medicine. AI prompting techniques are the key to using artificial intelligence efficiently and getting usable output.
Welcome to another episode of the Emergency Medicine Journal Club with Dr Justin Morgenstern. This month we cover a bunch of papers that look at a lot of topics and try to answer questions such as: Can I push Keppra safely? Does BP management in haemorrhagic stroke matter? How good is my intuition about PE diagnosis? Is it a good idea to keep geriatric patients in the ED overnight?
From Regulations.Gov NHTSA published a request for information on October 13, 2023, seeking comments from all sources (public, private, government, academic, professional, public interest groups, and other interested parties) on […] The post NHTSA Request for Information: Emergency Medical Services Education Agenda 2050 appeared first on American Ambulance Association.
St.Emlyn's - Emergency Medicine #FOAMed Air France Flight 447 takes off at 1930hrs on the final day of May in 2009, from Rio de Janeiro en route to Paris, carrying 228 passengers. In charge is … AI & Medicine: Saviour or Snake Oil? Read More » The post AI & Medicine: Saviour or Snake Oil? appeared first on St.Emlyn's.
This middle aged patient presented with chest pain: What do you think? There is VERY low voltage. There is some ST Elevation, but it is MINIMAL. But look how small the QRS is!! Let's stretch out the QRS vertically so it is not so tiny: On upper left is the original. On the right are the precordial leads stretched vertically, so that the QRS is not tiny.
A loading dose may be used to rapidly achieve steady-state pharmacokinetics. For drugs with a long half-life, this accelerates the attainment of therapeutic levels: For most drugs with single-compartment pharmacokinetics, a loading dose may be calculated using the following formula: (discussed further here) The graph below illustrates how this equation works: If (dosing interval)/(half life) […] EMCrit Project by Josh Farkas.
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