December, 2022

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Stop the Bleed

Chicago EMT Training

Learning how to stop the bleed and procuring the materials to do so is an inexpensive insurance policy. Especially if you're in an area that is prone to gun violence. You don't need a license or permit to carry these things. You never know when you'll need it or someone around you may need it. [link] First up is the Tourniquet. There are a few varieties that have been heavily tested.

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ECG of the Week 21st December 2022

EMergucate

This ECG was obtained from a 22 year old man who had taken a polypharmacy overdose 24 hours ago. He had suffered a bradycardic / asystolic arrest and is currently in the intensive care unit.

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WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do?

Emergency Medicine Cases

In this month's Waiting to Be Seen blog Dr. Howard Ovens outlines challenges, innovations and coping strategies in the EM Crisis. The post WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do? appeared first on Emergency Medicine Cases.

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SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients

The Skeptics' Guide to EM

Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. She is also the wonderful educator that creates the Paper in a Pic infographics summarizing each SGEM episode.

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Camera Measures Blood Pressure with Quick Look

Medgadget

At the University of South Australia, researchers designed a system that allows them to measure a patient’s blood pressure with a camera. The camera visualizes the patient’s forehead and focuses on two regions in particular to optically determine photoplethysmographic signals that AI algorithms then convert to blood pressure data. The researchers tested their system in 25 volunteers, and so far it has proven to be approximately 90% as accurate as traditional pressure cuff measurements.

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TIRBO #25: Two things NOT to hear

Critical Care Scenarios

On today’s TIRBO: A couple common lines I’d rather stop hearing people say in the ICU. On today’s TIRBO: A couple common lines I’d rather stop hearing people say in the ICU.

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EMCrit RACC Lit Review for December 2022

EMCrit Project

All the resus/acute critical care literature goodness for December 2022. EMCrit Project by Scott Weingart, MD FCCM.

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ECG Cases 38 – ECG Interpretation in Cocaine Chest Pain

Emergency Medicine Cases

Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associated chest pain require benzodiazepines +/- nitroglycerine for symptom relief, aspirin and ECG to look for signs of occlusion and reperfusion. In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern.

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SGEM#385: If the Bones are Good, the Rest Don’t Matter – Operative vs Non-Operative Management of Scaphoid Fractures

The Skeptics' Guide to EM

Date: November 30th, 2022 Reference: Johnson et al. One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. […] The post SGEM#385: If the Bones are Good, the Rest Don’t Matter – Operative vs Non-Operative Management

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Belt Monitors Heart Failure Patients

Medgadget

Researchers at Florida Atlantic University have developed a belt that can monitor heart failure patients for signs of disease progression. The wearable device measures heart rate, thoracic impedance, electrocardiogram, and motion, all of which can provide information on a heart failure patient’s status and potentially enable early detection of disease exacerbation.

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Lightning rounds #23: How we do end-of-life care

Critical Care Scenarios

A general discussion about how we recognize patients are dying, how we steer into discussions regarding goals of care, and the many biases and errors we often bring to the table. Two-part blog post at Critical Concepts on palliative care ICU admissions, including a detailed script for the conversation. Three-part blog post at Critical Concepts … Continue reading "Lightning rounds #23: How we do end-of-life care" A general discussion about how we recognize patients are dying, how we steer into di

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PulmCrit Blogitorial – SIESTA syndrome:  Sedation Induced EEG Suppression with Transient Agitation

EMCrit Project

This is SIESTA syndrome. The patient is locked in a cycle of unconsciousness, punctuated with brief episodes of agitation. Most of the time the patient is sedated to the point of having minimal EEG activity, which may hinder their ability to regain consciousness. . EMCrit Project by Josh Farkas.

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ECG of the Week 7th December 2022

EMergucate

Paramedics ring through to say that they are 10 minutes away with a 65 year old man who has a heart rate of approximately 170 with a thready pulse and a systolic blood pressure of 90.

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Ep 177 Bronchiolitis – Diagnostic Challenges and Management Pitfalls

Emergency Medicine Cases

In this main episode podcast Anton discusses with world expert and bronchiolitis researcher Dr. Suzanne Schuh, the challenges of the diagnosis and management of bronchiolitis during a time of crisis in pediatric emergency medicine and offers some evidence-based solutions to improving outcomes while minimizing valuable resources, as part of our 'Best of University of Toronto EM' series.

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SGEM #387 Lumbar Punctures in Febrile Infants with Positive Urinalysis-It’s Just Overkill

The Skeptics' Guide to EM

Date: Dec 15, 2022 Reference: Mahajan et al. Serious bacterial infections in young febrile infants with positive urinalysis results. Pediatrics. October 2022 Guest Skeptic: Dr. Brian Lee is a pediatric emergency medicine attending at the Children’s Hospital of Philadelphia and Assistant Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. […] The post SGEM #387 Lumbar Punctures in Febrile Infants with Positive Urinalysis-It’s Just Overkill first appeared

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Medgadget Visits Healthcare? Expo Taiwan

Medgadget

This past week, Medgadget was an official media partner with the Healthcareᐩ Expo Taiwan. This four-day annual event brings together healthcare companies from all over Taiwan and the rest of the world. It is also an opportunity for tech companies not typically associated with healthcare, such as ASUS, Intel, and BenQ, to showcase what they’re doing in medicine and healthcare.

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TIRBO #24: Two things people need to hear

Critical Care Scenarios

On today’s TIRBO, a couple things worth saying when a patient is struck down with unexpected critical illness: it’s going to take time, and it wasn’t anyone’s fault. Find us on Patreon here! Buy your merch here! On today’s TIRBO, a couple things worth saying when a patient is struck down with unexpected critical illness: it’s going to take time, and it wasn’t anyone’s fault.

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EMCrit 338 – End of Year Question & Answer Session

EMCrit Project

Rounding up the questions from the past few months. EMCrit Project by Scott Weingart, MD FCCM.

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Imaging Case of the Week 533 Answer

EMergucate

The pelvic x-ray shows: Right iliac wing fracture Right acetabular fracture Right inferior pubic ramus fracture Diastasis of the pubic … Continue reading →

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Journal Jam 21 Laceration Management – Does Timing of Closure, Irrigation, Gloves Type, Eversion Matter?

Emergency Medicine Cases

In this Journal Jam podcast Anton and Justin welcome special guest Dr. Haley Cochrane. We dive deep into the evidence for timing of closure and infection rate, fluid choice, volume and pressure of irrigation of lacerations, glove type and infection rate, how eversion of wound edges effects cosmetic outcomes and much more. You might be surprised to discover that the evidence for many things we do for lacerations that are considered "standard of care", is either weak or non-existent.

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SGEM #384: Take Me Out Tonight, I Don’t Want to Perforate My Appendix Alright

The Skeptics' Guide to EM

Date: November 16th, 2022 Reference: Lipsett SC, Monuteaux MC, Shanahan KH, et al. Nonoperative Management of Uncomplicated Appendicitis. Pediatrics 2022 Guest Skeptic: Dr. Angelica DesPain is an Assistant Professor of Pediatrics and a pediatric emergency medicine physician at the Baylor College of Medicine Children’s Hospital of San Antonio in San Antonio, TX.

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Diabetes Management Tech for Type II patients: Interview with Jeffrey Brewer, CEO of Bigfoot Biomedical

Medgadget

Bigfoot Biomedical , a medtech company based in California, has developed the Bigfoot Unity System, a diabetes management technology for patients on multiple daily injection therapy. The system uses continuous glucose monitoring data and doctor recommendations to provide insulin dose recommendations, helping patients to avoid uncertainty. The company argues that type 2 diabetes patients have been historically underserved by the medtech industry, in part because such patients typically tend to be

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Episode 54: The critically ill patient with pulmonary hypertension, with Ray Foley

Critical Care Scenarios

We look at the patient with known pulmonary hypertension admitted for new issues like sepsis and pneumonia, and how they differ from our usual bread and butter, with help from Dr. Raymond Foley, director of the medical ICU and the pulmonary/critical care fellowship at UConn Health, as well as director of their pulmonary vascular disease … Continue reading "Episode 54: The critically ill patient with pulmonary hypertension, with Ray Foley" We look at the patient with known pulmonary hypertension

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EMCrit 339 – Decisions, Decisions, Decisions with Andrew Petrosoniak

EMCrit Project

Making good decisions is the heart of Emergency Medicine and Critical Care. EMCrit Project by Scott Weingart, MD FCCM.

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ECG of the Week 21st December 2022 – Interpretation

EMergucate

ECG of the Week 21st December 2022 – Interpretation Looking at the rhythm strip, there is sinus rhythm, interspersed with … Continue reading →

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EMC Journal Club 1 – Does Treating Fever Make A Difference?

Emergency Medicine Cases

In this first EMC Journal Club (where we take the "boring" out of journal clubs and deliver clear, concise, practical practice changing critical appraisal knowledge based on an Emergency Medicine journal article that may have passed your radar - not too detailed and not too brief), Dr. Rohit Mohindra, an Emergency Physician at North York General in Toronto and SREMI researcher works his critical appraisal magic on the article "Fever therapy in febrile adults: systematic review with meta-analyses

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7d vs 14d of Antibiotics in Afebrile Men with UTI

REBEL EM

Background: Urinary tract infection (UTI) is one of the most common reasons for anti-microbial use (Tan, 2016). However, the optimal treatment duration for UTI in men is not well studied, and current practice guidelines are based on historical dogma. One clinical trial demonstrates that afebrile UTI can be treated successfully with antibiotics for seven days in women, but that seven days is inferior to 14 days during short-term follow-up and non-inferior during long-term follow-up (van Nieuwkoop

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Microbial Fuel Cell Powers Ingestible Devices

Medgadget

Researchers at Binghamton University have developed a microbial fuel cell that can power ingestible devices, such as cameras, that can detect health issues in the gastrointestinal tract, and specifically within the small intestine. The fuel cell contains dormant Bacillus subtilis endospores that only germinate and become active when they encounter nutrient-rich intestinal fluid.

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What Is the Best Nursing Field for 2023? 12 Fastest Growing Specialties

NHCPS Save a Life

Nursing is an ever-changing profession, but one thing is very clear. Nurses continue to be in demand with no signs of slowing. And nurses have greater opportunities for specialization than they used to with many interesting and fast-growing nursing fields to choose from. Here are some you’ll want to learn more about. Is Nursing a […] The post What Is the Best Nursing Field for 2023?

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EMCrit 340 – End of Year Round-Up on Surgical Critical Care Tips and Remimazolam with Joe Shiber and Sean Rees

EMCrit Project

For this last podcast of the year, I had a couple of pieces that were going to become Wees, but I thought I would combine them for synergistic goodness and make this end-of-year podcast. Today, we speak about some tips from a EM Surgical Intensivist and discussion of a brand new sedative, Remimazolam. EMCrit Project by Scott Weingart, MD FCCM.

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ECG of the Week 7th December 2022 – Interpretation

EMergucate

ECG of the week 7th December 2022 – Interpretation: There is a regular narrow complex tachycardia (QRS < 120ms, rate … Continue reading →

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30-something woman with a HEART score of zero, EDACS of 2, computer "Normal" ECG, and initial troponin < Limit of Detection

Dr. Smith's ECG Blog

I was working in triage very late when a 30 yo previously completely healthy woman walked in with 30 minutes of central chest pressure. This ECG was recorded: The computer called it "Normal" except for "Possible right ventricular conduction delay" What do you think? I immediately recognized an inferior-posterior-lateral OMI. There are hyperacute T-waves in II, III, and aVF.

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Episode 94: Better CPR at the end of the year with Josh Lupton and Ken Milne

The Overrun Podcast

We end the year with 2 great interviews about cardiac arrest. Josh Lupton is a physician in Oregon who found in 2021 that there might be an ideal number of rescuers for OHCA. Hint: It's more than you think. Then Ken Milne joins us from the S keptics Guide to Emergency Medicine to discuss whether heads-up CPR with a commercial device is ready for prime time.

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Exciting Medtech at the Healthcare? Expo Taiwan

Medgadget

Medgadget was recently invited to Taiwan to cover the 2022 Healthcareᐩ Expo in Taipei. As is the case for most trade shows, the exhibit hall comprised a large portion of the expo. Consisting of over 2000 exhibitors in two massive halls, the main hall showcased the best of Taiwan’s healthcare industry. Here are some notable trends we observed while roaming the aisles.

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Holiday Wellness

First Responders Wellness Center

HOLIDAYS & GET TOGETHERS Being a first responder comes with many challenges, one of which is navigating the holidays. Being home for the holidays is not always an option. So, if you do have to work, consider realistic plans that can be easily accomplished. Communication with your family and your work during this time will be the key. Ensure you are reasonable with your time and capabilities.

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Pro-MEDIC

The Bottom Line

In adults with an expected ICU stay of > 72 hours, does the provision of enteral melatonin compared to placebo increase the number of delirium-free assessments within 14 days or before ICU discharge?

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ECG of the Week 30th November 2022 – Interpretation

EMergucate

ECG of the Week 30th November 2022 – Interpretation This ECG was used to illustrate how a systematic approach ensures … Continue reading →

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