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Researchers at the University of Texas at Arlington, in collaboration with Shani Biotechnologies, a local firm, have created a point-of-care device that can accurately measure hemoglobin levels and perform pulse oximetry in individuals with dark skin. At present, methods to determine hemoglobin levels at the point of care, such as pulse oximetry, are inaccurate in individuals with higher levels of melanin in their skin, and there is a clear need to develop alternatives that work for everyone.
In this EM Quick Hits podcast: Justin Morgenstern on fluids in pancreatitis, Leeor Sommer on nasal fractures, Christina Shenvi on delirium, Sheldon Cheskes and Rohit Mohindra on Dose VF, and Noor Khatib and Kari Sampsel on intimate partner violence. The post EM Quick Hits 44 Fluids in Pancreatitis, Nasal Fractures, Delirium, DOSE VF, Intimate Partner Violence appeared first on Emergency Medicine Cases.
Date: November 10th, 2022 Reference: de-Madaria E et al. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). NEJM 2022. Guest Skeptic: Dr. Salim R. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University.
Much is made of “staying cool” during emergencies, but what does this really mean? What is calm, what role does it play in a clinical environment, when is it appropriate, and how do we learn it? This and more on today’s TIRBO. Find us on Patreon here! Buy your merch here! Much is made of “staying cool” during emergencies, but what does this really mean?
Scientists at the Wyss Institute for Biologically Inspired Engineering at Harvard have developed a mechanically active gel-elastomer-nitinol tissue adhesive, otherwise known as MAGENTA. The implantable device functions as a soft robot, and it can be adhered to the outside of a muscle. When an electrical charge is applied to the device, a spring inside made from nitinol (a shape memory alloy) heats up and begins to actuate, creating a contraction and stretching effect on the attached muscle.
While most of us have a clear algorithm in our minds for the management of life-threatening hyperkalemia, the same may not be said about the other life-threatening electrolyte abnormalities. In this ECG Cases blog Dr. Jesse MacLaren gives us an approach to potassium, calcium and magnesium abnormalities including risk factor assessment, ECG interpretation and management pearls.
Date: October 27th, 2022 Reference: Hayashi et al. Comparative efficacy of sedation or analgesia methods for reduction of anterior shoulder dislocation: A systematic review and network meta-analysis. AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency […] The post SGEM#381: Put Your Hand on My Shoulder and Reduce It first appeared on The Skeptics Guide to E
Bryan and Brandon go through their default, go-to drugs for common clinical indications in the ICU: stress ulcer prophylaxis, empiric antibiotics, hypertension, and more. Bryan and Brandon go through their default, go-to drugs for common clinical indications in the ICU: stress ulcer prophylaxis, empiric antibiotics, hypertension, and more.
Researchers at Oregon State University created a new type of hyperthermic magnetic nanoparticle that is intended to assist in destroying tumors through localized heating under an alternating magnetic field. Previous iterations of such technologies could heat up to about 44 degrees Celsius (111 F), which was only effective in easy-to-access tumors that can be reached with a hypodermic needle, allowing a clinician to inject a large number of the nanoparticles directly into the tumor.
Do not let a negative X-ray rule the day! Like almost all medical tests X-rays are far from perfect and should be ordered and interpreted only in the context of a thorough history and physical exam. In this 2nd part of our 2-part series on orthopedic x-rays with Dr. Arun Sayal and Dr. Yatin Chadha we discuss the pitfalls of obtaining and interpreting orthopedic X-rays, when orthopedic X-ray decision tools lead us astray, how understanding the concept of central ray helps dictate how we should or
Date: November 26th, 2022 Reference: James et al. Emergency Department Condition Acuity, Length of Stay, and Revisits Among Deaf and Hard-of-Hearing Patients: A Retrospective Chart Review. AEM November 2022 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Click on the LINK for a transcript […] The post SGEM#383: Tommy Can You Hear Me – Deaf and Hard-of-Hearing (DHH) Patients in the ED first appeared on The S
Lumbar Puncture This seemingly simple procedure seems to be the Achilles's heel or many resus docs! If you have a good baseline knowledge of how to do the lumbar puncture correctly, it is super easy. If you have bad habits, then you will make your poor patient look like a pin cushion. EMCrit Project by Scott Weingart, MD FCCM.
You have a trainee, orientee, intern/resident/fellow, student, or other learner who just seems slower than the rest. What should that mean to you? A perspective on this week’s TIRBO. You have a trainee, orientee, intern/resident/fellow, student, or other learner who just seems slower than the rest. What should that mean to you? A perspective on this week’s TIRBO.
Researchers at the University of Arizona have developed a battery-free light-powered pacemaker that uses optogenetic stimulation of cardiomyocytes to achieve heart pacing. With conventional pacemakers, the leads of the device are anchored into the wall of the heart, using invasive hooks or screws. Small electrical shocks are then sent through the entire heart, potentially causing discomfort and pain.
Dr. Navpreet Sahsi describes the challenges of building an Emergency Department in Bangladesh and how the experience has shaped his outlook on Emergency Medicine practice in North America on EM Cases' first Global EM blog. The post Global EM 1: Practicing EM in Bangladesh – Build It and They Will Come appeared first on Emergency Medicine Cases.
Happy Thanksgiving! As you slowly recover from stuffing yourself with turkey and getting ready for Christmas, check out this latest PEC podcast where we cover the Prehospital Emergency Care Journal Volume 26 Number 4. In this episode we cover manuscripts like: Comparison of Four Methods of Paramedic Continuing Education in the Management of Pediatric Emergencies & A Standardized Formulary to Reduce Pediatric Medication Dosing Errors: A Mixed Methods Study Click here to download today!
An exploration of clinical documentation and billing/coding with Dr. Robert Oubre (@Dr_Oubre), full-time hospitalist and CDI Medical Director for a community hospital in southern Louisiana. Takeaway lessons References An exploration of clinical documentation and billing/coding with Dr. Robert Oubre ( @Dr_Oubre ), full-time hospitalist and CDI Medical Director for a community hospital in southern Louisiana.
Researchers at The University of Texas MD Anderson Cancer Center have developed a nanotechnology platform that can make cancer cells more vulnerable to immune attack in the body. The researchers call their system the bispecific tumor-transforming nanoconjugate (BiTN) platform. The idea is to make solid tumors more appealing for the immune system by attaching a molecule that acts as an “eat me” signal to white blood cells.
Mindfulness yes it sounds great in theory, but did you know that practicing this skill can have very real and practical benefits in EMS? Mindfulness is the state of being conscious or aware of something. It can also refer to focusing awareness on the present moment, while calmly acknowledging our feelings, thoughts, and sensations without being overly reactive or overwhelmed.
This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. This patient, who is a mid 60s female with a history of hypertension, hyperlipidemia and GERD, called 911 because of chest pain.
Take Home Points Consider the diagnosis of testicular torsion in all patients with acute testicular pain Testicular torsion is a surgical emergency that requires immediate urologic consultation to increase the rate of tissue salvage. History, physical examination and ultrasound are all flawed in making the diagnosis. The gold standard is surgical exploration.
How to locate, secure, and dress your lines so they’ll stay put and stay clean. How to locate, secure, and dress your lines so they’ll stay put and stay clean.
A team of researchers at the University of Tsukuba in Japan has developed a fluffy soft robot that patients can interact with to reduce their stress and fear when undergoing painful or uncomfortable medical procedures. For some patients, particularly children, a fear of needles or uncomfortable and painful procedures can make such experiences especially challenging, and may mean that they attempt to avoid treatment altogether.
Whether it be at a college party or in the nursing home at 3 AM, managing an acute psychosis patient is something EMTs and Paramedics encounter with frequency during their tenure. A college student under the influence of mind-altering drugs and an elderly person suffering from sequelae of brain disease can be very similar sometimes… who knew! Today I wanted to talk about acute psychosis , a term that describes a patient’s mental disconnection from reality due to a various array of conditions.
A 30-something male was involved in a single vehicle crash and had multiple injuries. As a routine part of his critical trauma evaluation, he had an ECG recorded: There is an rSR" in V1 and V2, with downsloping ST segment and inverted T-wave which is very similar to a Brugada Type 1 phenocopy. I was shown this ECG and thought that it could perhaps be Brugada, but I was more suspicious for Right Ventricular (RV) myocardial contusion.
BACKGROUND: Direct oral anticoagulants (DOACs) such as rivaroxaban [Xarelto] and apixaban [Eliquis] have become more prevalent in the aging population and are associated with intracranial bleeding at rates up to 4.2%. (Xian 2019) 4-Factor Prothrombin Complex Concentrates (4F-PCC), or K-Centra, is a derivative of human plasma and is explicitly used to reverse vitamin K antagonists such as warfarin and non-specifically in the reversal of DOACs.
There are 2 types of heat stroke: ➊ Non-exertional (think elderly patient) ➋ Exertional (think athlete) Both need immediate cooling, by EMS ideally. But how can we do this effectively in the field? “Can someone bring me the body bag?” A case study was just published involving an 87-year-old woman found unconscious in a parking lot an oral temperature of 40◦C (104◦F) and an altered mental status.
SpineX , a medtech company based in California, has developed the Spinal Cord Innovation in Pediatrics (SCiP) device, a non-invasive spinal cord neuromodulation technology that is intended to treat children with cerebral palsy. The technology is designed to be used in conjunction with activity-based neurorehabilitation therapy with the goal of improving functional movements in such children.
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