July, 2022

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SGEM#373: Going Ultrasound for Small Bowel Obstructions

The Skeptics' Guide to EM

Date: July 28th, 2022 Reference: Brower et al. Point-of-Care Ultrasound-First for the Evaluation of Small Bowel Obstruction: National Cost Savings, Length of Stay Reduction, and Preventable Radiation Exposure. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. She is also the creator of all those wonderful Paper in a Pictures. […] The post SGEM#373: Going Ultrasound for Small Bowel Obstructions first appeared on The Skeptics Gu

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From The Vault: RBBB

EMS 12-Lead

Original publication date July, 2009. Concept Review How do you identify right bundle branch block (RBBB) on the 12 lead ECG? Most of us were told to look for “bunny ears” or to use the “turn signal” method, but all you really need for the ECG diagnosis of RBBB are the following: Supraventricular rhythm QRS duration equal or greater than 120 ms (0.12 s) Terminal R wave in lead V1 Slurred S wave in lead I Let’s look at an example.

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ECG Cases 33 Brugada Syndrome: 3-Step Approach to Diagnosis and Management

Emergency Medicine Cases

Jesse McLaren guides us through 7 cases and explains his 3-step approach to diagnosing and managing Brugada syndrome in this month's ECG Cases blog. The post ECG Cases 33 Brugada Syndrome: 3-Step Approach to Diagnosis and Management appeared first on Emergency Medicine Cases.

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ECG of the Week 6th July 2022

EMergucate

A 50 year old female presents to ED complaining of chest pain. The patient is well known to the department, with frequent presentations with chest pain.

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Brain-Computer Interfaces at Home: Interview with Dr. Solzbacher of Blackrock Neurotech

Medgadget

Blackrock Neurotech , a medtech company based in Salt Lake City, has pioneered an array of brain-computer interface technologies. Medgadget last spoke with Blackrock Neurotech a year ago about their thought-to-text brain computer interface, but since the company signed an agreement with a research institution to develop portable brain computer interface (BCI) systems.

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Lightning rounds #18: How to give a conference presentation

Critical Care Scenarios

Brandon and Bryan chat about academic presentations… how to prepare and submit them, selecting the right venue, giving a good talk, and the elephant in the room: why to do it at all. Brandon and Bryan chat about academic presentations… how to prepare and submit them, selecting the right venue, giving a good talk, and the elephant in the room: why to do it at all.

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SGEM Xtra: Here Comes the NINDS Again

The Skeptics' Guide to EM

Date: July 1st, 2022 Guest Skeptic: Dr. Ravi Garg is a Neurologist in the Department of Neurology, Division of Neurocritical Care at Loyola University Chicago. Reference: Garg R, Mickenautsch S. Risk of selection bias assessment in the NINDS rt-PA stroke study. BMC Med Res Methodol. 2022 Jun 15;22(1):172. This is an SGEM Xtra episode. Dr. Garg […] The post SGEM Xtra: Here Comes the NINDS Again first appeared on The Skeptics Guide to Emergency Medicine.

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EM Quick Hits 40 – GI Balloon Tamponade, SVT and Troponin, Falls in Older Patients, Vertical Vertigo, VAFEI Airway

Emergency Medicine Cases

In this month's EM Quick Hits podcast: Anand Swaminathan on GI balloon tamponade preparation and indications, Jesse McLaren on why troponin is rarely useful in SVT, Christina Shenvi on why we should not use the term "mechanical fall" in older patients, Nour Khatib & Jonathan Wallace on rural vertical vertigo case and Reuben Strayer on VAFEI - Video-Assisted Flexible Endoscopic Intubation for the anatomically challenging airway.

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ECG of the Week 6th July 2022

EMergucate

A 50 year old female presents to ED complaining of chest pain. The patient is well known to the department, with frequent presentations with chest pain.

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Self-Powered Implant Tracks Spinal Fusion Healing

Medgadget

Engineers at the University of Pittsburgh created a self-powered implant that can track spinal healing while also providing mechanical support. The device can be 3D printed so that it fits a given patient perfectly and the mechanical properties can also be easily tuned to customize for each situation. The spinal fusion cage contains a triboelectric nanogenerator that creates electricity when it is pressurized by the spine.

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TIRBO #14: Trajectories of illness and critical care

Critical Care Scenarios

How the arc of disease peaks and falls, and how the curve of our care should match it to avoid under- or over-treatment. How the arc of disease peaks and falls, and how the curve of our care should match it to avoid under- or over-treatment.

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SGEM#371: All My LOVIT, Vitamin C Won’t Work for You

The Skeptics' Guide to EM

Date: July 16th, 2022 Reference: Lamontagne F et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. 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.

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PulmCrit Wee – Urine toxicology screens should be removed from brain death guidelines

EMCrit Project

Prior to declaring a patient brain dead, confounding factors which could falsely cause the patient to appear dead must be eliminated. One important confounder is intoxication. Failure to recognize that a patient is intoxicated could lead to an incorrect diagnosis of brain death that in turn can lead to withdrawal of life support – thereby […].

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Ep 171 Posterior Stroke, EP Lead, HEAR Score, Ketamine for Suicidal Ideation, Peer Support Workers – Highlights from Calgary EM Hodsman Lecture Day

Emergency Medicine Cases

In this special edition main EM Cases podcast episode we feature the highlights from live podcasts recorded at Calgary EM during their annual Hodsman Lecture Day, covering a variety of current EM topics: The challenges of posterior circulation stroke (PCIS); Emergency Physician Lead to improve ED overcrowding, access block and job satisfaction; When not to order a troponin - The HEAR Score; Ketamine to relieve suicidal ideation and reduce acute risk; Peer Support Workers for ED patients with men

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Imaging Case of the Week 512 Answer

EMergucate

The frontal wrist x-ray shows loss of normal 1-2 mm distance between the the carpal bones and there is crowding … Continue reading →

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AI-Powered Robot Accelerates Medical Research

Medgadget

Researchers at the RIKEN Center for Biosystems Dynamics Research in Japan have developed an AI-powered robotic system that can perform laboratory experiments in regenerative medicine, learn from the results, and perform iterative rounds of experimentation to achieve a certain goal. In a proof-of-principle, the researchers set the robot the task of optimizing cell culture conditions to create a maximal number of retinal pigment epithelium (RPE) cells.

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Episode 49: Invasive pulmonary aspergillosis with Shmuel Shoham

Critical Care Scenarios

We discuss invasive aspergillosis, with a focus on when to consider and how to make this difficult diagnosis in the general ICU population—with Dr. Shmuel Shoham (@ShohamTxID), Associate Professor of Medicine at Johns Hopkins, transplant infectious disease physician, and an extensively published expert in invasive fungal infections as well as host of the Transplant ID … Continue reading "Episode 49: Invasive pulmonary aspergillosis with Shmuel Shoham" We discuss invasive aspergillosis, with a fo

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SGEM#370: Listen to your Heart (Score)…MACE Incidence in Non-Low Risk Patients with known Coronary Artery Disease

The Skeptics' Guide to EM

Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? AEM June 2022. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Case: You are working a shift in your local community emergency department […] The post SGEM#370: Listen to your Heart (Score)…MACE Incidence in Non-Low Risk Patients with known Coronary Artery Disease

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IBNCC – Traumatic Spinal Cord Injury (SCI)

EMCrit Project

Traumatic spinal cord injury is extremely common. In addition to the initial management of patients presenting with trauma, we should be comfortable in managing the longer-term sequelae (e.g., autonomic dysreflexia). The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes. EMCrit Project by Josh Farkas.

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REBEL Cast Ep111: The PREPARE II Trial – Fluid Bolus Prior to Intubation?

REBEL EM

Background: Some of the feared complications of endotracheal intubation include hypotension, cardiac arrest, and death (cardiovascular collapse). These complications can result from numerous causes including medication-induced vasodilation and decreased venous return to the heart due to increased intrathoracic pressure from positive pressure ventilation.

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Imaging Case of the Week 514

EMergucate

The following elbow x-rays are from a 5 year old who has sustained elbow injury after a fall on outstretched … Continue reading →

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Face Mask Deactivates SARS-CoV-2 Spike Protein

Medgadget

Researchers at the University of Kentucky created a novel membrane that can enzymatically degrade the SARS-CoV-2 spike protein, rendering the virus inactive. The membrane is intended to act as an insert within face masks, providing extra protection for groups at high risk of SARS-CoV-2 exposure, such as health care staff. The researchers functionalized the membrane with subtilisin enzyme, which can degrade the spike protein in as little as 30 seconds.

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Lightning rounds #17: Reading chest x-rays

Critical Care Scenarios

Brandon and Bryan share their approaches to the chest x-ray in the ICU. Plus: Bryan’s an FCCM! Here’s the Radiology Masterclass. Brandon and Bryan share their approaches to the chest x-ray in the ICU. Plus: Bryan’s an FCCM! Here’s the Radiology Masterclass.

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The Chicken or the Egg: The Relationship Between Nonalcoholic Fatty Liver Disease and Type 2 Diabetes - Clinical Correlations

Clinical Correlations

By Mahip Grewal Peer Reviewed Nonalcoholic fatty liver disease (NAFLD) is estimated to affect 25% of the world’s population. 1 NAFLD is a spectrum of disease ranging from nonalcoholic fatty liver (NAFL), which is generally nonprogressive isolated.

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IBNCC – Nonconvulsive status epilepticus

EMCrit Project

We throw around the term “nonconvulsive status epilepticus” a lot, and generally think that we know what that is. However, nonconvulsive status epilepticus is an enormously complex and heterogeneous diagnosis. This chapter attempts to clarify matters based on the most recent definitions, but in some situations the diagnosis may remain murky.

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Prehospital Emergency Care Podcast Ep. 116

Prehospital Emergency Care Podcast

It's hot outside! While you're cooling off inside, check out our latest podcast where we cover the PEC journal Volume 26 Number 2. In this episode we cover fascinating manuscripts like Utility of Glucose Testing and Treatment of Hypoglycemia in Patients with Out-of-Hospital Cardiac Arrest Implementing a Patient Tracking System in a Large EMS System Non-transport after Prehospital Naloxone Administration Is Associated with Higher Risk of Subsequent Non-fatal Overdose Click here to download today

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Imaging Case of the Week 511 Answer

EMergucate

The frontal chest x-ray shows superior mediastinal mass encircling the trachea, causing deviation of the trachea to the right.

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Smart Textiles Recognize Body Movements

Medgadget

Engineers at MIT have developed smart textiles that can detect and recognize body movements. The garments fit snugly, and contain a network of pressure sensors that can detect movement, and in conjunction with machine learning approaches, the technology can learn to recognize specific movements in wearers. The fabric contains conductive yarns and piezoresistive components that change their resistance when pressure is applied.

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TIRBO #13: Hospital relativity

Critical Care Scenarios

Time is always a factor in the ICU, but some time matters more than other time. Time is always a factor in the ICU, but some time matters more than other time.

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Evolution and the Vermiform Appendix - Clinical Correlations

Clinical Correlations

By Hannah Kopinsky, MD Peer Reviewed Appendicitis is the most common reason for urgent surgery related to abdominal pain in the US, with a lifetime incidence of 8.6% for men and 6.7% for women. 1 The current standard.

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IBNCC – ICU care post craniotomy

EMCrit Project

Management of the a patient following craniotomy focuses on the fundamentals of supportive neurocritical care. However, special attention is required to unique postoperative complications that may occur (depending on the procedure). The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes. EMCrit Project by Josh Farkas.

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REBEL Core Cast 85.0 – Superficial Venous Thrombosis

REBEL EM

Take Home Points SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation. The rate of concurrent DVT and PE in patients with SVT is 25% and 5%, respectively. REBEL Core Cast 85.0 – Superficial Venous Thrombosis Click here for Direct Download of the Podcast Definition: The presence of a clot in a superficial vein. Epidemiology: Although large prospective trials are lacking, superficial venous thrombosis (SVT) has been reported occur at a rate of 4 in 1000 per year

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Imaging Case of the Week 515

EMergucate

The chest x-ray is from an adult patient with sudden onset of upper abdominal pain. What can be seen?

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Soft Bioresorbable Implant Controls Pain by Cooling Nerves

Medgadget

A team of engineers at Northwestern University led by John Rogers, the person responsible for many advances in flexible electronics, created a drug-free implant that can control pain by cooling nerves. The soft implant is intended to be wrapped around a nerve during surgical procedures that would typically involve opioid-based analgesia afterwards. As a drug-free technology, the implant could help to avoid the addiction and side-effects that opioids frequently cause.

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Episode 88: Ceribell and Advancing Seizure Care with Dan Gerard

The Overrun Podcast

Dan Gerard is a man of many hats. He is the current President of the IAEMSC as well as the EMS Coordinator for Alameda county in California. He has spent his lengthy EMS career pursuing new advancements in pre-hospital medicine and is currently piloting a program in Alameda county that may be a game changer when it comes to recognizing and treating seizures in the field.

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Tasty Morsels of Critical Care 063 | Respiratory Compliance

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Today we’re not so much looking at a chapter of Oh’s manual but at the physiologic concept of respiratory compliance. I approach this with a degree of trepidation as the probability of screwing this up is infinitely higher than simply translating Oh’s manual into podcast form.

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EMCrit 328 – My Advice to New Residents (But Everyone Else Should Listen Too!)

EMCrit Project

things I've learned from my own mistakes and 2 decades of training residents. EMCrit Project by Scott Weingart, MD FCCM.

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