Sat.Sep 28, 2024 - Fri.Oct 04, 2024

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ECG Cases 51 – ECGs falsely labeled “normal”

Emergency Medicine Cases

In this ECG Cases blog we look at 5 cases of ECGs falsely labeled 'normal'. Can you spot the critical abnormality? Written by Jesse McLaren; Peer Reviewed and edited by Anton Helman. October 2024 Five patients presented with ECGs labeled ‘normal’. Can you use systematic ECG interpretation to identify the [.] The post ECG Cases 51 – ECGs falsely labeled “normal” appeared first on Emergency Medicine Cases.

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SGEM#454: I Just Died in Your Arms Tonight – Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes

The Skeptics' Guide to EM

Date: September 23, 2024 Reference: Essat et al. Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis. Annals of Emergency Medicine, May 2024 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from Australia who is also an ultrasounder. Case: You are working a busy shift in a rural emergency department (ED) and your excellent Family Medicine trainee presents a case of a 63-year-old woman with chest pain and some intermittent radiation into the inter-s

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SAEM Clinical Images Series: Didn’t See That Coming

ALiEM

A 23-year-old healthy male presented to the emergency department with left eye pain, soreness, and blurry vision after being hit in the left eye with a Nerf gun bullet two days prior. He had no prior ophthalmologic history and does not wear corrective lenses. Physical Exam Left eye : Visual acuity 20/30. Intraocular Pressure 17. Pupil 3mm, irregular, minimally reactive.

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Episode 201: Migraines

Core EM

We discuss migraines with one of the authorities in the field. Hosts: Benjamin Friedman, MD of Montefiore Brian Gilberti, MD [link] Download Leave a Comment Tags: Neurology Show Notes Initial Approach to Diagnosing Migraines: Differentiating between primary headaches (migraine, tension-type, cluster) and secondary causes (e.g., subarachnoid hemorrhage).

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Ep 198 Understanding and Improving Culture in Emergency Medicine: Key Insights

Emergency Medicine Cases

In this EM Cases podcast Anton chats with Dr. Peter Brindley and Dr. Leon Byker who have a deep interest in the Culture of Medicine to explore what culture in medicine is, why culture is so important, and then drive home 10 strategies to improving the culture in our departments emphasizing the importance of human connection, empathy, open communication, and a willingness to learn from mistakes in creating a positive and fulfilling work environment, so that we love our work, we love our departmen

EMS 138
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Lightning rounds 45: Noelia Bischoff on transitioning nursing roles

Critical Care Scenarios

We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse.

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Lab case 450 interpretation

EMergucate

Question 1: PH = 7.299 that is moderate acidaemia (less than 7.3), however we can argue that is mild as it is just 0.

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State Farm® and the National Volunteer Fire Council Award $1 Million in Grants to Local Fire Departments

NVFC

100 departments will each receive a $10,000 grant to purchase needed equipment Photo courtesy of Sejal Dave, Oronoco Fire Department. Just in time for Fire Prevention Week October 6-12, State Farm ® and the National Volunteer Fire Council have announced $1 million in grants to local volunteer fire departments. Through the State Farm Good Neighbor Firefighter Safety Program, 100 departments will each receive a $10,000 grant to obtain critical equipment that will help increase their responders’ sa

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A 30-something with acute chest pain

Dr. Smith's ECG Blog

This was sent to me from Sam Ghali ( @EM_Resus ) with no other information. I assumed it was a patient with acute chest pain. "What do you think, Steve? Real or just fake?" What do YOU think? It has some inferior ST elevation with some reciprocal ST depression and inverted T in aVL. This usually indicates inferior OMI. My answer: "Fake: pretty certain, but not 100% certain.

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REBEL Core Cast 128.0 – Toxic Alcohols

REBEL EM

Take Home Points Toxic alcohols generally refer to methanol and ethylene glycol as these substances pose significant metabolic derangement and end-organ damage. Patient who present shortly after ingestion will simply look inebriated – no different than ethanol intoxication. At this point, patients will have an elevated osmolar gap and little to no anion gap.

EMS 111
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Non-invasive or arterial pressure monitoring in PHEM?

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed This blog post reviews a study comparing non-invasive blood pressure (NIBP) and invasive blood pressure (IBP) monitoring in pre-hospital critical care. Using a retrospective cohort design, the study found that NIBP measurements are often inaccurate in patients with haemodynamic instability, particularly in hypotensive and hypertensive states.

OR 114
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Episode 97 – Cascading Prescriptions

The Curious Clinicians

Why does gabapentin cause edema? The medication lists of many older adults require some scrolling to get from top to bottom. In fact, the lists are often so lengthy and complicated that it’s difficult to discern what conditions a patient doesn’t have. One reason for this unwieldiness is a phenomenon known as the “ prescribing cascade ,” in which the side effects of one medication require treatment with another, and so on.

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Oral antibiotics are noninferior to IV in pediatric bone and joint infections (obviously)

First 10 EM

Some topics come up over and over again, and it may seem somewhat repetitive or wasteful to spend so much time on them, but seeing as so many people are still using outpatient IV antibiotics despite overwhelming evidence that oral antibiotics are just as good, if not better, I will continue to cover papers as […] The post Oral antibiotics are noninferior to IV in pediatric bone and joint infections (obviously) appeared first on First10EM.

OR 103
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VT in a Sick Patient? Paired with 2 old cases (see it at the bottom)

Dr. Smith's ECG Blog

== MY Comment , by K EN G RAUER, MD ( 8/30 /2024 ): == I was sent the ECG shown in Figure-1 — knowing only that the patient was being seen in the ED ( E mergency D epartment ). How would you interpret this tracing? Figure-1: The initial ECG in today's case. MY Initial Thoughts: In my experience — all-too-many emergency providers fail to appreciate the potential contribution that a brief ( 1-to-2 line ) history may convey when interpreting arrhythmias.

E-9-1-1 99
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The Art of Precepting with Keith Velaski

Medic Mindset

Some people love doing crosswords or Sudoku. I love finding my learner’s cheat code. I love figuring out what really works for this person versus the previous people that I had. It’s an opportunity for me to exercise my creativity. Keith Velaski Prodigy provides CAPCE approved CE for listening to selected Medic Mindset episodes. Thank you, iSimulate Eastern Kentucky University offers a Bachelors in Emergency Medical Care that is 100% online, offers free textbooks to all students, 

OR 98
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Tasty Morsels of Critical Care 083 | Chylothorax

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Today we look at quite a niche topic, that of chylothorax. We are used to many things in the pleural space, like simple fluid or blood or air but the presence of the myseterious substance chyle is a much more unusual and note worthy event. As a reminder of the basics which I of course knew implicitly and definitely did not have to resort to wikipedia to check… Chyle is largely formed in the small intestine as the gut transports fr

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Neonatal Suction Catheter Complications

SSCOR

Suctioning can be life-saving in neonates, particularly those born prematurely and those struggling with the transition from fetus to neonate. Like any medical intervention, it also presents some risks, especially if performed absent medical indication or hastily and thoughtlessly. Identifying the most common neonatal suction catheter complications can help you reduce patient risk, improving care outcomes and potentially saving lives.

OR 97
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Did Not Wait – DNW

Don't Forget the Bubbles

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. Critically unwell or injured patients are prioritised, whereas those who are felt to be less unwell wait longer for clinical review. Simpson et al. examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent. 21.4% of these were felt t

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ECG Pointers: A Dynamic Approach to Tachydysrhythmias

EMDocs

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations.

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10 Benefits of Using the Same Communication Tool Every Day

Pulsara

EDITOR'S NOTE: This article originally appeared on FireRescue1.com. Special thanks to our guest author, Courtney Levin, for EMS1 BrandFocus Staff. Photo courtesy of Colorado Springs Fire Department: Mark Warth, fire medical program coordinator at Colorado Springs Fire Department, shares the specific benefits the department has experienced since implementing Pulsara. __ The saying “practice makes perfect” is a little misleading.

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EMCrit Wee – Did this Really Just HAPPEN? – The HAPPEN Trial Hot Take – NIPPV for COPD

EMCrit Project

The HAPPEN Trial on NIPPV for AECOPD EMCrit Project by Scott Weingart, MD FCCM.

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50 yo with V fib has ROSC, then these 2 successive ECGs: what is the infarct artery?

Dr. Smith's ECG Blog

A 50 yo was resuscitated from ventricular fibrillation. He had a prehospital ECG recorded after ROSC: What do you think? This certainly looks like an anterior STEMI (proximal LAD occlusion), with STE and hyperacute T-waves (HATW) in V2-V6 and I and aVL. Although one may have all kinds of ischemic findings as a result of cardiac arrest (rather than cause of cardiac arrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion.

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emDOCs Videocast: EBM Update – Inhaled Corticosteroids for Asthma in the ED

EMDocs

Welcome to the emDOCs Videocast – please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today’s video evaluates inhaled corticosteroids (ICS) for asthma in the ED setting. EBM Updates: Inhaled Corticosteroids for Asthma in the ED Background : Asthma is a common ED issue, with patient presentations ranging from needing a medication refill to severe exacerbation in respiratory failure.

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Enhancing federal public safety operations with FirstNet

FirstNet Authority

Enhancing federal public safety operations with FirstNet Blog joseph.rey@fir… Wed, 10/02/2024 - 08:39 By Charlotte Whitacre, Director of Government Engagement, First Responder Network Authority Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters.

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An Overview of Thyromental Distance: What You Need to Know

SSCOR

Difficult airways come as a surprise in 93% of cases , yet most could have been predicted with the right assessment protocols. More than 5% of airways would get a high difficulty score from an assessment. But with the right preparation, the risks plummet.

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FAQs About NERIS: What Your Department Needs to Know

ESO

As fire departments prepare for the transition to the National Emergency Reporting Information System (NERIS), we understand there are many questions about how this new standard will fit into your operations. To help guide you through the changes and what’s coming next, we’ve compiled answers to frequently asked questions about ESO’s integration with NERIS, the development timeline, and how you can stay prepared.

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Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Bubble Time – A New, Simple Way to Detect RV Dysfunction Spoon Feed By agitating and injecting a saline flush into an IV catheter, right ventricular (RV) dysfunction was identified when bubbles were cleared from the

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The Education of Ginger Locke

The EMS Educator

Ginger Locke, newly-minted Prodigy teammate and host of the "Medic Mindset" podcast joins The EMS Educator podcast as co-host. She highlights the episode's key points with her "Mindset Minute." We then dive into Ginger's EMS origin story and her ideas about the future of EMS education. Alongside Hilary Gates, Rob Lawrence, and Maia Dorsett, Ginger explores key aspects of creating a positive learning environment in EMS education.

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Bubble Wrap PLUS – October 2024

Don't Forget the Bubbles

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

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The Benefits of an Automatic Cell Counter: A Comprehensive Guide

Paramedics World

Automation plays a significant role in the biopharmaceutical industry, and the automated cell counter is a crucial tool. With automation tools being quickly adopted by industry, it can be challenging… The post The Benefits of an Automatic Cell Counter: A Comprehensive Guide appeared first on Paramedics World.

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Upcoming Medicare Coding Changes

American Burn Association

Categories Advocacy Burn News MAC Spotlight Media Member Services Organization News Prevention Quality Care Research Return to News & Activities New Medicare coding and payment policy changes will be implemented effective October 1, 2024, which may have big implications on how hospitals are paid by Medicare when treating patients with inadequate housing or housing instability.

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FirstNet Enhances Federal Response

FirstNet Authority

FirstNet Enhances Federal Response joseph.rey@fir… Wed, 10/02/2024 - 08:25 The FirstNet Authority Government Engagement team collaborates with federal agencies with a public safety, emergency management, or homeland security mission – such as the Department of Defense (DOD) – to advance and support broadband technology planning and operations. To learn more about how we work with federal agencies, visit FirstNet.

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UCEM Relocates

Life in the Fastlane

Mike Cadogan UCEM Relocates The UCEM have relocated from Swarmington-on-the-Wold to the more picturesque setting of Enlightenment Boulevard thanks to the generosity of it's fondling members

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Overdose Decline Speculation

Peter Canning

Is the decline in drug overdose deaths more related to the increased availability of naloxone, improved treatment for people who use drugs, or changes in the street drug supply, which while still quite toxic may be less so due to adulteration with other chemicals? A recent article in NPR, The pipeline of deadly fentanyl into the U.S. may be drying up, experts say , speculates that the recent drop in overdose deaths being observed in many parts of the nation might be due to less fentanyl on the s

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Episode 153 Alpha-Gal Syndrome: A tick bite gone bad

This Podcast Will Kill You

One day, you’re enjoying a beautiful hike through the tall grass. A few months later, you find yourself in anaphylaxis from a post-hike hamburger. The culprit: a tick bite. In this much-requested episode, we take on alpha-gal syndrome, the red meat allergy triggered by the bite of a tick. Sometimes science is stranger than fiction. How exactly does an encounter with a tiny arachnid cause your throat to swell up and your skin break out into hives hours after eating red meat?

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Episode 144 Deep Dive: End Tidal CO2 in Cardiac Arrest

Prehospital Emergency Care Podcast

Cardiac arrest in the prehospital setting continues to be a critical area of focus for EMS clinicians, especially when it comes to measuring ventilation and perfusion. In this episode, we’ll do a deep dive on new research investigating the role of end tidal carbon dioxide (ETCO2) as a potential indicator of survival in out-of-hospital cardiac arrests.

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After 25 Years of Research here comes Eden-XP

Stem EMS

In medical transport, the stability and safety of the patient during transit are crucial. Since 2000, with the launch of the Eden project, Stem has developed one of the most […] L'articolo After 25 Years of Research here comes Eden-XP proviene da Stem Ems.