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I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma. The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framewor
A 49-year-old male was triaged to the Fast Track area with complaints of an abrasion to the neck following an assault. The patient was attending a party with his family when “someone started shooting.” The patient believes some stucco or stone fragment from a brick wall struck him in the neck during the initial incident, but his primary concern was for his more seriously wounded family members.
Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact. In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. In these cases, thrombolysis is recommended to improve morbidity and mortality. The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a phar
This talk, from Clare Skinner, on music, medicine and leadership , comes from our 2022 DFTB conference in Brisbane. [link] Years ago, before I became a medical student, I heard Professor Michael Field , Associate Dean of Medical Curriculum at the University of Sydney, nephrologist, and an accomplished flautist, being interviewed about his love of music on ABC Classic FM.
Introduced to the world by our friend Scott Weingart, delayed sequence intubation (DSI) is often summarized as procedural sedation for the procedure of preoxygenation. (Weingart 2011, Weingart 2015) It is a brilliant concept, makes a ton of sense on paper, and anecdotally has seemed to help a number of my patients. However, any long time […] The post Delayed sequence intubation: An RCT appeared first on First10EM.
What well-known adverse reaction results from ingestion of the pictured mushroom? Acute hepatitis Disulfiram-like reaction with ethanol consumption Pneumonitis from inhalation of spores Seizures from glutamate agonist activity [Image from Canstockphoto] Reveal the Answer 2. Disulfiram-like reaction with ethanol consumption Coprinus atramentarius or Ink Cap mushroom is well known to cause a disulfiram-like reaction when it is consumed prior to ethanol.
This was written by Magnus Nossen, from Norway, with comments and additions by Smith A 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. An ECG was recorded immediately and is shown below. How do you interpret the ECG? ECG#1 There is a regular tachycardia with a ventricular rate of about 180 bpm.
Jarlicia Islandriana Scott Paramedic Pafford Emergency Medical Services Clarksdale, MS Share on Instagram | Facebook | Twitter | LinkedIn How did you come to be in EMS? I found myself […] The post EMS Profiles | Meet Jarlicia Islandriana Scott appeared first on American Ambulance Association.
Jarlicia Islandriana Scott Paramedic Pafford Emergency Medical Services Clarksdale, MS Share on Instagram | Facebook | Twitter | LinkedIn How did you come to be in EMS? I found myself […] The post EMS Profiles | Meet Jarlicia Islandriana Scott appeared first on American Ambulance Association.
We chat with Leon Chen about his work setting up infrastructure for clinical POCUS at Memorial Sloan Kettering. Leon is an Adult/Gerontology Acute Care Nurse Practitioner in the ICU, Clinical Program Manager of Research and Simulated Learning, and an Associate Professor at Columbia University School of Nursing. Find us on Patreon here! Buy your merch … Continue reading "Lightning rounds #32: Creating a POCUS system with Leon Chen" We chat with Leon Chen about his work setting up infrastructure f
66 year-old-male with a history of type 2 diabetes and hypertension presented as a transfer for rapid progression of lower extremity pain, swelling, and blue-purple discoloration of the entire limb with concern for a possible necrotizing infection. His symptoms began earlier in the day and progressed over just a few hours. He had no known thromboembolic risk factors.
Sent by anonymous, written by Pendell Meyers, reviewed by Smith and Grauer A man in his 40s presented to the ED with HTN, DM, and smoking history for evaluation of acute chest pain. He was eating lunch when he had sudden onset chest pressure, 9/10, radiating to his back, with sweating and numbness in both hands. Triage ECG: What do you think? It's a very "fun" ECG, with initial ectopic atrial tachycardia (negative P waves in inferior leads conducting 1:1 with the QRSs), followed by spontaneous r
This content is for AAA members only. Please either Log In or Join! The post Impact of Partial Government Shutdown on Healthcare appeared first on American Ambulance Association.
The EM Cases Quiz Vault is now on Anki flashcards to help you solidify knowledge of Emergency Medicine Cases podcasts. Herein lies a guide to optimize EM Cases Anki decks, download links and more. The post EM Cases Quiz Vault on Anki appeared first on Emergency Medicine Cases.
background Today the Van de Bergh group in Belgium released a RCT investigating tight versus liberal glycemic control in the ICU. Before diving into this study, let's take a walk down memory lane. Major interest in tight glycemic control in the ICU began in 2001 with an RCT by the same group of investigators, also […] EMCrit Project by Josh Farkas.
Jameson Fernandez Emergency Medical Technician Cataldo Ambulance Somerville, Massachusetts Share this on Instagram | Facebook | X / Twitter | LinkedIn How did you come to be in EMS? The […] The post EMS Profiles | Meet Jameson Fernandez appeared first on American Ambulance Association.
This case comes from Jason Winter, of The Facebook Clinical Electrocardiology ECG Page. A 60-something woman called EMS for chest pain. Here is her first prehospital ECG: What do you think? There is very low voltage in the precordial leads, with a total QRS amplitude of only 3.5 mm in V2 and 4 mm in V3. In spite of this low voltage, there is ST elevation (as measured at the J-point and relative to the PQ junction, and as measured by the computer and shown on the right), of 0.54 mm in V2 and 0.65
Researchers at the University of Texas at Austin have developed an electroencephalogram (EEG) sensor that is incorporated into a virtual reality headset. The technology can measure brain activity while someone is undergoing an immersive virtual reality experience. The device may assist in enhancing medical virtual reality interventions, such as those used to treat post-traumatic stress disorder or phobias, by revealing brain activity during different tasks or experiences that help clinicians to
Author: Thijs Wolf, DO (EM Resident Physician, University of Rochester Medical Center); Andrew Bragg, MD (EM Attending Physician, University of Rochester Medical Center) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School) ; Alex Koyfman, MD (@EMHighAK) ; Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review o
2 middle aged males presented with chest pain. Which had the more severe chest pain at the time of the ECG? Here is the ECG of patient 1 , recorded about 2 hours after pain onset: A Massive Anterolateral STEMI/OMI Peak troponin I over 60,000 ng/L Here is the ECG of patient 2 , recorded about 2 hours after pain onset: This is OMI, but it is not STEMI Peak troponin I 440 ng/L Patient 1 at the top with the massive ST Elevation complained of 5/10 chest pain at the time the ECG was recorded.
CraniUS , a medtech company based in Baltimore, has developed the NeuroPASS drug delivery system. The technology is designed to deliver drugs to the brain, and it can bypass the blood-brain barrier. This layer of specialized endothelium significantly restricts which drug molecules can enter the brain, normally greatly limiting treatment options for patients with brain-based disease.
Take Home Points: In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. A newly “wide QRS”, especially with hemodynamic instability, should prompt consideration of sodium channel blockade and not ventricular tachycardia. Treatment is guided by administration of sodium-bicarbonate. Recall that the resultant alkalemia driven by sodium-bicarbonate will shift potassium intracellularly.
This content is for AAA members only. Please either Log In or Join! The post GAPBAC | Registration Open for Oct 31, Nov 1 Meetings appeared first on American Ambulance Association.
Researchers at the University of California San Francisco have developed an implantable bioreactor that may pave the way for artificial kidneys. Dialysis and kidney transplants both have significant disadvantages for patients with kidney failure, and so scientists are trying to develop a lab created kidney that would not require harsh immunosuppression or a donor kidney.
The emergency medicine workforce is an important issue with ramifications for physicians relocating or retiring, medical students considering the specialty, and graduating residents seeking their first jobs. In August 2021, an article published in the Annals of Emergency Medicine projected a surplus of more than 7,800 emergency physicians in 2030 based on multiple scenarios, including patterns of supply and demand for emergency physicians at that time. 1 The workforce in emergency medicine is c
Do you still cringe when a dizzy patient appears on your board? If so, we need to fix that and Peter Johns is here to help! EMCrit Project by Scott Weingart, MD FCCM.
Researchers at Pohang University of Science & Technology in South Korea have developed a durable strain sensor that can detect complex body movements. The technology will be useful for patients undergoing physical rehabilitation, allowing physical therapists to assess their movements in significant detail and measure progress. Conventional strain sensors are often affected by heat and humidity, making them less durable as a wearable, and they typically detect only biaxial strain, providing l
Authors: Joshua Lowe, MD (EM Attending Physician, USAF); John Patrick, DO (EM Attending Physician, USAF); Michael Yoo, MD (EM Attending Physician, USAF); Rachel Bridwell, MD (EM Attending Physician, USA) // Reviewed by: Alex Koyfman, MD (@EMHighAK) and Brit Long (@long_brit) Case: A morbidly obese (BMI >60) 25-year-old male with a past medical history of sickle cell anemia and type 1 diabetes presents to the ED with chest pain and shortness of breath.
Answers: PH = 7.24 that is moderate acidaemia. HCO3 = 16 mmol/L, so we have metabolic acidosis. Next, we need to calculate the anion gap and the compensation.
This is written by Magnus Nossen, with some edits by Smith This ECG diagnosis will be obvious to the majority of the readers of this blog. It is not obvious for the majority of doctors or even cardiologists. A 50 something male was seen in the emergency room due to typical chest pain. The pain had started the same day about two hours prior to medical contact.
Researchers at Oxford University have developed a tiny battery that can power small implantable devices, such as drug delivery technologies. The new battery is inspired by the ionic gradients that electric eels use to generate electricity. It involves tiny droplets of a conductive hydrogel that are placed near each other. Each droplet has a different ionic concentration, meaning that ions will flow from high concentration droplets to low concentration droplets.
Author: Micaela LaRose, MD (Emergency Medicine Resident, San Antonio, TX) // Reviewed by: Summer Chavez, DO, MPH, MPM (Attending Physician, University of Houston); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Policy Playbook returns to emDOCs with a concise summary of the latest developments in emergency medicine-related health policy over the summer months.
Every day, our EMS clinicians utilize protocols to guide medical care. These protocols are based on the latest evidence in prehospital care. However, keeping up with current evidence remains a challenge. In this podcast, we interview Dr. Christian Martin Gill & Dr. Rebecca Casche on their manuscripts: Recommendations for Improving the Quality of Prehospital Evidence-Based Guidelines & 2022 Systematic Review of Evidence-Based Guidelines for Prehospital Care Click here to download i
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