Sat.Mar 18, 2023 - Fri.Mar 24, 2023

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Is the Echo Pulse Check DNR

Core Ultrasound

Examining the Utility of Cardiac Ultrasound During Cardiac Arrest Peer reviewed by Ben Smith, MD 3/23/23 RWMA R Heart TEE Cardiac POCUS can be dramatically useful and life-saving in cardiac arrest. I like to think about it in three different broad categories: Procedural, identifying reversible causes, and guiding therapy. This video isn’t a discussion regarding its utility for procedures or diagnosing reversible causes, but it is talking about how maybe the echo pulse check is not the best way t

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Distractions

EMS 12-Lead

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. Fire/EMS crews found him clammy and uncomfortable. Vital signs were noted to be unremarkable with respect to any hypo-hypertensive crisis, hypoxia, etc.

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PulmCrit Hot Take: Steroid for severe pneumonia (CAPE COD trial)

EMCrit Project

Steroid is worthless for pneumonia! Wait, a new study shows it's beneficial! Hang on, a fresh meta-analysis shows that steroid it's useless! And wait, here's a fresh NEJM study showing mortality benefit!! This feels like a roller coaster. What's going on here? Several factors may explain this: Steroid is beneficial, but only in a subset […] EMCrit Project by Josh Farkas.

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SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza

The Skeptics' Guide to EM

Date: February 27, 2023 Reference: Walsh PS, Schnadower D, Zhang Y, Ramgopal S, Shah SS, Wilson PM. Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. JAMA Pediatr. 2022. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC.

ICU 101
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TIRBO #31: Giving better lectures

Critical Care Scenarios

Some basic tactics for keeping attention in your live talks, presentations, and lectures. Find us on Patreon here! Buy your merch here! Some basic tactics for keeping attention in your live talks, presentations, and lectures. Find us on Patreon here! Buy your merch here!

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Imaging Case of the Week 545

EMergucate

The following chest x-ray is from a 42-year-old with asthma exacerbation. What can be noticed?

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CRISPR Combined with Glowing Proteins for Viral Detection

Medgadget

Researchers at Eindhoven University of Technology in the Netherlands have developed a sensitive diagnostic test for viral pathogens that is suitable for use in low-resource regions. The test is based on CRISPR proteins that can detect viral genetic material but also incorporates luciferase proteins, which are bioluminescent proteins that are naturally found in fireflies and other creatures.

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2 Major U.S. Firefighter Funding Programs Set to Expire in September

Firefighters and EMS Fund

Firefighters and EMS personnel are on the front lines of emergency response, putting their lives on the line every day to protect their communities. However, they can only do so much without adequate funding and resources. That’s why two vital U.S. firefighter funding programs, Assistance to Firefighters Grant (AFG) and Staffing for Adequate Fire and […] The post 2 Major U.S.

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Lab case 400

EMergucate

21-year-old man brought for ED for impaired mental state, he was extremely agitated and needed 6 staff members to restrain … Continue reading →

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Biomimetic Construct Models Burn Injuries

Medgadget

Researchers at Harvard University have developed a model of burn injuries that will allow them to investigate the mechanisms underlying healing in such injuries and test out new approaches to enhance this process. Burns can take a long time to heal and can be prone to infection and complicated by the presence of large quantities of dead tissue at the injury site.

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REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal

REBEL EM

Background information : Alcohol has potentiating effects on the inhibitory GABA neurotransmission system and inhibitory effects on the excitatory glutamate neurotransmission system. Chronic alcohol use causes changes to preserve homeostasis, and when the stimulus is removed, alcohol withdrawal results due to decreased inhibition via the GABA system and increased excitation via the glutamate system.

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Watch what happens when you teach others how to find OMI

Dr. Smith's ECG Blog

Submitted by Dr. Caio Aguiar from Brazil, written by Pendell Meyers It is immensely rewarding to receive these emails, like I received from Dr. Aguiar last week: "Last year I had a couple of lessons with you while on my internship. I finished my residency of Emergency Medicine and I’m working at a great Emergency Department here in Brazil. Since then, I started looking for OMI EKG findings and not just STEMI.

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CAPE COD

The Bottom Line

In patients with severe community acquired pneumonia (CAP) does the use of hydrocortisone compared to a placebo reduce 28-day mortality?

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Moving Cells Using Ultrasound

Medgadget

Researchers at Caltech have developed a technique that lets them move groups of cells very precisely. It involves genetically modifying cells so that they express small protein air sacs in their interior. The sacs render the cells highly susceptible to manipulation using ultrasound waves, and the researchers can precisely move them into complicated shapes or patterns.

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REBEL Core Cast 98.0 – AVNRT

REBEL EM

Take Home Points AVNRT is a common tachydysrhythmia that results from a reentrant loop within the AV node. Unstable patients with AVNRT should be considered for immediate synchronized electrical cardioversion. Stable patients with AVNRT can have a trial of vagal maneuvers followed by chemical cardioversion with adenosine or verapamil and synchronized electrical cardioversion if that fails.

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A 50-Something Male with 2 hours of Chest discomfort

Dr. Smith's ECG Blog

This ECG was texted to me in real time, but I did not notice the message until about an hour after it came. "50 + yo. Concerning history, known CAD" Recorded 2 hours after pain onset: What do you think? This was my response: "This looks like a worrisome EKG. It looks like an Occlusion MI (OMI), but I am not 100% certain. But by now you must have a repeat ECG.

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Rethinking Preceptor Training

The EMS Educator

What training did you receive when you became a field preceptor? Many in EMS would reply, "Not much." In this episode, hosts Rob Lawrence, Maia Dorsett and Hilary Gates welcome educators Ginger Locke and Ashley Liebig from Austin, TX. Ginger and Ashley share their ideas about this topic after recently teaching a comprehensive preceptor training course.

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Imaging Technique Reveals Contraction Patterns During Labor

Medgadget

Researchers at the Eunice Kennedy Shriver National Institute of Child Health and Human Development have developed a new imaging technique called electromyometrial imaging (EMMI) which clinicians can use to create 3D maps of uterine contraction patterns during labor. The non-invasive imaging method utilizes rapid MRI scanning with an electromyogram obtained through sensors placed on the skin of the belly.

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Patellofemoral anatomy and disease

University of Maryland Department of Emergency Med

Patellofemoral anatomy and disease (part 1) During normal knee flexion, the patella slides within the trochlear grove. Both (patella and t.

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JAVELAN Service Dogs Give A New Outlook On Life.

First Responders Foundation

Our JAVELAN Team recently visited the Beemer American Legion where they received a very generous donation of $10,000. Reporter Ashley Gaughan of the West Point News wrote the following article and with permission, we are sharing her story. JAVELAN Service Dogs Give Veterans & Retired First Responders A New Outlook On Life. Many veterans and first responders will testify that their JAVELAN service dog has significantly changed their life for the better.

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85 year old with chest pain, STEMI negative, then normal troponin but with relatively large delta: discharge?

Dr. Smith's ECG Blog

Written by Jesse McLaren, with comments from Smith An 85 year old with a history of CAD presented with 3 hours of chest pain that feels like heartburn but that radiates to the left arm. Below is the ECG. What do you think? There’s sinus bradycardia, first degree AV block, normal axis, delayed R wave progression, and normal voltages. There’s minimal concave ST elevation in III which does not meet STEMI criteria, so this ECG is "STEMI negative".

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Empowering Stroke Survivors: Interview with Kirsten Carroll, General Manager at Kandu Health

Medgadget

Kandu Health , a digital health company based in California, has developed a platform to assist stroke survivors with aftercare. Healthcare for stroke patients is primarily focused on acute care to limit the damage caused by the stroke. However, the company has identified that stroke survivors are frequently underserved after hospital discharge, and in many cases are left to cope with the psychological and physical fallout of the stroke with minimal support.

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Predicting mass transfusion with RABT

University of Maryland Department of Emergency Med

Predicting the need for a mass hemorrhage protocol (MHP) activation is important both for individual patient outcome as well as for prope.

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Things to Consider for Persistent or Worsening Shock

University of Maryland Department of Emergency Med

Things to Consider for Persistent or Worsening Septic Shock Septic shock is one of the most common critical illnesses in emergency.

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Levels Is Making Metabolism and Blood Glucose Tracking Accessible To Everyone

Medgadget

Levels has done something truly transformative: the company made continuous glucose monitors (CGMs) accessible to the general population and every day consumer. In many circles, it seems the trend of bringing healthcare to the home and directly to the patient is continuing, but understanding metabolism and lifestyle habits through this new tech trend of smart, wearable devices adds another important component to enjoying improved health and well-being.

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Imagene Profiles Cancer Biomarkers in Real Time

Medgadget

Cancer therapies have proliferated over the past few decades, improving outcomes for many patients. But this variety requires accurate diagnostics and appropriate decision making to choose the optimal course of therapy. The current gold standard of identifying which cancer mutation is present is new generation sequencing (NGS), which provides a comprehensive genetic report, but can take up to six weeks to complete, requires a significant tumor sample size, and can only be done in an advanced lab

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