Sat.Mar 04, 2023 - Fri.Mar 10, 2023

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Imaging Case of the Week 544

EMergucate

Chest x-ray from an adult female with dry retching. What can be seen? Answer will be posted later.

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TIRBO #30: Experience is lying to you

Critical Care Scenarios

When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here! When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here!

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SGEM#395: Too Much Blood from My Nose – Will TXA Help?

The Skeptics' Guide to EM

Date: March 3, 2023 Reference: Hosseinialhashemi et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Ann Emerg Med. 2022 Guest Skeptic: Dr. Dominique Trudel is a CCFP-EM resident in Ottawa, Ontario. Her interest is serving French minority communities delivering care at the Montfort Hospital in Ottawa.

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Smartphone Photos to Detect Anemia

Medgadget

Researchers at University College London and at the University of Ghana have developed a smartphone-based system that can detect anemia through simple photos taken using the phone’s camera. The technology is intended for use in low- and middle-income countries where access to routine medical diagnostics may be unreliable. The process involves obtaining images of areas of the body which are least pigmented, including the white of the eye, the lower eyelid, and the lip.

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Top 10 Best EMS Watches for EMTs and Paramedics in 2023

EMT Training Station

A good watch is often overlooked. I have seen plenty of EMTs simply use their phones. This works for recording accurate vital signs on a stable patient. But what if your patient is not stable? In this article, we want to educate you on how to pick the best EMT watch for you so that you can provide the best patient care possible. As an EMT, paramedic, or medical first responder your main purpose is to provide emergency care to your patients.

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Colorado Fire Gear in Terrifying Condition, Says State Review

Firefighters and EMS Fund

According to local news broadcaster 9News, the Colorado Division of Fire Prevention and Control (DFPC) was recently terrified by the conditions Colorado’s firefighters currently work with. During a tour of fire training facilities around the state, they found many rural jurisdictions must make do with 30-year-old, outdated PPE. This is a clear example of money […] The post Colorado Fire Gear in Terrifying Condition, Says State Review appeared first on Firefighters and EMS Fund.

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A man in his 50s with chest pain

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers A man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. He had episodes of chest pain off and on all night, until about 1 hour prior to arrival when the pain became constant, crushing, 10/10 chest pain that radiated to both arms. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain.

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Managing the Patient with Alcohol Intoxication

REBEL EM

Background: Acute alcohol intoxication is often identified early in a patient’s visit by behavioral changes accompanied by slurred speech, ataxia, nystagmus, or the smell of alcohol. However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Patients may be agitated or altered, hindering their initial evaluation and diagnostic workup.

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Electric vehicles in medical transport

Stem EMS

Electric vehicles' arrival in medical transport is ongoing in many countries, even if end-users still have doubts about it. In terms of regulations, European organizations are not yet aligned and there are no certainties about special vehicles, as regulation EN1789 shows. The text does not refer to electric ambulances, even if they are already in the field in some European countries.

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What do you think of this ECG?? Is this during pain, or after pain resolution? Also, see the CT image of the heart.

Dr. Smith's ECG Blog

If you saw this ECG only knowing that it is an acute chest pain patient, what would be your interpretation? This is a trick question, as you will see below. But you can make a diagnosis here, and Pendell and I do this all the time when reading ECGs from databases. I sent this to Pendell without any information at all, and he replied "Postero-lateral Reperfusion.

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SGLT2 Inhibitors for Heart Failure with Preserved Ejection Fraction - Clinical Correlations

Clinical Correlations

By Raymond Barry Peer Reviewed A 2020 report published by the American Heart Association (AHA) in conjunction with the National Institutes of Health (NIH) found that an estimated 6.2 million American adults had heart failure between.

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REBEL Core Cast 97.0 – Acute Vision Loss II

REBEL EM

Take Home Points: Assess patients with floaters or flashers for retinal or vitreous detachment. Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. CRAO is a stroke of the eye; patients should be considered for a complete stroke work up. REBEL Core Cast 97.0 – Acute Vision Loss II Click here for Direct Download of the Podcast Definition: Decrease of visual acuity due to a non-traumatic cause.

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EMCrit 345 – I Guess We Need to Talk about CLOVERS and Fluids in Sepsis (Hopefully for the Last Time Ever)

EMCrit Project

CLOVERS Trial Primer and Fluids in Septic Shock EMCrit Project by Scott Weingart, MD FCCM.

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TIMI Risk Score for STEMI, NSTEMI and unstable Angina

ECG & Echo Learning

All patients with NSTE-ACS ( NSTEMI or unstable angina) are treated similarly with respect to anti-ischemic and anti-thrombotic drugs. Management must, however, be individualized with respect to the delay to coronary angiography (PCI). The majority of patients should undergo angiography within 24 hours, but high-risk patients should be evaluated with angiography earlier.

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Intravenous Haloperidol

Emergency Medicine Education

This is a good controversial review in favor or against Intravenous haloperidol. It is important to know that IV haloperidol is not FDA approved. QT Prolongation, Torsades de pointes, and alternative agents for sedation always should be considered.

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Paramedic clearance of cervical spine injuries

University of Maryland Department of Emergency Med

Applying a cervical collar to all patients involved in motor vehicle collisions and mechanical falls has been shown to add to patient disco.

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A 30-something with Chest pain and SOB

Dr. Smith's ECG Blog

A 30-something with h/o DM and HTN presents with CP and SOB and cough. The ECG is rather classic for pulmonary embolism, and indeed this was a large acute PE. This is a classic S1Q3T3. Most S1Q3T3 is not due to PE. This one is far more specific, as it is combined with sinus tachycardia and some T-wave inversion in V1-V3. So this entire ECG is very high probability for PE in a patient with acute dyspnea.

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Vernakalant (Brinavess)

ECG & Echo Learning

Indications for vernakalant Vernakalant (Brinavess) is indicated in adults for chemical conversion of recent onset atrial fibrillation to sinus rhythm. Vernakalant is used in the following settings: Non-surgery patients: atrial fibrillation ≤7 days duration. Post-cardiac surgery: atrial fibrillation ≤3 days duration. Vernakalant does not convert atrial flutter to sinus rhythm.

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The Brain is Connected to The Heart?

University of Maryland Department of Emergency Med

Title: Electrocardiographic Changes at the Early Stage of Status Epilepticus: First Insights From the ICTAL Registry. As the s.

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