The Skeptics' Guide to EM

FEBRUARY 11, 2023

Date: February 7, 2023 Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. NEJM 2022 Guest Skeptic: Dr. Sean Moore is an emergency physician working in Kenora Ontario, where he is Chief of Staff at Lake of the Woods District Hospital, Northern Medical Director for the Ornge air medical transport program and associate medical director with CritiCall […] The post SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular F

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Emergency Medicine Cases

FEBRUARY 14, 2023

Is low dose diltiazem as effective and safer than standard dose diltiazem for rate control in patients with atrial fibrillation with rapid ventricular response? Dr. Rohit Mohindra and Dr. Shelley McLeod critically appraise the latest study on diltiazem dosing and deliver a research methodology hot take on this month's EM Cases Journal Club. The post Journal Club 2 – Diltiazem Dosing in Atrial Fibrillation with Rapid Ventricular Response appeared first on Emergency Medicine Cases.

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Core Ultrasound

FEBRUARY 14, 2023

Joint pain is a fairly common complaint and accurately identifying fluid (or lack thereof) can be difficult and frustrating without POCUS! In this video I show you how to identify joint effusions (including shoulder, knee and hip effusions) and how to use ultrasound to accurately stick a needle in it to either drain that fluid or to aspirate it.

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Critical Care Scenarios

FEBRUARY 15, 2023

A candid discussion of our flaws, mistakes, weaknesses, and errors, and a look at why it’s important to reflect on these things in medicine, acknowledge them, and try to improve. Find us on Patreon here! Buy your merch here! A candid discussion of our flaws, mistakes, weaknesses, and errors, and a look at why it’s important to reflect on these things in medicine, acknowledge them, and try to improve.

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EMergucate

FEBRUARY 14, 2023

3 year old with respiratory distress. What can be noticed? Answer will be posted later.

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Emergency Medicine Cases

FEBRUARY 14, 2023

In this Part 3 of our 3-part podcast series on management of lacerations Dr. Haley Cochrane joins Anton and Justin to explore laceration aftercare and the evidence for keeping wounds dry or wet, wound dressings, topical antibiotics, prophylactic oral antibiotics, Vitamin E oil, aloe vera cream and UV protection with regards to cosmetic outcomes and infection rates.

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Medgadget

FEBRUARY 13, 2023

Researchers at Columbia University’s Irving Medical Center have developed a method to create three-dimensional bioengineered skin grafts. To date, bioengineered skin is typically created in flat sheets. However, these are difficult to fit to complex anatomy, such as the hand, and so these researchers have designed a more sophisticated technique that combines laser scanning, 3D printing, and cell culture to create seamless three dimensional skin grafts.

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EMergucate

FEBRUARY 14, 2023

38 year old lady presented to the emergency department with recurrent vomiting. She was found to have a slipped lapband.

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Emergency Medicine Cases

FEBRUARY 14, 2023

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing. The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on

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Medgadget

FEBRUARY 16, 2023

Researchers at MIT have developed an ingestible sensor that can reveal gastrointestinal motility issues, such as gastroparesis and gastroesophageal reflux disease. The technology is intended for use as an easy at-home method to diagnose such issues, which typically require more invasive and inconvenient procedures, such as endoscopy or X-ray imaging.

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NAEMSP

FEBRUARY 15, 2023

By Nicholas Maxwell, MD Case: You are bringing an elderly male with a DNR back to a living facility from a hospital. Approximately 10 miles away from the hospital, the patient suddenly decompensates. His pulse ox drops from 94% to 87% and his heart rate increased from about 110 beats per minute to approximately 180. His mental status is described as nodding off.

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EMergucate

FEBRUARY 12, 2023

Question 1: PH = 7.14, that is severe acidaemia pCO2 = 53 mmHg, So we have respiratory acidosis.

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FOAMcast

FEBRUARY 15, 2023

Apple Podcasts , Spotify , Listen Here References: National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network, Shapiro NI, Douglas IS, et al. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med. 2023;388(6):499-510. Surviving Sepsis Campaign guidelines 2021.

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Medgadget

FEBRUARY 14, 2023

A team at Rice University has developed an automated feeding platform for mosquitoes that allows researchers to test different types of repellent and investigate mosquito-borne disease transmission. Traditionally, such mosquito research would require human volunteers or animal subjects for the mosquitos to feed on, but this is obviously inconvenient and a little distasteful.

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EMS 20/20

FEBRUARY 15, 2023

Today we fly our F-18's while launching our AAM's at some MDMA during and EDM concert! Or maybe it's SSRI's, or SS, or MAO-I's, or TCA's. or maybe we just need to RTB. Today we fly our F-18's while launching our AAM's at some MDMA during and EDM concert! Or maybe it's SSRI's, or SS, or MAO-I's, or TCA's. or maybe we just need to RTB.

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EMCrit Project

FEBRUARY 15, 2023

All the lit goodness for Feb 2023 EMCrit Project by Scott Weingart, MD FCCM.

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University of Maryland Department of Emergency Med

FEBRUARY 17, 2023

This study looked at 69,321 head injured patients over age 65 in a health care database for delayed intracranial hemorrhage (within 90 days of vi.

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Medgadget

FEBRUARY 15, 2023

Researchers at Wake Forest University School of Medicine have tested a closed-loop acoustic stimulation neurotechnology in its ability to treat insomnia. The device in question has been developed by Cereset , a medtech company headquartered in Arizona. Insomnia is not just unpleasant, but can have significant long-term health consequences, including an increased risk of cardiovascular disease, obesity, and diabetes.

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Dr. Smith's ECG Blog

FEBRUARY 13, 2023

Written by Jesse McLaren Two 70 year olds had acute chest pain with nausea and shortness of breath, and called paramedics. Who needs the cath lab? (photocopy of prehospital ECGs digitized by PMcardio) ECG #1 (top): there’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression, and normal voltages. There’s inferior ST depression which is reciprocal to subtle lateral convex ST elevation, and the precordial T waves are subtly hyperacute – all concerning for STEMI(-)OMI of p

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Medgadget

FEBRUARY 17, 2023

Researchers at the Harvard Wyss Institute and the Dana-Farber Cancer Institute have developed a new method to prepare chimeric antigen receptor-T cells (CAR-T cells) for leukemia patients that could result in more effective treatment. CAR-T cells start life as T cells that are isolated from cancer patients, are stimulated and primed to recognize and attack cancer cells, expanded in number, and then reintroduced to the cancer patient with the goal that the cells will destroy their cancer.

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Medgadget

FEBRUARY 16, 2023

Scientists at Brown University have designed an automated liquid chromatography tandem mass spectrometry (LC-MS/MS) system that allows clinicians to rapidly and easily process patient samples to determine levels of antidepressant drugs in the body. Getting the correct dose of antidepressant drugs into the bloodstream is important to ensure efficacy and avoid side-effects.

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Medgadget

FEBRUARY 14, 2023

Researchers at the Harvard Wyss Institute have developed an electrochemical device, called the eRapid sensor, that can assist clinicians in quickly characterizing someone’s COVID-19 infection, including identifying the infecting viral variant and the nature of someone’s immunity to the virus in terms of whether it is vaccine-mediated or natural immunity.

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Medgadget

FEBRUARY 15, 2023

Researchers at Rice University have developed a bioprinting method that uses self-assembling peptides as a bioink. The technique involves using “multidomain peptides” that are hydrophobic at one end and hydrophilic at the other. When the peptides encounter water, they flip over each other to create hydrophobic sandwich structures that stack together to form fibers, creating the base structure of the printed hydrogel.

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Medgadget

FEBRUARY 14, 2023

Researchers at Nagoya University in Japan have developed a nanowire assay that can be used to capture and detect specific extracellular vesicles in a urine sample that indicate the presence of a brain tumor. These extracellular vesicles are naturally excreted in the urine but techniques to capture and analyze them have been complex, requiring different pieces of equipment, until now.

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University of Maryland Department of Emergency Med

FEBRUARY 13, 2023

Sympathetic Crashing Acute Pulmonary Edema (SCAPE) (also known as flash pulmonary edema) is an extreme form of hypertensive acute heart fa.

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University of Maryland Department of Emergency Med

FEBRUARY 16, 2023

It is often difficult to clinically differentiate between viral and bacterial conjunctivitis, but previous studies have shown that the va.

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Dr. Smith's ECG Blog

FEBRUARY 12, 2023

I was reading EKGs on the system before a shift, and saw this one: What do you think? I was worried that the ST depression and T-wave inversion in V2 and V3 might be posterior OMI. I went to the chart and found that the patient was a sepsis patient with hypotension and a K of 3.0. There was no chest pain. So I thought it probably is not posterior OMI and I just moved on and kept reading EKGs.

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Medgadget

FEBRUARY 17, 2023

Surgical robotics is dominated by various versions of the da Vinci system from Intuitive Surgical, a competent but expensive tool that’s become a standard in modern advanced hospitals. It took Intuitive about 30 years to achieve this status, but there are systems from J&J, Medtronic, CMR Surgical, and others that are chipping away at the company’s dominance.

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Dr. Smith's ECG Blog

FEBRUARY 17, 2023

This patient had many complaints including chest pain. The computer called this Acute STEMI What do you think? STEMI never has a very short QT. This QT interval is 320 ms, with a QTc of around 350, depending on which correction formula you use. (There is Bazett, Fridericia, Hodges, Framingham and Rautaharju -- see here at mdcalc: [link] If the ST Elevation here were due to STEMI, it would be an LAD Occlusion.

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