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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
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.
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.
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.
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.
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.
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.
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
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.
Earning your ACLS Certification card is a great accomplishment. It shows you know ACLS algorithms, rhythms, and doses inside and out. So, you know the ACLS Certification Exam will be no walk in the park. Many people, especially those with advanced medical degrees, think it will be easy. But it’s only easy if you’ve thoroughly […] The post 20 Tips to Pass the ACLS Certification Exam First Time appeared first on SaveaLife.com.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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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