Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Never fear. As our fearless leader likes to say: “children are not aliens, but they are a special population with unique anatomy and physiology.” Children compensate for blood and volume loss very well… until they don’t.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

American Ambulance Association

SEPTEMBER 18, 2023

Press Release from the Prehospital Blood Transfusion Initiative Coalition PREHOSPITAL BLOOD TRANSFUSION INITIATIVE COALITION BEING FORMED Contact: Bill Skillman bskillman@veli.co 781 315 7537 In cities, towns and rural communities across […] The post Prehospital Blood Transfusion Initiative appeared first on American Ambulance Association.

Ambulance 130

Ambulance 130

EMergucate

SEPTEMBER 18, 2023

Question 1: PH = 7.32 ( less than 7.35) so, we have mild acidaemia. PCO2 = 48 mmHg ( on arterial blood gas > 40), so we have respiratory acidosis.

130

130

First 10 EM

SEPTEMBER 18, 2023

Transfusion seems like the simplest intervention in medicine. The patient is losing blood, so let’s put some back in. Not much more complicated than an oil change. Sure, you need to use a specific brand, but as long as the system is topped up, everything should run just fine. Therefore, when someone (to be left […] The post Massive hemorrhage: a very deep dive appeared first on First10EM.

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144

REBEL EM

SEPTEMBER 21, 2023

Bottom Line Up Top: Troponins should not be routinely sent in patients presenting with SVT. Rarely, they may be necessary if the patient has concerning ischemic symptoms that persist after conversion to sinus rhythm. Clinical Scenario: A 44-year-old man presents with palpitations that started 45 minutes ago. He has no medical problems and denies any prior similar symptoms.

Coronary 142

Coronary ACS ED OR 142

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Case submitted by anonymous. Written by Smith. Ken's piece at the bottom is excellent. A 50-something presented with s udden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest.

Coronary 136

Coronary OR EMS ED 136

EMergucate

SEPTEMBER 19, 2023

The following chest x-ray is from an adult with chest pain. What can be seen? Answer will be posted later.

EMS 130

EMS 130

The Bottom Line

SEPTEMBER 22, 2023

Extracorporeal Life Support in Infarct-Related Cardiogenic Shock Thiele H. NEJM 2023; Online ahead of print. doi:10.1056/NEJMoa2307227 Clinical Question In patients presenting with acute myocardial infarction complicated by cardiogenic shock undergoing revascularisation, does the early unselected application of extracorporeal life support reduce mortality from any cause at day 30?

Life Support 117

Life Support 117

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

This ECG was texted to me with no other information. I assumed the presentation was consistent with acute MI. What did I say? "OMI. Activate the cath lab." The T-waves in V2-V6 are diagnostic. It does, in fact, the STE meets STEMI criteria since there is 1 mm of in V4 and V5. There is also some non-diagnostic STE in inferior leads. There is zero reciprocal ST depression. 50% of LAD OMI have zero reciprocal ST depression!

OR 123

OR STEMI Coronary 123

Critical Care Scenarios

SEPTEMBER 20, 2023

A brief discussion of the stuff in your pockets as you practice medicine. A brief discussion of the stuff in your pockets as you practice medicine.

100

100

Medgadget

SEPTEMBER 19, 2023

Researchers at Nanyang Technological University in Singapore have developed a tiny, flexible battery that is intended for use in smart contact lenses. The device is as thin as the human cornea and can be charged by a saline solution, which is particularly useful in the eye, as it is full of salty tears. When the battery-equipped smart lens is not in use, such as at night, then it can be stored in a saline solution, helping to further recharge the battery.

OR 109

OR 109

EMergucate

SEPTEMBER 19, 2023

54-year-old asthmatic patient presented with multiple episodes of vomiting. Her pulse-rate was 110 and blood pressure was 96/54.

100

100

Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

Written by Magnus Nossen MD, peer reviewed and edits by Smith, Meyers, Grauer A 60 something previously healthy female smoker sought medical attention after 2-3 days of intermittent chest discomfort. The chest discomfort was described as sharp. Episodes lasting 5-30 minutes. On the day of presentation she experienced another episode of chest discomfort accompanied by vomiting and throat pain.

STEMI 96

STEMI OR ACS ALS 96

Don't Forget the Bubbles

SEPTEMBER 16, 2023

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

E-9-1-1 75

E-9-1-1 ALS OR ED 75

Medgadget

SEPTEMBER 19, 2023

Researchers at ETH Zurich have developed an insulin delivery system that relies on music as a trigger. The unusual technology is based on calcium ion channels that typically reside in the cell membrane. Such channels are sensitive to mechanical deformation and these researchers discovered that sound waves will activate the channels. When insulin-producing cells are genetically modified to express this channel, they will experience an influx in calcium ions when music is played close by, promptin

OR 108

OR 108

EMDocs

SEPTEMBER 19, 2023

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , and Rachel Bridwell, MD ( @rebridwell ), we cover two more challenging cases. Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. Patient seized for approximately 20 minutes prior to EMS arrival. They administer two doses of 10 mg midazolam IM.

STEMI 72

STEMI Coronary Emergency Department EMS 72

University of Maryland Department of Emergency Med

SEPTEMBER 19, 2023

The BRASH syndrome (Bradycardia, Renal failure, AV nodal blockade, Shock, Hyperkalemia) has been increasingly described in the literature in.

ED 83

ED 83

REBEL EM

SEPTEMBER 18, 2023

An 85-year-old man presents for evaluation of left wrist pain. Last night, he missed the last step while descending the stairs at his house. He fell and landed on his hands and did not have other injuries. Acetaminophen and ibuprofen have not alleviated his pain. X-ray imaging is shown below. His physical exam reveals limited left wrist flexion and extension.

EMS 55

EMS OR 55

Medgadget

SEPTEMBER 20, 2023

Researchers at the Terasaki Institute in Los Angeles have developed a new method to create 3D printed muscle constructs with enhanced muscle cell alignment and maturation. The technique involves creating microparticles loaded with insulin-like growth factor (IGF) using a microfluidic platform. Then, these particles are included in a bioink that also incorporates myoblast cells and a gelatin-based hydrogel.

OR 107

OR 107

EMCrit Project

SEPTEMBER 17, 2023

All the amazing RACC literature for September 2023 EMCrit Project by Scott Weingart, MD FCCM.

78

78

American Burn Association

SEPTEMBER 19, 2023

Categories Advocacy Burn News MAC Spotlight Media Member Services Organization News Prevention Quality Care Research Return to News & Activities The American Burn Association (ABA) hosted a Research and Advocacy Summit in Washington, DC on September 12–13, 2023. The ABA convened research and advocacy leaders to develop an ABA roadmap for leading and directing priorities in burn research, advocating for funding, and supporting the development of investigators.

52

52

AAAM

SEPTEMBER 19, 2023

Dear colleagues, It is amazing how fast time goes by! This is my last message as President of AAAM, as I will pass along the presidency to Dr. Federico Vaca during the upcoming 67 th AAAM Conference in Indianapolis. Without any doubt, I have enjoyed this time very much, mostly by getting to collaborate closer with many amazing professionals who contribute to making our association truly unique.

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52

Medgadget

SEPTEMBER 19, 2023

Researchers at the University of Colorado Anschutz Medical Campus have developed a technique that may spot the very early signs of Alzheimer’s disease, years before symptoms arise. The method may alert patients and clinicians to an increased risk of the disease, potentially allowing them to take steps to slow the disease progression. The method involves using a simple EEG headband while sleeping.

OR 102

OR 102

Emergency Medicine Ireland

SEPTEMBER 18, 2023

Welcome back to the tasty morsels of critical care podcast. Following hot on the heels of tasty morsel number 72 on cardio renal syndrome is its partner in nephron injury: hepatorenal syndrome. This gets covered in a sub section of Oh’s manual chapter 44 on liver issues but there are a variety of other sources mentioned at the end that are worth a read.

Critical Care 52

Critical Care ICU OR 52

University of Maryland Department of Emergency Med

SEPTEMBER 21, 2023

Takeaway Points - A 10 percent reduction in ED volume reduces an ED patient's chance of dying by 24% at 30 days and by 17% at six months Th.

ED 64

ED 64

AAAM

SEPTEMBER 19, 2023

Join us at AAAM’s 67th Annual Conference for sessions and presentations on groundbreaking research in road safety science and engineering. We’re proud to introduce our two keynote speakers, Dr. Mary Pat Mckay and Dr. Trent Victor, who will be presenting on Wednesday October 4th and Thursday October 5th, respectively. Mary Pat McKay, MD, MPH Dr.

52

52

Medgadget

SEPTEMBER 20, 2023

Researchers at RMIT in Australia have developed a drug-free approach to kill bacteria and fungi that can infect surfaces on medical implants. Such pathogens can cause serious and difficult-to-treat infections around medical implants, sometimes requiring the removal of the implant. In addition, many microbes are increasingly resistant to common antibiotics, highlighting the need for drug-free approaches.

Plasma 90

Plasma OR 90

The FllightBridge ED

SEPTEMBER 22, 2023

Join Eric and Will Heuser, PharmD, discussing “The Influence of Low pH on Efficacy of Critical Care Pharmacology.

Critical Care 52

Critical Care 52

University of Maryland Department of Emergency Med

SEPTEMBER 16, 2023

This Scandinavian study from the Lancet says yes. They randomized 1800 patients over age 18 to appendectomy either within 8 hours or 24 hou.

OR 64

OR 64

Don't Forget the Bubbles

SEPTEMBER 18, 2023

Why do we care about antibiotics? As paediatricians, antibiotics are one of the most common classes of medications that we will end up prescribing. When we do this correctly, antibiotics can save lives. However, prescribing unnecessary antibiotics increases the risk of antimicrobial resistance while exposing children to potential side effects. This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department.

Emergency Department 142

Emergency Department E-9-1-1 ALS OR 142

AAAM

SEPTEMBER 19, 2023

In celebration of Child Passenger Safety Week, Consumer Reports (CR) has taken a significant step by making their comprehensive car seat ratings—covering categories such as infant, convertible, all-in-one, harness-to-booster, and booster seats— accessible to the public without a subscription. Why is this a game-changer? Accurate, reliable information is critical when it comes to ensuring the safety of our little ones during travel.

52

52

University of Maryland Department of Emergency Med

SEPTEMBER 19, 2023

Prior studies have shown that CPR education is associated with a greater willingness to perform CPR. This was a review of 23 studies.

CPR 65

CPR 65

University of Maryland Department of Emergency Med

SEPTEMBER 22, 2023

Since the switch from fee for service to value based care in the US, there has been a marked push to improve our documentation to expand ou.

Emergency Department 58

Emergency Department 58

University of Maryland Department of Emergency Med

SEPTEMBER 17, 2023

Point of Care Ultrasound has been shown to change medical management and decrease time to diagnosis. However, someti.

62

62

Don't Forget the Bubbles

SEPTEMBER 20, 2023

The Choosing Wisely ® campaign is an initiative that promotes collaborative conversations between clinicians and families to safely avoid unnecessary and potentially harmful tests. The American Academy of Paediatrics Section on Emergency Medicine (AAP SOEM) created a list of five key recommendations for Paediatric Emergency Medicine after a structured review process and expert consensus opinion.

E-9-1-1 133

E-9-1-1 Emergency Department ALS ED 133