Sat.Dec 02, 2023 - Fri.Dec 08, 2023

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SGEM#422: And It was all Yellow-Nasal Discharge and Antibiotics in Pediatric Sinusitis

The Skeptics' Guide to EM

Reference: Shaikh N, et al. Identifying children likely to benefit from antibiotics for acute sinusitis: a randomized clinical trial. JAMA July 2023 Date: October 17, 2023 Guest Skeptic: Dr. Alasdair Munro is a clinical research fellow specializing in pediatric infectious disease at the University of Southampton. He is currently involved with clinical trials of vaccines […] The post SGEM#422: And It was all Yellow-Nasal Discharge and Antibiotics in Pediatric Sinusitis first appeared on The Skep

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SAEM Clinical Images Series: Bulge in the Belly

ALiEM

A 45-year-old male status-post right nephrectomy secondary to a renal mass presented to the emergency department with right-sided flank pain. He endorsed low-grade intermittent right-sided flank pain since the nephrectomy one year prior, associated with an increasingly enlarging mass extending laterally from his right abdomen. Over the course of the past several days, the mass had become larger and more painful.

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Episode 68: Liver transplant with Meera Gupta

Critical Care Scenarios

We learn about liver transplant with Dr. Meera Gupta, transplant surgeon at the University of Kentucky Healthcare Transplant Center, and surgical director of the Kidney and Pancreas Transplant Program. We discuss eligibility, triage, the peri-operative course, and important post-op complications. Find us on Patreon here! Buy your merch here! Takeaway lessons We learn about liver transplant with Dr.

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Webinar | HHS Roadmap for Cybersecurity in Health Care

American Ambulance Association

On Wednesday, December 6, 2023, the Department of Health and Human Services (HHS) Office of Intergovernmental Affairs (IEA) will host a webinar on healthcare sector cybersecurity from 4:30 p.m. to 5:00 p.m. EST. HHS […] The post Webinar | HHS Roadmap for Cybersecurity in Health Care appeared first on American Ambulance Association.

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Imaging Case of the Week 572 Answer

EMergucate

The portable chest x-ray shows evidence of pneumoperitoneum. The patient had a perforated sigmoid diverticulitis which resulted in profound pneumoperitoneum.

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SAEM Clinical Images Series: Penile Lesion with a Poor Prognosis

ALiEM

A 49-year-old male presented to the emergency department of an academic hospital with the chief concern of penile pain. Prior medical history is notable for end-stage renal disease on hemodialysis three times per week, but the patient has not been dialyzed in the past four days, hypertension, insulin-dependent diabetes mellitus, heart failure with reduced ejection fraction (59% two months prior), seizure disorder, prior pulmonary embolism (eight months prior), a left nephrectomy seven months ago

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OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.

Dr. Smith's ECG Blog

Acute coronary syndrome in a pediatric patient? Written by Kirsten Morrissey, MD with edits by Bracey, Grauer, Meyers, and Smith An older teen was transferred from an outside hospital with elevated serum troponin and and ECG demonstrating ST elevations. The patient was obese and had a medical history of only recurrent tonsillitis status post tonsillectomy and adenoidectomy but was otherwise healthy and fully vaccinated.

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More Trending

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Imaging Case of the Week 575

EMergucate

The CT abdomen image is from an adolescent female patient with gradually worsening lower abdominal swelling and difficulty passing urine.

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5 Minute Sono – Fetal Heart Rate

Core Ultrasound

In this video, we guide you through the steps of using M-mode on a point-of-care ultrasound machine to accurately assess the fetal heart rate.

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Webinar: Beyond STEMI: Diagnosing Acute Coronary Occlusion on the ECG. The Queen of Hearts can do it for you!!

Dr. Smith's ECG Blog

Beyond STEMI: Diagnosing Acute Coronary Occlusion on the ECG. The Queen of Hearts AI app can do it for you. With explainability too.

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PulmCrit wee – Loading dose pharmacokinetics for antibiotics

EMCrit Project

A loading dose may be used to rapidly achieve steady-state pharmacokinetics. For drugs with a long half-life, this accelerates the attainment of therapeutic levels: For most drugs with single-compartment pharmacokinetics, a loading dose may be calculated using the following formula: (discussed further here) The graph below illustrates how this equation works: If (dosing interval)/(half life) […] EMCrit Project by Josh Farkas.

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Lab case 430

EMergucate

14-year-old girl, COVID day 2, presented with delirium. Her venous blood gases showed the following: Ph = 7.

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5 Minute Sono – Ectopic Pregnancy

Core Ultrasound

Intrauterine Pregnancy Fetal Heart Rate Basic Ob/Gyn Scanning The post 5 Minute Sono – Ectopic Pregnancy first appeared on Core Ultrasound.

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"A patient just arrived as a transfer for NSTEMI."

Dr. Smith's ECG Blog

Written by Willy Frick The OMI paradigm has taught me that any diagnosis of NSTEMI is cause for immediate evaluation. "A patient just arrived as a transfer for NSTEMI." I quickly reviewed the patient’s records and saw that she was a 53 year old woman with a history of BMI 40, but no other identifiable risk factors for coronary artery disease. Her first hsTnI at the referring facility was undetectable.

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First10EM updates and audience survey

First 10 EM

First10EM is wrapping up its 9th year in existence. There have been 453 blog posts to date, and I am getting very close to having written 1 million words in total, or the equivalent of 20 average length nonfiction books. (Actually, the stats don’t include static pages like the catalog of research bias, so I […] The post First10EM updates and audience survey appeared first on First10EM.

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Lab case 430 interpretation

EMergucate

Question 1: PH = 7.475, that is mild alkalaemia. pCO2 = 24 mmHg. So, we have respiratory alkalosis.

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Clinical Conundrums: How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis?

REBEL EM

How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis? Bottom Line Up Top: After prompt recognition and appropriate treatment with IM epinephrine, the risk of biphasic reactions are exceedingly low. There is no set observation time to monitor patients as long as their symptoms have resolved. At the time of discharge, appropriate patient education and prescriptions for IM epinephrine are essential.

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EMCrit 363 – Retrograde Intubation

EMCrit Project

Retrograde, in 2023 is basically a backwards way of doing things. EMCrit Project by Scott Weingart, MD FCCM.

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Foohey’s Figures Updates

First 10 EM

If you haven’t yet discovered the Foohey’s Figures section of First10EM, now is the time. Foohey’s Figures is run by the brilliant educator Dr. Sarah Foohey, and is dedicated to graphics that distill emergency medicine topics down to their basics. They are amazing for quick reference on shift and are easy to save to your […] The post Foohey’s Figures Updates appeared first on First10EM.

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Imaging Case of the Week 573 Answer

EMergucate

The chest x-ray shows multiple cavities in both lung fields.

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Pre-Hospital End Tidal CO2 as a Predictor of Trauma Mortality

University of Maryland Department of Emergency Med

A retrospective study of 2 years of data from 24 trauma centers looking at end tidal CO2 as a predictor of mortality in trauma patients found: Click to view the rest

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Red Leg in the Heartland of America: A Rural Physician’s Approach to the Patient with a Potential DVT

EMDocs

Author: Braeden D. Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

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EMCrit Wee – Jason Bartos on the Minneapolis ECPR Experience

EMCrit Project

The best Resus ECMO Lecture EVER!!!! EMCrit Project by Scott Weingart, MD FCCM.

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Imaging Case of the Week 574 Answer

EMergucate

The OM facial x-ray shows black eyebrow sign on the right.

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The Vital Role of EMTs in Sports

Unitek EMT

Explore the critical role EMTs play in preserving the health and well-being of athletes in the high-stakes environment of sports. Emergency Medical Technicians (EMTs) play a crucial role in sports emergencies by providing immediate medical care to athletes who sustain injuries or experience medical issues during sporting events. EMTs are trained to assess and stabilize […] The post The Vital Role of EMTs in Sports appeared first on Unitek EMT.

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Initial Hematology Work Up for Cytopenias

EMDocs

Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA); Alec Pawlukiewicz, MD (EM Attending Physician; Killeen, TX) // Reviewed by: Brit Long, MD (EM Attending Physician, San Antonio, TX) Even prior to COVID-19’s strain on emergency departments (ED), boarding has been a longstanding issue. Especially for clinicians working in EDs with limited resources and consultants, the ED workup may not provide comprehensive care, and thoughtful evaluation can improve inpatient care and aid consul

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Country Stars Alan Jackson, Anne Wilson, Brad Paisley, Brenda Lee, Carrie Underwood, Darius Rucker, Dierks Bentley, George Strait, Jon Pardi, Keith Urban, Luke Bryan, and Reba McEntire Join Forces for First Responders Children’s Foundation

First Responders Childrens' Foundation

(Nashville, Dec. 7, 2023) – For the third year in a row, country music’s biggest artists are giving back during the holiday season through a charitable holiday campaign led by Universal Music Group. This year, for the first time, the “Music 4 Good” holiday campaign extends across several Universal Music Group labels and features artists from multiple genres.

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Lab case 429 interpretation

EMergucate

Question 1: PH = 7.31, that is mild acidaemia PCO2 is high (51 mmHg). So we have respiratory acidosis.

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Upstander Training and Implicit Bias

The EMS Educator

You've heard the term "bystander," but probably not "upstander." What is it? Hosts Rob Lawrence, Maia Dorsett and Hilary Gates are joined by University of Pittsburgh's Rickquel Tripp, MD, MPH, CDR, USNR: Vice Chair of Diversity, Inclusion & Health Equity, Department of Emergency Medicine; Associate Professor of Emergency Medicine; EMS Medical Director, Penn Hills, SouthEast Regional, Lower Valley and Foxwall; Emergency Department Attending Physician.

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EM@3AM: Oculomotor Nerve Palsy

EMDocs

Author: Haley Sinatro, MD (EM Resident, UTSW); Colin Danko, MD (Assistant Professor, UTSW EM) // Reviewed by: Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

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Episode 81 – Avoiding Malaria

The Curious Clinicians

How does sickle cell trait protect against malaria infection and mortality? In any medical genetics course, sickle cell trait (SCT) and sickle cell disease (SCD) are sure to be brought up early and often. They follow an easily-understood inheritance pattern and can be used as examples in teaching biochemistry basics such as protein folding and the function of hemoglobin.

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New University of Dundee Abstract Shows Improved Door-to-CT Times with Pulsara

Pulsara

Initial data shows improvement in door-to-CT times for thrombolysis patients Earlier this year, the University of Dundee , Scotland became the first facility in Europe to implement Pulsara. In combination with radiology AI solution Brainomix , the University began using Pulsara to improve patient care and enhance communication around stroke patients.

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Transfusion Updates: Restrictive vs Liberal Transfusion in Myocardial Infarction

FOAMcast

Apple Podcasts , Spotify , Listen Here The Association for the Advancement of Blood & Biotherapies (AABB) released 2023 International Red Blood Cell Transfusion Guidelines. This podcast reviews the guidelines as well as a recently released trial evaluating restrictive versus liberal transfusion strategy in patients with myocardial infarction. Carson et al.

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Wrestler

Peter Canning

“I can’t wake him up!” The mother says as we come into the bedroom. Her voice and hands are shaking. “He was fine when I went out for groceries. Now he won’t respond.” She is crying. “Honey! Honey!” she says. Her son lies limply back on his bed, breathing only about four times a minute. He is wearing a New York Knicks jersey and has a few days growth of beard.

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Bubble Wrap PLUS – December 23

Don't Forget the Bubbles

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). 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.

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Initial Main Stage Schedule for FAST24 Released

The FllightBridge ED

We are thrilled to announce the early release of our main stage schedule for the upcoming FAST24 conference, taking place in the vibrant city of…

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ACEP Clinical Policy: Sedation of Severely Agitated Patients

FOAMcast

Apple Podcasts , Spotify , Listen Here The American College of Emergency Physicians (ACEP) just released a clinical policy on the management of emergency department patients presenting with severe agitation. This podcast reviews the clinical policy. We previously covered parenteral agents and a small trial of ketamine in this podcast. The policy committee was unable to make any Level A recommendations due to limitations in included studies.