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We all know that Gravity Works ! While this fact can adversely affect anyone, it offers the greatest challenge for those who cannot protect themselves , like children less than 3 months of age ! We last pondered this in 2011 Morsel , just a couple years after PECARN head injury data was published. Since that time there have been several studies externally validating the PECARN rule in all age groups and in multiple different countries.
I am pleased to announce the availability of my latest paperback book. As a consultant working with agencies across the nation that are representative of many distinct models of service, as well as being an EMS provider and a chief fire officer myself, I feel highly invested in the process to improve strategic dispatch and deployment decisions. It is my unique collective experience gained over more than 13 years of consultation and experimentation that is shared through these pages.
In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life. The post ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes appeared first on Emergency Medicine Cases.
At long last, Core Ultrasound Image Review episode #20! In this episode, we discuss median nerve blocks, fibroids, pneumonia, pleural effusions, CRAO, AAA, abscesses, endocarditis, DVTs, CVC confirmation and gallstones. Check out the YT for the full video! CUIR #19 CUIR #18 CUIR #17 The post Core Ultrasound Image Review, Episode 20! first appeared on Core Ultrasound.
Researchers at Northwestern University have trailed an implanted ultrasound device in patients, which is used in combination with microbubbles to transiently open pores in the blood brain barrier, allowing chemo drugs to enter. We have reported on this technique before as a lab-based concept (see flashbacks below), but this is the first time that it has actually been trialed in human patients, in this case patients with glioblastoma, a difficult to treat brain cancer.
In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key.
Date: April 25, 2023 Reference: Walsh et al. Revisiting “Excited Delirium”: Does the Diagnosis Reflect and Promote Racial Bias? WJEM 2023 Guest Skeptic: Dr. Brooks Walsh is a former paramedic, and is currently an emergency physician in the Bridgeport Hospital, Yale-New Haven Health in Connecticut. This is an SGEM Xtra episode. Brooks reached out to me recently to see […] The post SGEM Xtra: I’m So Excited – But Don’t Call It Excited Delirium first appeared on The Skeptics Guide to Emergency Medi
Date: April 25, 2023 Reference: Walsh et al. Revisiting “Excited Delirium”: Does the Diagnosis Reflect and Promote Racial Bias? WJEM 2023 Guest Skeptic: Dr. Brooks Walsh is a former paramedic, and is currently an emergency physician in the Bridgeport Hospital, Yale-New Haven Health in Connecticut. This is an SGEM Xtra episode. Brooks reached out to me recently to see […] The post SGEM Xtra: I’m So Excited – But Don’t Call It Excited Delirium first appeared on The Skeptics Guide to Emergency Medi
At long last, Core Ultrasound Image Review episode #20! In this episode, we discuss median nerve blocks, fibroids, pneumonia, pleural effusions, CRAO, AAA, abscesses, endocarditis, DVTs, CVC confirmation and gallstones. Check out the YT for the full video!
Researchers at the University of Texas at Austin have developed a new chest wearable that can obtain both electrocardiogram and seismocardiogram data from the underlying heart. While basic ECG can be monitored via smart watches, no other wearable combines it with seismocardiography, which would conventionally be obtained by listening to the heart using a stethoscope.
In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key.
Bryan and Brandon share their favorite podcasts, blogs, social media, and other online channels for medical education. Podcasts Blogs/websites Twitter accounts So, with Twitter, we could post all day and still leave a bunch of people out. Here are a few…the best way to find good Twitter followers is to start with these and see … Continue reading "Lightning rounds #27: Our favorite FOAM" Bryan and Brandon share their favorite podcasts, blogs, social media, and other online channels for medical ed
Researchers at the University of California San Diego have developed a wearable ultrasound patch that is intended to provide information on the stiffness of underlying tissues as deep as 4 cm below the surface of the skin. The patch consists of a flexible 16 x 16 ultrasonic array with a silver-epoxy composite backing layer that is designed to absorb excessive vibrations.
In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life. The post ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes appeared first on Emergency Medicine Cases.
In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. We’ve incorporated some of our favourite elements from their presentations in this blog post. You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. You’re just about aware of the tannoy in the background.
Researchers at Houston Methodist have developed an implant that can provide localized and sustained release of immunotherapies to treat pancreatic cancer. Their device is tiny, at approximately the size of a grain of rice, and they have termed it a “nanofluidic drug-eluting seed” Pancreatic cancer is particularly difficult to treat, and current therapies have problems penetrating the tumor while resulting in significant side-effects elsewhere in the body.
Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. 1, 2 Phenobarbital has been studied as an alternative or adjunct to benzodiazepines with encouraging results, but primarily among inpatient services. 3, 4 Much of the appeal of phenobarbital lies in its ability to stave off severe alcohol withdrawal symptoms days after administration, without
PH = 7.395, that is within normal range. pCO2 = 42 mmHg, Normal for venous blood gases ( Normal pCO2 is 40 mmHg for arterial blood and 48 mmHg for venous). HCO3 = 25 mmol/L.
Researchers at MIT have developed an ‘electroceutical’ capsule that is designed to be swallowed and which will deliver a small electrical current to the stomach wall. The device contains an external electrode that wraps around its exterior and small grooves that draw liquid away from the electrode and help it to contact the stomach wall.
Question I was shocked to see bank runs in March 2023. I thought those went away after regulatory changes in the Great Depression. What takeaway should there be from the troubles that Silicon Valley Bank (SVB) and other banks had during March 2023? Answer In March 2023, depositors of SVB engaged in a classic “bank run” that resulted in the Federal Deposit Insurance Corporation (FDIC) stepping in and putting the bank into receivership.
Background: Clinically significant pneumothoraces in patients on mechanical ventilation can be dangerous as positive pressure ventilation can cause an increase in intrapleural pressure and trigger tension physiology. Occult pneumothoraces are those not suspected clinically or not evident on plain radiographs but later identified on computerized tomography (CT) imaging.
This was sent by a colleague. A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go. She had one BP that was measured at 160/120, uncertain when and what the BP was at other moments.
A team of medical engineers at Cornell University has developed a knitted glove that is designed to treat hand edema, where fluid accumulation leads to swelling in the hands. The condition can make it difficult for patients to perform daily activities, and current treatment often involves receiving a manual edema massage performed by a trained healthcare worker.
1-year-old Ruby presents with pallor and faltering growth. She is of Asian origin and has a family history of thalassaemia. Her blood tests show a microcytic anaemia. What do you do next? Thalassaemias are inherited blood disorders that can cause anaemia. Usually, haemoglobin, comprised of four globin chains and a haem group, carry oxygen around the body.
Take Home Points Many patients with renal colic require a CT scan. Diagnostic imaging should focus on eliminating concerning mimics; not on clinching the diagnosis of renal colic. POCUS and radiology department US are important modalities in evaluation of renal colic. REBEL Core Cast 101.0 – Imaging in Renal Colic Click here for Direct Download of the Podcast References Moore CL et al.
Sent by Pete McKenna M.D. Edits by Meyers and Smith A man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of acute chest pain. Triage ECG: What do you think? This is diagnostic of proximal LAD occlusion. This is a huge anterolateral OMI. Deadly. I cannot be anything else.
Researcher scientists at the University of Texas at Austin have developed a brain decoding technology that combines an fMRI scanner and artificial intelligence, similar to well-known AI systems such ChatGPT or Bard. The technology can spell out our thoughts in text form, but more importantly may allow patients who cannot otherwise communicate, such as those experiencing significant paralysis, to communicate their thoughts.
About one billion doses of acetaminophen are taken safely per annum, and 60 million people in the U.S. take acetaminophen on a weekly basis. 1,2 With such enormous popularity it is no surprise that each year there are 56,000 emergency department (ED) visits, 2,600 hospitalizations, and 500 deaths in the U.S. related to acetaminophen toxicity. 2 Some cases of acetaminophen toxicity are simple to recognize and manage, such as an intentional single recent ingestion of a large number of regular-rele
Check out 90 Seconds: The Epic Story of Eli Beer! Support EMS 20/20 by purchasing through our affiliate links below: Amazon: [link] ArtScroll (Publisher): [link] Pitter patter! New episode out TODAY! Chris hops on a bus driven by Spencer headed to struggle street when it comes to a wonky ECG. To STEMI or not to STEMI? Can Chris get it right, or is he 10-ply?
Researchers at ETH Zurich in Switzerland have developed a high-throughput screening method for anti-cancer drugs that they have called “pharmascopy” To date, the researchers have tested the system with multiple myeloma samples, a cancer that has a poor prognosis and is difficult to treat because of drug resistance. In such cancers, finding the right drug or drug combination for a given patent is critical.
ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.
NEJM study in 2016 showed no survival benefits or favorable neurological outcome regarding use of Amiodarone vs Lidocaine vs placebo in OHCA. In a recent publication by Acad Emerg Med , a post hoc analysis of original study was done and the authors found time to Amiodarone in OHCA could be associated with better survival to discharge if it was given within 8 minutes.
RF (radio frequency) technology uses radio waves to transmit and receive information wirelessly. RF is often seen in health monitoring devices such as wearables, implants, remote monitoring systems, and telemedicine. Mostly, though, it is used for communications, but the folks at Movano Health believe that they can use RF to monitor things like blood pressure and blood glucose.
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