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Date: October 20, 2023 Reference: Cai et al. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: You are in your group meeting and have heard about a case at a nearby emergency department (ED) where the […] The post SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess first appeared on The Skeptics Guide to Emergency Medicine.
A 26-year-old male with no significant past medical history presented to the ED after slipping on wet pavement and hitting his head on the ground three hours prior. He endorsed a constant, achy 7/10 headache accompanied by nausea and photophobia. He denied vomiting, dizziness, diplopia, loss of consciousness, or seizures. Nothing made it better or worse.
Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Dr. James Broselow, a family medicine-turned-emergency medicine physician from Hickory, North Carolina , recognized that his team spent a lot of time trying to calculate doses of medications rather than spending their mental energy on the actual medical decisions for the resuscitation.
A 70 something male presented in severe respiratory distress. The patient had altered mental status and so he was prepared for intubation. Before intubation, he became hypotensive. On the monitor patient had wide-complex tachycardia. The following 12-lead was obtained: What do you think? Differential is ventricular tachycardia versus supraventricular tachycardia with aberrancy versus sinus tachycardia with a aberrancy.
The National EMS Advisory Council (NEMSAC) will host a hybrid meeting on Wednesday and Thursday, November 15-16, 2023, from 1:00 pm – 4:15 PM ET. Join us for national EMS program […] The post National EMS Advisory Council Meeting November 15-16, 2023 appeared first on American Ambulance Association.
A 32-year-old man with a history of traumatic globe rupture from a stab wound two months ago, status post repair, presented to the emergency department for worsening right eye pain and green malodorous drainage for the past three days. These symptoms started when he got a fleck of sawdust in the right eye about four days prior to presentation, which he was able to brush out with his finger.
We chat with Janelle Bludorn (@JanelleRBlu), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia. Find us on Patreon here! Buy your merch here! Resources We chat with Janelle Bludorn ( @JanelleRBlu ), former emergency medicine PA, Assistant Professor and Academic Coordinator at the Duke PA program, about transitioning from clinical work into teaching and academia.
Written by Michael Doyle DO and Timothy Palmieri MD. Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm. By EMS report, open pill bottles were found nearby at the scene, including quetiapine, fluoxetine, hydroxyzine, and gabapentin.
Written by Michael Doyle DO and Timothy Palmieri MD. Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm. By EMS report, open pill bottles were found nearby at the scene, including quetiapine, fluoxetine, hydroxyzine, and gabapentin.
The Problem: Emergency Medicine (EM) in Pakistan has moved from developing to developed stage in the last decade [1]. As the specialty evolves in Pakistan and other countries, there is a need to improve and assimilate novel learning methods to elevate education standards. The COVID-19 pandemic catalyzed the routine use of video-conference platforms such as Zoom.
Some folks on twitter asked my thoughts on AMIKINHAL trial, so I thought I'd jot them here. AMIKINHAL is a multi-center RCT that evaluated the ability of inhaled amikacin to prevent VAP (ventilator-associated pneumonia) among patients who had been intubated for three days. It's available here at NEJM. It was a positive trial, which is […] EMCrit Project by Josh Farkas.
Case Your patient is bleeding. A lot. Their vital signs are abnormal. They look very sick. (I am being intentionally vague, because the post is going to look at massive hemorrhage in general, rather than getting into the specifics of any one condition.) This post is a condensed clinical summary of appropriate actions in the […] The post Massive hemorrhage: The clinical approach appeared first on First10EM.
Maryland enacted the first “prudent layperson standard” (PLP) in state law in 1993 (see related timeline). The PLP standard they devised protected a patient’s access to emergency medical services, including on-call services, if the medical condition of the patient manifests itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson could reasonably expect that the absence of immediate medical attention could result in serious jeopardy to the health of t
A 3-year-old girl presents with acute onset convergent strabismus. Fundoscopy examination reveals papilloedema. What are the next steps in the management of their daughter? First thoughts – is this a space-occupying lesion? If you haven’t seen it already, please check out HeadSmart. It details presentations commonly associated with a brain tumour in each age group.
More guidelines! Today we'll walk through some interesting bits of the new IDSA/SCCM guideline on evaluation of new fever in the adult ICU patient (available free here). how should temperature be evaluated? This is frankly a mess. Bladder catheter or esophageal probe are best, but usually not used. Rectal temperature is 2nd best, but unwieldy […] EMCrit Project by Josh Farkas.
Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc. A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store. He did not have chest pain. Here is his triage ECG: What do you think?
In trauma patients with exsanguinating haemorrhage, does the use of the REBOA (resuscitative endovascular balloon occlusion of the aorta) device with standard care in the emergency department, compared with standard care alone, impact 90-day-mortality?
This content is for AAA members only. Please either Log In or Join! The post Clarification: Applicability of NSA to Ground Ambulance Services appeared first on American Ambulance Association.
Author: Devin Morris, MD (EM Resident Physician, UTSW / Parkland Memorial Hospital); Colin Danko, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Görgens, MD (EM Resident Physician, Zucker-Northwell NS/LIJ, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an exped
Take Home Points: A CCTA is an anatomic test to determine if a patient has normal coronary arteries, non-obstructive disease, or obstructive disease. The warranty period for a CCTA is anywhere from 3-10 years depending on the characteristics of the plaque. A nuclear stress test is a functional study that allows for ischemia-driven management. The warranty period of a nuclear stress test is 2 years.
Researchers at the University of Massachusetts Amherst have developed a new method of detecting very small amounts of DNA. The breakthrough could allow clinicians to spot genetic markers of disease at the point-of-care, as the approach does not require conventional laboratory analysis, which is usually time-consuming and costly. In fact, the approach has led to a 100-fold increase in DNA detection sensitivity, with no corresponding increase in cost.
A 5-month-old infant presents to the Paediatric ED. His parents have noticed that he has been making funny movements’ over the last few weeks. He has also seemed a bit more withdrawn and miserable. “Could it be colic? Or reflux?” they ask. This is a fairly common presentation with small babies. Determining what parents mean by ‘funny movements’ can be hard.
A 5-year-old boy is brought in by his parent for a dental injury. The patient was walking his dog when it ran after a squirrel. The patient was pulled forward, causing him to hit his tooth on the asphalt. His parent noticed a dental problem and immediately brought the patient to the ED. The physical exam is shown below. Which of the following is the best next recommendation?
Researchers at Northwestern University have developed a sophisticated microfluidic system that incorporates tissue from up to eight different organ systems. The technology is unprecedented in allowing researchers to study complex interactions between different organs during disease. Moreover, it also allows for more comprehensive drug testing that investigates the effects of drug candidates on multiple organ systems at once.
Check out the First Responders Wellness Center Fall Newsletter with articles on the fight-or-flight hormone cortisol, stress and burnout, Q&A with Dr. Carrie Steiner, grounding tools for your coping toolbelt, and information about what to expect during annual wellness visits.
The Case A two-year-old female, seen three days ago at different local emergency department (ED)—Children’s General—presents with fever, headache, and neck pain. Her parents say that when she was previously seen, blood and urine were tested, and some type of X-ray and a spinal tap were performed. They were told she might have a kidney infection and she was prescribed cephalexin (Keflex).
@RobertHermanMD on Making Waves from Mayo clinic. Artificial Intelligence-Augmented ECG Interpretation Using Smartphone Technology @TheEKGGuy [link] == MY Comment , by K EN G RAUER, MD ( 10/26 /2023 ): == Our THANKS to Drs. Anthony Kashou & Robert Herman for their wonderful ongoing work toward continued evolution and improvement of clinical ECG utilization.
Researchers at ETH Zurich in Switzerland have developed an alternative to injections as a way to deliver large drugs, such as peptides, minimally invasively into the blood stream. The suction cup created by these researchers is inspired by octopus suckers, and it affixes to the mucosal lining of the inside of the cheek. The cup stays in place because a vacuum is drawn when the patient presses it onto their cheek lining.
Partnering with Cordico, the Gurnee Police Department recently announced their comprehensive and confidential WELLNESS APP! This app provides mental health wellness tools to the department and their families right on their smart devices. Officers will be able to practice mindfulness, learn about resilience, find a culturally competent therapist, self-assess their behavioral health, get work-out videos, and get the support they need for mental and physical wellness.
“So how long has he been in jail? I mean his core temp is 27.” I think that the only acceptable answer from the corrections officers at that time would have been “20 minutes or less,” but that was not the response. I sighed, wondering if I was the only person who thought that this situation was dubious. After perusing this with residents and colleagues for more than five years, I now think the nature of the possible prisoner-abuse situation would have been clear to anyone, but the next steps ha
By Matthew Auda Peer Reviewed Let’s begin with a case. The patient is a 67-year-old female with a past medical history of hypothyroidism referred to your Cardiology Clinic by her primary care physician for cardiovascular disease.
Researchers at MIT have developed an enhanced mRNA vaccine system that can elicit a greater immune response at lower doses. The vaccine technology is so potent that it may be useful for intranasal COVID-19 vaccines. This would have the benefit of localized immunity in the nasal mucus membranes that could kill the SARS-CoV-2 virus before it enters the body.
Chicago Police Officers-FOP Wellness Fair Today 1200-2000 Homan Square 3340 W Filmore. We will be in the 3rd floor conference room. Please come we have goodie bags for you!
On the night of December 2, 1984, a deadly gas leak at the Union Carbide pesticide plant in Bhopal, India led to what has been described as the world’s worst industrial disaster. In the immediate aftermath of the gas leak, thousands of people died and hundreds of thousands were injured from exposure to the toxic gas methyl isocyanate. But long after the international headlines and news reports dwindled to silence, long after Union Carbide paid a paltry settlement to survivors, long after the dis
A 72-year-old male presents to the emergency department (ED) with severe chest pain and difficulty breathing after an MVC. Physical examination reveals tenderness and localized swelling over the left lateral chest wall, with X-ray confirming multiple rib fractures. The patient’s vital signs are stable, but he is visibly distressed and struggling to find a comfortable position.
Cleveland, Ohio- FlightBridgeED proudly announces the appointment of its esteemed educators, Ashley Bauer and Eric Bauer, as Adjunct Faculty at the prestigious Case Western Reserve…
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