Sat.Nov 04, 2023 - Fri.Nov 10, 2023

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Journal Club 5 Appendicitis Delay to Appendectomy – Safe?

Emergency Medicine Cases

You diagnose uncomplicated appendicitis in the ED. The on call General Surgery team wants to wait until the next morning to perform an appendectomy. Is your patient at risk for appendiceal perforation with a delay to surgery? Dr. Rohit Mohindra and Dr. Shelley McLeod analyze the latest RCT that attempts to answer this question, the PERFECT study, on this EM Cases Journal Club.

EMS 254
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SAEM Clinical Images Series: Wolf in Sheep’s Clothing

ALiEM

A 55-year-old female with a history of hyperlipidemia presents after a syncopal episode. She had mild nausea and diarrhea on the morning of presentation but otherwise had no prodromal symptoms before suddenly losing consciousness in a grocery store. Of note, she recalls a similar syncopal episode in the remote past, also preceded by gastrointestinal symptoms at that time.

OR 195
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Crash Responder Safety Week, November 13–17, 2023

American Ambulance Association

Take Part in Crash Responder Safety Week, November 13–17, 2023 Crash Responder Safety Week (CRSW) takes place November 13 –17, 2023. Emergency medical services (EMS) and other emergency responders provide care […] The post Crash Responder Safety Week, November 13–17, 2023 appeared first on American Ambulance Association.

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Episode 67: Whipples with Michael Cavnar

Critical Care Scenarios

We learn about pancreaticoduodenectomy (the Whipple) with Michael Cavnar (@DrMikeCavnar), surgical oncologist at University of Kentucky, with a fellowship in Complex General Surgical Oncology from Sloan Kettering. He specializes in GI surgical oncology (liver, pancreas, stomach, etc), with ongoing research in GI stromal tumors and hepatic artery infusion pump chemotherapy.

ICU 130
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Ep 188 Hemoptysis – ED Approach and Management

Emergency Medicine Cases

Key principles and approach to management of both non-massive and massive hemoptysis with Dr. Scott Weingart and Dr. Bourke Tillmann, who answer questions such as: What are the factors to consider in the decision to intubate patients with massive hemoptysis? How can one reliably distinguish hemoptysis from pseudohemoptysis? What is the evidence for tranexamic acid in patients with hemoptysis?

ED 226
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SAEM Clinical Images Series: Man with a Recurrent Rash

ALiEM

A 33-year-old male presented to the emergency department with a diffuse pruritic rash that appeared several days after starting Trimethoprim/Sulfamethoxazole (TMP-SMX) for a dental infection. Initially beginning on the torso and low back, the rash spread to the palms, soles, and genitalia. Progression stopped after discontinuing TMP-SMX. He conveyed a remote history of a similar rash following use of an unknown medication, and noted that several of the current lesions arose at the same location

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The Difficulty of an EMT class

Chicago EMT Training

The class usually starts out optimistic and hopeful with how the rest of the semester will play out. Not unlike when I applied to Malcolm X College years ago, we try to forewarn the amount of time it takes to truly understand the material in this class. It's not inherently difficult but rather the volume of content that is overwhelming. We all have something going in outside of the EMT class.

EMT 130

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Global EM 5 Is it Ethical? 5 Core Principles When Choosing a Global Health Project

Emergency Medicine Cases

Dr. Navpreet Sahsi outlines 5 core ethical principles in choosing and participating a global health project on EM Cases' Global EM blog. The post Global EM 5 Is it Ethical? 5 Core Principles When Choosing a Global Health Project appeared first on Emergency Medicine Cases.

EMS 133
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SGEM Xtra: Say What You Need to Say…but Don’t Say “Sepsis Screening”

The Skeptics' Guide to EM

Reference: Roland D, Munro A. Time for paediatrics to screen out sepsis “screening.” BMJ. June 2023 Date: Sept 12, 2023 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Professor for the University of Leicester’s SAPPHIRE group. He specializes in Paediatric Emergency Medicine and is a passionate […] The post SGEM Xtra: Say What You Need to Say…but Don’t Say “Sepsis Screening” first appeared on The Skeptics Guide to Emergency Medicine.

OR 129
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"I Need a Medic!"

Chicago EMT Training

We occasionally get an inquiry asking to become a paramedic. It's encouraging to hear that there is still interest in becoming first responders! A quick breakdown on the differences between an EMT-B(asic) and an EMT-P(aramedic) Basic Life Support (BLS) vs Advanced Life Support (ALS) So there it is. The two main levels of care you would probably see in the prehospital setting.

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Imaging Case of the Week 571

EMergucate

The following knee x-ray is from an adult with knee swelling post twisting injury. What can be seen?

EMS 130
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Welch, Sanders, & Balint Introduce Treatment in Place Bill

American Ambulance Association

This content is for AAA members only. Please either Log In or Join! The post Welch, Sanders, & Balint Introduce Treatment in Place Bill appeared first on American Ambulance Association.

Ambulance 100
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Glasses Provide Audible Prompts for Blind Wearers

Medgadget

A team at the University of Technology Sydney has developed an assistive technology for blind people and those with low vision. The system consists of glasses that can view their surroundings through an on-board camera, appraise the objects nearby using computer vision technology, and then play a sound that provides a cue for the wearer as to their surroundings.

OR 114
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Decision Rules are Destroying Medicine

Broome Docs

Controversial title… courtesy of Dr Justin Morgenstern. In this podcast Justin tells me about the evidentiary basis for our modern obsession with clinical decision rules and tools. We discuss the reasons that these tools may seem like a great idea, the reality of practice and how we may be able to do better in the future. So if you have ever used a decision tool in the ED – Wells, Ottawa, PECARN, San Francisco, HEART… or any other acronym you need to stop and have a listen to u

ED 102
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hypertonic saline versus Mannitol, the unresolved question

EMergucate

Comparison of Intracranial Pressure Measurements Before and After Hypertonic Saline or Mannitol Treatment in Children With Severe Traumatic Brain Injury Patrick M.

OR 100
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November 2023 News from the College

ACEP Now

ACEP Calls Out Insurer Abuses During Surprise Billing Congressional Hearing ACEP member Seth Bleier, MD, FACEP, testified in front of the influential House Ways and Means Committee during a public hearing in October to call out insurers and advocate for fixes to the severely flawed implementation of the No Surprises Act. Dr. Bleier raised concerns that the Independent Dispute Resolution process has been virtually inaccessible for smaller practices and called out cases where physician groups were

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Robotic Ankle Helps with Postural Control in Amputees

Medgadget

Researchers at North Carolina State University have developed a robotic prosthetic ankle that can provide stability for lower limb amputees. The ankle uses electromyographic sensors placed on the sites of muscles in the residual limb that then convey the intentions of the wearer with regard to movement. So far, the system has been shown to assist with postural control, which in this context refers to the many complex and unconscious movements that the muscles in our legs make to maintain balance

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Wide complex and apparent hyperacute T-waves. Does absence of change from previous ECG mean that it is not New?

Dr. Smith's ECG Blog

By Magnus Nossen, edits by Grauer and Smith The patient is a 70-something female with DMII, HTN and an extensive prior history of coronary artery disease and myocardial infarctions. She's had multiple PCI procedures. She also has sick sinus syndrome (SSS) and intermittent high grade AV block for which she had a dual chamber pacemaker implanted. On the day of presentation she complained of typical chest pain, and stated it feels like prior MI.

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. Top 10 Take Home Pearls 1. Treatment of cardiac arrest and life-threatening toxicity due to poisoning often requires specialized treatments that most clinicians do not use frequentl

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Lab case 426

EMergucate

60-year-old women presented to the emergency department compla ining of headache and fatigue.

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Magnetic Dressing Improves Diabetic Wound Healing

Medgadget

Researchers at the National University of Singapore have developed a magneto-responsive hydrogel wound dressing that also contains two different regenerative cell types. The hydrogel is also embedded with magnetic particles that can be stimulated using an external magnetic field. The action of the magnetic field on the gel-encapsulated particles causes mechanical stresses within the gel to act on the cells, stimulating them to grow and enhancing their regenerative potential.

OR 102
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EMCrit 361 – Life Threatening Tox and Toxicologic Cardiac Arrests from the AHA

EMCrit Project

AHA Guidelines on Critical Care Toxicology EMCrit Project by Scott Weingart, MD FCCM.

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emDOCs Podcast – Episode 89: Antibiotics for Uncomplicated Diverticulitis

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we discuss the controversy of antibiotics for patients with uncomplicated diverticulitis. For more on the ED evaluation of diverticulitis, please see Part 1. Episode 89: Antibiotics for Uncomplicated Diverticulitis Background: Previously antibiotics were utilized for all patients with diverticulitis.

ACPE 88
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The power of children’s books

Don't Forget the Bubbles

Starting conversations with stories There’s something about a bookshop – a calm and comforting sense that I am surrounded by stories. The knowledge that within each beautiful book are words, illustrations, and photographs from which I can learn so much. I gently run my fingers over the front cover of a book that I know my daughter will like. Turning it over, I scan the back.

OR 86
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A Wearable to Manage Parkinson’s Motor Symptoms: Interview with Lucy Jung, CEO at Charco Neurotech

Medgadget

Charco Neurotech , a medtech company based in the United Kingdom, has developed CUE1, a non-invasive wearable that is intended to assist those with Parkinson’s disease to manage their motor symptoms. The device is typically affixed to the sternum, and provides vibratory action in a focused region of the body. The technology is based on the observation of a doctor in the early 1800s, who noticed that their patients’ motor symptoms were significantly reduced when they traveled to their appoi

OR 82
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Explain this ECG in the context of active chest pain, slightly elevated troponin without a delta, RCA culprit, and previous with LBBB

Dr. Smith's ECG Blog

A 60-something yo female presented w/ exertional chest pain for 3 days. She had a recent positive stress test about one week ago. Pain was 8/10 and constant. She has been experiencing progressively worsening exertional dyspnea and chest tightness mostly when climbing up flights of stairs since early September. She underwent exercise echocardiogram in mid October where she exercised for nearly 7 minutes on the standard Bruce protocol and had typical anginal pain and shortness of breath.

E-9-1-1 81
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EM@3AM: Testicular/Scrotal Abscesses

EMDocs

Authors: Jacob Kirkland, MD (EM Resident Physician, UTSW – Dallas, TX); Steve Field, DO (Assistant Professor of EM/Attending Physician, UTSW – Dallas, TX) // Reviewed by: Sophia Görgens, MD (EM Fellow 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 expedited rev

EMS 68
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Research Roundup: Old article dump

First 10 EM

One of the downsides of subscribing to more than 50 journal feeds is the huge number of interesting papers that I flag for later, but never find time to return to. I have started clearing out old PDFs for papers I never found time to fully appraise, but I figured that if the titles caught […] The post Research Roundup: Old article dump appeared first on First10EM.

EMS 61
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Collaborate Live 2023 – Joshua Parish – Learning

FirstWatch

FirstWatch customer-partner, Joshua Parish, Assistant Chief, Milwaukee Fire Dept, takeaway from Collaborate Live 2023 – Discovering more of what FirstWatch does. The post Collaborate Live 2023 – Joshua Parish – Learning appeared first on FirstWatch.

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15 Things Every EMT Should Carry

Unitek EMT

The importance of a well-stocked and organized medical kit. Emergency Medical Technicians (EMTs) are critical first responders in the field of emergency healthcare. They play a pivotal role in providing immediate medical care to individuals in crisis situations, whether it’s responding to accidents, medical emergencies, or natural disasters. EMTs are often the first point of […] The post 15 Things Every EMT Should Carry appeared first on Unitek EMT.

EMT 52
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Episode 80 – A Scleroderma Crisis

The Curious Clinicians

Why do we use ACE inhibitors to treat scleroderma renal crisis? In a day of seeing adult patients in any type of clinic, it’d be hard to not hear the words “ACE inhibitor” at least once. Since the introduction of captopril in the mid-1970s and subsequent family members like lisinopril, ACE inhibitors have been game changers in controlling blood pressure, preventing cardiac remodeling, and protecting renal function.

ACS 52
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Episode 128 Skin Cancer: We love and fear the sun

This Podcast Will Kill You

For every article about the risks of sun exposure or a guide to sunscreens, you don’t have to look far to find one about the health benefits of sunshine or a how-to for achieving the best tan. Messaging around sun exposure is mixed, to say the least, and it’s no wonder that despite having more sun protection tools than ever before, rates of skin cancer have never been higher.

E-9-1-1 52
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Collaborate Live 2023 – Joshua Parish – Networking

FirstWatch

FirstWatch customer-partner, Joshua Parish, Assistant Chief, Milwaukee Fire Dept, takeaway from Collaborate Live 2023 – Training with the FirstWatch team and networking with other agencies. The post Collaborate Live 2023 – Joshua Parish – Networking appeared first on FirstWatch.

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ACEP Council Tackles Key Issues During Philadelphia Meeting

ACEP Now

More than 60 resolutions were considered during the ACEP23 Council Meeting in Philadelphia in October, with many of them drawing considerable debate before 44 were ultimately adopted. The ACEP Council, the College’s representative governing body, meets annually to discuss and consider resolutions on issues impacting emergency physicians. The Council consists of members representing ACEP’s 53 chapters, 39 sections of membership, the Association of Academic Chairs of Emergency Medicine, the Counci

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Episode 104: Dan Gerard and Whole Blood

The Overrun Podcast

Dan Gerard is the president of the International Association of EMS Chiefs, who authored a position statement in August of 2023 supporting the use of whole blood as the standard of care for hemorrhagic injury. IAEMSC joins a growing list of national and international organizations that support this change. In this interview, Ed and Dan talk to Dan Gerard who explains the rationale behind the position statement and the change they hope to make with the position statement.

EMS 52
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The Results Are In: 2022 General Election Impact

Firefighters and EMS Fund

During the 2022 general election, Firefighters and EMS Fund tested its singular capability to turn out voters in support of Pro-Fire and EMS politicians and encourage them to support ballot measures that will benefit their local fire departments. We chose to engage citizens who did not vote in recent elections, indicating those voters were under-served […] The post The Results Are In: 2022 General Election Impact appeared first on Firefighters and EMS Fund.

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Collaborate Live 2023 – Santo Pasqua – HTSD

FirstWatch

FirstWatch customer-partner, Santo Pasqua, Deputy Chief, Hamilton Paramedic Service, takeaway from Collaborate Live 2023 – Offload delays and the FirstWatch Hospital Transport Status Dashboard. The post Collaborate Live 2023 – Santo Pasqua – HTSD appeared first on FirstWatch.