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A 29 year-old-male with a past medical history of left eye enucleation secondary to a gunshot wound several years prior presents to the Emergency Department (ED) for blurry vision, redness, and concern for a deformity to his right eye. The patient states symptoms started 2-3 months ago and he initially thought symptoms were due to allergies and recalls rubbing his eye a lot.
Background: The increased utility and accessibility of point-of-care ultrasound (POCUS) has allowed clinicians the freedom to rethink their diagnostic approach for many common diseases, including peritonsillar abscess (PTA). Clinical evaluation may prove difficult since many PTA and peritonsillar cellulitis symptoms overlap. Physical examination is approximately 75% sensitive and 50% specific for identifying PTA.
Recently, two sets of guidelines for neuroprognostication following cardiac arrest were released – almost simultaneously. In a perfect world, two evidence-based guidelines based on the same evidence would be the same. But of course, this isn't actually the case. The guidelines differ significantly. The Neurocritical Care Society guidelines recommended this general approach:(36949360) Meanwhile, the Canadian […] EMCrit Project by Josh Farkas.
Researchers at MIT have developed lipid nanoparticles that are highly efficient at delivering mRNA therapies to lung cells. Getting therapeutic agents into the lungs can be challenging, but there are a variety of medical challenges that could be addressed by efficiently targeting lung cells with nanoparticle technologies. These latest particles are highly efficient at delivering mRNA which can then encode therapeutically useful proteins in the lungs.
Researchers at the University of Washington have developed GlucoScreen, a smartphone system that can accurately measure blood glucose levels. The technology consists of a test strip onto which a user places a drop of blood. Following an electrochemical reaction on the strip, the data are transmitted to the smartphone through a series of taps on the touch screen, somewhat like Morse code.
Written by Jesse McLaren, with comments from Smith A 50-year old patient on the medical wards developed acute chest pain, with an ECG labeled (see computer interpretation at the top) and confirmed as normal. What do you think? There’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression, and normal voltages. Lead aVL jumps out as abnormal because there is a discordant T wave inversion and mild ST depression.
Ballot measures are used to help support local fire departments and firefighters when funds run low and more budget is needed. For first responders and firefighters, communicating our needs to the public before an election is essential when a ballot measure is on the ballot. It may mean the difference between new equipment, up-to-date training, […] The post Local Ballot Measures for Firefighters in 2023: How Did the People Vote?
Researchers at Northwestern University have developed a transistor that can boost the signal created by electrochemical sensors by 1000-fold. The breakthrough may enable the development of highly sensitive implantable sensors that can measure tiny changes in electrochemical signaling in the body. This could allow clinicians to monitor tissue responses in near real time, instead of running a blood sample on bulky and expensive lab equipment and getting the results hours or even days later.
Article by Erin Lincoln, MD Case Scenario: You are dispatched to a 68-year-old male in cardiac arrest. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. He is found to be in ventricular fibrillation (VF). After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest.
In a lecture series entitled “Get off the fence”, in which I discuss practice changing evidence based medicine, I have discussed the role of antibiotics in diverticulitis multiple times this year. Although I have discussed the topic previously on First10EM, I wanted to provide a quick summary of the most important publications as a quick […] The post Antibiotics are not needed in uncomplicated diverticulitis appeared first on First10EM.
One case sent by Dr. Sean Rees MD, written by Pendell Meyers, other case by Sam Ghali and Steve Smith Take a look at these two ECGs below from two patients in the ED, first without any clinical context. Full case details and outcomes are below. Case 1: Case 2: Case 1: What do you think? This was sent to Dr. Smith by SamGhali (@EM_RESUS) with zero other info.
By Mercedes Fissore-O’Leary Peer Reviewed I. It is his youngest’s birthday today. His oldest is in the military, like he was. Except he served in the navy, in Vietnam. He has a birthday.
My first post went live seven years ago today. A lot has changed since then. Aside from not writing here regularly, I’ve moved, married, changed job roles and have expanded the family with kids. It’s a good opportunity to take time and reflect on how far I’ve come and where I’d like to go next. Anniversaries are only arbitrary if you don’t put in the work to make them significant.
Date: April 12, 2023 Reference: Weizmann et al. Incidence of Cardiac Arrest During Sports Among Women in the European Union. JACC November 2022 Guest Skeptic: Dr. Susanne (Susy) DeMeester is an Emergency Physician practicing at St Charles Medical Center in Bend, Oregon. She has been very involved with EMRAP’s CorePendium as the cardiovascular section editor.
Missing the final 2nd FSX due to other obligations at home (owner being sick) Malpi was eager to attend the final Review Meeting in Brussels on the 4th of April 2023 and meet the Project Officer (PO) and old friends within the INGENIOUS project. For this important trip, it was necessary to dress up, smell good, and look sharp and prepared. Polar bears ( SBFF ) have learned the hard way never to travel on the same day to events/meetings so Malpi travelled the day before, contemplating over what w
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