Pediatric EM Morsels

JUNE 30, 2023

I’m sure you can recall at least several parents who bring their children into the ED for concern of recurrent pneumonias. Often the parents focus on a possible underlying immunodeficiency. Fortunately, most commonly these pneumonias are due to viral infections, and we can often offer reassurances to the parent. The differential could also include aspiration , asthma , and bronchiectasis depending on the patient’s history.

E-9-1-1 258

E-9-1-1 ED EMS OR 258

Emergency Medicine Cases

JUNE 27, 2023

We miss potentially dangerous and even lethal drug interactions in EM more often than we realize. In this main episode EM Cases podcast with Dr. David Juurlink and Dr. Walter Himmel we review the common categories of drugs, the high risk patients and the key drug interactions that we need to know about in Emergency Medicine. The post Ep 184 Must Know Drug Interactions in Emergency Medicine appeared first on Emergency Medicine Cases.

EMS 185

EMS 185

The Skeptics' Guide to EM

JUNE 24, 2023

Date: June 16, 2023 Reference: Reed et al. Pilot Testing Fentanyl Test Strip Distribution in an Emergency Department Setting: Experiences, Lessons Learned, and Suggestions from Staff. AEM June 2023 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate.

Overdose 179

Overdose Emergency Department ALS ED 179

Don't Forget the Bubbles

JUNE 30, 2023

A PEM adventure It’s time for another PEM adventure. Join us on another journey (with an inbuilt time travel machine) in managing Elsa, a 2-year-old girl who is a HUGE fan of the Disney movie, Frozen. Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. Emergency Medical Services found her apneic and pulseless.

CPR 145

CPR Life Support Critical Care ALS 145

EMergucate

JUNE 26, 2023

The chest x-ray shows features of right middle lobe pneumonia. There is air space opacity silhouetting the right heart border.

EMS 130

EMS 130

Emergency Medicine Cases

JUNE 26, 2023

With increasing forest fires, heat waves, floods, storms, vector-borne illnesses and heat waves, the emergency department is uniquely positioned to declare sentinel events, advocate on behalf of vulnerable populations and lead by example. Dr. Matt Douglas-Vail explains the need for Increased education on climate change and planetary health, Increased resource allocation in emergency departments for climate-related pathologies and increased disaster planning for climate-related emergencies on thi

EMS 163

EMS Emergency Department 163

Critical Care Scenarios

JUNE 28, 2023

The value of performing chart checks to see how your patients are doing after your care. The value of performing chart checks to see how your patients are doing after your care.

100

100

EMergucate

JUNE 27, 2023

The following chest x-ray is from an adolescent with chest pain, fever and dyspnoea. What can be seen?

EMS 130

EMS 130

First 10 EM

JUNE 26, 2023

I think the conclusions of the paper are incredibly obvious, and therefore not practice changing, but I worry that a superficial read might lead to misinterpretation, and therefore the paper is probably worth covering. (This is the same research group that published the infamous PESIT study, and all the subsequent misinformation about PE risk in […] The post PE risk in severe exertional dyspnea appeared first on First10EM.

EMS 117

EMS 117

Medgadget

JUNE 28, 2023

Researchers at the University of Connecticut have developed an ultrasound implant that can assist in opening the blood brain barrier to allow chemotherapy to enter and treat brain cancer. However, unlike cumbersome ultrasound systems, this technology can be implanted directly into the brain, and does not require a follow-up surgery to remove the device later as it degrades away to nothing in the brain over time.

86

86

Don't Forget the Bubbles

JUNE 26, 2023

In this case-based article, we’ll talk about single ventricle defects and their management (both medical and surgical), then look at the two main shunt options during Stage 1 reconstruction. Single ventricle defects Many complex congenital heart defects have single ventricle physiology. This means that one ventricle is too small, weak or obstructed to pump effectively, leaving the other ventricle to supply both systemic and pulmonary circulations in parallel via a shunt such as the ductus

Critical Care 128

Critical Care ALS OR CPR 128

EMergucate

JUNE 26, 2023

Boot shaped heart The frontal chest x-ray shows boot-shaped heart and pulmonary plethora.

EMS 130

EMS 130

EMDocs

JUNE 24, 2023

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: How to Improve STI Test Accuracy – Swab or Urine? Spoon Feed Vaginal swabs are more accurate than urine samples in diagnosing Chlamydia trachomatis , Neisseria gonorrhoeae , and Trichomonas vaginalis.

OR 77

OR 77

Medgadget

JUNE 26, 2023

BBy , a medtech company based in New York, has developed a spray drying method that hospitals can use to process human breast milk into a shelf-stable powder. Human breast milk is an incredibly important source of nutrition for neonates in intensive care units (NICUs). At present, human donor milk is frozen and must be defrosted prior to use in such facilities.

OR 84

OR 84

Dr. Smith's ECG Blog

JUNE 26, 2023

== MY Comment , by K EN G RAUER, MD ( 6/26 /2023 ): == The tracing in Figure-1 was sent to me — without the benefit of any history. How would YOU interpret this tracing? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Initial Thoughts: My attention was immediately drawn to the long lead rhythm strip in Figure-1.

ED 79

ED OR 79

EMergucate

JUNE 26, 2023

The neck x-ray shows Diffuse subcutaneous emphysema in the neck.

EMS 130

EMS 130

EMDocs

JUNE 28, 2023

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

EMS 68

EMS ED OR 68

Medgadget

JUNE 26, 2023

Scientists at Rice University have developed a highly flexible nanoelectrode that is designed for long-term implantation in the brain. The brain stimulation provided by the technology is incredibly fine-grained, thanks to the very low current it can deliver. This results in a very discrete area of neurostimulation, potentially allowing for much finer control of small groups of neurons.

OR 78

OR 78

EMCrit Project

JUNE 29, 2023

So today we have our June-u-airway update. A bunch of papers and thoughts on how you should be intubating in 2023. DSI for everyone, induction agent choice, apox and much more! EMCrit Project by Scott Weingart, MD FCCM.

66

66

EMergucate

JUNE 25, 2023

80 year old lady presented with recurrent vomiting after colonoscopy. Her venous blood gases showed the following: PH = 7.

100

100

University of Maryland Department of Emergency Med

JUNE 24, 2023

Use of intravenous lidocaine has been proposed as an adjunct/replacement for opioids in trauma patients with rib fractures. These small st.

71

71

Medgadget

JUNE 28, 2023

Researchers at MIT have developed a metal-free electrode using conductive polymers. The electrode is flexible and strong enough for long-term implantation in the body. The device is intended as an advanced replacement for rigid metal electrodes that can cause tissue damage and scarring over the long term, leading to device failure. The new technology required quite a bit of refinement to achieve the correct properties of flexibility, strength, and electrical conductivity.

OR 69

OR 69

Prehospital Emergency Care Podcast

JUNE 30, 2023

For paramedics, click HERE for CAPCE credits! The next frontier in Prehospital medicine is prehospital blood use. The AABB (formerly the American Association of Blood Banks) is an international authority on transfusion medicine and tissue banking. The Trauma, Hemostasis and Oxygenation Research (THOR) Network is an international multidisciplinary network of civilian and military providers.

Paramedic 52

Paramedic 52

FOAMfrat

JUNE 30, 2023

What would your impression of your patient be if you noticed alternating large and small beats on your arterial line tracing or pleth wave on the SPO2? In this blog, we'll evaluate this waveform to see if there is any useful information to glean from this simple assessment. Let's start with the idea of a metronome swinging from side to side, and see how this relates to Pulsus Alternans!

Coronary 52

Coronary OR EMS 52

ECG & Echo Learning

JUNE 28, 2023

Posterior (posterolateral) acute myocardial infarction (STEMI) The heart is rotated 30° to the left in the thorax. This positions the basal portion of the left lateral wall posteriorly in thorax (Figure 1). This area is most frequently designated as the posterolateral wall, but it may also be referred to as the posterior wall, or the inferobasal wall.

STEMI 52

STEMI ACS OR 52

NHCPS Save a Life

JUNE 25, 2023

In the fast-paced world of healthcare, staying up-to-date and equipped with the right information is crucial for saving lives. Thanks to the advent of health care apps, medical professionals now have a powerful tool at their fingertips. In this article, we will explore the Medicode app, an exceptional health care app designed to empower physicians, […] The post Revolutionizing Emergency Care: The Medicode Health Care App appeared first on SaveaLife.com.

Advanced Life Support 52

Advanced Life Support Life Support 52

EMCrit Project

JUNE 28, 2023

When to pull the trigger. EMCrit Project by Scott Weingart, MD FCCM.

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83

University of Maryland Department of Emergency Med

JUNE 25, 2023

The use of a fascia iliaca compartment block has been shown to reduce pain, decrease length of stay and decrease the opiate requirements for patient.

58

58

ECG & Echo Learning

JUNE 28, 2023

The electrical axis of the heart Although often ignored, assessment of the electrical axis is an integral part of ECG interpretation. The electrical axis reflects the average direction of ventricular depolarization during ventricular contraction. The direction of the depolarization (and thus the electrical axis) is generally alongside the heart’s longitudinal axis (to the left and downwards).

40

40

Emergency Medicine Education

JUNE 27, 2023

As you know, I usually link peer review manuscripts in this page, but I found a recent publication by ACEP Now very informative.

40

40

Don't Forget the Bubbles

JUNE 30, 2023

A PEM Adventure Ranulf is a 14-year-old explorer. He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. Whilst you were busy managing head injuries and drownings, Ranulf had been out with a group of boys from school this evening. They had been enjoying a celebratory dinner following their safe return from a trip to the Amazon rainforest.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

Dr. Smith's ECG Blog

JUNE 28, 2023

EMS was dispatched for a 30-something male who feels his heart is racing. Sudden onset. The patient had no previous medical history. Vitals were normal except for a heart rate of 226. A prehospital 12-lead was recorded: There is a regular wide complex tachycardia. The computer diagnosed this as Ventricular Tachycardia. Is it definitely VT?? The patient was given 6mg, then 12 mg, of adenosine, without a change in the rhythm.

OR 93

OR ED EMS 93

REBEL EM

JUNE 26, 2023

Background: Hemorrhage is the leading cause of mortality in trauma patients. Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy.

FFP 132

FFP Frozen Plasma ALS Plasma 132

Medgadget

JUNE 26, 2023

Researchers at the Singapore University of Technology and Design have created a flexible knee wearable that contains integrated circuitry within its knitted structure. The wearable can track joint movement in real time, assisting clinicians in spotting the early signs of movement disorders or allowing them to track the progress of patients undergoing physical therapy to improve their movement.

OR 76

OR 76

EMDocs

JUNE 27, 2023

Authors: Anthony Rodriguez, MD (EM Resident Physician, Denver Health); Spencer Tomberg, MD (EM Attending Physician, Denver Health); and Matthew Folchert, MD (Orthopedic-Hand Attending Surgeon, Denver Health) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Manny Singh, MD (@MPrizzleER); Brit Long, MD (@long_brit) Case: A 35-year-old right hand dominant male presents to your ED with a deep laceration to his left pinky finger that occurred while working as a chef.

ED 67

ED EMS OR 67

Dr. Smith's ECG Blog

JUNE 30, 2023

These were texted to me only with "chest pain." First: 2nd: What was my response? Smith: Young thin black male. No OMI. Texter: Can't fool you. It was indeed. Queen: #1: NOT OMI, HIGH CONFIDENCE Queen: #2: NOT OMI, HIGH CONFIDENCE ECG 1 Interpretation: there is terminal T-wave in V3-V6. Is this Wellens' pattern A? No. this is classic Benign T-wave Inversion.

E-9-1-1 52

E-9-1-1 Coronary ED OR 52

REBEL EM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? This stemmed a lot of discussion in the background between Swami, myself, and Scott. We felt it was worthwhile to record this as a podcast to better flush out some nuanced points. Below you will find some of the points we discussed.

CPR 140

CPR ICU EMS ALS 140