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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.
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.
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.
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.
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.
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
A PEM adventure Meet Polly, a 6-year-old girl with a penchant for shopping. Besides a few febrile convulsions when she was two, she’s a healthy 6-year-old. Having just bought the most gorgeous pair of red ballet pumps that would go delightfully with the red bow she bought in Harrods last week, she was skipping down Regent’s Street with her nanny. As they crossed the front of Liberty, a huge letter L came plummeting down, crashing in front of her.
A PEM adventure Meet Polly, a 6-year-old girl with a penchant for shopping. Besides a few febrile convulsions when she was two, she’s a healthy 6-year-old. Having just bought the most gorgeous pair of red ballet pumps that would go delightfully with the red bow she bought in Harrods last week, she was skipping down Regent’s Street with her nanny. As they crossed the front of Liberty, a huge letter L came plummeting down, crashing in front of her.
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.
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.
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.
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.
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.
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
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.
== 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.
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.
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.
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.
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.
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.
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.
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.
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!
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.
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.
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.
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.
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).
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.
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