ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. He looks really bad, stating that he has been vomiting blood. He is hypotensive. He then vomits a copious amount of blood right in front of you. You intubate the patient and initiate the massive transfusion protocol, but everything you pour into him seemingly comes right back out.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

Critical Care Scenarios

MAY 17, 2023

Understanding the causes of doubled vent breaths, including premature/short cycling and reverse triggering, plus a basic approach to managing them. Understanding the causes of doubled vent breaths, including premature/short cycling and reverse triggering, plus a basic approach to managing them.

100

100

EMergucate

MAY 16, 2023

The following chest x-rays are from a young adult with chest pain. What can be seen?

EMS 130

EMS 130

Core Ultrasound

MAY 17, 2023

Thoracic ESB Intro to NB Serratus Anterior block

130

130

ALiEM

MAY 17, 2023

The 2023 Emergency Medicine Match was an unprecedented year that took many of us in the education community by surprise. There were 132 (46%) EM residency programs with at least one unfilled PGY-1 position, and there were 554 (18.4%) overall unfilled EM positions. Dr. Sara Krzyzaniak (EM program director at Stanford) hosts this important episode with Dr.

EMS 130

EMS ALS 130

REBEL EM

MAY 15, 2023

You are working in a rural ED, and an older woman from a local assisted care facility arrives via ambulance in obvious respiratory distress. EMS is able to tell you that she is currently being treated for pneumonia. The patient is on a nonrebreather mask, and vital signs on arrival are BP 110/50 mm Hg, HR 120 bpm, RR 40/min, T 98.6°F (37°C), and SpO2 86%.

EMS 90

EMS Ambulance ED OR 90

Medgadget

MAY 19, 2023

Scientists at the Japan Advanced Institute of Science and Technology in Ishikawa, Japan have developed an anti-cancer treatment that consists of bacteria that are naturally found inside some tumors. Isolating and then injecting these bacteria into existing tumors appears to provoke a strong immune response that can lead to tumor destruction, without the need for advanced techniques such as bacterial genetic engineering or complex drug delivery.

OR 87

OR 87

EMCrit Project

MAY 17, 2023

More on burnout with an expert. EMCrit Project by Scott Weingart, MD FCCM.

90

90

REBEL EM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. These patients can have a vasodilated vascular bed and the initial use of fluids is hypothesized to serve two purposes: Augmenting the macrovascular system (stroke volume and cardiac output) and augmenting the microvascular perfusion (capillary blood flow).

OR 89

OR ICU EMS ED 89

Medgadget

MAY 17, 2023

Researchers at the University of Illinois at Urbana-Champaign have developed a bioinspired implant coating that is designed to be implanted along with devices such as spinal implants. The technology has been inspired by dragonfly and cicada wings that contain tiny pillars that can skewer bacteria, providing mechanical anti-microbial action. Unlike current approaches that use antibiotics that are gradually released by the implant, the mechanical approach will not become depleted over time or caus

OR 82

OR 82

Dr. Smith's ECG Blog

MAY 18, 2023

This case was provided by Steven Souchtchenko, a recent graduate of our Hennepin Healthcare EM/IM residency (i.e., a former trainee of mine). Case A 45 yo man with no previous cardiac history presented to an ED not associated with a cath lab. He complained of jaw pain radiating to left shoulder for 6 hours. He stated he had had a brief similar episode the evening prior.

ED 52

ED OR EMS 52

Clinical Correlations

MAY 18, 2023

By Hadley Greenwood Peer Reviewed Medications originally developed as agents to treat type 2 diabetes have been making headlines for their use as weight loss drugs, even in individuals without diabetes. The medical community has known.

52

52

University of Maryland Department of Emergency Med

MAY 19, 2023

It is time to abandon the ABC's that ATLS teaches and move to hemorhage control (circulation) as well as resucitation before we deal wi.

OR 57

OR 57

Medgadget

MAY 19, 2023

Student researchers at Rice University have developed a paper strip test for hypothyroidism, similar to those that are commonly used for COVID-19 testing. Babies with congenital hypothyroidism require prompt diagnosis and treatment, but in many parts of the world a lack of healthcare resources can mean that the condition can go undiagnosed for long periods, affecting a child’s development.

OR 80

OR 80

Dr. Smith's ECG Blog

MAY 13, 2023

I was reading EKGs on the system and saw this one, with no other information. What was my interpretation of these apparently abnormal precordial leads? Smith: Normal variant ST Elevation and T-wave inversion, probably in a young African American male. The Queen of Heart PM Cardio Bot also states: "Not OMI with High Confidence" Additionally, as Ken notes below, the limb leads are reversed.

OR 52

OR 52

The EMS Show

MAY 16, 2023

We had a great discussion with the banana man himself! An emergency and EMS physician who is involved in so much cool stuff, you have to listen! Sharks? Spiders? Snakes? USAR? All of it!

EMS 40

EMS 40

University of Maryland Department of Emergency Med

MAY 18, 2023

This study looked at "low risk" patients who were being transferred from a community hospital to the system quaternary referral center.&nb.

Interfacility Transport 47

Interfacility Transport 47

Medgadget

MAY 17, 2023

Researchers at Ecole Polytechnique Fédérale de Lausanne (EPFL) in Switzerland have created a machine learning approach to scan millions of protein fragments and assess their structure and binding properties. Based on the surface chemistry and geometry of a protein, the developed software can determine a ‘fingerprint’ for each protein and predict how they might bind to various protein fragments.

70

70

Ambulance Driver Files

MAY 16, 2023

Starting June 20, 2023, Amazon is raising prices on all books published through Kindle Direct Publishing, supposedly to better align with current paper and materials costs. It’s a pretty substantial bump. My full-length books, both hardcover and paperback, will be about $4 more expensive per copy. Get yours while they’re (relatively) cheap.

52

52

The EMS Show

MAY 16, 2023

We had a great discussion with the banana man himself! An emergency and EMS physician who is involved in so much cool stuff, you have to listen! Sharks? Spiders? Snakes? USAR? All of it!

EMS 40

EMS 40

University of Maryland Department of Emergency Med

MAY 14, 2023

Did you know that you can use the linear probe with pulse wave (PW) doppler over the femoral artery to look for a pulse during CPR pauses?

CPR 46

CPR 46

The Bottom Line

MAY 19, 2023

What’s new in the Critical Care literature – monthly updates

Critical Care 52

Critical Care 52

Don't Forget the Bubbles

MAY 15, 2023

Although hypoglycaemia is one of the most common paediatric emergencies, consensus on a definition and investigations have not been reached. Even the definition of hypoglycaemia itself is a contentious subject. Specific guidance regarding intervention thresholds and investigation indications vary across countries and institutions. Given the lack of consensus guidelines, a straightforward, structured approach to investigation and management is paramount to ensure accurate diagnosis and timely, ap

ED 101

ED Plasma OR ALS 101

EMT Training Station

MAY 19, 2023

This article is for informational purposes only and is NOT a replacement for proper education and training. Table of Contents The human body, a marvel of biological engineering, is made up of several intricate systems working in harmony to enable life as we know it. The musculoskeletal system is one such essential system, a complicated network of bones, muscles, tendons, ligaments, and joints that collaborate to permit movement and safeguard vital organs.

EMT 52

EMT EMT Emergency Medical Services First Aid 52

University of Maryland Department of Emergency Med

MAY 19, 2023

Does IV contrast help to make the diagnosis in ED abdominal pain patients undergoing CT scan? The authors of this study tried to answer that.

ED 44

ED 44

The Bottom Line

MAY 19, 2023

What’s new in the Critical Care literature – monthly updates

Critical Care 40

Critical Care 40

The Skeptics' Guide to EM

MAY 13, 2023

Date: April 12, 2023 Reference: Edlow et al.Guidelines for Reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department. AEM May 2023 Guest Skeptic: Dr. Jonathon Edlow has practiced emergency medicine for nearly 40 years and is a Professor of Emergency Medicine at Harvard Medical School.

Emergency Department 100

Emergency Department ED OR 100

Dr. Smith's ECG Blog

MAY 16, 2023

Sent by Dan Singer MD, written by Meyers, edits by Smith A man in his late 30s presented with acute chest pain and normal vitals except tachycardia at about 115 bpm. Here is his triage ECG: What do you think? Dr. Singer sent this to me with just the information: "~40 year old with acute chest pain". I immediately responded: "cool fake! Not OMI. Do you have a prior?

Coronary 52

Coronary STEMI ED OR 52

University of Maryland Department of Emergency Med

MAY 16, 2023

Pediatric patients represent up to 10% of EMS transports, but studies suggest that between 10-60% of these patients can be safely transported.

EMS 40

EMS 40

Medgadget

MAY 17, 2023

Researchers at the University of Hawaii at Manoa have developed a wearable that can take multiple sweat samples and which also supports on-board colorimetric biomarker analysis. Unlike many sweat collecting methods, which often involve a simple absorbent pad that must be removed and analyzed once wet with sweat, the ‘sweatainer’ employs a complex microfluidic architecture to take multiple sweat samples over time and store them in different compartments for later analysis. 3D printing was the key

OR 87

OR 87

First Responders Wellness Center

MAY 14, 2023

CHICAGO (CBS) -- Grief is compounding for the Chicago Police Department. Areanah Preston is the second officer the department lost this year. In March, Officer Andres Mauricio Vasquez Lasso was shot and killed while responding to a domestic violence call. CBS 2's Noel Brennan spoke with an expert who understands better than most - the trauma officers deal with on the job.

First Responder 52

First Responder OR 52

Don't Forget the Bubbles

MAY 17, 2023

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research.

ALS 60

ALS ACS Emergency Department EMS 60

University of Maryland Department of Emergency Med

MAY 15, 2023

Bicarbonate Use for Lactic Acidosis? The administration of sodium bicarbonate to treat severe acidosis remains controversial and int.

ED 40

ED 40