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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.
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.
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.
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.
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).
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
The Beers criteria (named after Dr. Beers and not your Friday night escapades) is a guideline to help guide safe prescribing practices in the geriatric population. Polypharmacy and medication side effects are a common, and generally under-recognized, reason for patients to present to the emergency department. Adverse events and drug interactions should almost always be […] The post Beers criteria for potentially inappropriate medication use in older adults appeared first on First10EM.
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%.
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.
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.
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.
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
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.
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.
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.
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.
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?
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.
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.
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!
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.
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
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!
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