Sat.May 13, 2023 - Fri.May 19, 2023

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Trick of Trade: Inflating the Esophageal Balloon of a Blakemore/Minnesota Tube without a Manometer 

ALiEM

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
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TIRBO #35: Vent double-triggering

Critical Care Scenarios

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.

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SGEM#403: Unos, Dos, Tres – Vertigo: The GRACE-3 Guidelines

The Skeptics' Guide to EM

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.

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Imaging Case of the Week 553

EMergucate

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

EMS 130
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EM Match Advice 40: Program Directors Reflect on the 2023 Match

ALiEM

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
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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

REBEL EM

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).

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Lumbar Erector Spine Plane Block

Core Ultrasound

Thoracic ESB Intro to NB Serratus Anterior block

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More Trending

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Beers criteria for potentially inappropriate medication use in older adults

First 10 EM

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.

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Rosh Review EM Scholar Monthly Question

REBEL EM

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%.

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Bubble Wrap PLUS – May 2023

Don't Forget the Bubbles

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.

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Intratumoral Bacteria as an Injectable Anti-Cancer Treatment

Medgadget

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.

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EMCrit Special – Burnout with Liz Crowe

EMCrit Project

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

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Introduction to Key Musculoskeletal Concepts for EMTs

EMT Training Station

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
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45 yo with jaw pain radiating to left shoulder for 6 hours

Dr. Smith's ECG Blog

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
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Implant Coating Fights Infection and Monitors Strain

Medgadget

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

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Weight Loss Advances with GLP-1 Receptor Agonists: Too Good to be True? - Clinical Correlations

Clinical Correlations

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.

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FORMER CPD Officer, now psychologist

First Responders Wellness Center

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.

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A man in his late 30s with acute chest pain and ST elevation

Dr. Smith's ECG Blog

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?

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Paper Strip Tests for Hypothyroidism

Medgadget

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.

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Circulation before Airway or Breathing in Trauma Care

University of Maryland Department of Emergency Med

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.

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Episode 21 - Getting to know Dr. Ben Abo

The EMS Show

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
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What is this strange looking ECG in a young woman?

Dr. Smith's ECG Blog

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.

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Machine Learning Aids Rapid Design of Protein Therapeutics

Medgadget

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.

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IV placement prior to interfacility transport by private vehicle - is it safe?

University of Maryland Department of Emergency Med

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

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Episode 21 - Getting to know Dr. Ben Abo

The EMS Show

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
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Kindle Direct Publishing Raises Print Prices

Ambulance Driver Files

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.

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Emergency Evidence Updates – April 2023

The Bottom Line

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

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Femoral arterial doppler during cardiac arrest

University of Maryland Department of Emergency Med

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?

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Hypoglycaemia in the ED

Don't Forget the Bubbles

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 103
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Does IV contrast help to make the diagnosis in ED abdominal pain patients undergoing CT scan?

University of Maryland Department of Emergency Med

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.

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What do caregivers think of alternate EMS dispositions for pediatric patients?

University of Maryland Department of Emergency Med

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
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Bicarbonate Therapy in the ED

University of Maryland Department of Emergency Med

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

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Critical Care Evidence Updates – April 2023

The Bottom Line

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