Sat.Aug 13, 2022 - Fri.Aug 19, 2022

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ECG of the Week – 17th August 2022 – Interpretation

EMergucate

You are reviewing the ECG of a man who has had an intermittent history of chest pain during exercise. His PMH includes being an active smoker but he has no other cardiac risk factors.

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ECG Cases 34 – ECG Interpretation in Aortic Dissection

Emergency Medicine Cases

Which patients with ECG evidence of coronary occlusion require a CT scan to rule out aortic dissection? What are the range of ECG findings in acute aortic dissection and how do they change management? Dr. Jesse McLaren guides us through 9 cases to answer these and other questions on ECG interpretation in aortic dissection. The post ECG Cases 34 – ECG Interpretation in Aortic Dissection appeared first on Emergency Medicine Cases.

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Something Winter This Way Comes

EMS 12-Lead

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic @DidlakeDW A 50 y/o Male was taking his dog for a leisurely stroll through the park when he suddenly experienced new onset chest discomfort. He waited for it to subside, but after 30 minutes of persistence he called 911. EMS personnel found him seated on a bench, uncomfortable, but without gross distress.

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AR Headset Helps Surgeons Place Implants: Interview with Louie Vogt of Enovis Surgical

Medgadget

Enovis , a medtech company based in Delaware formerly known as DJO, recently announced the launch of ARVIS (Augmented Reality Visualization and Information System), an augmented reality technology that is designed to assist surgeons during implant placement in the hip and knee. The hands-free technology consists of an eyepiece that is mounted on a surgical helmet that provides the surgeon with real-time information about the position of an implant with respect to patient anatomy.

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Imaging Case of the Week 517

EMergucate

The pelvic x-ray is from a 15 year old footie player with sudden pain in the right hip during a … Continue reading →

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EM Quick Hits 41 – IO Limitations, Missed Ectopic Pregnancy, Bronchiolitis O2 Monitoring, DRE in Cauda Equina Syndrome, Withdrawal of Life Sustaining Care

Emergency Medicine Cases

In this EM Quick Hits podcast: Anand Swaminathan on limitations and practical tips on intraosseus access,Tahara Bhate QI corner on missed ectopic pregnancy, Sarah Reid from EM Cases Summit on oxygen saturation monitoring in bronchiolitis and management of infant gastro-esophageal reflux, Brit Long on the value of rectal exam in diagnosis of cauda equina syndrome, Hans Rosenberg & Ariel Hendin on withdrawal of life-sustaining care in the ED.

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Episode 50: Rib fractures and surgical plating with Ron Barbosa

Critical Care Scenarios

We look at the rib fracture patient requiring ICU admission, including a discussion of surgical repair, with Dr. Ron Barbosa (@rbarbosa91), Portland trauma surgeon and SICU director at Legacy Emmanual Medical Center. Takeaway lessons Algorithms and protocols for admitting disposition exist but are generally poorly predictive. ICU admission in rib fracture patients is still most … Continue reading "Episode 50: Rib fractures and surgical plating with Ron Barbosa" We look at the rib fracture patien

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ECG of the Week – 17th August 2022

EMergucate

You are reviewing the ECG of a man who has had an intermittent history of chest pain during exercise. His PMH includes being an active smoker but he has no other cardiac risk factors.

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IBNCC – Approach to CNS infection

EMCrit Project

This chapter explores some general aspects of neurological infectious diseases, including important historical features and high-risk groups. It also includes a more general discussion of lumbar puncture performance and interpretation. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes. EMCrit Project by Josh Farkas.

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My Burnout

The Overrun

There’s been a lot of talk about clinician mental health during the Great Pandemic. As a group, we’ve been stretched farther than ever thought, been forced to do even more with even less, endured PPE shortages, medication shortages, and the realization that a significant portion of the population who cheered for us and banged pot lids now look at us with scorn and disbelief.

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Wearable Tracks Mental States

Medgadget

Researchers at New York University have created a wearable system that can measure electrodermal activity, a property of the skin that is influenced by mental states, such as stress or excitement. The system is called Multimodal Intelligent Noninvasive brain state Decoder for Wearable AdapTive Closed-loop arcHitectures (MINDWATCH) and it can assess electrodermal activity by measuring skin conductance.

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Imaging Case of the Week 516 Answer

EMergucate

The mortise view of ankle shows a faint vertical lucency through the distal tibial epiphysis.

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EMCrit Wee – RACC-Lit for August 2022

EMCrit Project

So much literature goodness for the scorching summer heat… EMCrit Project by Scott Weingart, MD FCCM.

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The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis

REBEL EM

The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis James C. Fletcher, MD, FACEP and Nicholas Slattery, MD Background: Diverticulitis is a common finding amongst Emergency Department patients, accounting for more than 360,000 visits in 2013 alone 1. Additionally, the rate of diverticulitis appears to be increasing among both patients presenting to the Emergency Department and the population in general.

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Light-Activated Hydrogel Disrupts Oral Biofilms, Whitens Teeth

Medgadget

Researchers at Nanchang University in China developed a photodynamic hydrogel treatment for teeth that disrupts bacterial biofilms, helps to prevent cavities, and whitens teeth. The gel is applied to the teeth and is then activated using green light, which is less harsh on nearby skin than the high intensity blue light that is sometimes used for teeth whitening procedures.

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Lab case 375 interpretation

EMergucate

Question 1: PH = 7.659, that is severe alkalaemia. pCO2 = 12.6 mmHg (<40), so we have respiratory alkalosis.

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Does this ST Depression Maximal in V3 Represent Posterior OMI?

Dr. Smith's ECG Blog

I saw this EKG when reading through the system: What do you think? This is what I wrote: ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE RIGHT AXIS DEVIATION [QRS AXIS > 100] RIGHT BUNDLE BRANCH BLOCK MARKED ST DEPRESSION, CONSIDER SUBENDOCARDIAL INJURY "Severe ischemia (STE in I and aVL with reciprocal STD in inferior leads; precordial STD precordial maximal in V3): subendocardial ischemia vs. acute coronary occlusion.

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Sodium Bicarbonate Administration During CPR and Survival Outcomes

Handtevy

Sodium bicarbonate is indicated for select patients including preexisting metabolic acidosis, hyperkalemia, or tricyclic antidepressant overdose. However, many providers are still administering it for cardiac arrests even though we know it makes matters worse. Introduction Cardiopulmonary resuscitation (CPR) is a life-saving procedure performed on individuals experiencing cardiac arrest.

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Catheter-Free Urodynamics Testing: Interview with Derek Herrera, CEO at Bright Uro

Medgadget

Bright Uro , a medtech company based in California, has created the Glean Urodynamics System, a catheter-free urodynamics testing system. At present, urodynamics testing can help clinicians to diagnose and assess patients with lower urinary tract symptoms, including a frequent urge to urinate and incontinence. The procedure typically involves inserting a catheter into the bladder and another into the vagina or rectum.

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Lab case 376

EMergucate

23-year-old man presented with headache and confusion.

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The Great Conversation

The EMS Educator

On Aug. 17, 2022, the NREMT Board rescinded a resolution that would have done away with graduation from a nationally accredited paramedic program as a requirement for eligibility for national certification. Why? What led to the decision? What prompted the resolution in the first place? Join NREMT Executive Director Bill Seifarth, NREMT Board Chair Kevin Mackey and NREMT Board Member Maia Dorsett as they discuss the process and answer burning questions about this dramatic period of events.

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It Can Be Fine to Fail

A Paramedic's Notebook

We are involved with an initiative at work that is running dangerously close to missing its deadline. It’s a national initiative that aims to take a stance on an equity issue, and the marketing behind the initiative put the deadline for a time once long in the future that is now rapidly approaching. Folks in industry have individually worked to support the initiative’s aims, but it’s a big, hairy, unwieldy problem that will take everyone to solve.

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Drop It Like It's Hot

EMS 20/20

With help from gravity, two EMT's find themselves doing the one thing we swore to never do. Is today's episode a master class in recovery, or did the crew grab shovels and dig even deeper? Listen to find out as Spencer dishes out the story and Chris rants about naming medical conditions after people. With help from gravity, two EMT's find themselves doing the one thing we swore to never do.

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Tough Ultrasound-Controlled Bioadhesives

Medgadget

Scientists from McGill University in Canada created a technique of using ultrasound-mediated cavitation to make bioadhesives better stick to body’s tissues, including wet surfaces that are typically challenging for such materials. The new method involves ultrasound to create microbubbles within the adhesive. The bubbles burst, which then temporarily forces some of the adhesive components deeper into the underlying tissue, helping to create a stronger bond.

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