Sat.Feb 24, 2024 - Fri.Mar 01, 2024

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EM Quick Hits 55 – Induction Agents, Gabapentinoids, Neuroprotective Intubation, Approach to Paresthesias, Preventing Burnout

Emergency Medicine Cases

Anand Swaminathan on an update on the appropriate selection of induction agents. Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Katie Lin on pearls for neuroprotective intubation. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Eric Wortmann on preventing burnout in emergency medicine. Please support EM Cases with a donation [link] The post EM Quick Hits 55 – Induction Agents, Gabapentinoids, Neuroprotective Intubation, Approach to Paresthesi

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SAEM Clinical Images Series: Neonatal Rash

ALiEM

An 18-day-old male presented for a rash on his face for two days. The patient was born via spontaneous vaginal delivery full term without complications to a mom who has a history of genital HSV but without active lesions at delivery and on acyclovir. The patient presented with a vesicular rash on his face including around his eyes. He had conjunctival discharge noted by mom.

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SGEM#341: You Make Me Feel Like a Natural Treatment

The Skeptics' Guide to EM

Reference: Li, T., & Gal, D. (2023). Consumers prefer natural medicines more when treating psychological than physical conditions. Journal of Consumer Psychology 2023, Date: February 23, 2024 Guest Skeptic: Ethan Milne is a Marketing PhD student at the Ivey Business School (Western University). He researches how moral outrage and status-seeking personalities motivate social media aggression, and how […] The post SGEM#341: You Make Me Feel Like a Natural Treatment first appeared on The Skeptics G

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Lung Abscess in Children

Pediatric EM Morsels

We have digested many Morsels regarding various pulmonary complaints. While some are very rare (ex, Pulmonary Embolism , Pulmonary Hypertensive Crisis , Negative Pressure Pulmonary Edema , CPAM ) others are commonly encountered (ex, Croup , Bronchiolitis , Sinusitis ). It is pneumonia , however, that often generates the most conversations. When should I consider a CXR ?

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Episode 194: Nitrous Oxide Toxicity

Core EM

We review Nitrous Oxide Toxicity: Symptoms, diagnosis, and treatment overview Hosts: Stefanie Biondi, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Toxicology Show Notes Patient Case Illustration Hypothetical case: 21-year-old male with no previous medical history, experiencing a month of progressively worsening numbness, tingling, and weakness.

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SAEM Clinical Images Series: Two Pupils for the Price of One

ALiEM

A 24-year-old female with no pertinent PMHx presents to the ED with a chief complaint of eye pain. She reported a 10-day history of worsening right eye pain following being punched in that eye. She had been managing her pain with ice and had not taken any OTC medications. Her mom convinced her to go to the ED and she first went to an outside hospital, but was referred to come to our institution.

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ECG of the Week – Feb 28th 2024

EMergucate

The following ECG is from a 40-year-old man who presents overnight with left sided sharp chest pain which has woken him from sleep. He describes the pain as radiating into his left arm.

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Update on February 22 Network Outage

FirstNet Authority

Update on February 22 Network Outage Blog joseph.rey@fir… Thu, 02/29/2024 - 13:49 By Joe Wassel, Executive Director and CEO, First Responder Network Authority Learn more about how FirstNet is transforming public safety communications — contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters. Follow us on Twitter , Facebook , Instagram , and LinkedIn for the latest FirstNet Authority updates.

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How to Cite Videos, Podcasts, Apps, Media, and Blogs in a Publication or CV (AMA style 11th edition)

ALiEM

As medical education podcasts, videos, and blogs continue to grow in popularity it is crucial that we cite them correctly, both in publications and on our CVs. We also must recognize the important contributions of media such as clinical photographs, radiology images, and ECGs. The American Medical Association (AMA) Manual of Style released its 11th edition in 2020.

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Lab case 438

EMergucate

Answers: PH = 7.39, that is within normal range/ pCO2 = 48 mmHg, that is slightly elevated (Can be considered normal for venous blood) HCO3 = 29 mmol/L.

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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

REBEL EM

Background: Ventilator-associated pneumonia (VAP), or what the CDC recently renamed infection-related ventilator-associated complication (IVAC), is defined as a nosocomial pneumonia occurring on day 3 of mechanical ventilation that was preceded by 2 days of stable or decreasing ventilator requirements. 1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 3, 4 It is the most common nosocomial infection in patients on m

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Episode 71: Transplant medications with Olivia Philippart

Critical Care Scenarios

We discuss the medications typically used after organ transplant, their impact on critical illness, and how to manage them when these patients show up sick—with Olivia Philippart, transplant clinical pharmacist specializing in liver and kidney transplant at University of Kentucky HealthCare. Find us on Patreon here! Buy your merch here! Takeaway lessons References From: Fishman … Continue reading "Episode 71: Transplant medications with Olivia Philippart" Photo by Tim Webb We discuss the medicat

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Decompensated. Liver disease in the ED. St Emlyn’s

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed A review of Acute on Chronic Liver Disease (ACLD / decompensated liver disease) in the ED. How we can improve patient outcomes. #FOAMed @stemlyns The post Decompensated. Liver disease in the ED. St Emlyn’s appeared first on St.Emlyn's.

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Imaging Case of the Week 585

EMergucate

The following ankle x-ray is from a 13 year old with severe ankle pain & swelling post twisting injury to … Continue reading →

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Entering its 10th Year, Wildfire Community Preparedness Day is May 4

NVFC

First 100 people to post their project plans online will receive a free campaign banner The National Fire Protection Association® (NFPA®) and State Farm have announced that Wildfire Community Preparedness Day will be held on Saturday, May 4, reflecting the 10th anniversary of the campaign. Each year, Wildfire Community Preparedness Day actively encourages groups and individuals living in wildfire-prone areas to complete projects that can help make their homes and communities safer from wildfire.

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How to make a medical podcast using AI (part 2)

Life in the Fastlane

Sheralyn Guilleminot and Franz Wiesbauer How to make a medical podcast using AI (part 2) The original hope was that using AI might allow us to create a single podcast episode in one afternoon. But things didn’t go quite the way we planned.

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How to Become a Community Paramedic

Unitek EMT

Explore the educational pathway, skills, and opportunities in community paramedicine. Community Paramedicine represents a transformative approach to healthcare delivery, particularly in underserved or rural areas where access to healthcare services is often limited. By extending the traditional role of emergency medical services (EMS) personnel, Community Paramedics are instrumental in bridging gaps within the healthcare system, […] The post How to Become a Community Paramedic appeared fir

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Lab case 439

EMergucate

61-year-old man presented to ED with hypoglycemia that was difficult to correct with oral and IV dextrose.

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Serving the Whole Community: Recruiting and Retaining Minority Firefighters

NVFC

Practical tips for diversity, equity, and inclusion in your community By Larry Conley The American firefighter has many faces and backgrounds. Though the paid firefighter receives the most attention through media, movies, etc., most firefighters in America are volunteers. I have always felt that volunteer firefighters are extra special because they put themselves in harm’s way without monetary compensation.

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Addressing Burnout in First Responders: Strategies for Wellness and Resilience

First Responders Foundation

First responders—firefighters, police officers, paramedics, and emergency medical technicians—face intense stressors that are inherent to their jobs. The high-stakes nature of their work, exposure to traumatic experiences, and the physical demands of their roles can lead to burnout, a state of physical, emotional, and mental exhaustion. Addressing burnout is crucial not only for the well-being of first responders but also for maintaining the quality of public safety services.

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Free 50 Question NREMT – Basic Practice Exam

EMT Training Station

As an EMT veteran and EMT instructor, I can’t stress enough the importance of NREMT basic exam practice tests. They’re not just about memorizing stuff; they get you in tune with the exam’s feel and type of questions. The real deal is about quick thinking under pressure, much like in the field. Practicing also eases your nerves, helping you spot your weak spots.

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Lab case 439 Interpretation

EMergucate

Question 1: PH = 7.30 that is mild acidaemia. HCO3 = 16 mmol/L (>24) so we have metabolic acidosis.

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The Fight to Save AFG and SAFER Continues

NVFC

Thank you to all those who contacted their Representative to express the importance of the Assistance to Firefighters Grants (AFG) and Staffing for Adequate Fire and Emergency Response (SAFER) grant programs and request that they sign the letter urging the leadership of the House of Representatives to include AFG, SAFER, and U.S. Fire Administration reauthorization in the upcoming “must pass” funding bill.

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"Seizure" in a 60 year old male

Dr. Smith's ECG Blog

This 60 yo male had an apparent tonic clonic seizure. He had no history of seizures. He was unconscious for 8 minutes and slowly awoke in the ambulance, complaining of nausea only. First responders found him to be very tachycardic , confused, perserverating and with no memory of the event. There was tongue biting. Lightheadedness continued. The tachycardia was gone by the time paramedics arrived.

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Ep. 138 Deep Dive Under and Over Triage Field Triage Guidelines

Prehospital Emergency Care Podcast

The Field Triage Guidelines (FTG) are used across North America to identify seriously injured patients for transport to appropriate-level trauma centers. We should aim for an under-triage rate of 5% and an over-triage rate of 25-35%. But how faithful are we to these recommendations? In this podcast, we interview the lead author Joshua Lupton MD MPH M.Phil on the manuscript: Under-Triage and Over-Triage Using the Field Triage Guidelines for Injured Patients: A Systematic Review Click here to

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The Research Roundup (February 2024)

First 10 EM

Welcome back to another edition of the research roundup, where we discuss an eclectic collection of articles selected through the very rigorous process of whatever I happened to find interesting in my recent reading. The BroomeDocs podcast version can be found here: [link] Putting nail bed repair to bed? Jain A, Greig AVH, Jones A, […] The post The Research Roundup (February 2024) appeared first on First10EM.

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CPD update for UoT CPD conference, Whistler 2024. St Emlyn’s

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Key papers from the university of toronto CPD update in emergency medicine Whistler 2024 #uoftem24 #FOAMed #EBM #EM @stemlyns @davidcarr333 The post CPD update for UoT CPD conference, Whistler 2024. St Emlyn’s appeared first on St.Emlyn's.

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Pneumocystis jirovecii Pneumonia and HIV: A Practical Guide for ED Diagnosis and Management

EMDocs

Authors: Kamoga Dickson, MD (EM Resident Physician, Makerere University of Health Sciences); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Louis) // Reviewed by: Joshua Lowe, MD (USAF Physician); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 42-year-old female with advanced acquired immunodeficiency syndrome (AIDS) presents to the Emergency Department (ED) with two weeks of progressive dyspnea that worsens with exertion, associated with a dry cough an

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EMCrit 369 – Iodinated Contrast Issues: Part 1 – Is Contrast-Induced Nephropathy (CIN) a Thing in Patients with Tenuous Renal Function

EMCrit Project

Do you still need to worry about contrast in patients with tenuous renal function? EMCrit Project by Scott Weingart, MD FCCM.

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The First10EM monthly wrap-up for February 2024

First 10 EM

The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month. Obviously the format means the focus is mostly on content I have found, but I hope […] The post The First10EM monthly wrap-up for February 2024 appeared first on First10EM.

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Global Health map – connecting UK emergency care practitioners

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed In our modern world global health is vitally and increasingly important. Anisa Jafar takes us through a project designed to connect and map global health practitioners. Follow the links and join the network. The post Global Health map – connecting UK emergency care practitioners appeared first on St.Emlyn's.

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ECG Pointers: Ashman’s Phenomenon

EMDocs

Authors: Rachel Bridwell (Attending EM Physician); Brannon Inman, MD (EM Crit Care, Orlando Health); Lloyd Tannenbaum (Staff Physician, Hackensack University Medical Center) // Reviewed by: Jamie Santistevan, MD ( @jamie_rae_EMdoc, EM Physician, Presbyterian Hospital, Albuquerque, NM); Manpreet Singh, MD ( @MPrizzleER ); Brit Long, MD ( @long_brit ) Case: You’re working on shift and the nurses hand you an ECG asking what you want for rate control on this: Do you think this is atrial fibrillatio

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NIV for status asthmaticus

Don't Forget the Bubbles

Non-invasive BiPAP can be a successful ventilation strategy for status asthmaticus, removing the need for intubation and the complications associated with this. A 6-year-old known asthmatic presents to ED with a two-day history of cough and coryza, worsening wheeze and work of breathing over the last day. He is usually managed with beclomethasone twice daily and salbutamol as needed.

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Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial

EMOttawa

Methodology: 3.5/5 Usefulness: 3/5 Freund Y, et al. JAMA. 2023 Dec 19;330(23):2267-2274. Question and Methods: Multicenter RCT involving comatose patients with suspected acute poisoning and GCS <9 compared a conservative airway strategy of withholding intubation versus routine practice for the primary hierarchical composite end point of in-hospital death, length of ICU stay, and length of […] The post Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A

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St Emlyn’s podcast round up January 2024.

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Our regular podcast round up with @docib and @emmanchester of the best of the blog from January 2024. This month we focus on habits, the management of the comatose overdose patient and retention/recruitment issues in UK emergency medicine. #foamed @stemlyns The post St Emlyn’s podcast round up January 2024. appeared first on St.Emlyn's.

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Medical Malpractice Insights: Excellent documentation supports standard of care and avoids lawsuit

EMDocs

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.

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ARiE Trial – Rifaximin for encephalopathy

The Bottom Line

In critically ill adults with overt acute hepatic encephalopathy (HE) admitted to ICU, does the addition of rifaximin to broad spectrum antimicrobials affect time to resolution of HE?

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