Sat.Dec 17, 2022 - Fri.Dec 23, 2022

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ECG of the Week 21st December 2022

EMergucate

This ECG was obtained from a 22 year old man who had taken a polypharmacy overdose 24 hours ago. He had suffered a bradycardic / asystolic arrest and is currently in the intensive care unit.

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WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do?

Emergency Medicine Cases

In this month's Waiting to Be Seen blog Dr. Howard Ovens outlines challenges, innovations and coping strategies in the EM Crisis. The post WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do? appeared first on Emergency Medicine Cases.

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SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients

The Skeptics' Guide to EM

Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. She is also the wonderful educator that creates the Paper in a Pic infographics summarizing each SGEM episode.

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Lightning rounds #23: How we do end-of-life care

Critical Care Scenarios

A general discussion about how we recognize patients are dying, how we steer into discussions regarding goals of care, and the many biases and errors we often bring to the table. Two-part blog post at Critical Concepts on palliative care ICU admissions, including a detailed script for the conversation. Three-part blog post at Critical Concepts … Continue reading "Lightning rounds #23: How we do end-of-life care" A general discussion about how we recognize patients are dying, how we steer into di

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ECG of the week 14th December 2022 – Interpretation

EMergucate

ECG of the week 14th December 2022 – Interpretation This ECG was included as a reminder of the Sgarbossa criteria … Continue reading →

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ECG Cases 38 – ECG Interpretation in Cocaine Chest Pain

Emergency Medicine Cases

Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associated chest pain require benzodiazepines +/- nitroglycerine for symptom relief, aspirin and ECG to look for signs of occlusion and reperfusion. In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern.

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Belt Monitors Heart Failure Patients

Medgadget

Researchers at Florida Atlantic University have developed a belt that can monitor heart failure patients for signs of disease progression. The wearable device measures heart rate, thoracic impedance, electrocardiogram, and motion, all of which can provide information on a heart failure patient’s status and potentially enable early detection of disease exacerbation.

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Imaging Case of the Week 533

EMergucate

The pelvic x-ray is from an adult taken post MVA.List 5 findings. How will you manage?

EMS 130
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Ep 177 Bronchiolitis – Diagnostic Challenges and Management Pitfalls

Emergency Medicine Cases

In this main episode podcast Anton discusses with world expert and bronchiolitis researcher Dr. Suzanne Schuh, the challenges of the diagnosis and management of bronchiolitis during a time of crisis in pediatric emergency medicine and offers some evidence-based solutions to improving outcomes while minimizing valuable resources, as part of our 'Best of University of Toronto EM' series.

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Exciting Medtech at the Healthcare? Expo Taiwan

Medgadget

Medgadget was recently invited to Taiwan to cover the 2022 Healthcareᐩ Expo in Taipei. As is the case for most trade shows, the exhibit hall comprised a large portion of the expo. Consisting of over 2000 exhibitors in two massive halls, the main hall showcased the best of Taiwan’s healthcare industry. Here are some notable trends we observed while roaming the aisles.

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PulmCrit Blogitorial – SIESTA syndrome:  Sedation Induced EEG Suppression with Transient Agitation

EMCrit Project

This is SIESTA syndrome. The patient is locked in a cycle of unconsciousness, punctuated with brief episodes of agitation. Most of the time the patient is sedated to the point of having minimal EEG activity, which may hinder their ability to regain consciousness. . EMCrit Project by Josh Farkas.

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Imaging Case of the Week 532 Answer

EMergucate

The main finding on the elbow x-ray is that there is a radial head dislocation.

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What Is the Best Nursing Field for 2023? 12 Fastest Growing Specialties

NHCPS Save a Life

Nursing is an ever-changing profession, but one thing is very clear. Nurses continue to be in demand with no signs of slowing. And nurses have greater opportunities for specialization than they used to with many interesting and fast-growing nursing fields to choose from. Here are some you’ll want to learn more about. Is Nursing a […] The post What Is the Best Nursing Field for 2023?

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30-something woman with a HEART score of zero, EDACS of 2, computer "Normal" ECG, and initial troponin < Limit of Detection

Dr. Smith's ECG Blog

I was working in triage very late when a 30 yo previously completely healthy woman walked in with 30 minutes of central chest pressure. This ECG was recorded: The computer called it "Normal" except for "Possible right ventricular conduction delay" What do you think? I immediately recognized an inferior-posterior-lateral OMI. There are hyperacute T-waves in II, III, and aVF.

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EMCrit 339 – Decisions, Decisions, Decisions with Andrew Petrosoniak

EMCrit Project

Making good decisions is the heart of Emergency Medicine and Critical Care. EMCrit Project by Scott Weingart, MD FCCM.

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Lab case 391

EMergucate

42-year-old alcoholic man presented with vomiting. His venous blood gases showed the following: PH = 7.

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Episode 94: Better CPR at the end of the year with Josh Lupton and Ken Milne

The Overrun Podcast

We end the year with 2 great interviews about cardiac arrest. Josh Lupton is a physician in Oregon who found in 2021 that there might be an ideal number of rescuers for OHCA. Hint: It's more than you think. Then Ken Milne joins us from the S keptics Guide to Emergency Medicine to discuss whether heads-up CPR with a commercial device is ready for prime time.

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See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

by Emre Aslanger Dr. Aslanger is our newest editorial member. He is an interventional cardiologist in Turkey. Dr. Aslanger is also the author of the DIFFOCULT study: Emre K. Aslanger , a, ⁎ Özlem Yıldırımtürk , b Barış Şimşek , c Emrah Bozbeyoğlu , c Mustafa Aytek Şimşek , a Can Yücel Karabay , b Stephen W. Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction.

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Holiday Wellness

First Responders Wellness Center

HOLIDAYS & GET TOGETHERS Being a first responder comes with many challenges, one of which is navigating the holidays. Being home for the holidays is not always an option. So, if you do have to work, consider realistic plans that can be easily accomplished. Communication with your family and your work during this time will be the key. Ensure you are reasonable with your time and capabilities.

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Lab case 390 interepretation

EMergucate

Question 1: PH = 6.88, that is severe acidaemia HCO3= 5.3 mmol/L. So, we have metabolic acidosis.

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Pro-MEDIC

The Bottom Line

In adults with an expected ICU stay of > 72 hours, does the provision of enteral melatonin compared to placebo increase the number of delirium-free assessments within 14 days or before ICU discharge?

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This Call Bugs Me

EMS 20/20

Are we dealing with another Peanut Butter Spider Sandwich situation, or is this title just clickbait? Or is it neither? An altered LOC patient has some curious and life threatening symptoms in this week's episode, and Chris briefly discusses how EMS 20/20 does advertising business at the end. if that's your thing. Are we dealing with another Peanut Butter Spider Sandwich situation, or is this title just clickbait?

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Episode 15: Self-Care (PS: You aren't as important as you think you are)

The EMS Show

Finding yourself becoming a little "crispy" around the edges? Maybe it's time to pause and take a look inside and come up with a plan. Dr. Sahni talks about his experience with just that and how getting away may have been the right Rx for him. How do you navigate that? So many people depend on you.how can the world POSSIBLY go on when you decide to take care of yourself.turns out, it does.

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A woman in her 70s with chest pain

Dr. Smith's ECG Blog

Submitted and written by Quinton Nannet, MD, peer reviewed by Meyers, Grauer, Smith A woman in her 70s recently diagnosed with COVID was brought in by EMS after she experienced acute onset sharp midsternal chest pain without radiation or dyspnea. She felt nauseous and lightheaded with no neurologic deficits. EMS noted prehospital vitals for heart rates in the 60s, SPO2 of 98% on room air, initially hypotensive to 66/34 with improvement to 100/70 after 800 mL of IV fluids by EMS.

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Thrombolytic-induced Angioedema:

University of Maryland Department of Emergency Med

Thrombolytic-induced angioedema is a known complication of alteplase or tenecteplase administration, occurring in 0.9-5.1% of patients wh.

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Officer Suicide Prevention

First Responders Wellness Center

Doctor Calls For More Mental Health Support For Chicago Cops After 3rd Officer Suicide in a Week – NBC Chicago [link]

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Episode 15: Self-Care (PS: You aren't as important as you think you are)

The EMS Show

Finding yourself becoming a little "crispy" around the edges? Maybe it's time to pause and take a look inside and come up with a plan. Dr. Sahni talks about his experience with just that and how getting away may have been the right Rx for him. How do you navigate that? So many people depend on you.how can the world POSSIBLY go on when you decide to take care of yourself.turns out, it does.

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A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

Written by Emre Aslanger (Emre is our newest editor. He is an interventionalist in Turkey and one of 3 originators of the OMI/NOMI paradigm, along with Pendell and Smith. Here are his publications.) Case A 39-year-old male without prior medical history presents with chest pain that started 2 hours prior to presentation. He says that the pain intensity was 10/10 at home but now about 4/10.

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Let food be thy medicine

University of Maryland Department of Emergency Med

Over half of U.S. adults in the United States consume dietary supplements. Study design: A quality improvement study using dat.

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Suicide Prevention Article

First Responders Wellness Center

[link]

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First Responder Grief During the Holidays

First Responder Wellness

This article is courtesy of Patrick McCurdy, Retired Sergeant/Deputy. — “I sat with my anger long enough until she told me her real name was grief.” C.S. Lewis It was Christmas Eve. We were looking for a domestic violence assault suspect. It was a pretty bad assault, and we were determined to find him. Everyone inside of the house said that he had run away, but there were no tracks in the fresh snow, and a K9 confirmed that there was no scent trail.

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REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

REBEL EM

Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it.