Sat.Mar 25, 2023 - Fri.Mar 31, 2023

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Pseudosubluxation: Rebaked Morsel

Pediatric EM Morsels

Children love to trick us! Sometimes it is all in good fun and other times it is quite serious! They like to pretend to be well when they are truly sick ( remember to check that Cap Refill and to never trust a Neonate! ) and they often show us “odd” findings that are really normal (ex, Growth Plates, Primitive Reflexes ). They like to keep us on our toes so much, that even their cervical bones can deceive us.

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Global EM 3 So you want to be a humanitarian doctor?

Emergency Medicine Cases

Dr. Nav Sahsi gives us a quick primer on Doctors Without Borders, explains the difference between humanitarian work and development work and describes the motivation, personal skills, education, time commitment and flexibility required for humanitarian work for all those with an interest in Global EM. The post Global EM 3 So you want to be a humanitarian doctor?

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SGEM#398: Another Ab Gets BUSED – POCUS in the ED for Biliary Disease

The Skeptics' Guide to EM

Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. He is also now a fully-fledged “sonologist”.

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Imaging Case of the Week 546

EMergucate

The following pelvic x-ray is from a 10-year-old with pain in the left pelvis after a trampoline injury.

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Episode 58: Toxic alcohols with Jerry Snow

Critical Care Scenarios

We look at evaluating the patient with encephalopathy and unexplained anion gap, including the workup and treatment of toxic alcohol poisoning, with guest Dr. Jerry Snow (@ToxicSnowEM), medical toxicologist and director of the toxicology fellowship at Banner University Medical Center in Phoenix. Find us on Patreon here! Buy your merch here! Click here to claim … Continue reading "Episode 58: Toxic alcohols with Jerry Snow" We look at evaluating the patient with encephalopathy and unexplained ani

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EM Quick Hits 47 HFNC, Dissection Drugs, ADJUST-UNLIKELY for PE, Antibiotic Course Duration, Skin Glue Hacks, ESP Block, Learner Oversight

Emergency Medicine Cases

In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UN

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Nanoparticles Get Lymphatic Vessels Pumping

Medgadget

Researchers at the Georgia Institute of Technology have developed a nanotechnological solution for lymphedema, a failure of the lymphatic system that results in uncomfortable and irreversible fluid retention. Previous research efforts have focused on trying to grow new lymphatic vessels, but these researchers have taken a different approach, and instead engineered a drug delivery technology that can directly target sluggish lymphatic vessels and kickstart their pumping action.

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EMCrit 346 – COMMS Lab – Resus Communication with Hayden Richards

EMCrit Project

Hayden Richards is a communications maven. EMCrit Project by Scott Weingart, MD FCCM.

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Ep. 125: Women in EMS

Prehospital Emergency Care Podcast

Happy Women's day PEC Podcast listeners! In this Deep Dive episode of the PEC podcast, Dr. Maia Dorsett discusses the Prehospital Emergency Care Manuscript titled Characteristics and Experiences of Women Physicians and Professionals in NAEMSP with the authors: Kathy Staats MD FACEP kstaats@ucsd.edu Anurhada Luke MD Luke.Anuradha@mayo.edu Click here to download it today!

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Smart Bandage Monitors and Treats Chronic Wounds

Medgadget

Researchers at the California Institute of Technology have developed a smart bandage for chronic wounds, such as those sometimes experienced by patients with diabetes. The bandage is flexible and stretchy, but contains electronic components that can monitor the wound for signs of infection, including abnormal temperature, increased uric acid levels, and changes in pH.

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Lab case 401

EMergucate

50 year old male with a background of alcohol dependence presents to ED after 24 hours of no alcohol use. He looked anxious and sweaty.

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PSCE conference in Lavrion, Greece

Ingenious

The INGENIOUS coordinator, the Institute of Communication and Computer Systems (ICCS) will organise the PSCE Conference in Lavrion, Greece on 10-11 May 2023 in collaboration with the National Technical University of Athens (NTUA) and the Public Safety Communication Europe (PSCE). The Conference will focus on Security threat posed by fake-based technologies, Military Cooperation for crisis management, New Technologies for Search and Rescue Operations and Horizon scanning in public safety.

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A 50-something with chest pain. what to do? And get the PM Cardio app for your own use here!

Dr. Smith's ECG Blog

This was sent to me by a friend. It is from a 50-something with chest pain: What do you think? This was marked as "Not a STEMI" by the physicians. It is not a STEMI, but it is diagnostic of an LAD OMI (Occlusion MI). There is subtle ST Elevation in V1-V4 and hyperacute T-waves in V2-V6. There is also subtle but diagnostic INFERIOR ST Elevation, with reciprocal ST Depression in aVL.

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Steroids for Severe Community-Acquired Pneumonia

FOAMcast

Apple Podcasts , Spotify , Listen Here The role of steroids in pneumonia is controversial. Steroids were found to reduce mortality in COVID-19 patients requiring at least supplemental oxygen but are not associated with a mortality benefit in influenza. In 2019, the Infectious Disease Society of America recommended against the routine use of steroids in hospitalized patients with community-acquired pneumonia (CAP) while the Society for Critical Care Medicine recommends steroids in these patients.

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How Does Compassion Fatigue Affect First Responders?

First Responder Wellness

A first responder’s work can be rewarding, but over time, it can also take its toll on an individual and lead to emotional exhaustion. This exhaustion can result from high emotional involvement, such as working with traumatized individuals in the community without adequate support. In the emergency services community, compassion fatigue can often be thought of as the emotional exhaustion manifesting itself as the reduced ability of a responder to engage with empathy or compassion toward t

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Anyone Here Using Okta And "Traumasoft?"

EMT City

The private that I work for is switching programs again. This time we are switching to "Okta" and "Traumasoft." Anyone use these? What are they like? Any info greatly appreciated.

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Is this Rhythm Puzzling to You?

Dr. Smith's ECG Blog

= My Comment by K EN G RAUER, MD ( 3/30 /2023 ): = The ECG in Figure-1 was sent to me without the benefit of any history. I thought the rhythm illustrated a number of essential concepts for clinicians dedicated to Emergency Care. Do YOU know what the rhythm is? IF this arrhythmia is puzzling to you — READ ON! I illustrate how to make the diagnosis within less than 15 seconds.

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Episode 19: How about a quickie?

The EMS Show

30 mins. down and dirty. Mike and Ritu discuss getting old (mostly Ritu) and his 30th Medical School Class reunion, as well as the upcoming ESO Training Academy and Wave Conference, being held in Austin April 11-14. Be sure and join us on our social channels over on Facebook and Twitter! Have an idea for a podcast? let us know!

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Norepinephrine, hydrocortisone, and fludrocortisone

Emergency Medicine Education

JAMA published a retrospective cohort study among septic patients who received vasopressor (norepinephrine) and hydrocortisone to show if adding fludrocortisone was more effective to this regimen compare with only giving hydrocortisone. 88275 patients reviewed and in hospital mortality and discharge to hospice as a primary outcome measured. Patients treated with combination of hydrocortisone-fludrocortisone (47.2%) had lower adjusted absolute risk difference 3.7% compare with hydrocortsone group

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A-Hip-A

EMS 20/20

After Chris defends his position on TXA, Spencer UTTERLY STUMPS him in this week's episode where a patient is KILLED by HIP PAIN! Spoiler: Patient not actually killed by hip pain. After Chris defends his position on TXA, Spencer UTTERLY STUMPS him in this week's episode where a patient is KILLED by HIP PAIN! Spoiler: Patient not actually killed by hip pain.

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Traumatic injuries associated with sexual assault

University of Maryland Department of Emergency Med

A retrospective review of patients over age 13 presenting to one urban level one trauma center and one urban community hospital looked at traumat.

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Episode 18: Exploring F1 (non EMS!!!!!)

The EMS Show

Why in the world would an EMS podcast do a podcast and not talk about EMS? Well, if you haven't figured it out by now, we are different! Join us as we discuss the new American sweetheart, Formula One racing! If you are new or interested, this is the show for you! We were joined by our favorite Brit, Rob Lawrence, and Kaileb Verkest to talk everything about F1.

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Emergency Evidence Updates – February 2023

The Bottom Line

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

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SGEM#399: I’m So Tired – Emergency Medicine and Fatigue

The Skeptics' Guide to EM

Date: March 28, 2023 Reference: Fowler et al. Objective assessment of sleep and fatigue risk in emergency medicine physicians. AEM March 2023 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You arrive at 7am to relieve your colleague after a night shift. You find her at […] The post SGEM#399: I’m So Tired – Emergency Medicine and Fatigue first appeared on The Skeptics Guide to Emergency Medicine.

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Are Mechanical Compression Devices Useful For In- Hospital Cardiac Arrest?

University of Maryland Department of Emergency Med

This is a review of the literature surrounding using mechanical compression devices for in-hospital cardiac arrest. The bottom line is there is.

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Episode 18: Exploring F1 (non EMS!!!!!)

The EMS Show

Why in the world would an EMS podcast do a podcast and not talk about EMS? Well, if you haven't figured it out by now, we are different! Join us as we discuss the new American sweetheart, Formula One racing! If you are new or interested, this is the show for you! We were joined by our favorite Brit, Rob Lawrence, and Kaileb Verkest to talk everything about F1.

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Critical Care Evidence Updates – February 2023

The Bottom Line

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

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The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

REBEL EM

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. The TOMAHAWK (Desch 2021), COACT (Abella 2019), and PEARL (Lemkes 2019) trials examined patients with OHCA without ST elevation with a shockable rhythm, and investigators found no difference in delayed versus emergency angiogram.

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Neuromuscular Blocker Dosing in Patients With Myasthenia Gravis

University of Maryland Department of Emergency Med

Myasthenia gravis is an autoimmune disease of the neuromuscular junction, most commonly due to antibodies attacking acetylcholine receptors in.

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A 40-something with 100 minutes of chest pain

Dr. Smith's ECG Blog

I was reading ECGs on the system, and saw this one: What do you think? I knew that, if the patient had presented with chest discomfort, that this ECG is diagnostic of inferior posterior OMI, even though it is not a STEMI. However, it is difficult to recognize for an interpreter who is does not have special expertise in OMI ECG diagnosis. We taught an AI system from PM Cardio to recognize patterns of subtle OMI (beware: this version of the app is not available to the public yet).

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Tasty Morsels of Critical Care 071 | Non invasive ventilation in the ICU

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Oh Chapter 37 is dedicated to NIV in the ICU and is probably worth some time given that this is a common respiratory support both in the ICU and throughout the hospital. Many of the benefits of NIV are similar to those seen with ventilation with the blue plastic tube through the vocal cords.For example you still get: positive airway pressure which recruits alveoli and improves oxygenation improved alveolar ventilation which improves min

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Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Traditionally patients were managed on the ventilator with lung volumes of 10 – 15 ml/kg. However, that practice is long-outdated and patients managed on lower tidal volumes (6 ml/kg) were found to have decreased mortality. 1 This practice of lower tidal volumes has been termed “lung protective ventilation” (LPV) and is now the standard of care for

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Cervical Spine Injuries in Patients Over Age 65

University of Maryland Department of Emergency Med

In a systematic review looking at patients over age 65 who sustained a cervical spine injury from a low-level fall, there was a 3.8% preval.

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Hypoxia is bad for traumatically brain injured patients

University of Maryland Department of Emergency Med

This study is a secondary analysis of another studying looking at hypertonic saline in traumatic brain injury (TBI) making it not the most.

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IM TXA?

University of Maryland Department of Emergency Med

This paper looks at the possibility of intramuscular tranexamic acid (TXA) administration. Pharmacologic studies support this route as gi.

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We're supposed to flood pancreatitis patients with fluids. right?

University of Maryland Department of Emergency Med

The classic teaching is that patients with acute pancreatitis should be aggressively hydrated with IV fluids. But as we increasi.

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