EMCrit Project
MARCH 21, 2023
Steroid is worthless for pneumonia! Wait, a new study shows it's beneficial! Hang on, a fresh meta-analysis shows that steroid it's useless! And wait, here's a fresh NEJM study showing mortality benefit!! This feels like a roller coaster. What's going on here? Several factors may explain this: Steroid is beneficial, but only in a subset […] EMCrit Project by Josh Farkas.
The Skeptics' Guide to EM
MARCH 31, 2023
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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Pediatric EM Morsels
MARCH 31, 2023
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.
Emergency Medicine Cases
MARCH 28, 2023
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?
EMergucate
MARCH 26, 2023
The following pelvic x-ray is from a 10-year-old with pain in the left pelvis after a trampoline injury.
Core Ultrasound
MARCH 24, 2023
Examining the Utility of Cardiac Ultrasound During Cardiac Arrest Peer reviewed by Ben Smith, MD 3/23/23 RWMA R Heart TEE Cardiac POCUS can be dramatically useful and life-saving in cardiac arrest. I like to think about it in three different broad categories: Procedural, identifying reversible causes, and guiding therapy. This video isn’t a discussion regarding its utility for procedures or diagnosing reversible causes, but it is talking about how maybe the echo pulse check is not the best way t
EMS 12-Lead
MARCH 19, 2023
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. Fire/EMS crews found him clammy and uncomfortable. Vital signs were noted to be unremarkable with respect to any hypo-hypertensive crisis, hypoxia, etc.
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Medgadget
MARCH 17, 2023
Researchers at Linköping University in Sweden have developed a method whereby the body can ‘grow its own’ electrodes. The minimally invasive technique involves injecting a hydrogel that is laden with enzymes into target tissues. The enzymes interact with molecules that are present in the tissue to change the structure of the gel and allow it to become electrically conductive.
Emergency Medicine Cases
MARCH 28, 2023
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
EMergucate
MARCH 18, 2023
The following chest x-ray is from a 42-year-old with asthma exacerbation. What can be noticed?
EMCrit Project
MARCH 17, 2023
A new format of ED Critical Care perfectly suited to rural environments EMCrit Project by Scott Weingart, MD FCCM.
Critical Care Scenarios
MARCH 29, 2023
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
The Skeptics' Guide to EM
MARCH 11, 2023
Date: March 8, 2023 Reference: Smida et al. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital Emergency Care 2023 Guest Skeptic: Dr. Chris Root is a third-year resident physician in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM. […] The post SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking f
Medgadget
MARCH 9, 2023
Researchers at University College London and at the University of Ghana have developed a smartphone-based system that can detect anemia through simple photos taken using the phone’s camera. The technology is intended for use in low- and middle-income countries where access to routine medical diagnostics may be unreliable. The process involves obtaining images of areas of the body which are least pigmented, including the white of the eye, the lower eyelid, and the lip.
Emergency Medicine Cases
MARCH 14, 2023
In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes?
EMergucate
MARCH 11, 2023
The elbow x-ray shows Small irregular densities suggestive of avulsion fractures posterior to the elbow associated with soft tissue swelling.
EMCrit Project
MARCH 25, 2023
Hayden Richards is a communications maven. EMCrit Project by Scott Weingart, MD FCCM.
Critical Care Scenarios
MARCH 22, 2023
Some basic tactics for keeping attention in your live talks, presentations, and lectures. Find us on Patreon here! Buy your merch here! Some basic tactics for keeping attention in your live talks, presentations, and lectures. Find us on Patreon here! Buy your merch here!
The Skeptics' Guide to EM
MARCH 4, 2023
Date: March 3, 2023 Reference: Hosseinialhashemi et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Ann Emerg Med. 2022 Guest Skeptic: Dr. Dominique Trudel is a CCFP-EM resident in Ottawa, Ontario. Her interest is serving French minority communities delivering care at the Montfort Hospital in Ottawa.
Medgadget
MARCH 9, 2023
Researchers at Columbia University Irving Medical Center and the Université de Paris, France, have tested an ultrasound denervation catheter in its potential to treat hypertension. The technology is called the Paradise ultrasound denervation device and it has been developed by ReCor Medical , a medtech company with offices in California and the UK. The concept is based on the phenomenon whereby overactive neural activity in the kidney can lead to increases in sodium and water retention, underlyi
Prehospital Emergency Care Podcast
MARCH 31, 2023
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!
EMergucate
MARCH 11, 2023
The chest x-ray shows an incidental finding of Azygous lobe.
EMCrit Project
MARCH 10, 2023
CLOVERS Trial Primer and Fluids in Septic Shock EMCrit Project by Scott Weingart, MD FCCM.
Critical Care Scenarios
MARCH 15, 2023
We discuss our approach to keeping up with research, learn about new studies, interpret them, and some general thoughts on how to apply new literature to our practice. Find us on Patreon here! Buy your merch here! We discuss our approach to keeping up with research, learn about new studies, interpret them, and some general thoughts on how to apply new literature to our practice.
Dr. Smith's ECG Blog
MARCH 31, 2023
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.
Medgadget
MARCH 17, 2023
Researchers at Ecole Polytechnique Fédérale de Lausanne (EPFL) in Switzerland have developed a method to 3D print mineralized constructs with a little helping hand from bacteria. The technique consists of printing a polymer bioink that contains bacteria that will produce calcium carbonate when exposed to a urea solution. The two-step process also involves printing a construct and then exposing it to urea for several days, over which time the bacteria naturally mineralize the structure.
FOAMcast
MARCH 27, 2023
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.
EMergucate
MARCH 7, 2023
Chest x-ray from an adult female with dry retching. What can be seen? Answer will be posted later.
First Responder Wellness
MARCH 27, 2023
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
Critical Care Scenarios
MARCH 8, 2023
When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here! When the lessons of memory, clinical experience, and time may be more deceptive than instructive. Find us on Patreon here! Buy your merch here!
Dr. Smith's ECG Blog
MARCH 30, 2023
= 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.
Medgadget
MARCH 1, 2023
Scientists at the University of Massachusetts Amherst have developed a biosensor that is based on protein nanowires that are created by bacteria. The protein nanowires are highly sensitive to ammonia, in this case, which is present in the breath of patients with kidney disease, but it is likely possible to create nanowires for a huge array of other health biomarkers.
REBEL EM
MARCH 27, 2023
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
EMergucate
MARCH 27, 2023
Question 1: PH = 6.9, that is severe acidaemia HCO3 = 22 mmol/L. So, we have metabolic acidosis. Next, we need to calculate the Anion gap and the compensation.
First Responders Foundation
MARCH 24, 2023
Our JAVELAN Team recently visited the Beemer American Legion where they received a very generous donation of $10,000. Reporter Ashley Gaughan of the West Point News wrote the following article and with permission, we are sharing her story. JAVELAN Service Dogs Give Veterans & Retired First Responders A New Outlook On Life. Many veterans and first responders will testify that their JAVELAN service dog has significantly changed their life for the better.
Critical Care Scenarios
MARCH 1, 2023
We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky.
Dr. Smith's ECG Blog
MARCH 27, 2023
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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