The Skeptics' Guide to EM
JULY 8, 2023
Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM.
Emergency Medicine Cases
JULY 18, 2023
On this month's EM Quick Hits podcast David Carr on differential diagnosis of normal unenhanced CT renal colic, Leeor Sommer on recognition and management of perichondritis and auricular abscess, Suzanne Schuh on IV magnesium sulphate for pediatric asthma, Jess McLaren on Occlusion MI ECG interpretation requiring cath lab activation and Justin Morgenstern on update on steroids for pneumonia.
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ALiEM
JULY 22, 2023
You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. However, the crystalloid fluids are not flowing freely. Multiple attempts were made to place this line with the latest having a flash of blood return and a smoothly flowing saline flush. You can not seem to find your pressure infusion cuff to squeeze the IV bag and accelerate fluid administration.
EMergucate
JULY 19, 2023
Characteristics Associated With Serious Self-Harm Events in Children and Adolescents Mert Sekmen,a,b Carlos G.
Pediatric EM Morsels
JULY 7, 2023
In the past, we have discussed several causes of Knee Pain in children. Some of those causes are benign (ex, Osgood Schlatter’s Disease ) while others are scary (ex, osteosarcoma ). Evaluating the limping child , though, requires us to ponder not only the common (ex, Toddler’s Fracture ), but also to be vigilant for the severe (ex, Septic Arthritis ).
REBEL EM
JULY 5, 2023
Take Home Points Provider assessment of how the patient looks is extremely important. If it looks and feels like a STEMI clinically, get serial ECGs and consult Cardiology immediately. POCUS has been a phenomenal tool in the management and early diagnosis of a lot of abnormal ECG and chest pain presentations. Isolated elevation in aVR with diffuse ST depressions can be a sign of Left Main occlusion.
The Skeptics' Guide to EM
JULY 29, 2023
Date: July 21, 2023 Reference: McDonald et al. Patterns of change in prehospital spinal motion restriction: a retrospective database review. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.
Paramedicine Now brings together the best content for paramedicine professionals from the widest variety of thought leaders.
ALiEM
JULY 20, 2023
Welcome to the AIR Infectious Disease Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to infectious diseases in the Emergency Department. 6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board.
EMergucate
JULY 31, 2023
50-year-old man with history of type II diabetes and colorectal cancer. He is on Metformin and other anti-diabetic medications.
American Ambulance Association
JULY 24, 2023
Register Now: National EMS Advisory Council Meeting August 9-10 The National EMS Advisory Council (NEMSAC) will host a hybrid meeting on Wednesday, August 9, 2023, at 1:00 pm ET, […] The post NEMSAC | Meeting August 9-10 appeared first on American Ambulance Association.
Emergency Medicine Cases
JULY 18, 2023
You are working the ambulatory section of your ED and evaluating a 6-year boy with a possible distal radius injury. He lives with autism spectrum disorder and is uncomfortable in X-ray rooms, and you wonder if there is a role for PoCUS to help exclude a fracture. With expert clinical commentary by Dr. Arun Sayal and Research Methodology Hot Take by Dr.
The Skeptics' Guide to EM
JULY 22, 2023
Date: July 21, 2023 Reference: Prekker et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. He is board certified in both Emergency Medicine […] The post SGEM#410: Do You See What I See?
EMS 12-Lead
JULY 24, 2023
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (ret) @DidlakeDW Expert commentary and peer review by Dr. Steve Smith [link] @smithECGBlog A 57 y/o Female with PMHx HTN, HLD, DM, and current use of tobacco products, presented to the ED with chest discomfort. She described it as tightness, centralized, and associated with both dyspnea and diaphoresis.
ALiEM
JULY 24, 2023
Dr. Sara Krzyzaniak (EM program director at Stanford) hosts this episode with Dr. Michelle Lin (ALiEM/UCSF) featuring all-star guests Dr. Alexis Pelletier-Bui (EM associate program director at Cooper University Hospital) and Dr. Elizabeth Werley (EM program director at Penn State Hershey). Both our guests serve as key representatives on behalf of the EM specialty on the AAMC ERAS Supplemental Application Working Group and provide you with a sneak peek behind what is coming for the totally revamp
EMergucate
JULY 27, 2023
The frontal chest x-ray shows a cavity with fluid level projected over the right dome of diaphragm.
American Ambulance Association
JULY 20, 2023
This content is for AAA members only. Please either Log In or Join! The post CMS Releases Advance Copy of CY 2024 Physician Fee Schedule Proposed Rule appeared first on American Ambulance Association.
First 10 EM
JULY 3, 2023
The pace of these literature summaries has decreased over the years, but perhaps that means that quality has increased? I think there is an interesting variety of papers this time around, from sepsis, to b t, to patient access to their own results online. A few huge papers dropped in the past few weeks, including RCTs […] The post Research Roundup (July 2023) appeared first on First10EM.
The Bottom Line
JULY 1, 2023
What’s new in the Critical Care literature – monthly updates
Critical Care Scenarios
JULY 26, 2023
The dilemma of lung-protective ventilation in patients with strong spontaneous breathing. The dilemma of lung-protective ventilation in patients with strong spontaneous breathing.
ALiEM
JULY 17, 2023
The Study In an Annals of Emergency Medicine paper , Preiksaitis et al. sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. The authors completed a cross-sectional, observational study using National Residency Matching Program (NRMP) data and examined 9 variables as potential predictors of unfilled PGY1 positions using regression analyses [2].
EMergucate
JULY 27, 2023
The chest x-ray is technically inadequate. AP view has magnified the cardiac shadow.
American Ambulance Association
JULY 20, 2023
Washington, DC— While the Centers for Medicare & Medicaid Services (CMS) has decided to end the Emergency Triage, Treat, and Transport (ET3) Model two years early on December 31, 2023, […] The post AAA Encourages CMS to Consider Revised Innovation Model for Treatment in Place appeared first on American Ambulance Association.
REBEL EM
JULY 24, 2023
Background: Rapid Sequence Intubation (RSI) is a procedure fraught with potential complications including hypotension which, in turn, can result in cardiovascular collapse. While there are numerous potential causes of hypotension peri-RSI, induction medications represent an important, modifiable variable. Over the last decade, airway experts have advocated for reduced induction agent dosing to lessen the risk of hypotension particularly in at risk patients.
Don't Forget the Bubbles
JULY 24, 2023
Discitis is an inflammatory condition involving the intervertebral discs and end plates of vertebral bodies. It encompasses a spectrum of conditions that includes discitis , spondylodiscitis , and vertebral osteomyelitis. Discitis is uncommon. However, there is a bimodal peak in children, those under 6 years and adolescents. Neonates can also be affected.
Critical Care Scenarios
JULY 19, 2023
We dive into when to initiate renal replacement therapy, the modalities, settings, and physics involved, troubleshooting problems, and more, 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 We dive into when to initiate renal replacement therapy, the modalities, settings, and physics involved, troubleshooting problems, and more, with Dr.
First 10 EM
JULY 17, 2023
I have written about the resuscitation of anaphylaxis and asthma before. However, I was forwarded the AMAX4 algorithm for the patient with asthma or anaphylaxis who is either unconscious or requiring assisted ventilation, and I think it is an important addition for our sickest patients. The heartbreaking backstory to this algorithm and website, created by […] The post Critical anaphylaxis and asthma: The AMAX4 algorithm appeared first on First10EM.
EMergucate
JULY 27, 2023
The chest x-ray shows a hyperinflated right lung field.
American Ambulance Association
JULY 20, 2023
This content is for AAA members only. Please either Log In or Join! The post Perez and Finstad Push Medic to Paramedic Provision appeared first on American Ambulance Association.
REBEL EM
JULY 26, 2023
Take Home Points Methylxanthines are a drug class that includes caffeine, theophylline, and theobromine. The three main mechanisms that account for the clinical presentation of methylxanthine toxicity are: catecholamine release, adenosine antagonism, and phosphodiesterase inhibition. Beta agonism will lead to hyperlactatemia, hypokalemia, hyperglycemia, and tachycardia.
Don't Forget the Bubbles
JULY 19, 2023
Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. She went to the optician today to get a new pair of glasses. When they examined her and found that she had enlarged optic discs, they sent Olivia to the ophthalmology ED. The Ophthalmology SHO agreed and referred Olivia to you. They had explained to Olivia and her parents that she needed urgent neuroimaging as the enlarged optic discs could be a sign of a brain tumour.
Critical Care Scenarios
JULY 12, 2023
5 things you pretty much must be doing if you want to be excellent at critical care. See also on the blog: The ten laws of critical care Practicing medicine like an adult 5 things you pretty much must be doing if you want to be excellent at critical care.
ACEP Now
JULY 8, 2023
ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.
EMergucate
JULY 27, 2023
The chest x-ray shows presence of pneumomediastinum as indicated on the image. There is no obvious pneumothorax.
American Ambulance Association
JULY 19, 2023
From CMS on July 19, 2023 The next CMS Ambulance Open Door Forum scheduled for: Date: Thursday, July 27, 2023 Start Time: 2:00pm-3:00pm PM Eastern Time (ET); Please dial-in at […] The post 7/27 CMS Ambulance Open Door Forum appeared first on American Ambulance Association.
The Bottom Line
JULY 1, 2023
In critically ill adults undergoing tracheal intubation, does the use of a videolaryngoscope (VL) compared to a direct laryngoscope (DL) improve the first-pass success rate?
Don't Forget the Bubbles
JULY 12, 2023
4-year-old Mark presents with lethargy, jaundice, and abdominal pain after eating one portion (40g) of broad beans. Could he have G6PD deficiency? G6PD , short for glucose-6-phosphate dehydrogenase, is an enzyme active in all cell types and is key to protecting red blood cells from oxidative damage and early destruction. A child with reduced G6PD enzyme activity has increased red blood cell breakdown – haemolysis – when exposed to specific triggers.
Critical Care Scenarios
JULY 5, 2023
We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles for doing it right. Bluejacket_headshot Download We chat with Callie Tennyson, DNP, ACNP-BC, AACC, CHSE, assistant professor from the Duke University School of Nursing, about the use of the internet and social media for medical education: trends, challenges, and principles f
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