EMCrit Project

APRIL 15, 2023

Recently, two sets of guidelines for neuroprognostication following cardiac arrest were released – almost simultaneously. In a perfect world, two evidence-based guidelines based on the same evidence would be the same. But of course, this isn't actually the case. The guidelines differ significantly. The Neurocritical Care Society guidelines recommended this general approach:(36949360) Meanwhile, the Canadian […] EMCrit Project by Josh Farkas.

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ALiEM

APRIL 17, 2023

A 29 year-old-male with a past medical history of left eye enucleation secondary to a gunshot wound several years prior presents to the Emergency Department (ED) for blurry vision, redness, and concern for a deformity to his right eye. The patient states symptoms started 2-3 months ago and he initially thought symptoms were due to allergies and recalls rubbing his eye a lot.

Emergency Department 130

Emergency Department OR ED 130

EMergucate

APRIL 16, 2023

Deep Sulcus Sign. There is a supine pneumothorax on the right as evidenced by a deep sulcus sign.

EMS 130

EMS 130

REBEL EM

APRIL 17, 2023

Background: The increased utility and accessibility of point-of-care ultrasound (POCUS) has allowed clinicians the freedom to rethink their diagnostic approach for many common diseases, including peritonsillar abscess (PTA). Clinical evaluation may prove difficult since many PTA and peritonsillar cellulitis symptoms overlap. Physical examination is approximately 75% sensitive and 50% specific for identifying PTA.

ALS 128

ALS OR ED EMS 128

Critical Care Scenarios

APRIL 19, 2023

When scooching a patient in the bed can make a difference. When scooching a patient in the bed can make a difference.

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Medgadget

APRIL 18, 2023

Researchers at the University of Washington have developed GlucoScreen, a smartphone system that can accurately measure blood glucose levels. The technology consists of a test strip onto which a user places a drop of blood. Following an electrochemical reaction on the strip, the data are transmitted to the smartphone through a series of taps on the touch screen, somewhat like Morse code.

79

79

EMergucate

APRIL 16, 2023

The knee x-ray shows a small curvilinear bony avulsion adjacent to the lateral tibial plateau implying a Segond fracture.

EMS 130

EMS 130

The Bottom Line

APRIL 21, 2023

In patients in the ICU with delirium, does haloperidol compared with placebo, increase the number of days alive and out of the hospital at 90 days?

ICU 52

ICU 52

Medgadget

APRIL 19, 2023

Researchers at Northwestern University have developed a transistor that can boost the signal created by electrochemical sensors by 1000-fold. The breakthrough may enable the development of highly sensitive implantable sensors that can measure tiny changes in electrochemical signaling in the body. This could allow clinicians to monitor tissue responses in near real time, instead of running a blood sample on bulky and expensive lab equipment and getting the results hours or even days later.

OR 74

OR 74

EMergucate

APRIL 16, 2023

The neck x-rays are from a 6-year-old with neck pain, difficulty swallowing following a recent bout of upper respiratory tract … Continue reading →

EMS 130

EMS 130

Dr. Smith's ECG Blog

APRIL 21, 2023

Written by Jesse McLaren, with comments from Smith A 50-year old patient on the medical wards developed acute chest pain, with an ECG labeled (see computer interpretation at the top) and confirmed as normal. What do you think? There’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression, and normal voltages. Lead aVL jumps out as abnormal because there is a discordant T wave inversion and mild ST depression.

STEMI 52

STEMI Coronary EMR EMT 52

Firefighters and EMS Fund

APRIL 20, 2023

Ballot measures are used to help support local fire departments and firefighters when funds run low and more budget is needed. For first responders and firefighters, communicating our needs to the public before an election is essential when a ballot measure is on the ballot. It may mean the difference between new equipment, up-to-date training, […] The post Local Ballot Measures for Firefighters in 2023: How Did the People Vote?

Firefighter 52

Firefighter First Responder EMS 52

The Bottom Line

APRIL 20, 2023

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

Critical Care 52

Critical Care 52

NAEMSP

APRIL 19, 2023

Article by Erin Lincoln, MD Case Scenario: You are dispatched to a 68-year-old male in cardiac arrest. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. He is found to be in ventricular fibrillation (VF). After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest.

E-9-1-1 52

E-9-1-1 Advanced Life Support Overdose CPR 52

First 10 EM

APRIL 17, 2023

In a lecture series entitled “Get off the fence”, in which I discuss practice changing evidence based medicine, I have discussed the role of antibiotics in diverticulitis multiple times this year. Although I have discussed the topic previously on First10EM, I wanted to provide a quick summary of the most important publications as a quick […] The post Antibiotics are not needed in uncomplicated diverticulitis appeared first on First10EM.

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Dr. Smith's ECG Blog

APRIL 17, 2023

One case sent by Dr. Sean Rees MD, written by Pendell Meyers, other case by Sam Ghali and Steve Smith Take a look at these two ECGs below from two patients in the ED, first without any clinical context. Full case details and outcomes are below. Case 1: Case 2: Case 1: What do you think? This was sent to Dr. Smith by SamGhali (@EM_RESUS) with zero other info.

OR 52

OR STEMI ACS ALS 52

Clinical Correlations

APRIL 17, 2023

By Mercedes Fissore-O’Leary Peer Reviewed I. It is his youngest’s birthday today. His oldest is in the military, like he was. Except he served in the navy, in Vietnam. He has a birthday.

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A Paramedic's Notebook

APRIL 21, 2023

My first post went live seven years ago today. A lot has changed since then. Aside from not writing here regularly, I’ve moved, married, changed job roles and have expanded the family with kids. It’s a good opportunity to take time and reflect on how far I’ve come and where I’d like to go next. Anniversaries are only arbitrary if you don’t put in the work to make them significant.

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University of Maryland Department of Emergency Med

APRIL 20, 2023

Multiple modalities are available for pain control in the pediatric setting. Ketamine has recently been introduced into the prehosp.

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The Bottom Line

APRIL 20, 2023

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

Critical Care 40

Critical Care 40

Medgadget

APRIL 18, 2023

Researchers at MIT have developed lipid nanoparticles that are highly efficient at delivering mRNA therapies to lung cells. Getting therapeutic agents into the lungs can be challenging, but there are a variety of medical challenges that could be addressed by efficiently targeting lung cells with nanoparticle technologies. These latest particles are highly efficient at delivering mRNA which can then encode therapeutically useful proteins in the lungs.

OR 121

OR 121

The Skeptics' Guide to EM

APRIL 15, 2023

Date: April 12, 2023 Reference: Weizmann et al. Incidence of Cardiac Arrest During Sports Among Women in the European Union. JACC November 2022 Guest Skeptic: Dr. Susanne (Susy) DeMeester is an Emergency Physician practicing at St Charles Medical Center in Bend, Oregon. She has been very involved with EMRAP’s CorePendium as the cardiovascular section editor.

ALS 137

ALS Coronary OR 137

University of Maryland Department of Emergency Med

APRIL 19, 2023

CCM recently published Stanford's experience with their Emergency Critical Care Program (ECCP), an ED based intensivist consultation/management mo.

Critical Care 40

Critical Care Emergency Department ED 40