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This page shows you the most recent publications within this specialty of the MedWorm directory.

Diffuse ST Elevation and Chest Pain, What is it?
A male in his 40s presented by EMS with 24 hours of chest pain.  The pain was central, anterior, dull and squeezing, and 5/10, not worsened with activity but associated with mild shortness of breath.No prehospital 12-lead could be found.Here is the initial ECG at time zero:QTc is 386 ms.  There is scary ST elevation especially in V2 and aVL, with some reciprocal ST depression in III. However, the ST elevation in V2 has a saddleback appearance.  I have seen Anterior saddleback ST elevation as a finding in anterior MI only once ever, in all the ECGs and MIs I have reviewed.If you apply the early repol vs. LAD ...
Source: Dr. Smith's ECG Blog - July 6, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Mad Libs for medicine. Do you think you can use these?
Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can’t see straight. You laugh until you can’t breathe, and your parents beg you to stop! Let’s be children again. Share these with the nurses, and give the shift a little levity. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 5, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

LITFL Review 187
Welcome to the 187th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Incredible talk on vulnerability from SMACC Chicago given by Tim Leeuwenburg. This is a must watch for any physician. [AS] Did you miss SMACC Chicago? Great podcasts released by St. Emlyn’s and FOAMCast highlighting pearls from the workshops an...
Source: Life in the Fast Lane - July 5, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Test your medicine knowledge: 40-year-old man with headache and epistaxis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is admitted to the emergency department with a 1-day history of headache and epistaxis. He has had type 1 diabetes mellitus requiring insulin for 30 years and two episodes of ketoacidosis in the past year. On physical examination, temperature is 36.0 °C (96.8 °F), blood pressure is 100/70 mm Hg, pulse rate is 120/min, and respiration rate is 22/min. There is mild proptosis of the right eye with periorbital edema and a black eschar on the inferior turbinate of the right nostril. Skin examinati...
Source: Kevin, M.D. - Medical Weblog - July 4, 2015 Category: Journals (General) Authors: Tags: Conditions Infectious disease Source Type: blogs

The fourth year of medical school should be eliminated. Here’s why.
I came across an article featured on NPR and it immediately grabbed my attention.  Traditionally medical student education is accomplished in a four-year program in medical schools nationwide but University of California, Davis is now offering their medical training as a three-year obligation.  A three-year medical school as opposed to a four-year program is intriguing, thought provoking and possibly controversial.  Interested yet? Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 4, 2015 Category: Journals (General) Authors: Tags: Education Emergency Medical school Source Type: blogs

After a drowning: An impossible question a doctor faces
I head to work at my new locums job on the California coast. Summer 2015 is going to be a great one, I think to myself. I make the turn into the hospital parking lot, and a rusty old Trans Am cuts me off. I slam on the brakes to the soundtrack of screeching tires. Geez, I think to myself. It’s my first day at this job, and they’re already trying to kill me. I drive on, and I pull into my parking space. My headache is starting a little too early for this shift, I think to myself. The sun is out, the sand is hot, and it seems like everyone must be at the beach but me.  The humid heat is as thick and soothing as suntan o...
Source: Kevin, M.D. - Medical Weblog - July 3, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

Leave the Sim Lab Behind at #smaccUS
This is a guest post by Jesse Spurr (@inject_orange) On the afternoon of the 23rd June the inaugural SMACC Leave the Sim Lab Behind workshop was held. A dream team (Editor’s note: team of dreamers?) was assembled to help participants take simulation into their workplace: Dr Jon Gatward @jgatward Dr Chris Nickson @precordialthump Dr Andrew Petrosoniak @petrosoniak Dr Ernie Wang @Dr_Commonsense Jesse Spurr @inject_orange We were very ably assisted by volunteers Ali Gould (@intransition2) and Laura Raiti (@lauraraiti). Dr Claire Desmond (@domerdr and Simulation Fellow at Northwestern) provided equipment and logist...
Source: Life in the Fast Lane - July 3, 2015 Category: Emergency Medicine Authors: Chris Nickson Tags: Simulation SMACC andrew petrosoniak Chris Nickson ernie wang in situ simulation jesse spurr jon gatward leave the sim lab behind smacc chicago Source Type: blogs

Seven Big Ideas From Spotlight Health
A few of us from Health Affairs were lucky enough to attend Spotlight Health at the Aspen Ideas Festival in Aspen, Colorado. Besides seeing Elmo, what were some of the most interesting takeaways? Here are just seven of the ideas that surprised us, impressed us, and even made us reexamine what we thought we already knew. 1. From What Science Tells Us About Beating Addiction Predisposition to addiction is 50 percent hereditary, that is, determined by our genetics. Addiction is more influenced by genetics than many other conditions we tend to think of as running in our family, like high cholesterol and high blood pressure. 2....
Source: Health Affairs Blog - July 2, 2015 Category: Health Management Authors: Rob Lott and Rachel Dolan Tags: Elsewhere@ Health Affairs Featured Organization and Delivery Population Health Public Health Quality addiction Aspen Ideas Festival Cancer Hurricane Katrina infectious disease NIH Precision Medicine SDH Spotlight Health Source Type: blogs

Looking back on a life teaching CPR
“Turn out the light, the party’s over,” sang color commentator Dandy Don Meredith on ABC’s Monday Night Football when a seminal fourth quarter play occurred and the game was suddenly in the bag. For me, that’s where it’s at right now — just a few ticks of the clock away First, for the American Heart Association then for the American Red Cross, I’ve been teaching CPR to the general public — occasionally to newly-minted EMTs — on and off since 1978. Though I haven’t been keeping score, I estimate (conservatively) that I’ve instructed between twelve and f...
Source: Kevin, M.D. - Medical Weblog - July 2, 2015 Category: Journals (General) Authors: Tags: Conditions Emergency Heart Source Type: blogs

End America’s Defense Dole for South Korea
South Korean President Park Geun-hye postponed her trip to the U.S. because of a public health emergency at home. Unfortunately, the delay won’t make a future Park trip any more useful. There is much on which the two nations should cooperate. But the military alliance is outdated. Despite having surged past the North, enjoying a 40-to-1 economic advantage and 2-to-1 population edge, Seoul continues to play the helpless dependent, unable even to command its own forces in a war. South Korea eventually took off economically and adopted democracy. Yet through it all South Korea’s defense dependency on America persisted. Th...
Source: Cato-at-liberty - July 2, 2015 Category: American Health Authors: Doug Bandow Source Type: blogs

Research and Reviews in the Fastlane 089
This study found that athletes with pathologic TWI (except those in aVR, III, V1) were likely to have underlying cardiac pathology (45% of patients). Hypertrophic cardiomyopathy was the most common finding (81% of cardiac pathology). These authors recommend that all athletes with pathologic TWI be referred for further cardiac testing. Recommeded by Anand Swaminathan The R&R iconoclastic sneak peek icon key The list of contributors The R&R ARCHIVE R&R Hall of famer You simply MUST READ this! R&R Hot stuff! Everyone’s going to be talking about this R&R Landmark paper A paper that ...
Source: Life in the Fast Lane - July 1, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: R&R in the FASTLANE critical care Education Emergency Medicine Intensive Care recommendations research and reviews Source Type: blogs

Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.   Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have a...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Patient's Lie Masks the Cause of Chest Pain
A man in his 30s comes to your emergency department at 3 a.m. profoundly diaphoretic and reporting severe 10/10 chest pain. He has been at a party all night, and the chest pain started about 30 minutes earlier. He had a previous heart attack, but cannot remember many of the details. He reports no medication or drug use. No doubt this is a concerning presentation, and you immediately order an ECG, blood work, and an aspirin.   While this is in process, you review the electronic medical information, which reveals that the previous “heart attack” was actually observation for chest pain rule-out. The ECG showed nonspecifi...
Source: Spontaneous Circulation - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Don’t Smoke ’Em if You Got ’Em
A 22-year-old man with no past medical history presented to the emergency department with altered mental status. He was brought in by police who reported using a TASER on him three times after he became violent with them. His friends report he smoked K2. His initial vital signs included a temperature of 99.9°F, a heart rate of 137 bpm, blood pressure of 151/76 mm Hg, a respiratory rate of 22 bpm, and pulse oximetry of 98% on room air. The patient was agitated and combative, and was placed in four-point restraints.   K2 is a synthetic cannabinoid. Other commonly used synthetic cannabinoids include spice, moon rocks, comat...
Source: The Tox Cave - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Just Say 'No' to X-Ray
A 27-year-old woman came into the ED in the middle of the night complaining of not being able to sleep. She was sure the continuous right-sided foreign body sensation under the angle of her jaw came from a fish bone stabbing her during a late-night dinner. A CT revealed an embedded fish bone. ENT removed the foreign body endoscopically, and she was discharged on oral antibiotics, and had an uneventful follow-up visit a few days later.     The question with my residents always seems to be, "Should we get an x-ray?" And my answer now is, "No."   It is certainly possible that careful inspection of the ...
Source: Lions and Tigers and Bears - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Pain Management with Low-Dose Ketamine Infusions
Ketamine is a fascinating drug with multiple potential applications in the emergency department, but emergency physicians should consider this phencyclidine-like dissociative agent for pain management.   Pain, as we know, has complex mechanisms and pathways. Peripheral and central sensitization of pain pathways are recognized as part of the process of chronic and subacute pain syndromes. The NMDA receptor is central to the sensation of pain, and ketamine’s ability to centrally block the NMDA receptor is widely recognized and accepted as the mechanism for pain relief.   Ketamine is rapidly distributed into the brain and...
Source: M2E Too! Mellick's Multimedia EduBlog - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Primary Care Workforce: The Need To Lower Barriers For Nurse Practitioners And Physicians
For the past three years, we have tracked primary care workforce numbers comparing the annual primary care residency match data with the primary care nurse practitioner (NP) graduation rates. The physician numbers continue to be relatively flat while the nurse practitioner data continues to surge. Under the Affordable Care Act (ACA), 16.4 million people are now enrolled for health care coverage. But we have yet to see the same sorts of increases in medical school graduates entering primary care. The National Center for Health Workforce Analysis (HRSA) predicts primary care shortages as high as 20,400 physicians by 2020. Ho...
Source: Health Affairs Blog - July 1, 2015 Category: Health Management Authors: Joanne Pohl, Debra Barksdale and Kitty Werner Tags: Featured Health Professionals Organization and Delivery Population Health National Resident Matching Program primary care delivery primary care workforce triple aim Source Type: blogs

Idioms and axioms provide a glimpse into medical culture
Idioms are expressions everyone understands as something other than what the literal words say.  For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs. We say things like: It’s raining cats and dogs. It was a piece of cake! I heard it straight from the horse’s mouth. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 28, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

King v. Burwell And A Right To Health Care
Do Americans have a fundamental right to health care? This oft-debated question is timely given the Supreme Court’s stunning ruling yesterday in King v. Burwell, in which health insurance subsidies on the federal exchange were upheld in a 6-3 decision. Here I will place the King v. Burwell opinion in the larger context of to what extent Americans are provided a right to care. The Constitution itself does not stipulate a general right to health care, but a patchwork of rights to certain aspects of health care have emerged over time from both constitutional and statutory law. Constitutional Law Reproductive Health In Grisw...
Source: Health Affairs Blog - June 26, 2015 Category: Health Management Authors: Gregory Curfman Tags: Equity and Disparities Featured Following the ACA Insurance and Coverage Medicaid and CHIP Medicare Population Health Access King v. Burwell Reproductive Health right to health care Supreme Court Source Type: blogs

Health Affairs Briefing: Medicaid’s Evolving Delivery Systems
As Medicaid marks its 50th year in existence, and enrollment surpasses 70 million people, the July 2015 issue of Health Affairs includes a collection of papers focused on how the program is shaped by and has reshaped care delivery. You are invited to join us on Wednesday, July 8, 2015, at a forum featuring authors from the new issue at the National Press Club in Washington, DC. Panels will cover primary care, complex populations, payment, and coverage. WHEN: Wednesday, July 8, 2015 9:00 a.m. – Noon WHERE: National Press Club 529 14th Street NW Washington, DC, 13th Floor Register Now! Follow live tweets from the brief...
Source: Health Affairs Blog - June 26, 2015 Category: Health Management Authors: Tracy Gnadinger Tags: Elsewhere@ Health Affairs Insurance and Coverage Medicaid and CHIP California HealthCare Foundation Health Affairs Briefing Source Type: blogs

Funtabulously Frivolous Friday Five 109
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 109 Question 1 A friend casually remarks that she has an afternoon appointment with Doctor Fish, and asks you if you’ve heard anything about them. You caution her that…? + Reveal the Funtabulous Answer expand(document.getElementById('ddet672869585'));expand(document.getElementById('ddetlink672869585')) Doctor Fish Otherwise known as Garra rufa, are used in ‘fish foot spas‘ (nibbling off dead skin) ...
Source: Life in the Fast Lane - June 26, 2015 Category: Emergency Medicine Authors: Niall Hamilton Tags: Frivolous Friday Five dermographism Edward Jenner FFFF Fish spa LITFL rat warfarin zombies Source Type: blogs

Six Problems With The ACA That Aren’t Going Away
As Congress and the Obama Administration await the Supreme Court’s decision in King v. Burwell, there is heightened interest in what happens after the decision. One common assumption is that if the court rules in favor of the administration, there will be no need to make any major changes in the Affordable Care Act (ACA). This assumption is wrong. There is an urgent need to make major changes in the law regardless of how the Supreme Court rules. These are changes that will require bi-partisan cooperation — something that is rare in health policy. The changes are needed because there are at least six major problems ...
Source: Health Affairs Blog - June 25, 2015 Category: Health Management Authors: John Goodman Tags: Costs and Spending Following the ACA Insurance and Coverage Medicare employer coverage GDP global budgets individual mandate Medicare Advantage premium subsidies Source Type: blogs

Good practice in ambulance commissioning
NHS Clinical Commissioners -This briefing pulls together examples of good practice from across the country. The purpose of the briefing is to share innovative ways of commissioning emergency care, to help ambulance commissioners to think about new ways of working, in partnership with providers, to deliver effective and efficient ambulance services in their local area. Briefing NHS Clinical Commissioners - news (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - June 25, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Commissioning Source Type: blogs

Coral reef aorta
Heavy calcification of visceral part of aorta, extending into its lumen and causing malperfusion of limbs or viscera is known as ‘coral reef aorta’ [1]. It may cause hypertension due to involvement of renal arteries, which was the commonest finding noted in about 44 percent of patients in one series with 70 patients [2]. Intermittent claudication due to lower limb ischemia was noted in a similar number of patients. About a quarter of them had chronic visceral ischemia causing abdominal pain, loose stools and weight loss. Majority of them underwent aortic reconstruction with thromboendarterectomy in this series....
Source: Cardiophile MD - June 24, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

The Call To A New Kind Of Care: Integrative Medicine Group Visits Offer Promise In The Treatment Of Chronic Pain And Depression
I first met Mr. J when I was a newly minted doctor at Boston Medical Center (BMC). He walked into my office with an air of confidence, his head high, but his eyes rested warily upon me. He had been a member of the Black Panthers and now was a strong member in the organized labor movement. His gaze quickly softened and crumbled though as I sat with him and asked him gently what brought him in. He was in a broken place — his body ravaged by years of pain that now interfered with his everyday activities: his blood pressure was high and contributing to daily headaches, his once strong body had grown corpulent with inacti...
Source: Health Affairs Blog - June 24, 2015 Category: Health Management Authors: Katherine Gergen Barnett Tags: Equity and Disparities Health Professionals Hospitals Innovations in Care Delivery Organization and Delivery Public Health Boston Medical Center ICD-10 code IMGV Institute of Medicine International Classification of Diseases National Source Type: blogs

New video: AFM Erica Shaddock
Erica Shaddock, Univerity of the Witwatersrand, Johannesburg, has been an Associate Faculty Member in the Respiratory Disorders Faculty since 2008. She works with Faculty Member Charles Feldman to write article recommendations in the Respiratory Diseases Section. Recently, Erica visited us … Continue reading → (Source: Naturally Selected)
Source: Naturally Selected - June 24, 2015 Category: Biomedical Science Authors: Adie Chan Tags: Critical care & emergency medicine Faculty Members Respiratory Disorders Video Source Type: blogs

It’s time for radiologists to stop hedging
There’s a simple way to define value. Ask why we exist. Imaging exists because clinicians are uncomfortable with uncertainty. Imaging exists because emergency physicians feel that being 98 percent correct about the absence of pulmonary embolism is not good enough. Radiologists exist because imaging is not an assay on a Western blot with a 100 percent accuracy. Radiologists exist because information is imperfect, and clinicians do not like the imperfection. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 24, 2015 Category: Journals (General) Authors: Tags: Physician Radiology Source Type: blogs

Chest X-ray for the Part 1 exam
BSCC Anatomy 100 The following two videos will assist you in the part one exam. The points in the first video relate to the marks scheme provide to the present day. Be sure to point out obvious structures such as the ribs, clavicles, spine, lungs etc. The second video goes into further detail on the AP film and also the lateral chest x-ray which maybe helpful in the emergency department. Question: Please describe the main features on this chest x-ray in particular the mediastinum Examiner explanation: + Show: Real-time video/audio expand(document.getElementById('ddet1786602464'));expand(document.getElementById('ddetli...
Source: Life in the Fast Lane - June 22, 2015 Category: Emergency Medicine Authors: Neil Long Tags: Anatomy Basic Science BSCC chest Chest X-Ray cxr Source Type: blogs

Real ED Stories – Book Review
Emergency is an anatomy book. It is a collection of stories penned by Emergency Physicians across Australia, and through them the heart of the Emergency Department is meticulously dissected. The raw stories of individuals, of both patients and their clinicians, are laid wide open, for all to see. Emergency is a book that is by turns painful, occasionally gruesome, many times uplifting, but always, in its honesty, brilliantly authentic. These are short stories, written not by masterful authors, but by the doctors working at the coalface of Australasian ED’s. And in that is its strength. Some of the stories read like catha...
Source: Life in the Fast Lane - June 22, 2015 Category: Emergency Medicine Authors: Michelle Johnston Tags: Book Review ACEM Foundation Real ED Stories Source Type: blogs

How to improve patient satisfaction in the emergency department
In the last several shifts I’ve worked in the ED I’ve had more people stop and compliment me on my care. I’ve heard the usual, “Do you have a private practice?” compliment and, “I’ve been here a lot and you really took the time to hear what I was saying, I appreciate that.” Kudos are nice. They are what makes a tough shift go by quicker. They remind me why I have decided to dedicate my life to people who find themselves at their worst possible moment of health and well-being. The kudos have also caused me to pause and wonder what the heck I was doing differently since I don’t think today I am treating p...
Source: Kevin, M.D. - Medical Weblog - June 20, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

Nature And Nurture: What’s Behind the Variation In Recent Medical Home Evaluations?
Recent evaluations of two regional medical home pilots (i.e., efforts to improve the capabilities and performance of primary care practices) within the Pennsylvania Chronic Care Initiative (PACCI) have produced differing results. In the southeast region of the state, the intervention was associated with improvements in diabetes care, but no changes in other measures of quality, utilization, or costs relative to comparison practices. By contrast, the northeast region’s intervention was associated with favorable changes, relative to comparison practices, in a wider array of quality measures as well as reductions in rates o...
Source: Health Affairs Blog - June 19, 2015 Category: Health Management Authors: Mark Friedberg, Connie Sixta and Michael Bailit Tags: Featured Health Professionals Hospitals Long-term Services and Supports Organization and Delivery Population Health Quality AHRQ Chronic Care Commonwealth Fund EHRs medical homes NCQA Patient-Centered Medical Home Pennsylvania Source Type: blogs

A physician survived the Nepal earthquake. Here’s what he learned.
The morning after his brother’s bachelor party, standing on the fourth floor of his family home, Dr. Arvind Goel, felt the ground move under his feet. “First it was minor vibrations and then it built up in a crescendo and then the couch where my four-month-old son was lying began to shake.” “It was creepy,” Goel, 32, continued. “The furniture began to shake, then the light fixtures fell from the wall and then they began to swing like a pendulum. The large screen TV was about to fall.” Goel, a practicing nephrologist, was in Katmandu, Nepal, last month for his younger brother’...
Source: Kevin, M.D. - Medical Weblog - June 18, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

Research and Reviews in the Fastlane 088
This article seeks to protocolize this modality into 5 specific assessments (the “5Es”): Pericardial Effusion, Qualitative Left Ventricular Ejection Fraction, Ventricular Equality, Exit (Aortic Root measurement/assessment) and Entrance (IVC diameter and respirophasic variation). This approach is a nice way to remind clinicians of all the areas EP FOCUS can assess. The article also highlights a number of pitfalls that can lead to misdiagnosis that are critical to understand. Recommended by Anand Swaminathan Critical CareJovin TG et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. NEJM 20...
Source: Life in the Fast Lane - June 17, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: R&R in the FASTLANE critical care Education Emergency Medicine examination Intensive Care research and reviews Source Type: blogs

Foundations Begin Investing In Climate Change And Health: New Report
Conclusion While climate change has long been the bailiwick of environmentalists, the impacts of climate change are hitting every sector and every community. Grantmakers with health as a funding priority are beginning to engage in preparedness, policy analysis, and advocacy efforts and are elevating health protection, equity, and healthy economic development in strategies to create a climate for health. Editor’s Note Related Health Affairs content: David Tuller, “As Fracking Booms, Dearth of Health Risk Data Remains,” Entry Point, June 2015 issue. Kim Knowlton and coauthors, “Six Climate Change–Related Events in...
Source: Health Affairs Blog - June 17, 2015 Category: Health Management Authors: Karla Fortunato Tags: Equity and Disparities Featured GrantWatch Public Health Climate Change Environmental Health Health Philanthropy Health Promotion and Disease PreventionGW Nonmedical Determinants Source Type: blogs

Four Great Instructional SMACC Videos from Hennepin
These great procedural videos on online at SMACC.  All done at Hennepin County Medical Center's Emergency Department by my incredible colleagues.All are embedded below.3 were Winners of the SMACC instructional video contest  (Winners in September, April, and May)Minnesota Tube by Drs. Jacoby, Helland, Simpson, and Joing (WINNER)ILMA by Drs. Rowland-Fisher, Joing, Prekker, and Reardon (WINNER)Williams Airway by Drs. Kornas, Rowland-Fisher, Joing, and Reardon Nasopharyngoscopy by Drs. Paetow, Rowland-Fisher, and Reardon (WINNER)September Winner Minnesota Tube from Social Media and Critical Care on Vimeo.April ...
Source: Dr. Smith's ECG Blog - June 17, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

The Ethics of Resuscitation
A Brief History and Center for Practical Bioethics’ Efforts to Improve CPR OutcomesPromise and ProblemsCardio-pulmonary resuscitation has offered food-for-thought for philosophers and bioethicists from its beginning, and the Center for Practical Bioethics has a long history of grappling with this subject.In 1966, the National Academy of Sciences reported that closed chest cardio-massage and CPR should be ordinary treatments for hospitalized patients. Before that, CPR was a “hit-and-miss” proposition. Through the 1970s and 80s, the use of CPR became more prominent in hospitals, and CPR expanded to include ...
Source: blog.bioethics.net - June 16, 2015 Category: Medical Ethics Authors: Practical Bioethics Tags: Health Care syndicated Source Type: blogs

The saga of the boot illustrates the problem of health care costs
While there are worse times to sprain an ankle and chip a bone than just one week before a long­awaited trip to Venice, I couldn’t think of one as I sat in the emergency room for eight hours last fall. Venice, the place of canals and not cars; ancient bridges sans escalators. How ironic that just a few days before I was crowing to my husband over my hotel coup. A quaint, 18th-century hotel in the heart of Venice, right off the Rialto Bridge for less than 100 euros a night! Just because people did not like to climb stairs! Two ­hundred and seventy-eight to be exact! Continue reading ... Your patients are rating you onl...
Source: Kevin, M.D. - Medical Weblog - June 15, 2015 Category: Journals (General) Authors: Tags: Patient Emergency Orthopedics Source Type: blogs

What’s it like to be a rural surgeon? Read this to find out.
Recently I’ve been asked to write about rural surgery, what it’s like, what’s good about it.  Everything has its ups and downs. First of all let me say that whatever your job is, the money you get paid to do that job is for the crappy part, and every job has a crappy part.  The trick is to find a job that has a crappy part that you can tolerate.  Remember Mikey?  His brothers didn’t want to try the cereal, so they decided, “Let’s get Mikey.  He hates everything.” Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social ...
Source: Kevin, M.D. - Medical Weblog - June 15, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Surgery Source Type: blogs

HIT Newser: We Need Interoperability, Says HELP
By MICHELLE RONAN NOTEBOOM Judy Faulkner pledges to donate her wealth Epic founder and CEO Judy Faulkner announces plans to give away 99% of her estimated $2.3 billion wealth to charity. Faulkner joins 136 other individuals and family in the Giving Pledge, which was launched by Warren Buffett and Bill and Melinda Gates to encourage billionaires to give the majority of their wealth to philanthropic causes. What’s not to like about that? Good to know that if Epic wins the $11 billion bid for the VA’s EHR system, some of the government’s money will eventually trickle back down to charity. Are EHRs creating ...
Source: The Health Care Blog - June 15, 2015 Category: Consumer Health News Authors: michelle Tags: THCB Uncategorized Abilto Aledade Apervita Epic HIT Newser Meaningful Use Medspher Orion Health Source Type: blogs

LITFL Review 186
Welcome to the 186th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week The importance of grit in medicine can’t be stated enough. Mike Lauria discusses the concept and its import. [AS]   The Best of #FOAMed Emergency Medicine Excellent lecture on the non-utility of backboards and collars via Anton Helman and...
Source: Life in the Fast Lane - June 14, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

The Uncertainty of Truth
An excerpt from The Uncertainty of Truth: We live in a world where uncertainty has been eliminated. The publication of the Doctrine of Certitude meant that uncertainty was officially forbidden for the first time in history. The passage of this law rendered the phrases ‘I don’t know’, ‘I’m not sure’ and even ‘Huh …’ illegal and punishable by life imprisonment. Neoastrophysicists, using chaos theory, have modelled intergalactic maps that predict even the smallest particle of space dust’s coordinates within a half millimeter of its actual location. Cosmometeorologists have derived atmospheric m...
Source: Life in the Fast Lane - June 13, 2015 Category: Emergency Medicine Authors: Chris Nickson Tags: EMA Journal Emergency Medicine FOAM dispatches from the FOAM frontier Schrodinger's cat uncertainty of truth Source Type: blogs

Emergency Physicians Must Make the Tough Decisions
This recent case, which occurred within the past year, was sent to me by an unnamed 2nd year EM resident.  She says she is a believer in all things FOAM!As this case could have been managed better, she will remain anonymous.  But rather than being critical of the management, just try to learn from it.Case presentation:A middle-aged woman with a history of vascular disease presented to a community Emergency Department after an episode of syncope. She complained of 24 hours of severe chest pain radiating to her back, and epigastric abdominal pain. Initial vital signs were BP 128/85, HR 122, RR 22 and O2 saturation ...
Source: Dr. Smith's ECG Blog - June 12, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Where you were born determines if you live. This 1-minute video shows you why.
Can you imagine a world without health care?  This video shows you.  Courtesy of the U.K.-based Save the Children.   Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 11, 2015 Category: Journals (General) Authors: Tags: Video Emergency Source Type: blogs

Doctors: Now is the time to develop your style with patients
I’m thankful that my first rotation was family medicine out in Youngstown, Ohio. Youngstown is a small town halfway between Cleveland and Pittsburgh. Everything moves a little slower out there compared to what I’m used to in Brooklyn and Manhattan. Similarly, my family medicine rotation as a whole was slower and calmer compared to my other rotations. I didn’t see any emergency conditions or an excessive number of rare pathologies in the doctor’s office I rotated through. I saw routine diseases that affect the majority of Americans: hypertension, diabetes, chronic pain, concerning moles and freckles, so on and so fo...
Source: Kevin, M.D. - Medical Weblog - June 11, 2015 Category: Journals (General) Authors: Tags: Education Primary care Source Type: blogs

Research and Reviews in the Fastlane 087
Welcome to the 87th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out...
Source: Life in the Fast Lane - June 10, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: R&R in the FASTLANE critical care Education Emergency Medicine Intensive Care recommendations Review Source Type: blogs