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Total 199 results found since Jan 2013.

A Sweet Wide Complex Tachycardia
A 29-year-old man with history of type 1 diabetes mellitus presents with two weeks of feeling ill that became worse over the previous two days. This included a productive cough, subjective fevers, and frequent vomiting. He reports no headache, chest pain, or abdominal pain. He has had financial problems after losing his job about a month earlier, and is currently living in a local motel. His brother brought him to the emergency department for evaluation after finding him in bed confused, with vomit on the floor.   He appeared ill, and was oriented only to self. Vital signs were blood pressure 78/43 mm Hg, pulse 146 bpm, r...
Source: Spontaneous Circulation - November 12, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Take Me Out to the Ballgame
A 31-year-old man presented to the ED with syncope. He was previously healthy, takes no medications, and had run a marathon the day before. He was riding the light rail home from a baseball game when he developed vague 4/10 epigastric abdominal pain associated with nausea and diaphoresis. He remembers feeling lightheaded and flushed before momentarily passing out. His wife said he became quite pale immediately beforehand. He did not have any headache, chest pain, or shortness of breath before or after the syncopal episode. He has a significant family history of premature coronary artery disease. He had normal vital signs ...
Source: Spontaneous Circulation - October 11, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

All The Good Stuff
I recently saw the awesome workshops being lined up for the 30th ACEM Annual Scientific Meeting in Adelaide this November. I asked Thiru what really good stuff was going down this year — this it what’s being served up: Critical care stuff — Updates in Resus, Trauma, Cardiology… Topical stuff — Time based targets, Sepsis guidelines, Thrombolysis for stroke, International EM… Education stuff — “Management for Clinicians” workshop by RACMA, CRP update, Communication workshop, SIMWARS, US “finishing school”, “How to publish workshop” “Tox workshop” “Radiology workshop”… Ext...
Source: Life in the Fast Lane - August 20, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Conference Emergency Medicine Featured South Australia ACEM adelaide all the good stuff ASM Source Type: blogs

Semantics
A 17 year old patient comes in by ambulance for chest pain and tachycardia. His heart rate was in the 130s. He was hypertensive. He was sweating. He had a history of ADHD and was on Adderall. No other medications. No alcohol or drugs. His exam was unimpressive and all the testing came back negative, but the patient still remained tachycardic. So we gave him a couple doses of Ativan, thinking he may have taken a little too much Adderall. Still no better. Then we started doing some additional tests to rule out the less common reasons for his symptoms. D-dimer normal. He denied alcohol or drugs, but we checked for them anyway...
Source: WhiteCoat's Call Room - August 13, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs

SMACC: The Dark Art of IVC Ultrasound
Thanks to plenty of people for their input, but especially Kylie Baker and Adrian Goudie When I was first taught about sonographic assessment of the Inferior Vena Cava (IVC), the following table was unveiled with great solemnity: IVC diameter (cm) IVCCI Estimated RA pressure (mm Hg) <1.7 >50% 0-5 >1.7 >50% 6-10 >1.7 <50% 11-15 ‘dilated’ none >15 We were told to learn these measurements, take them to the bedside and use them on our critically ill patients to guide resuscitation. We were commanded to use M-mode assessment in the subxiphoid ling axis, and ideally a sniff test. IVC ultra...
Source: Life in the Fast Lane - July 26, 2013 Category: Emergency Medicine Doctors Authors: Justin Bowra Tags: Emergency Medicine Featured Intensive Care SMACC inferior vena cava ivc justin bowra Ultrasound Source Type: blogs

Making a Dream a Reality
By Joseph Kim, MD.   As a Korean-American, I have always been curious about exploring my heritage. Fortunately, I have had the opportunity to visit South Korea several times, including two trips during residency. Each time I visited, I realized that I had developed a desire to live in South Korea one day. But deciding to work in Korea as a physician was an enormous decision, and I did not want to make it lightly. I wanted to have the chance to explore the life of an emergency physician in South Korea before making such a life-altering decision.    I began researching potential hospitals that might allow me to rotate...
Source: Going Global - June 11, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Strip Tease
Part of the fun of #FOAMed is to explore myriad of alternative ways of providing high quality medical education in an asynchronous learning environment. To this end we are constantly scouring the web to read, review and revel in innovative ways to educate Strip Tease StripTease is aimed at providers who need to make fast interpretations of critical care monitoring equipment. The site is primarily aimed at on-call inpatient residents, pre-hospital personel and emergency responders. The focus is on rapid real-time ECG interpretation. Single rhythm strips as would be presented on a bedside monitor, a defibrillator or an alar...
Source: Life in the Fast Lane - May 31, 2013 Category: Emergency Medicine Doctors Authors: Mike Cadogan Tags: Cardiology ECG Education eLearning Emergency Medicine Featured Investigation [tests ] Medical Specialty EKG rhythm strip strip interpretation strip tease Source Type: blogs

The LITFL Review 102
Welcome to the 102nd edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around. The Most Fair Dinkum Ripper Beaut of the Week Resus.ME Cliff Reid over at Resus.ME smashes his way to top spot this week, as he brings us 3 great hot-of-the-pres...
Source: Life in the Fast Lane - April 23, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs

Prof Montage 3 minute cardiology
The pleomorphic education revolution is upon us In the FOAMed age I am constantly amazed at the resourcefulness of medical educators globally to produce high quality, entertaining, thought-provoking, stimulating and controversial multimedia…for free. We are throwing off the shackles of peer review and boldly placing both feet in the anarchistic torrent of crowd-sourced education, feedback, commentary and response. As technology develops; broadband access to data improves and educators embrace the new medium – we will see an exponential growth in alternate teaching methods. Prof Montage is a cardiologist practi...
Source: Life in the Fast Lane - February 12, 2013 Category: Emergency Medicine Doctors Authors: Mike Cadogan Tags: Education eLearning Emergency Medicine Featured FOAMed Reviews Web Culture Website cardiac physiology Cardiology clinical epidemiology medical education Prof Montage ProfMontage Source Type: blogs

Ideal job - 6 years out
One of my attendings once told me that it takes about 5 - 7 years for a new ER doctor to master the specialty. This was music to my ears, because I knew that I was *not* confident upon residency graduation to jump into this very stressful specialty. I needed to wade in...from the shallow end of the pool...slowly.When I graduated, I did not look for jobs that required me to "roll up my sleeves" and do *real* emergency medicine. Contrary to what my colleagues seemed to believe, I realized that I was not quite ready to be a sole doctor in a small town ER, with no specialist support...trying to save lives. Emergency medicine i...
Source: EM Physician - Backstage Pass - April 4, 2011 Category: Emergency Medicine Authors: Taylor Source Type: blogs