General Archives - The Emergency Medical Minute

General

Podcast 856: ED Errors and Counterstudy

Contributor: Nicholas Tsipis, MD Educational Pearls: What study was Dr. Tsipis talking about? In December of 2022, the Agency for Healthcare Research and Quality (AHRQ) put out a study titled “Diagnostic Errors in the Emergency Department: A Systematic Review.” This study triggered many news stories from prominent outlets with headlines such as, “More than 7…

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Podcast 833: NS vs LR

Contributor: Travis Barlock, MD Educational Pearls: Normal Saline (NS) contains 154 mEq of both Sodium (Na) and Chloride (Cl),  and has a pH of 5.5 Normal Na and Cl in adult humans are about 140 mEq/L and 103 mEq/L. respectively   Excess negative charge resulting from hyperchloremia is managed via bicarbonate excretion leading to loss of…

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Podcast 825: ALS vs PD Transport

Contributor: Aaron Lessen, MD Educational Pearls: In urban settings, it is becoming more common for police to transport critical patients from scene to hospital A 2022 multicenter observational study compared mortality rates in patients with penetrating injury to torso and/or proximal extremity when transported by EMS versus police Approximately 18% of patients were transported by…

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Podcast 784: Wastewater Surveillance for COVID

Contributor: Jared Scott, MD Educational Pearls: About 50% of those infected with SARS-CoV-2 will shed the virus in their feces   Wastewater surveillance can be used to track COVID burden, which may be easier than collating test data from multiple hospitals across a region  Viral shedding begins 5-7 days prior to symptom onset, so wastewater data…

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Podcast 777: Grass, Weed, and Ancient Rome

Contributor: Chris Holmes, MD Educational Pearls: Antiemetics were used in ancient Rome to help with sea-sickness and included toxic substances such as wine and wormwood and white hellborn The first antihistamine used for nausea, dramamine, was introduced in 1947 for motion sickness After this chlorpromazine, prochlorperazine, and promethazine came about in the 1950s and 1960s…

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Podcast 776: Single-Site Blood Cultures

Contributor: Aaron Lessen, MD Educational Pearls: Traditionally, blood cultures are drawn from two separate sites despite no data to suggest this is better than drawing blood from one site Recent study evaluated multi-site versus single-site blood cultures to determine if there was a difference in accuracy or contamination Positive yield was 20% in the single-site…

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Podcast 774: Maggots

Contributor: Chris Holmes, MD Educational Pearls: Maggots were discovered as a therapy to help wound healing in WWI, but this fell out of favor after the discovery of penicillin One study from Israel used maggots in treating diabetic foot wound with positive results but notable patient discomfort Maggots debride tissue, kill MRSA, promote angiogenesis, and…

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Podcast 757: History of Fevers and Thermometers

Contributor: Chris Holmes, MD Educational Pearls: Dr. Carl Reinhold August Wunderlich, of the mid-1800s, was the first physician to suggest temperature was related to disease processes and his measurements set the 37˚C (98.6˚F) as the baseline temperature Thermometers were adapted to be sold to the public with guidelines for temperature measurement interpretation Taller and thinner…

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Podcast 756: Violence Towards ED Staff

ACEP survey was done in 2018 looking at violence towards staff in the ED with only 10% of those solicited responding Survey found 47% of respondents were assaulted and 71% had witnessed violence towards staff Regarding what was done about the violence, 28% said patients were flagged by the hospital, 21% said patient was arrested…

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Podcast 753: Ring Cutting Raptors

Contributor: Aaron Lessen, MD Educational Pearls: Techniques regarding ring removal in the ED were evaluated in a recent study which looked at using trauma shears versus the motorized ring cutters A certain type of trauma shear has a ring-cutter attached to it, 7 seconds to remove vs. about 70 seconds for motorized ring cutters Both…

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