Tropical Travel Trouble 005 RUQ Pain and Jaundice
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 005
Guest Post: Dr Branden Skarpiak – Global Health Fellow, Department of Emergency Medicine. UT Health San Antonio
A 35 year old male presents to your emergency room for right upper quadrant pain that has gotten worse over the last 2-3 days. He also describes associated nausea, vomiting, and fevers. He denies other abdominal pain, or change in his bowel or bladder habits. His wife notes that he has started to “look more yellow” recent...
Source: Life in the Fast Lane - March 19, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine amebic amoeba amoebiasis amoebic dysentery amoebic liver abscess bloody diarrhoea e.dispar e.histolytica entamoeba histolytica Source Type: blogs
LITFL Review 322
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 322nd 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 chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The Intensive Care Network have more podcasts from the CICM ASM. A new batch focusing on live...
Source: Life in the Fast Lane - March 11, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
LITFL Review 302
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 302nd 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 chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The ALIEM AIR Series delivers another amazing collation of the best resources in FOAM. This w...
Source: Life in the Fast Lane - October 15, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Expanding Access to Ultrasound in Tanzania
BY CHLOE MCCOY, MDI knew I wanted a global health experience that offered the opportunity to have an impact on patients but also on the health care infrastructure and local physicians. This led me to research trips that involved teaching opportunities, specifically ones involving ultrasound.As a resident at Palmetto Health Richland, we learn how to use ultrasound in our daily practice to make quick and accurate decisions about clinical care. Our program's emphasis on its use made ultrasound a standard-of-care component of emergency medicine for me over the past several years. Teaching ultrasound seemed like a great oppo...
Source: Going Global - May 5, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Aortic Dissection: Teaching Points
Case Details:48 yrs old lady with tearing pain chest on CT angiography shows large, dissection of the entire aorta , including Ascending aorta , with celiac, SMA, renal arising from true lumen (cerebral vessels showing no dissection) with cobweb sign and beak signs positive.Teaching points by Dr MGK Murthy, Dr Pritam, CT Technologist: Mr Shekhar1. Aortic dissection occurs when the blood enters medial layer through a penetrating ulcer or tear of intima 2. Two types: Acute, when clinical symptoms14 days More useful , Stanford A: involvement of ascend...
Source: Sumer's Radiology Site - January 9, 2017 Category: Radiology Authors: Sumer Sethi Source Type: blogs
Research and Reviews in the Fastlane 129
This study looks at CMAC DL vs CMAC VL and found that 1st pass success rate was not statistically significantly different. The most important insights in this trial are in the discussion where the authors note a high number of protocol violations:
“This may demonstrate that emergency intubation is a dynamic process, and that plans may change second-to-second based on new information gained immediately before or during tracheal intubation.”
Airway management is a complex process and it’s unlikely that we’ll ever have a study looking at one particular facet that has a profound effect on success rates....
Source: Life in the Fast Lane - April 6, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Cardiology Education Emergency Medicine Pediatrics Resuscitation EBM literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
Research and Reviews in the Fastlane 128
This study looks at the accuracy of Emergency Physicians (EPs) in using POCUS to diagnose RV dysfunction. The small group of highly trained EPs were able to reliably identify RV issues with a (+) LR = 90 and a (-) LR of 0. While this looks great, it’s important to note the high level of training and the small number of patients (26) with RV dysfunction. More work needs to be done on how this applies to the typical EP.
Recommended by: Anand Swaminathan
Airway
Mosier JM et al. The Physiologically Difficult Airway. W J Emerg Med 2016. PMID: 26759664
This article reviews patient features portending a physiologicall...
Source: Life in the Fast Lane - March 29, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Cardiology Education Emergency Medicine R&R in the FASTLANE Respiratory critical care EBM literature recommendations research and reviews Source Type: blogs
LITFL Review 215
Discussions. [SR]
In the UK, junior doctors (equivalent of interns/residents) have just staged a walkout due to unfair working conditions. Dr Helgi (@traumagasdoc) sums up some of the issues for anaesthetist/critical care trainees in this blog post. [SO]
The Best of #FOAMed Emergency Medicine
Fantastic podcast on UK Trauma Units from the St Emlyns Team and Tim Coates. [SL]
Cliff Reid discusses prehospital dogma focusing on our resuscitation approach to crush injuries. [AS]
The Best of #FOAMcc Critical Care
Another great SMACC podcast as Manoj Saxena discusses temperature control in TBI. [SO]
The Best of #FOAMtox Toxic...
Source: Life in the Fast Lane - January 17, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Research and Reviews in the Fastlane 052
This study looked at compliance with discharge instructions. Surprisingly (or maybe not so), 39% of pediatric patients returned to play (RTP) on the day of the injury. RTP is widely recognized as a risk for recurrent and more severe concussions as well as significant morbidity. It is the duty of the Emergency Physician to stress the importance of discharge instructions as well as the importance of appropriate follow up.
Recommended by: Anand Swaminathan
PediatricsSingleton T et al. Emergency department care for patients with hemophilia and von Willebrand disease. J Emerg Med. 2010; 39(2): 158-65. PMID: 18757163
Bleeding...
Source: Life in the Fast Lane - October 9, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Administration Anaesthetics Cardiology Clinical Research Education Emergency Medicine Haematology Infectious Disease Intensive Care International Emergency Medicine Microbiology Neurosurgery Obstetrics / Gynecology Ophthalmology Source Type: blogs
Small Bowel Intussusception Secondary to Polyp-MRI Diagnosis
These MRI images in a pregnant female show multiple polypoid lesions involving the small bowel. The polyps have variable in appearance. The presence of multiple gastrointestinal polyps can be seen in Peutz-Jeghers syndrome, familial adenomatous polyposis, juvenile polyposis, Cowden disease, and Cronkhite-Canada syndrome etc. Important complication is intussusception as seen in these images. An intussusception is composed of two parts: the intussuscipiens, or receiving loop, and the intussusceptum, or donor loop, which includes an entering limb and a returning limb with attached mesenteric fat interposed between...
Source: Sumer's Radiology Site - August 12, 2014 Category: Radiologists Authors: Sumer Sethi Source Type: blogs
How and when is the physical exam useful?
Dr. Danielle Ofri has an important piece in the NY Times – The Physical Exam as Refuge . As an outpatient physician, she makes the case that the physical examination provides a special time for the physician to focus entirely on the patient. Is examination time the refuge for the harried physician, and the opportunity to engage the patient in extended conversation about their condition?
While I did outpatient medicine for almost 20 years, for the past 15 I have focused only on inpatient medicine. As some comments suggest, the physical examination yields more information when the patient has clinical symptoms that ...
Source: DB's Medical Rants - July 12, 2014 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Altered Mental Status and Intussusception
I recently spent some time with a group of academicians in Raleigh-Durham, NC. Jonathan Singer, MD, a recently clinically retired pediatric emergency medicine physician and faculty at the Wright State Emergency Medicine program, was part of the group. He has impressed me over the years as a tough, no-nonsense academician with a penchant for clinical photography and writing poetry and Broadway plays. The group got into a discussion about pediatric bowel intussusceptions during the meeting, and I was surprised to learn that Dr. Singer wrote one of the first papers describing the altered mental status associated with intussus...
Source: M2E Too! Mellick's Multimedia EduBlog - January 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Altered Mental Status and Intussusception
I recently spent some time with a group of academicians in Raleigh-Durham, NC. Jonathan Singer, MD, a recently clinically retired pediatric emergency medicine physician and faculty at the Wright State Emergency Medicine program, was part of the group. He has impressed me over the years as a tough, no-nonsense academician with a penchant for clinical photography and writing poetry and Broadway plays. The group got into a discussion about pediatric bowel intussusceptions during the meeting, and I was surprised to learn that Dr. Singer wrote one of the first papers describing the altered mental status associated with intussus...
Source: M2E Too! Mellick's Multimedia EduBlog - January 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The LITFL Review 109
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.
Welcome to the 109th edition, brought to you by:
Kane Guthrie [KG] from LITFL
Tessa Davis [TD] from LITFL and Don’t Forget The Bubbles
Brent Thoma [BT] from BoringEM, and
Chris Nickson [CN] ...
Source: Life in the Fast Lane - September 16, 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
