68 minutes with chest compressions, full recovery. Plus recommendations from a 5-member panel on cardiac arrest.
The following is told with full permission of the patient, who is a paramedic who also started, owns and runs with his wife a company for teaching CPR. He has taught CPR to over 100,000 people. And he's a wonderful guy. Here is his story:Near midnight in December, this 56 yo very healthy and vigorous paramedic was out on a run with a critical case when his partner found him unresponsive in the front seat of the ambulance. The partner began manual chest compressions immediately and called for help. He was found to be in ventricular fibrillation and was defibrillated 4 times, unsuccessfully.&nb...
Source: Dr. Smith's ECG Blog - April 6, 2013 Category: Cardiology Authors: Steve Smith Source Type: blogs
Increasing Success with Infant Spinal Taps
I think infant lumbar punctures are actually easier than spinal taps on older children and adults. Unfortunately, success, as measured by acquiring sparkling clear (nontraumatic) spinal fluid, is sometimes elusive. Twenty to thirty percent of spinal taps in the training setting, in fact, can be traumatic or unsuccessful. (Pediatr Emerg Care 2010;26[7]:487.) Three easy steps, however, can increase one’s odds for success.
Use Local AnesthesiaThe evidence shows that the success rate is improved when injected or topical anesthesia is used, but this practice is commonly ignored by practitioners. The literature clearly supp...
Source: M2E Too! Mellick's Multimedia EduBlog - April 3, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Activist ignites a movement for patients through art and story
KANSAS CITY, Mo. – Regina Holliday bounds across the stage at the old Sam’s Town casino, jumps onto a grey cinder block and flings her arms open wide in welcome.
Holliday, an artist and patient advocate from Washington, balances there for just a moment, beaming before the small cadre of advocates, doctors and tech gurus who are as determined as she is to make patients equal participants in every area of health care. They are here, on the banks of the Missouri River early on a Saturday morning, for a conference she has organized in just weeks.
Regina Holliday shows off one of the more than 200 jackets she has painted (...
Source: Disruptive Women in Health Care - February 22, 2013 Category: Health Medicine and Bioethics Commentators Authors: dw at disruptivewomen.net Tags: Advocacy Partnership With Patients patient advocate Source Type: blogs
The Book and its Cover
When you work in an urban hospital, sometimes it’s difficult not to become jaded.
There are certain neighborhoods that generate a disproportionate number of patients for some emergency departments. Meth is rampant. Marriage pretty much nonexistent. More bars than there are restaurants. Domestic abuse frequent, but prosecutions rare. Police know people more by their street names than by their real names.
South Heights was one of those neighborhoods.
The emergency department frequently treats South Heights kids who are neglected by their parents. I’ve seen young South Heights kids with seizures from cocaine. Now ...
Source: WhiteCoat's Call Room - February 19, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
The LITFL Review 094
Welcome to the awesome 94th 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
StEmylns
Top spot this week has been smashed by two great post from the StEmylns team!
First up we have Simo...
Source: Life in the Fast Lane - February 12, 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
Sterile Water Irrigation Denied By Insurance. Patient Not Sterile Enough.
I feel bad for our patients. Insurance economic algorithms are defining the patient and doctor experience regardless of situations unique to the patient experience. If our recommendations as physicians or your needs as a patient do not comply with your insurance company's economic algorithms, you and your physician will likely get denial of care letters. That means hours of headaches and delayed therapy for you and hours of headaches and uncompensated expenses for your physician's office in communication with your insurance company. It is no wonder many offices have started chargin...
Source: The Happy Hospitalist - February 8, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Study Identifies Itch-specific Nerves
Scientists have been looking for itch-specific nerves for decades. New research from investigators at Johns Hopkins University and Yale University in the United States and several universities in China has identified sensory neurons in mice that are dedicated to relaying itchy sensations from the top layers of skin to the spinal cord [1].
In 1835, Johannes Peter Müller proposed the law of specific nerve energies. It stated that everything we feel and experience relies on the stimulation of particular neuronal pathways — and thus that the actual, external stimulus is irrelevant. He wrote:
The same cause, such as e...
Source: Highlight HEALTH - January 29, 2013 Category: Medical Scientists Authors: Diana Gitig, Ph.D. Source Type: blogs
Trigger Point Therapy in the Emergency Department
Patients with myofascial pain conditions or trigger point pain commonly present to the emergency department seeking therapeutic relief. It is not rare to see patients with specific areas of unrelenting muscle spasm who have undergone multiple medical therapies and expensive imaging studies without diagnostic or therapeutic success. Unfortunately, the outcome of most emergency department visits for these patients is another failure to accomplish definitive therapy. We usually prescribe more ineffective therapies that simply perpetuate the therapeutic delay. This blog hopes to present hard-hitting therapeutic interventions t...
Source: M2E Too! Mellick's Multimedia EduBlog - January 7, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Six Mistakes of Awake Intraosseous Infusion
I’ve been inserting and teaching how to insert an intraosseous (IO) needle for several decades. Like most of you, however, almost all of the IO needle insertions that I have performed were on obtunded or cardiac arrest patients (mostly pediatric and a few adult). Several years ago I did my first intraosseous needle insertion on an altered but awake adult.
Much to my chagrin, I quickly learned that I really didn’t know what I was doing. I even documented my ineptness with a video so that others could learn from my mistakes. Most emergency physicians are comfortable with using IO needles during resuscitation, but their s...
Source: M2E Too! Mellick's Multimedia EduBlog - November 5, 2012 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Priapism Emergency
Last month I focused on managing a common female genital problem, the Bartholin Gland abscess. In the spirit of equality, this month’s blog post looks at an important male genital problem, priapism. Unfortunately, the literature guiding treatment is not the most robust. Nevertheless, we do have recommendations and guidelines created by national and international experts who have digested the available literature. The guidelines created by the American Urological Association are the most frequently touted resource.(1)
I have written and delivered several lectures to our residents on this topic over the past several yea...
Source: M2E Too! Mellick's Multimedia EduBlog - September 5, 2012 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Real Teens Ask: Is Propofol a Drug?
Since the death of Michael Jackson in 2009, “propofol” has been mentioned often in the news. The substance was found to be the cause of his death and was the center of the highly publicized trial of his doctor.
So, it’s no surprise there is a lot of curiosity about propofol. NIDA received questions about it during last year’s Drug Facts Chat Day.
During Chat Day, Cam from California asked about the basics—
Is propofol a drug?
Yes. Propofol is a common type of anesthetic—a drug that doctors use to “put people to sleep” for surgery. It is given to patients through an “intravenous drip,” (called an “IV...
Source: NIDA Drugs and Health Blog - January 26, 2012 Category: Addiction Authors: Sara Bellum Source Type: blogs
