There is a new kid on the block for the treatment of stroke - tenecteplase (TNK). In this post, Dr. Morris explains the evidence behind its preferred use over alteplase (tPA) as well as address some common concerns about its use for stroke.
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Renal colic is a commonly encountered diagnosis in the emergency department that is known to cause significant pain. In clinical practice, the initial goal is prompt pain management while simultaneously working to confirm the suspected diagnosis. Because of the severity and acuity of the pain associated with renal colic, opioid pain management has often been used. Given the overall goal of reducing the use of opioid pain medications, emergency physicians have been working to identify alternative pain management strategies with agents such ketorolac and lidocaine. In this journal club, we examine the evidence in support of these treatment strategies.
The 21st Century CURES act has mandated that starting on April 5th, 2021 patient notes (with a few very narrow exceptions) must be easily available to patients via their patient portal. How did this come about, and what does it mean for us?
Read MoreIn this Vodcast episode. Dr. Andrew Fried, ultrasound Jedi, give us a masterclass on placing ultrasound guided IVs.
Read MoreOn January 23rd, 1849 Elizabeth Blackwell became the first female graduate of a US medical school, graduating from Geneva College in New York as the Valedictorian of her class. Despite the passage of 172 years from that remarkable moment, female physicians continue to face both implicit and explicit gender bias within the medical profession and culture. This journal club examined the impact of gender bias on female emergency medicine trainees.
Read MoreThe use of TXA in the care of the trauma patient has become prevalent since the publication of the MATTERs and CRASH-2 studies which demonstrated significant mortality benefits in trauma patients who received early TXA after admission. Since these publications, there continues to be several additional questions regarding its TXA: 1) If earlier treatment with TXA for the trauma patient is better, would there be benefit in its administration in the prehospital setting? 2) Is there benefit to the use of TXA in patients with TBI to prevent the progression and subsequent morbidity and mortality? 3) Lastly, does TXA carry a significant risk for side effects, including venous thromboembolic events? This journal club reviewed four articles that aim to answer these questions.
Read MoreThis year we are very fortunate to have Dr. Amal Mattu, EKG Jedi, as teaching faculty for our 39th Maine Medical Center/Maine ACEP Winter Symposium. In this lecture, he helps us differentiate septal STEMIs from other potentially life threatening mimics.
Read MoreKids poop. Most of the time it is benign (aside from the blowouts, the wiping, cleaning and changing of clothes). Occassionaly, pediatric diarrhea has a more serious etiology. In this interview with pediatrician Dr. Jay Larmon we go over the spectrum of pediatric diarrhea, from the '“A-okay” to the “not-so-right” . . . and everything in between.
Read MoreIn medicine we often draw a solid line between community and academic medicine, but this is likely a fallacy. In fact there is a huge amount of academia that can be found and thrive in a community hospital. In this interview we talk with Dr. Salim Rezaie of the REBEL EM blog and podcast, a man who has walked both sides of this imaginary line between community and academics. In our chat we discuss ways to get involved in academics in the community and the vast array of rewards that come with that, including improved patient care, increased fervor for your work, decreased burnout, and increased career longevity.
Read MoreCOVID vaccines have dominated the media and our recent efforts to combat the SARS-CoV-2 virus. It will likely take some time, however, until we reach herd immunity. To help curb the severity of disease, the medical community continues to investigate other therapeutics. By examining the virus life cycle and our immune system’s response to it (both protective and destructive), we may be able to develop anti-viral and immune therapy that counteracts the cytokine storm and leads to acute respiratory distress syndrome, respiratory failure, shock, organ failure and potentially death. In this journal club, we reviewed the use of steroids and convalescent plasma for the treatment of patients with SARS-CoV-2.
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