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SOBRE EL AUTOR **

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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

My Heart is Racing! Select Cardiac Arrhythmias and Practice Updates

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Contenido:

sábado, 19 de agosto de 2017

Malignant Otitis Externa

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emDocs - August 16, 2017 - Authors: Yetter E, Isaksen L and Mulvey L
Edited by: Koyfman A and Singh M
"Take Home Points
  • Consider MOE if someone treated for Otitis Externa is not improving and/or they have fever and tenderness to palpation of the mastoid.
  • Pseudomonas is the most common etiology and coverage should be directed appropriately. However in rare cases fungal infections may also be the cause, such as in AIDS patients.
  • Obtain CT and/or MRI imaging of the mastoid.
  • Consult ENT."

DRESS

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emDocs - August 15, 2017 - Authors: Nemero M and Oliver J
Edited by: Koyfman A and Long B
"Key Points
  • DRESS syndrome should be suspected whenever a patient presents with a fever, morbilliform rash, and lymphadenopathy following a medication change.
  • Liver failure is the leading cause of mortality in DRESS syndrome
  • Frequently co-exists with herpesvirus, CMV, or EBV reactivation
  • The mainstay of treatment is stopping the offending agent
  • DRESS without severe organ involvement is treated outpatient with topical steroids
  • DRESS with severe organ involvement warrants hospitalization and the use of systemic corticosteroids"

Acute Heart Failure

Current Heart Failure Reports
Sameer Kurmani & Iain Squire. Curr Heart Fail Rep - DOI 10.1007/s11897-017-0351-y
Open Access - First Online: 07 August 2017
"Summary
We provide an introduction to AHF and discuss its definition, causes and precipitants. We also present epidemiological and demographic data to suggest that there is significant patient heterogeneity and that AHF is not a single pathology, but rather a range of pathophysiological entities. This poses a challenge when designing clinical trials and may, at least in part, explain why the results in this area have been largely disappointing."

Apnoeic Oxygenation

St.Emlyn’s - August 16, 2017 - By Simon Carley
..."This is a randomised controlled trial which is spot on for a therapeutic trial. Patients were randomised either to having 15L/min through nasal canullae or not. Pretty simple design in all honesty, which is great. Oxygen sats were meaured throughout with apnoea time being measured from the point of the laryngoscope entering the mouth to ETCO2 being seen on the monitor. That all seems fair enough to me.
Cleverly they recorded all O2 sats using a remote observer as a way of introducing a degree of blinding into the study as it was clearly impossible to blind the clinicians at the bedside..."

martes, 15 de agosto de 2017

Amiodarone in Cardiac Arrest

R.E.B.E.L.EM - August 14, 2017 - By Alicia Skelton
"Authors Conclusions:
“Amiodarone significantly improves survival to hospital admission. However, amiodarone does not improve survival to discharge or neurological outcomes compared to placebo or other antidysrhythmics.”
Our Conclusions: 
This systematic review and meta-analysis demonstrates that while amiodarone significantly increased survival to hospital to admission compared with placebo or other antidysrhythmics for OHCA, it does not significantly improve favorable neurological outcome or survival to hospital discharge. Ultimately, these outcomes are more meaningful from both a cost and quality of life perspective.
Potential to Impact Current Practice: 
 Given this review and analysis, providers should consider removing amiodarone from their routine cardiac arrest algorithm and focus on interventions that have the ability to improve survival such as high quality chest compressions and defibrillation.
Clinical Bottom Line: 
Based on the available evidence, amiodarone does not appear to be associated with any meaningful clinical outcome in cardiac arrest including neurological outcome or survival to hospital discharge."

Osmolal gap

PulmCrit
PulmCrit- August 14, 2017 - By Josh Farkas
..."This raises the question: What is the performance of the serum osmolal gap? Is this an evidence-based test for intoxicated patients?
  • There is disagreement regarding the best formula to calculate the osmolal gap, and what the appropriate cutoff value should be.
  • Most patients with an elevated osmolal gap don’t have toxic alcohol poisoning. Osmolal gap may be increased by numerous factors including renal failure, ketoacidosis, shock, electrolyte abnormalities, and contrast dye.
  • Performance of the osmolal gap to detect toxic alcohols varies widely depending on the equation used and laboratory techniques. A recent study suggests that it might have a positive likelihood ratio of ~1.2-1.7 and a negative likelihood ratio of ~0.3-0.45.
  • These performance characteristics are inadequate for broad clinical use, with the potential for frequent false-positive and false-negative results.
  • The use of osmolal gap as a diagnostic test for toxic alcohols is poorly supported by available evidence. If a new test were developed with this level of evidentiary support, there is no way it would gain FDA approval."

The expert patient in the ED

the expert patient in the ED St.Emlyn's
St. Emlyn´s - By Simon Carley - August 11, 2017
"Conclusions
  • No matter how good a department is, and I love mine with a passion (told you I am a dinosaur) it can always be better.
  • The ‘expert patient’ can be dangerous but simple safe processing reduces that danger.
  • Do not take the “expert’s diagnosis” for granted, no matter how senior, always do the simple skills we were taught in medical school.
  • No one else noticed my low sodium on my first visit, yet roughly a third (32%) of acute head injuries may have low sodium with ADH secretion believed to be the cause (so any FRCEM candidates might want to look out for a question on this soon).
  • Have systems set up in your department to counter the real problems that VIPs can encounter. It’s pretty simple in theory but does demand a tight team who trust each other and look after each other."

martes, 8 de agosto de 2017

Perichondritis

R.E.B.E.L.EM - July 20, 2017
"Take-Home Points:
  • Perichondritis is a pseudomonal infection of the outer ear marked by tenderness and erythema and distinguished by a spared lobule.
  • Misdiagnosis or mistreatment can result in devastating patient outcomes.
  • Treatment of perichondritis includes a foundation of anti-pseudomonal antibiotic therapy with or without surgical intervention.
  • Urgent specialist evaluation and hospital admission should be considered when abscess or necrosis are suspected or patient follow-up may be challenging.
  • Fluoroquinolone therapy appears safe in pediatric populations in the context of appropriate monitoring and follow-up."


lunes, 7 de agosto de 2017

Spinal Immobilization

R.E.B.E.L.EM - August 07, 2017
"THE BOTTOM LINE:
  • There is no high-level evidence that prehospital spinal immobilization positively impacts patient oriented outcomes
    • Spinal Immobilization Does NOT Help Immobilize the Cervical Spine
    • Spinal Immobilization Does NOT Decrease Rates of Spinal Cord Injury
    • Spinal Immobilization Increases the Difficulty of Airway Management
    • Spinal Immobilization Can Cause Pressure Ulcers
    • Spinal Immobilization Changes the Physical Exam
    • Spinal Immobilization Worsens Pulmonary Function
    • Spinal Immobilization Increases Intracranial Pressure
  • There is no evidence that immobilizing awake, alert patients without deficits/complaints provides benefit
  • Selective spinal immobilization protocols can help identify patients at low risk for injury and avoid immobilization"

The SPARK Study

The Bottom Line - August 4, 2017 - By Celia Bradford
(Bagshaw. J Crit Care 2017;epublished July 12th)
"Clinical Question
In critically ill patients, with mild renal failure, does furosemide infusion compared to placebo worsen kidney function?
Authors’ Conclusions
A furosemide infusion compared to placebo did not change the incidence of progression to a worse degree of kidney injury"

miércoles, 2 de agosto de 2017

A Year at Sydney HEMS

St. Emlyn´s - August 2, 2017
"This post, detailing my reflections on clinical retrieval medicine, is the fifth in a series recording my reflections on the twelve months I spent working for Sydney HEMS in prehospital and retrieval medicine. The first post covers medical education – you can find it here. The second covers human factors – you can find it here. The third covers clinical lessons from retrieval medicine – you can find it here. The fourth covers more clinical lessons – you can find it here.
This post is about the leadership lessons I’ve learned during my year of prehospital and retrieval medicine. As a registrar in the service, much like in Emergency Medicine in the UK, the day-to-day clinical work was the same irrespective of whether you were a consultant or registrar..."

martes, 1 de agosto de 2017

Articles of the Month (July 2017)

First10EM - By Justin Morgenstern - July 31, 2017
"Welcome back to another edition of the articles of the month. I am considering changing the format of my article reviews going forward. Because multiple articles are grouped together in a single post, I frequently have a hard time finding articles I have reviewed when I am looking for them. I might start posting each article as its own blog post, with 8-10 posts over the course of a month. I’d love to hear what people think of that idea – whether it would be better or worse for your reading habits. Either way, Casey and I will still discuss the best articles each month on the Broome Docs podcast."

viernes, 28 de julio de 2017

Extremity Hematoma

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emDocs - Jul 26, 2017 - Authors: Morales J and Williams M
Edited by: Koyfman A and Long B
"Pearls:
  • Most extremity hematomas can be managed conservatively without the need for imaging studies.
  • Consider imaging if the patient is not improving as expected or concerned for other complicating injury such as fracture, tumor, or arterial vascular injury. Musculoskeletal ultrasound has been found to be a useful tool in evaluating hematomas, muscle contusions and other muscle injuries but is operator dependent. Soft tissue MRI generally not indicated in the ED setting.
  • Myositis ossificans takes approximately 6 weeks to be visualized on plain film.
  • Have a low threshold to evaluate for developing compartment syndrome if suspicious based on clinical findings.
  • Know potential indications for emergent surgical evacuation and admission.
  • Antithrombotic/anticoagulant reversal generally not indicated unless compartment syndrome or hemodynamic instability. Specialist consultation advised to assist with risk/benefit assessment."

jueves, 27 de julio de 2017

Sistemas de trauma

AnestesiaR -
AnestesiaR - Por Vizuete - 17 Julio 2017
"El trauma grave sigue siendo la principal causa de muerte en gente joven en nuestro medio y siguen siendo los accidentes de tráfico la causa fundamental. Para algunos autores el sistema de trauma es el sistema “gold estandar” para prestar la atención sanitaria adecuada al paciente traumático. En esta revisión, dividida en dos partes, se pretende definir que es un sistema de trauma, sus componentes, resaltar la importancia, la situación y desarrollo a nivel internacional y nacional y los requisitos necesarios para su puesta en marcha."
*
AnestesiaR - Por Vizuete - 26 Julio 2017
"En esta segunda parte, pretendemos comentar los componentes básicos de un sistema de trauma, así como otros que también son necesarios para la puesta en marcha del mismo. Queremos resaltar aspectos fundamentales como la coordinación entre los diferentes profesionales que atienden al paciente, la existencia de un Código Trauma o aquellos requerimientos que deben cumplir los hospitales que atienden a pacientes traumáticos, estando entre ellos la presencia del equipo de trauma. También resaltaremos el papel que debe jugar la administración sanitaria, para que la creación de esta estructura asistencial tenga éxito y cumpla sus funciones."

martes, 25 de julio de 2017

Dexamethasone for Acute Pharyngitis

R.E.B.E.L. EM - Emergency Medicine Blog
REBEL Cast Episode 39 –  - July 24, 2017 24
Background: Sore throat is a common presentation to the emergency department as well as primary care clinics. Corticosteroids inhibit transcription of pro-inflammatory mediators in airway endothelial cells responsible for pharyngeal inflammation and symptoms of pain. They have been used in other upper respiratory tract infections such as acute sinusitis and croup. In adults, previous studies with dexamethasone are in combination with antibiotics but studies of children have included dexamethasone without antibiotics. This study is unique as it is evaluating the benefits of oral corticosteroids for acute sore throat in primary care in the absence of antibiotics..
Author Conclusion: “Among adults presenting to primary care with acute sore throat, a single dose of oral dexamethasone compared with placebo did not increase the proportion of patients with resolution of symptoms at 24 hours. However, there was a significant difference at 48 hours.”
Clinical Take Home Point: Corticosteroids may play a beneficial role in sore throat just like in other upper respiratory infections but the effect is more likely to be beneficial in those with more severe symptoms.

Recurrent VTE

Emergency Physicians Monthly
EP Monthly - By Hatfield L - July 21, 2017
"While recurrent venous thromboembolism is rare, it presents a unique challenge to emergency physicians seeking to understand the breadth of available anticoagulants. Here’s an essential run-down."

Cannabinoid Hyperemesis Syndrome

Gastroenterology & Endoscopy News - July 19, 2017 - By Kate O’Rourke
"The incidence of cannabinoid hyperemesis syndrome has increased with the loosening of marijuana laws in the United States, according to a new study presented at the 2017 Digestive Disease Week (abstract Tu1688).
Cannabinoid hyperemesis syndrome and cyclic vomiting syndrome are barely known to physicians and characterized by recurrent episodes of heavy nausea, vomiting and frequent abdominal pain. Complete and persistent resolution of all symptoms of the disease following cannabis cessation is the only reliable criterion applicable to distinguish cannabinoid hyperemesis syndrome from cyclic vomiting syndrome (Ger Med Sci 2017;15:Doc06).
Researchers said raising awareness of some of the medical problems that can occur with the use of cannabis is critical..."

lunes, 17 de julio de 2017

Apneic Oxygenation (ApOx)

R.E.B.E.L.EM - Jul 17, 2017
"Background: 
Apneic oxygenation (ApOx) is the passive flow of oxygen into the alveoli during apnea. This passive movement occurs due to the differential rate between alveolar oxygen absorption and carbon dioxide excretion producing a mass flow of gas from the upper respiratory tract into the lungs. Another important component of this maneuver is maintaining a patent airway so that supplemental oxygen administered through the nares is able to be delivered to the alveoli. This practice has been a game changer in emergency airway management for many providers. However, there are still some naysayers that believe in the sickest patients ApOx may not be so beneficial. This post is a review of two recent systematic reviews/meta-analyses published in the critical care and ED/retrieval settings on the use of ApOx..."

CVO saturation

PulmCrit (EMCrit)
PulmCrit – July 17, 2017 - By Josh Farkas
Summary: The Bullet
  • It is impossible to estimate the cardiac output merely by looking at the central venous oxygen saturation.
  • Even if a Fick calculation is performed which takes other variables into account (e.g. hemoglobin concentration), the central venous oxygen saturation cannot be used to accurately calculate the cardiac output.
  • A normal or high central venous oxygen saturation cannot be used to reassure us that the patient has adequate tissue oxygen delivery.
  • The central venous oxygen saturation probably cannot contribute useful information for patient evaluation (i.e. information which is more accurate than what could be otherwise surmised based on other clinical parameters)."

sábado, 15 de julio de 2017

Lidocaine

Emergency Physicians Monthly
EP Monthly - By Shenvi C & Serrano K - July 10, 2017
"Lidocaine is used routinely in the ED to numb up lacerations before repair and abscesses before I&D, or to perform digital blocks, hematoma blocks, nerve blocks, or intra-articular analgesia. Every medical student is taught how to infiltrate the skin with a thin needle, producing a blanching skin wheal. Lidocaine is also one of the ACLS 2015 antiarrhythmics for VF or pulseless VT. However, there are numerous other ways in which lidocaine can be used. The data supporting them is variable, and many of the uses are off-label. However, given the subjectivity inherent in the experience of pain, and the myriad mechanisms by which pain and noxious stimuli are sensed and transmitted, it is not surprising that there is some variability in the clinical response to lidocaine from patient to patient. Here we will outline a few of the interesting ways that lidocaine can be used. Personally, we have used it successfully basis for NG tube placement, urethral catheterization, in lower cervical muscular injections for headaches, atomized before nasal scope, and nebulized for cough or for ENT..."

Prehospital Emergency Procedures

MEDEST - LUG 13 2017
"In Emergency Medicine “Simplicity” is synonymous of efficiency, efficacy and reproducibility.
More the time frame is stressful more we need procedures that are efficient, efficacious and standardised, in one word SIMPLE.
Critcothyrodotomy and chest drain are procedures usually performed in high stressing scenarios and more simply they are more chance of success they have.
I don’t like complicate kits. They need training of course but even a calm and protected environment, and the middle of a street or a busy ER room aren’t nothing like that. 
I don’t like blindly performed procedures but prefer trusting my own senses and sensibility when performing high invasive procedures that, mostly of the times, are a lifesaving last chance.
So this is the best way I know to perform a surgical access to the airway and to drain a highly unstable tense pneumo: using simple instruments, always present in every emergency pack, and trusting my own tactile sensitivity."

BP in Neurological Emergencies

EMOttawa - July 13, 2017 - By Rob Suttie
"Objectives:
  • Explore the data for safety and efficacy of urgent BP lowering in hemorrhagic stroke.
  • Is there any benefit from management of elevated BP in acute ischemic stroke that is not a candidate for tPA?
  • What is the data for BP target in aSAH awaiting definitive management?"

Non-Response to Vasopressors

R.E.B.E.L. EM - Emergency Medicine Blog
R.E.B.E.L.EM - July 13, 2017
"Intro: Vasoactive substances are powerful therapeutic medications that can boost a patient’s blood pressure and perfusion to target organs. They are often used in resuscitation to support tissue perfusion though their benefits are mostly unproven and may be harmful in certain circumstances (i.e. hypovolemia, hemorrhage). The cognitive response to hypotension should not be reaching for a pressor. The primary therapy for any sick hypotensive patient is treatment of the underlying pathology..."

martes, 11 de julio de 2017

Interventional therapy for AIS

A summary of the evidence for endovascular therapy in stroke
First10EM - By Justin Morgenstern - July 11, 2017
"In part 2 of our EM Cases Journal Jam, we explored the literature looking at endovascular therapy for acute ischemic stroke. The studies of interventional therapy for stroke tend to get broken down into the early (negative) studies and the later (positive) studies. For consistency, I’ll use the same break down...
Summary
The studies here have to be rated as low quality. I would like to see at least 1 properly blinded study, and we clearly need more research to determine which patients are best managed with endovascular treatment, the harms of screening, and the societal impacts of this strategy. However, the recent studies are consistent and demonstrate an important benefit. Based on what we know today, I would want this therapy for myself."

June 2017 EM Articles

EM Topics
EMTopics - June 30, 2017
*NNR THIS MONTH = 56
You'd have to read 2533 articles to find these 45 marvels of modern statistics.
*NNR - number needed to read

domingo, 9 de julio de 2017

IVC / IVF

EMCrit
EMCrit - July 8, 2017 by Scott Weingart
"So on the ISepsis section of the blog, Paul just posted on the uselessness of IVC ultrasound for fluid assessment. Now since I don't really believe in large volume repletion anymore, I don't really care about fluid responsiveness all that much either. But I never let a good opportunity for debate pass me by, so it was a delightful happenstance that one of the authors of a negative trial on IVC ultrasound for fluid responsiveness sent me an email a few weeks ago. It seems Dr. Keith Corl, who was lead author of a 2002 trial mentioned in Paul's post, did not let the matter go. He just published a repeated, and in his estimation, much better trial:


I'll be posting a wee about it and Paul's post very soon; EMNerd tells me he is working on one as well. In the meanwhile, why don't you read through the trial and tell us what you think in the comments section."

Intubation during CPR

PulmCCM
Pulm CCM - July 8, 2017
..."There was serious concern that prioritizing airway and breathing led to inadequate circulation, sacrificing precious brain and other organs' health for the sake of an unneeded advanced airway. The 2015 AHA guidelines (and their European counterparts) further downplayed any advantage of endotracheal intubation over bag-mask ventilation during CPR...

Anyway, don't sacrifice immediacy or quality of chest compressions to intubate during CPR, is what I think this paper (and AHA) are trying to tell us. 

viernes, 7 de julio de 2017

The Thessaly Test for Meniscal Injury

An online community of practice for Canadian EM physicians
CanadiEM - By Maeghan Fu - July 7, 2017
meniscal injury
..."Summary
The Thessaly test is a relatively new physical examination technique for the detection of meniscal injury (both medial and lateral) in the emergency department. Clinical research has demonstrated high sensitivity and specificity for this test, especially when performed at 20° knee flexion. Moreover, compared to the more commonly taught McMurray test, the Thessaly test is much easier to perform and similarly easy to learn and teach.10 The general consensus among recent studies is that the Thessaly test should be the preferred method for detection of meniscal injury and is a useful clinical tool..."

Thrombolytics for stroke

A summary of the evidence for (or against) thrombolytics for stroke
First10EM - Justin Morgenstern - May 26, 2017
"Thrombolytics for stroke: undoubtedly the biggest controversy in emergency medicine. Also, the topic of this week’s Emergency Medicine Cases Journal Jam podcast. Rory Spiegel, Anton Helman, and I take a deep dive into the evidence. Why would we do this? No, it isn’t just that we have too much time on our hands. The journal jam podcast exists because we truly believe it is important to understand why we do what we do, both to ensure we are always providing the best care for our patients, but also so that we can explain that care to our patients. The evidence for (or against) thrombolytics is important precisely because the topic is so controversial. You will hear arguments on both sides. So will your patients. It is only through a familiarity with the studies, their strengths, and their weaknesses, that you will be able to decide for yourself what the evidence really shows and guide your patients to the best decision for their circumstances..."

martes, 4 de julio de 2017

The gag reflex

PulmCrit (EMCrit)
PulmCrit - July 4, 2017 -  ::By Josh Farkas 
"Summary: The Bullet
  • The gag reflex is a traditional component of the neurologic examination, but isn't evidence-based.
  • The reproducibility of the gag reflex is poor, due to variation in the techniques used to elicit it.
  • The specificity of the gag reflex is poor, being absent in ~20% of younger patients and ~40% of elderly patients.
  • The gag reflex is an unreliable predictor of aspiration, because it tests only a small fraction of the nerves and muscles required to control secretions via swallowing.
  • The gag reflex should not be used to assess whether patients can protect their airways.
  • The only rational use of the gag reflex appears to be certification of brain death."

ED Medication Errors

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emDocs - July 3, 2017 - Author: Fontes K - Edited by: Koyfman A & Long B
"Take home points
  1. Avoid using the serum creatinine value to make decisions about drug dosing in older patients. Use GFR or calculate creatinine clearance (CrCl).
  2. When prescribing to older adults, minimize the number of CNS medications and their cumulative anticholinergic burden as much as possible.
  3. Use caution when prescribing new medications to elderly patients already taking antidiabetic agents, calcium channel blockers, and selective serotonin reuptake inhibitors, as drug-drug interactions with these agents can lead to falls and delirium.
  4. Consider using a validated screening tool to identify and avoid potentially inappropriate medications and drug combinations in older patients (MAI and STOPP/START may be more appropriate to the ED setting)."

Fall Prevention in Geriatric Patients

R.E.B.E.L.EM - July 3, 2017 - By Pescatore R
Post Peer Reviewed By: Anand Swaminathan and Salim Rezaie
"Background: 
Falls are the most common cause of traumatic mortality in geriatric patients. Each year, about 1/3 of community-dwelling adults over the age of 65 suffer standing-level falls. Over age 80, the incidence rises to nearly half (Carpenter 2014). Of the patients admitted to the hospital for injuries resulting from a fall, 33% will be dead within the year (Masud 2001). The emergency physician is tasked with the rapid evaluation and management of these patients, as well as the simultaneous responsibility of identifying those patients at risk for recurrent fall and intervening on modifiable risk factors. The American Geriatrics Society, Centers for Disease Control, and American College of Emergency Physicians all recommend that acute care providers screen for the risk of recurrent fall..."

PE: YEARS Study

EM Topics
EM Topics - July 3, 217
One size fits all
The YEARS study was a simplified way to work up patients for possible PE. Here was the method used in picture form.
From cited article
Source
Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet. 2017 May 23. pii: S0140-6736(17)30885-1. doi: 10.1016/S0140-6736(17)30885-1. [Epub ahead of print]

Trombosis venosa superficial

EMpills - Carlo D'Apuzzo - 6 Giu 2017
"E l’una. La prossima paziente che ci apprestiamo a visitare è una donna di quasi 90 anni.
Nella scheda di triage leggo: inviata dal medico curante per sospetta trombosi venosa gamba destra.
L’attesa per Miriam è stata lunga, quasi 6 ore. Quando la vedo vengo preso dallo sconforto.
E’ presente una tumefazione cordoniforme bluastra su un terreno varicoso, non dolente alla palpazione. La gamba non è edematosa e la paziente ci appare in ottime condizioni generali. I parametri vitali assolutamente normali
“E’ due giorni che mi è venuta, il mio medico mi ha detto di venire subito. Pensa sia una trombosi…”
La guardiamo con l’eco. E’ presente una trombosi superficiale di circa 3 cm di estensione a livello della superficie mediale della gamba. Il circolo venoso profondo pervio.
Cosa fare? Qual è l’approccio terapeutico migliore in una situazione come questa? 
Dobbiamo anticoagulare la paziente o somministrare antinfiammatori? La compressione aiuta? E la mobilizzazione?
Un buon motivo per cercare di approfondire..."

sábado, 1 de julio de 2017

dasSMAC - Day 3

R.E.B.E.L. EM - Emergency Medicine Blog
R.E.B.E.L.EM - June 29, 2017 - By Astin M
Post Peer Reviewed by Rezaie S
"The 2017 edition of the Social Media And Critical Care (SMACC) conference was held in Berlin, Germany this year (#dasSMACC). Over 2000 emergency physicians, intensivists, anesthetists, EMS providers, and nurses piled into the Tempodrom for three days of inspiring lectures and an all-around good time. This conference is truly a leader in innovation and continues to push the boundaries of medical education and entertainment. Here are some of the lessons learned and take home messages from the third day of the conference.
The final day of SMACC began with a panel on the future of medical education. Simon Carleyserved as the moderator for the panel that included Walter Eppich, Jenny Rudolph, Chris Nickson, Victoria Brazil, Daniel Cabrera, and Sandra Viggers..."