So I read a publication called the Expert Witness Newsletter on Substack. The anonymous author publishes case transcripts from actual malpractice cases and then weighs in with his perspective–quite a good read! He recently documented a case of missed PE in which the doc lost with a $10 million dollar verdict. The case was a…
Spoon Feed —In cirrhotic upper GI bleeding (UGIB) patients, guidelines recommending routine 5–7 days of prophylactic antibiotics did not lower mortality compared with shorter courses, or no antibiotics, in a contemporary Bayesian meta-analysis. SourceProphylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A Systematic Review and Bayesian Meta-Analysis. JAMA Intern Med. 2025 Aug 11:e253832….
Sedation practices in the ICU have evolved dramatically over the past decade — but are we truly following the evidence? In this episode of The Critical Care Practitioner Podcast, Jonathan takes you through the key milestones in sedation guidance, the persistent gap between recommendations and real-world practice, and the emerging shift toward human-centered, wakeful care….
Skip to content This post is a summary and discussion of the following article from JAMA Pediatrics: Reed JL, Palmer CA, Casper TC, et al. Gonorrhea and Chlamydia Screening for Adolescents and Young Adults in Emergency Departments. JAMA Pediatr. Published online September 08, 2025. doi:10.1001/jamapediatrics.2025.2139 Adolescents account for nearly half of the 2.5 million newly diagnosed sexually…
Authors: Hailey VanRonzelen (MS-3, Kansas City University, RN-BSN); Jessica Pelletier, DO, MHPE (Assistant Professor of EM/Assistant Residency Director, Mizzou – Columbia, MO) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Source link
Authors: Hailey VanRonzelen (MS-3, Kansas City University, RN-BSN); Jessica Pelletier, DO, MHPE (Assistant Professor of EM/Assistant Residency Director, Mizzou – Columbia, MO) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Welcome to EM@3AM,…
Background Paediatric generalised convulsive status epilepticus (GCSE) are some thing we see a fair amount of in Virchester. Many are a result of febrile seizures, but as we are a tertiary centre we see the full range of causes presenting to PED. Seizures that fail to stop spontaneously within five minutes are much less likely….
Evaluating a limping child is a core skill in Pediatric Emergency Medicine, and it’s one of those presentations where your differential can expand quickly if you don’t anchor it with age, a careful exam, and a good sense of red flags. In this post, you’ll find a comprehensive overview of history-taking, physical exam, imaging, labs,…
This is the eighth in a series of blog posts on new research in emergency toxicology. The last post was about nitazenes and can be found here. We deal with all sorts of poisons here in Virchester, so be prepared for anything. Hydrofluoric acid (HFA) is a corrosive substance used widely in industry and occasionally…
Let’s talk quickly about Nalbuphine, the Diet Coke of opioids. mechanism Most opioids are basic. They’re pure μ-opioid agonists. Nalbuphine is more complex, with a multimodal mechanism of action. Key effects include: [#1] Partial agonism at μ-opioid receptors: Nalbuphine functions as a partial μ-agonist, similar to buprenorphine. Compared to buprenorphine, nalbuphine seems to stimulate the…