Tactical Medicine News Blog

Acute Pancreatitis Background: Definition: Acute inflammatory process of the pancreas; a retroperitoneal organ with endocrine and exocrine function. Epidimiology (Rosen’s 2018) US Incidence: 5 – 40/100,000 Mortality: 4-7% Progression to severe disease: 10-15% of cases (mortality in this subset 20-50%) Etiology: Alcohol (~ 35% of cases) Gallstones (~ 45% of cases) Medications/toxins Hypertriglyceridemia Non-gallstone Obstruction (i.e. strictures, masses) Trauma Infectious Pathophysiology: Phase 1: Local inflammation Results from obstruction of the pancreatic or bile ducts or direct toxicity to pancreatic cells Inflammation results in pancreatic enzyme activation within the pancreas and ducts Premature enzyme activation leads to pancreatic autodigestion Phase 2 Enzyme digestion leads to necrosis of the pancreas Erosion into vascular structures can occur as well leading to hemorrhage Phase 3 Release of systemic inflammatory mediators systemic immune response syndrome and multisystem organ dysfunction (i.e. acute renal failure, cardiac dysfunction, ARDS, disseminated intravascular coagulation)

Up to now Anton and The EM Cases Team have been developing the EM Cases resources based on informal feedback, flashes of inspiration and brainstorming sessions. It's time for an official survey so that we can make EM Cases the best that it can be for your learning - the scientific way. Five minutes of your time will mean a whole world of benefit for you and your colleagues - the thousands of EM Cases listeners - and you will be automatically eligible for a free Kindle Paperwhite... The post EM Cases Survey appeared first on Emergency Medicine Cases.

In this Part 1 of our two part podcast on GI bleed emergencies we answer questions such as: How do you distinguish between an upper vs lower GI bleed when it's not so obvious clinically? What alterations to airway management are necessary for the GI bleed patient? What do we need to know about the value of fecal occult blood in determining whether or not a patient has a GI bleed? Which patients require red cell transfusions? Massive transfusion? Why is it important to get a fibrinogen level in the sick GI bleed patient? What are the goals of resuscitation in a massive GI bleed? What's the evidence for using an NG tube for diagnosis and management of upper GI bleeds?  In which patients should we give tranexamic acid and which patients should we avoid it in? How are the indications for massive transfusion in GI bleed different to the trauma patient? What are your options if the bleeding can't be stopped on endoscopy? and many more... The post Episode 101 GI Bleed Emergencies Part 1 appeared first on Emergency Medicine Cases.

In this Part 1 of our two part podcast on GI bleed emergencies we answer questions such as: How do you distinguish between an upper vs lower GI bleed when it's not so obvious clinically? What alterations to airway management are necessary for the GI bleed patient? What do we need to know about the value of fecal occult blood in determining whether or not a patient has a GI bleed? Which patients require red cell transfusions? Massive transfusion? Why is it important to get a fibrinogen level in the sick GI bleed patient? What are the goals of resuscitation in a massive GI bleed? What's the evidence for using an NG tube for diagnosis and management of upper GI bleeds?  In which patients should we give tranexamic acid and which patients should we avoid it in? How are the indications for massive transfusion in GI bleed different to the trauma patient? What are your options if the bleeding can't be stopped on endoscopy? and many more... The post Episode 101 GI Bleed Emergencies Part 1 appeared first on Emergency Medicine Cases.

The EM Cases Rapid Reviews Videos library is growing! You might have had trouble remembering all the details of Episode 99 Highlights from EMU Conference from this past year and Leeor Sommer's brilliant talk on Lyme Disease. But don't fret! In this short video Taryn Lloyd reviews the ED recognition, diagnosis and management of the often elusive acute and disseminated Lyme Disease... The post Rapid Reviews Video on Lyme Disease appeared first on Emergency Medicine Cases.