Tactical Medicine News Blog

Did you know that there is a section in the Annals of Emergency Medicine that is written by EM residents only? As Annals’ Resident Fellow, I wanted to share a great writing and publishing opportunity with my fellow residents. Many of the residents who have published in this series have gone on to do great things in EM as faculty members. 

Multi-detector computed tomographic pulmonary angiography (CTPA) allows for better visualization of peripheral pulmonary arteries allowing for diagnosis of small peripheral emboli limited to the subsegmental pulmonary arteries. Interestingly as these SSPE’s get diagnosed more and more, two questions come to mind: What is the prognostic utility of diagnosing SSPEs? What is the morbidity and mortality of SSPEs compared to more proximal PEs? A recent study in 2013 Blood looked at these questions. 1

Health-care associated pneumonia (HCAP) is the term used to describe patients presenting with pneumonia who may be at higher risk of multi-drug resistant (MDR) pathogens than other patients presenting from the community due to recent contact with the health care system. What are the criteria for HCAP?

Emergent airway management and severe sepsis are both high-risk situations that are commonly encountered by emergency physicians. It is well known that complications can be high in both situations, which in turn can lead to increased morbidity and mortality. For instance, about 1/4 of patients who are hemodynamically stable prior to intubation get post-intubation hypotension (PIH) after rapid sequence intubation. Also septic patients may not be reliably identified by systemic inflammatory response syndrome (SIRS) markers early in their disease course. The Shock Index (SI) may be an adjunct that is easy to calculate and could predict both PIH and severe sepsis.

The Social Media Index was moved from BoringEM to ALiEM on the morning of Thursday, November 21st. The increased exposure for my previously obscure little prototype got it a lot of attention. By that afternoon Dr. Scott Weingart (@EMCrit) had weighed in with an audio response critical of the index and requested that EMCrit be removed. This set off a lively discussion on Twitter as a good chunk of the FOAM community got in on this important discussion.