Author: WikEM

To better facilitate communication we have an open telegram channel https://t.me/wikem_org Anyone can join and chat directly with other users and editors for help and general discussion.… Read more

Our new redesign is live! Please provide any comments on this forum thread https://forum.wikem.org/t/redesign-feedback/936

The login issues that have plagued many users especially on Android during the last week should hopefully be fixed.  Thank you for bearing with us as we grow.  As always, if you enjoy WikEM, please donate.  Everything from the software to the content is made for free and open use. Without a small amount of money software development and maintenance for WikEM is not possible.

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A recent issue with our android app and in preparation for our site upgrade we are undergoing maintenance. We anticipate being online within the next hour.… Read more

Update: the app has been restored.

For an unknown reason, our Android app has just been removed from the app store. Little to no information has been provided to us from Google and we are working to get the app reinstated.… Read more

Last month we had a disastrous bug that caused many users to download high definition images over their cellular connection.  In the coming app update we will be rolling out a new feature that allows for control over downloaded content. Although initially on iOS it will follow on android. From the updates icon on the WikEM app launch screen you can see the following toggles to control downloaded and updated content.

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• Negative-pressure pulmonary edema (NPPE)  occurs after a patient makes strong inspiratory effort against a blocked airway. The negative pressure causes hydrostatic edema that can be life-threatening if not but minimized if treated early, usually resolves after 24-48 hours.
• Patients have and airway obstructive process either from an allergy, laryngospasm, trauma, and commonly in the case of hangings.

Tetrodotoxin is from the pufferfish, blue octopus and some poisonous frogs. Neurotoxicity results from inhibition of Na-K pumps causing paresthesias and rebound hypersensitivity. Like most poisons in toxicology, the treatment is aggressive supportive care.… Read more

The following guest post is written by MD candidate Joseph N. Ponce at McGovern Medical School, Houston TX, and describes the current state of evidence with adjunctive techniques to treat refractory VF.

Refractory ventricular fibrillation (RVF) is a life-threatening cardiac arrhythmia unresponsive to traditional methods of defibrillation and advanced cardiovascular life support (ACLS). Current literature lacks a uniform definition for RVF, however, some studies provide more specific clinical definitions of refractory ventricular fibrillation such as ventricular fibrillation that is resistant to at least three defibrillation attempts, 300 mg of amiodarone, and does not exhibit return of spontaneous circulation (ROSC) after > 10 min of cardiopulmonary resuscitation (CPR).… Read more

Cerebral venous thrombosis (CVT) is a rare disorder involving occlusion of the venous sinus (most commonly superior sagittal and lateral sinuses) .  CVT is a very difficult diagnosis with a highly variable onset that may include visual, neurologic or even infectious like symptoms.  Predisposing factors include:

• Cancer
• Pregnancy
• Local infections (otitis media, sinusitis, cellulitis)
• Hypercoagulable states
• Trauma
• Drugs (ecstasy, androgens, OCPs)
• Compression of venous sinus (tumor, abscess)

Suspect CVT in patients presenting with headache, signs of increased ICP, or focal neurologic deficits, especially if any of above predisposing factors are present.  Do not use a D-dimer to rule out CVT. The workup includes, an MRI and MRV unless there is a contraindication, then CT venogram… Read more

We are always working to make bedside knowledge more accessible and quickly available for clinicians and healthcare providers in emergency settings for free.

• Over the weekend our iOS app received a major update to fix many bugs and improve the appearance of content.
• The website has quick links to the critical care quick reference, antibiotic guide, journal club, and popular pages
• The forum is available for discussion anything Emergency Medicine and new EM job postings
• The newsletter provides monthly updates on educational topics and highlights learning resources on the internet

We keep all content free because were realize how important information and knowledge sharing is to daily clinical practice and because our users are our patrons and keep everything running.… Read more