The June Newsletter is out. Topics include hemophilia, Lyme disease, mammalian bites, and arthritis.… Read more
Category: News
Vasopressors
The goal of vasopressor use is to reach critical organ perfusion pressure. Estimated required mean arterial pressures (MAP) are listed in the vasopressor review by organ. It is generally safe to aim for a goal map of 65 mmHg. Vasopressors also promote increased venous return and should be used in septic patients after failed response to adequate volume resuscitation.… Read more
Thryoid Storm
Scott Weingart has put out a great EMCrit Podcast on the treatment and diagnosis of Thyroid Storm. With thyrotoxicosis and thyroid storm being relatively rare diseases, wiki page highlights the treatment and diagnosis. The severity of hyperthyroidism, thyrotoxicosis and thyroid storm can be assessed with the Burch-Wartofsky score. Treatment is focused on: Aggressive supportive care and early propranolol administration to decrease peripheral hormone conversion and decrease sympathetic surge. Also along with propranolol, thionamide administration (specifically PTU) blocks new hormone synthesis. Iodide can be administered afterwards to prevent further hormone production.… Read more
PID and Hospitalization
Regarding pelvic inflammatory disease (PID), which of the following is NOT a criteria for which hospitalization should be considered?
A. Pregnancy
B. Tuboovarian abscess
C. Vaginal bleeding
D. A surgical emergency can not be excluded (e.g., appendicitis).
E. The patient is unable to tolerate an outpatient oral regimen.
…an excerpt from The Kaji Review … Read more
Demystifying the Editorial Levels of WikEM
All content on WikEM is reviewed by editors who are committed to content quality and correctness. The WikEM organization is extremely egalitarian with an open and transparent promotion process. The more your contribute to the wiki, the greater your level of influence and recognition within the organization. The wiki software tracks contributions and ranks authors based on contribution
- Casual users can contribute small changes
- Residents can participate individually or as part of a residency elective
- Any physician can advance through the official editorial levels.
As more content moves to the internet on platforms other than textbooks and journals, WikEM will use metrics such as these to advance the academic and educational careers of our contributors.… Read more
Sponsorship: MedNexus
WikEM is proud to announce this week’s sponsor, MedNexus, a search engine designed for healthcare providers. They are developing a really exciting set of tools using semantic search to create a “Google for Medicine”. Their search and discovery tools allow a provider to quickly find the most relevant articles, reviews, guidelines, and medical content to answer clinical questions while caring for patients.
The power of their system rests in a sophisticated ranking system to organize content by quality and relevance. This means their results are not only more targeted to your clinical question but also of greater quality than a stand web search.
MedNexus offers a web search portal, iOS app, and they have an Android version on the way! We also had the privilege of talking… Read more
DKA and Cerebral Edema
Which of the following is NOT a risk factor for cerebral edema in diabetic ketoacidosis (DKA)?
A. Elevated blood urea nitrogen
B. Low serum potassium on presentation
C. Treatment with bicarbonate
D. Age < 3 years
E. Failure of serum sodium to rise steadily with correction of hyperglycemia
…an excerpt from The Kaji Review … Read more
Hyponatremia Review Question
A 60kg female patient is seizing and has a serum sodium of 113 mEq/L with no underlying history of seizures. What should be the treatment of her hyponatremia?
A. Hypertonic saline 3% – 290 ml over 2 hours
B. Normal saline 3% – 50 ml over 30 minutes
C. Phenytoin 1 gram
D. Hypertonic saline 3% – 1000 ml IV bolus
E. Hypertonic saline 3% – 750 ml over 2 hours
Read more questions from the Kaji Review… Read more
Automated creation of a critical care reference
One of the reasons we are so passionate about using a wiki for knowledge organization, is the ability to intelligently derive information from other information. The wiki is a dynamic platform. Caution up front, this post will not focus on medical knowledge as many of our blog posts, but will discuss the technical details of how we used the wiki to automate the creation of 14 pages of data with over 50 medication and equipment doses. The process provides an example of how placing medical knowledge on a wiki provides an exponential number of opportunities of organization, derivation, and advanced learning.
The first concept to explore is structured vs unstructured data. At the most basic form, data that has information attached to it is structured and data that has no describing information… Read more
April Newsletter
The April Newsletter is available. It features cardiac ultrasound, the surviving sepsis updates after the most recent randomized trials, lightning injuries and the Kaji Review.
Also please support our ongoing sponsor: Push Health: a virtual medical practice on your phone… Read more