Ken Grauer, MD

MAY 17, 2025

== P lease N OTE : After today No new ECG Blog posts for 3- to -4 weeks. I will also not be prompt in replying to emails. == All material on this ECG Blog site remains open! The INDEX tab ( in the upper right of each page ) has linked Contents, listed by subject. So IF you are looking for ECG material There is plenty on this web site! And IF you look at the TOP of every page in this blog You'll see a Menu of Tabs that link to a variety of blog features, including my ECG podcasts, Audios &a

EKG/ECG 393

EKG/ECG EMS Administration Wellness 393

Sensible Medicine

MAY 17, 2025

On a recent shift, I received sign-out for Room 20, a 46 year old man with a history of schizophrenia as well as alcohol and cannabis abuse. He came to us from a nursing home where he lives. He accidentally set his room on fire with a cigarette, prompting the nursing home to kick him out for being a risk to the facility. Although he had no acute medical issues, he was sent to the emergency department so “the health care system” could find him a new home.

Psychiatric 91

Psychiatric COPD Emergency Department Hospitals 91

Don't Forget the Bubbles

MAY 12, 2025

Its the first week of your new placement in the Emergency Department of a Paediatric Major Trauma Centre. Youve just finished discharging your third case of flu that day when the red phone rings a 14-year-old child has been stabbed in the chest and is severely injured. The nurse in charge has input out a major trauma alert, and the consultant has asked you to request the relevant bloods and imaging after the primary survey.

Radiology 104

Radiology Radiology Fractures Emergency Department 104

EMDocs

MAY 12, 2025

Author: Jonathan Warren, MD (Clinical Ultrasound and EMS Fellow, Department of Emergency Medicine , Harbor-UCLA Medical Center) and Lilly Bellman, MD (Pediatric POCUS Director, San Francisco Emergency Medicine Associates, California Pacific Medical Center) // Reviewed By: Steve Field, MD; Brit Long, MD (@long_brit) Case: A 41 year old male presents to the ED with right upper quadrant pain that worsens after eating.

Ultrasounds 81

Ultrasounds Best Practices EMS Wellness 81

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

Outcomes

PulmCCM

MAY 12, 2025

Anemia is the norm in critically ill patients. Over the past 25 years, critical care has shifted from a normalization heuristic to a restrictive, anemia-tolerant approach to transfusion. Hemoglobin levels less than 8 g/dL are common and usually left alone. There’s good evidence this approach doesn’t increase mortality: But much less is known about how severe anemia may impact long-term functional recovery after critical illness.

Blood Transfusions 90

Blood Transfusions Outcomes Hospitals Pediatrics 90

The Skeptics' Guide to EM

MAY 17, 2025

Reference: Cohen et al; SUSPECT study group. Can we avoid casting for suspected scaphoid fractures? A multicenter randomized controlled trial. J Orthop Traumatol. 2025 Date: May 1, 2025 Guest Skeptic: Dr. Matt Schmitz is an orthopedic surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. He practices at the Rady Childrens Hospital in San Diego and is Professor of Orthopedics at UC San Diego.

Fractures 85

Fractures Emergency Department Research Outcomes 85

Taming the SRU

MAY 18, 2025

The adrenal system allows our bodies to respond to physiologic stressors and to regulate multiple metabolic processes within the body. Disorders of the adrenal axis can be chronic in onset, causing subacute or subclinical presentations, or acute, leading to frank clinical presentations that need to be managed more emergently by ER physicians. Recognition and diagnosis of these disorders can be difficult as the presenting symptoms are often subtle and nonspecific, making it all the more important

Emergency Department 52

Emergency Department Stroke Administration COPD 52

JournalFeed

MAY 17, 2025

The JournalFeed podcast for the week of May 12-16, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Monday Spoon Feed : Short-term ambulatory cardiac monitoring has diagnostic usefulness, although limited, in patients discharged from the emergency department.

Emergency Department 52

Emergency Department 52

EMergucate

MAY 13, 2025

A 33yr old male presents with exertional chest pain, his ECG is below: What is the specific finding and concern … Continue reading →

EKG/ECG 52

EKG/ECG EMS 52

Mind The Bleep

MAY 19, 2025

Whether you’re chasing a better work-life balance , lucrative opportunities, scenic landscapes or a new clinical challenge, Canada is becoming an increasingly attractive destination for international medical graduates (IMGs), especially UK doctors. Canada offers multiple pathways for to work in Canada either as an attending (consultant) doctor or entering into a residency (training) program.

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Life in the Fast Lane

MAY 12, 2025

James Miers and Hasan Sarwar Procedure: Nail bed repair Emergency Procedure, instruction and discussion: nail bed repair - a deceptively simple injury that can lead to permanent nail deformity if managed incorrectly

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The Trauma Pro

MAY 13, 2025

In my last post, I reviewed using the Cribari grid to evaluate over- and under-triage at your trauma center. This technique has been a mainstay for over a decade, but it has shortcomings. The most important one is that it relies only on the Injury Severity Score (ISS) to judge whether some type of mistriage occurred. As you know, the ISS is usually calculated after discharge, so it can only be applied after the fact.

Blood Transfusions 113

Blood Transfusions Radiology Radiology 113

EMDocs

MAY 17, 2025

Authors: Matt Treasure, DO (EM Resident Physician, Christus Spohn/Texas A&M University College of Medicine, Corpus Christi, TX); Rogelio Trey Martinez, DO, MPH (EM Resident Physician, Christus Spohn/Texas A&M University College of Medicine); Justin Hacnik, MD (EM Attending Physician, Christus Spohn/Texas A&M University College of Medicine, Corpus Christi, TX); J.D.

EMS 80

EMS Resuscitation Administration Hyperthermia / Hypothermia 80

Northwestern EM Blog

MAY 13, 2025

Written by: Melissa Kubacki, MD, MS (NUEM 26) Edited by: Jalea Moses, MD (NUEM 24) Expert Commentary by : Matt Levine, MD Introduction: Compartment syndrome is a cant miss diagnosis for any painful extremity examinationespecially in those with any traumatic mechanism. Having a high clinical index of suspicion along with the skills to accurately measure compartment pressures, while in the emergency department, could save a limb.

Fractures 63

Fractures Academics Emergency Department Hospitals 63

Sensible Medicine

MAY 12, 2025

I have a great (and sad) story to tell today. It’s about hubris and the need for proper control arms in device trials. The reason control arms popped in my head was an unusually candid editorial in JAMA regarding the management of tricuspid regurgitation. The authors criticize the evidence base underpinning the new push to intervene on the tricuspid valve.

Operations 60

Operations Leadership Outcomes Wellness 60

Emergency Medicine Cases

MAY 12, 2025

There are many nuances in the management of patients with pulmonary embolism in cardiac arrest, peri-arrest or simply in shock: We need to optimize oxygenation and airway management, hemodynamic support, acid/base management, thrombolysis and/or catheter-directed therapies that Anton dives into with guest experts Dr. Lauren Westafer, Dr. Bourke Tillmann and Dr.

Airway Management 40

Airway Management Shock EMS Ultrasounds 40

The Trauma Pro

MAY 16, 2025

A hybrid operating room is a special OR suite that allows advanced imaging to be carried out simultaneously with one or more additional operative procedures. Its that simple. It contains specialized imaging equipment, including fluoroscopy and infusion equipment for radiographic dye administration. Some also contain CT and/or MRI capabilities, but the shielding required for these makes them rare.

Operations 147

Operations Administration Hospitals 147

Dr. Smith's ECG Blog

MAY 12, 2025

Written by Pendell Meyers A woman in her 60s had acute chest pain and shortness of breath. EMS arrived and recorded this ECG (no baseline ECG available): What do you think? Sinus rhythm, RBBB, and anterolateral OMI pattern with concordant STE in V2, inappropriate STD (precordial swirl pattern) in V5 anv V6, HATW in I and aVL, with reciprocal STD and negative HATW in III and aVF.

EKG/ECG 117

EKG/ECG EMS Wellness 117

The Bottom Line

MAY 15, 2025

Whats new in the Critical Care literature monthly updates

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Critical Care North Hampton

MAY 16, 2025

Discover the perioperative risks of GLP-1 drugs like semaglutide, focusing on delayed gastric emptying and aspiration during anaesthesia.

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EMCrit

MAY 15, 2025

Our first episode uses a simple case to act as touch-point for a discussion of resus nursing in the ED. EMCrit Project by Scott Weingart, MD FCCM.

Sepsis 82

Sepsis 82

EM Ottawa

MAY 15, 2025

The importance and efficacy of feedback as an educational tool is well established within medical education literature, with widespread consensus that it is essential for learner development.(1) Reflecting this, the Accreditation Council for Graduate Medical Education (ACGME) designates feedback as an essential and required aspect of resident training across all specialties.

Wellness 74

Wellness 74

Dr. Smith's ECG Blog

MAY 15, 2025

Written by Magnus Nossen The patient in today's case is a young adult male who has had annual cardiological follow-ups due to a pathological ECG. His previous studies include annual Holter monitoring for palpitations and biennial echocardiograms. The Holter recordings and echocardiograms were unremarkable. The patient contacted EMS for chest pain and had the following ECG recorded.

EKG/ECG 72

EKG/ECG EMS Wellness Hospitals 72

The Bottom Line

MAY 15, 2025

Whats new in the Critical Care literature monthly updates

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Core Medical Group

MAY 15, 2025

How long does it take to become a travel nurse? Learn how many years of college you need, degree requirements, and the fastest path to travel nursing.

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EMCrit

MAY 16, 2025

I'm writing a letter to the editor in response to a recent article in the Journal of Hospital Medicine. I'm posting it here rather than submitting it to the journal to avoid burying it behind a paywall (and because I have the attention span of an intensivist hopped up on lots of coffee). First, I […] EMCrit Project by Josh Farkas.

Hospitals 76

Hospitals Administration 76

Sensible Medicine

MAY 14, 2025

The most common question we get asked is: is there a course on how to become better at critically reading medical research. Here it is! This is the second of 9 videos that we recorded as part of a course on clinical appraisal, and there will be many more to come. This and future videos will be made available as a thank you to paid subscribers.

Research 65

Research 65

EM Ottawa

MAY 12, 2025

Methodology: 4/5 Usefulness: 3.5/5 Wilson SJ, et al. Ann Emerg Med. 2024 Mar;83(3):235-246. doi: 10.1016/j.annemergmed.2023.09.005. Questions and Method:To determine the diagnostic accuracy of emergency physician performed point of care ultrasound (POCUS) for acute cholecystitis diagnosis compared to final diagnosis as per surgical pathology, discharge diagnosis or radiology performed ultrasound.

Ultrasounds 64

Ultrasounds Radiology Radiology 64

EB Medicine

MAY 16, 2025

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the May 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Chronic Neurologic Disease: Parkinson Disease, Myasthenia Gravis, and Multiple Sclerosis Parkinson's Disease Importance of maintaining medication schedule for Parkinson's patients Strategies for ensuring patients receive their medications promptly Overview of Carbidopa Levodopa's mechanism of action Myasthenia Gravis Descr

Emergency Department 59

Emergency Department 59

EMDocs

MAY 18, 2025

Hello World The post Hello WOrld appeared first on emDocs.

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Critical Care North Hampton

MAY 14, 2025

Join Professor Mervyn Singer at SOA25 Congress to explore 40 years of ICU evolution, discussing breakthroughs and ongoing challenges.

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Sensible Medicine

MAY 16, 2025

Following up with another 35 “diseases just learned.” Please look back to last week’s intro if you are just coming to this series. Like Part I, this is a gift to our paid subscribers. This Substack is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber.

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Mind The Bleep

MAY 18, 2025

It is very common that we perform a cardiovascular examination in paediatrics, particularly in babies, but we will often leave out key steps which would be expected in a clinical exam setting.

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Greater Sydney Area HEMS

MAY 15, 2025

Visit the post for more.

Hospitals 52

Hospitals 52

NRC Health

MAY 15, 2025

NRC Health is proud to celebrate our Chief Experience Officer Jennifer Baron for being named one of Women We Admires Top 50 Women Chief Experience Officers of 2025. The post NRC Healths Jennifer Baron Named One of 2025s Top Women Chief Experience Officers appeared first on NRC Health.

Leadership 52

Leadership 52

PulmCCM

MAY 15, 2025

Nutrition is complex, and so it should not be surprising that the data on nutritional support in hospitalized patients represent something of a paradox. A relatively robust evidence base suggests strongly that an assertive approach to nutrition can save lives in hospitalized patients who are malnourished or at risk. However, in the most severely ill patients, the choice of nutritional support and the number of calories delivered have shown no significant effect on outcomes.

Outcomes 52

Outcomes Hospitals Research 52