Dr. Smith's ECG Blog

JANUARY 2, 2025

Applying my method to the March 19, 2019 case that I show in Figure-1 the rhythm in this Figure-1 ECG is regular, with an R-R interval just under 4 large boxes. Figure-1: My "correction factor" for QTc estimation when the QRS is not wide ( from My Comment in the March 19, 2019 post in Dr. Smith's ECG Blog ). J Am Coll Cardiol.

EKG/ECG 122

EKG/ECG Sepsis Wellness Documentation/Coding 122

PEMBlog

JUNE 18, 2025

Researchers conducted a retrospective cohort study across 30 US and 1 Canadian pediatric emergency departments, analyzing data from 5641 children (ages 6 months to 17 years) treated with epinephrine for an acute allergic reaction between 2016 and 2019.

Anaphylaxis 98

Anaphylaxis Pediatrics Allergic Reactions Emergency Department 98

Ken Grauer, MD

OCTOBER 10, 2024

The October 16, 2019 post in Dr. Smith's ECG Blog. Please check out the November 12, 2019 post in Dr. Smith's ECG Blog — in which I reviewed the case of a different kind of regular SVT Rhythm ( AFlutter ). ECG Blog #40 — Another regular SVT that turned out to be AFlutter.

EKG/ECG 425

EKG/ECG Sepsis Wellness 425

Ken Grauer, MD

JUNE 14, 2024

I i llustrate the ECG finding of T-QRS-D below in Figure-3 , which I've excerpted from My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog. Figure-3: Comparison between ST elevation in lead V3 due to a repolarization variant ( TOP — from 4/27/2019 ) — vs acute OMI ( BOTTOM — from 9/20/2015 ), which manifests T-QRS-D ( See text ).

EKG/ECG 407

EKG/ECG Wellness Hospitals 407

PHARM

JULY 6, 2025

Email Address: Follow Join 753 other subscribers Categories Categories Select Category #UGH CAFE 2015 Aeromedical retrieval agitation airway andy-buck apps body-piercing BrowOfJustice c-spine cardiac arrest children chris-cresswell conference CPR cup-song ecg ED education EKG Emergency anaesthesia Emergency medicine and critical care EVO ezdrugid FOAMEd (..)

Psychiatric 52

Psychiatric EKG/ECG Military CPR 52

Pediatric EM Morsels

OCTOBER 27, 2023

2019 Jan;22(1):147-156. x exp[0.02 x length or height (cm)] There is a great review article that lists many other weight estimation formulae. Accuracy of the Broselow Tape in South Sudan, “The Hungriest Place on Earth” Acad Emerg Med. 2016;23(1):21-28. doi:10.1111/acem.12854 Public Health Nutr. doi: 10.1017/S1368980018002549.

Pediatrics 274

Pediatrics Resuscitation Documentation/Coding Wellness 274

The Trauma Pro

MAY 23, 2025

Ann Surg 269(2):370-376, 2019. The Survival Benefit of a Novel Trauma Workflow that Includes Immediate Whole-body Computed Tomography, Surgery, and Interventional Radiology, All in One Trauma Resuscitation Room.

Radiology 147

Radiology Radiology Operations Resuscitation 147

Mount Sinai EM

OCTOBER 10, 2024

2019 , included all ages and any reference standard. 2019) , of 6 studies with 352 patients, established a single ONSD cutoff of 5 mm to detect elevated ICP. ICP and ONSD had a correlation coefficient of 0.7. All studies defined elevated ICP as >20, however ONSD cutoff varied from 4.8

Urgent Care 241

Urgent Care Ultrasounds 241

Ken Grauer, MD

APRIL 5, 2024

For additional examples of this phenomenon whereby automatic truncation of an EMS ECG may mistakenly result in LVH serving to mimi c ischemia — Check out My Comment at the bottom of the page of the following posts in Dr. Smith's ECG Blog — the November 29, 2023 post — June 20, 2020 — March 31, 2019 — March 29, 2019 — and t he December 27, 2018 post.

EKG/ECG 238

EKG/ECG EMS Hospitals 238

Pediatric EM Morsels

SEPTEMBER 22, 2023

McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. References Coleman-Satterfield, TT. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. In: Strange and Schafermeyer’s: Pediatric Emergency Medicine. 5 th Edition. Neurogenic Shock. Updated 2022 Feb 10]. 5 th Edition.

Shock 307

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 307

Ken Grauer, MD

JANUARY 13, 2024

The March 31, 2019 post in Dr. Smith's ECG Blog — My Comment ( at the bottom of the page ) illustrates the potentially misleading effect the pre-hospital ECG may have in patients with LVH , by cutting off S wave voltage in the anterior leads.

EKG/ECG 400

EKG/ECG Hospitals 400

ACEP Now

DECEMBER 7, 2024

Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. 2019 Dec;50(12):e440-e441]. published correction appears in Stroke.

Stroke 98

Stroke Research Hospitals Outcomes 98

PHARM

JUNE 9, 2025

Email Address: Follow Join 751 other subscribers Categories Categories Select Category #UGH CAFE 2015 Aeromedical retrieval agitation airway andy-buck apps body-piercing BrowOfJustice c-spine cardiac arrest children chris-cresswell conference CPR cup-song ecg ED education EKG Emergency anaesthesia Emergency medicine and critical care EVO ezdrugid FOAMEd (..)

Psychiatric 52

Psychiatric EKG/ECG Military CPR 52

Pediatric EM Morsels

JUNE 14, 2024

Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g.

Pediatrics 144

Pediatrics EMS Outcomes 144

Ken Grauer, MD

DECEMBER 15, 2023

The January 9, 2019 post in Dr. Smith's ECG Blog ( Please scroll down to the bottom of the page to see My Comment ). The importance of the new OMI ( vs the old STEMI ) Paradigm — See My Comment in the July 31, 2020 post in Dr. Smith's ECG Blog. This case is remarkable for the dynamic ST-T wave changes that are seen.

EKG/ECG 381

EKG/ECG EMS Hospitals 381

PHARM

JUNE 11, 2025

Email Address: Follow Join 752 other subscribers Categories Categories Select Category #UGH CAFE 2015 Aeromedical retrieval agitation airway andy-buck apps body-piercing BrowOfJustice c-spine cardiac arrest children chris-cresswell conference CPR cup-song ecg ED education EKG Emergency anaesthesia Emergency medicine and critical care EVO ezdrugid FOAMEd (..)

Psychiatric 52

Psychiatric EKG/ECG Military CPR 52

EMDocs

NOVEMBER 19, 2024

New York, NY: McGraw-Hill Education; 2019. Cambridge: Cambridge University Press; 2019. Published 2019. Juurlink D. Antipsychotics. In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. Goldfrank’s Toxicologic Emergencies, 11e. Minns AB, Clark RF. Toxicology and overdose of atypical antipsychotics.

Hyperthermia / Hypothermia 101

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 101

Pediatric EM Morsels

JULY 7, 2023

Horan, 2006 ] Anatomy of the PTF Joint [ Cunningham, 2019 ] The PTF joint is a synovial joint between the lateral condyle of the tibia and the head of the fibula. Cunningham, 2019 ] Treatment [ Horan, 2006 ] 1st option for Subluxation and Anterolateral Dislocation is Manual Reduction ( similar to reducing that Nursemaid’s Elbow ).

Dislocations 144

Dislocations Fractures Pediatrics EMS 144

EMDocs

DECEMBER 1, 2024

Flea-Borne Typhus: Epidemiology Summary 2013-2019. Rosh Review Website Link References: Texas Department of State Health Services. Flea-Borne Typhus. Accessed August 19, 2024. California Department of Public Health. Accessed August 19, 2024. Centers for Disease Control and Prevention. Murine Typhus—United States, 2002. 2003;52(50):1209-1211.

EMS 96

EMS Infectious Diseases Shock Airway Management 96

University of Maryland CC Project

MAY 31, 2025

Skip to content University of Maryland Home Clinical Pearls & Cases Menu Toggle Airway Mechanical Ventilation Medical Education Neuro Critical Care Procedures Pulmonary Statistics and Epidemiology Trauma Critical Care Ultrasound Core Content Lecture Series Menu Toggle Cardiovascular Gastrointestinal Hematology/Oncology Infectious Disease Mechanical (..)

Sepsis 40

Sepsis Infectious Diseases Ultrasounds Airway Management 40

University of Maryland CC Project

MAY 31, 2025

Skip to content University of Maryland Home Clinical Pearls & Cases Menu Toggle Airway Mechanical Ventilation Medical Education Neuro Critical Care Procedures Pulmonary Statistics and Epidemiology Trauma Critical Care Ultrasound Core Content Lecture Series Menu Toggle Cardiovascular Gastrointestinal Hematology/Oncology Infectious Disease Mechanical (..)

Outcomes 40

Outcomes Infectious Diseases Ultrasounds Airway Management 40

Ken Grauer, MD

OCTOBER 29, 2023

For my clarifying Figure illustrating T-QRS-D ( 2nd bullet ) — See My Comment at the bottom of the page in Dr. Smith’s November 14, 2019 post. Smith’s ECG Blog with 20-minute video talk by Dr. Meyers on The O MI M anifesto.

EKG/ECG 195

EKG/ECG 195

ACEP Now

APRIL 7, 2025

percent in real (inflation-adjusted) dollars – almost entirely during 2019 and 2020, according to the report. Key findings from the report include: Since 2018, ED facility commercial allowed amounts rose 18.65 During this same period, professional physician average allowed amounts dropped 7.42 percent in real dollars.

Emergency Department 98

Emergency Department Operations 98

Pediatric EM Morsels

JUNE 9, 2023

Specific Therapies for Variceal Hemorrhage : [ Luoto, 2020 ; Castillo, 2019; Garcia-Tsao, 2007 ] Antibiotic prophylaxis (usually for 7 days) Ceftriaxone is reasonable 1st choice. Castillo, 2019 ] Somatostatin (or its analogues, like Octreotide) Guidelines do recommend this… There is great variability in its administration, though.

Pediatrics 157

Pediatrics Head Injuries Airway Management Resuscitation 157

EMCrit

JUNE 12, 2025

A Comparison of Parenteral Phenobarbital vs. Parenteral Phenytoin as Second-Line Management for Pediatric Convulsive Status Epilepticus in a Resource-Limited Setting. Front Neurol. DOI: [ 10.3389/fneur.2019.00506 2019.00506 ] Scheppke KA, Pepe PE, Garay SA, Coyle CW, Antevy PM, Perlmutter MC, Scheppke EK, Crowe RP.

Pediatrics 96

Pediatrics Resuscitation Emergency Department Research 96

First 10 EM

MAY 27, 2024

Connolly 2019) At that point, I concluded that andexanet alfa should clearly not be used (although our pharmacies didn’t listen and wasted a lot […] The post Andexanet alfa: expensive and harmful?

EMS 126

EMS 126

Pediatric EM Morsels

NOVEMBER 17, 2023

2019 Sep;74(9):1186-1190. Epub 2019 Jul 16. West J Emerg Med. 2023 Apr 28;24(3):579-587. doi: 10.5811/westjem.59560. PMID: 37278787; PMCID: PMC10284523. Shah A, Carlisle JB. Cuffed tracheal tubes: guilty now proven innocent. Anaesthesia. doi: 10.1111/anae.14787. PMID: 31313280. Shi F, Xiao Y, Xiong W, Zhou Q, Huang X.

Pediatrics 190

Pediatrics Emergency Department Outcomes Sepsis 190

PEMBlog

APRIL 22, 2025

2019-1895L. References Patient- And Family-Centered Care in the Emergency Department for Children With Autism. Nicholas DB, Muskat B, Zwaigenbaum L, et al. Pediatrics. 2020;145(Suppl 1):S93-S98. doi:10.1542/peds.2019-1895L. Medical Management of Children With Autism in the Emergency Department. Wolpert KH, Kim SJ, Kodish I, Uspal NG.

Pediatrics 77

Pediatrics Emergency Department Administration Hospitals 77

Emergency Medicine Journal

JUNE 19, 2025

2 There is currently little evidence on the impact of rota design on the wellbeing of ED staff, although RCEM published guidance on implementing self-rostering in 2019. 3 One previous report indicates self-rostering may improve wellbeing in EM and acute internal medicine trainees in a single trust.

EMS 40

EMS Emergency Department Research 40

University of Maryland CC Project

MAY 31, 2025

Skip to content University of Maryland Home Clinical Pearls & Cases Menu Toggle Airway Mechanical Ventilation Medical Education Neuro Critical Care Procedures Pulmonary Statistics and Epidemiology Trauma Critical Care Ultrasound Core Content Lecture Series Menu Toggle Cardiovascular Gastrointestinal Hematology/Oncology Infectious Disease Mechanical (..)

Infectious Diseases 40

Infectious Diseases Ultrasounds Airway Management Sepsis 40

Pediatric EM Morsels

JULY 26, 2024

Epub 2019 Dec 19. Anti-N-methyl-D-aspartate receptor encephalitis with accompanying ovarian teratoma in female patients from East China: Clinical features, treatment, and prognostic outcomes. 2020 Feb;75:55-62. doi: 10.1016/j.seizure.2019.12.016. 2019.12.016. PMID: 31874360.

Psychiatric 274

Psychiatric Seizures Outcomes Pediatrics 274

Taming the SRU

OCTOBER 28, 2024

2019 Jun;217(6):1047-1050. 2019 Oct;45(5):927-931. Matthees NG, Mankin JA, Trahan AM, Israr S, Jones MD, Dameworth JL, Petersen SR, Weinberg JA. Pneumomediastinum in blunt trauma: If aerodigestive injury is not seen on CT, invasive workup is not indicated. PubMed] 12. Lee WS, Chong VE, Victorino GP. 2015 Aug;150(8):757-62. PubMed] 14.

COPD 97

COPD Pediatrics Emergency Department Ultrasounds 97

University of Maryland CC Project

MAY 31, 2025

Skip to content University of Maryland Home Clinical Pearls & Cases Menu Toggle Airway Mechanical Ventilation Medical Education Neuro Critical Care Procedures Pulmonary Statistics and Epidemiology Trauma Critical Care Ultrasound Core Content Lecture Series Menu Toggle Cardiovascular Gastrointestinal Hematology/Oncology Infectious Disease Mechanical (..)

Infectious Diseases 40

Infectious Diseases Ultrasounds Airway Management Sepsis 40

University of Maryland CC Project

MAY 31, 2025

Skip to content University of Maryland Home Clinical Pearls & Cases Menu Toggle Airway Mechanical Ventilation Medical Education Neuro Critical Care Procedures Pulmonary Statistics and Epidemiology Trauma Critical Care Ultrasound Core Content Lecture Series Menu Toggle Cardiovascular Gastrointestinal Hematology/Oncology Infectious Disease Mechanical (..)

Infectious Diseases 40

Infectious Diseases Airway Management Ultrasounds Sepsis 40

Ken Grauer, MD

JUNE 26, 2023

Please check out the November 12, 2019 post in Dr. Smith's ECG Blog — in which I reviewed the case of a different kind of regular SVT Rhythm ( AFlutter ). González-Torrecilla et al: Ann Noninvasive Electrocardiol 16(1):85-95, 2011 — Reviews distinction between AVNRT vs AVRT and other regular SVT rhythms in patients without WPW.

EKG/ECG 366

EKG/ECG Wellness 366

RebelEM

SEPTEMBER 7, 2023

BACKGROUND: intracerebral hemorrhage (ICH) makes up 10-15% of all strokes and significantly contributes to overall stroke-related morbidity and mortality ( Hostettler 2019 ). 2019 Jul;19(7):679-694. Epub 2019 Jun 12. 2019 May;68:38-45. Intracerebral hemorrhage: an update on diagnosis and treatment. Expert Rev Neurother.

Seizures 128

Seizures Stroke Outcomes Research 128

PulmCCM

JUNE 10, 2025

The A2B Trial: Clonidine Vs. Dexmedetomidine From 2019 to 2023, 1,438 critically ill patients requiring mechanical ventilation were enrolled at 41 ICUs in the UK. They were randomized to either receive propofol, dexmedetomidine (0.7 to 1.4 μg/kg/hour), or clonidine (1.0 to 2.0 μg/kg/hour).

Wellness 65

Wellness 65