Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

Which had the more severe chest pain at the time of the ECG? However, pain severity is associated with rapid intervention because patients with severe pain seek attention earlier and providers pay more attention to them (see reference 2 below). 2 middle aged males presented with chest pain. 414 patients were included in the analysis.

EKG/ECG 93

EKG/ECG Hospitals Outcomes Wellness 93

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Pads need to be as close together as possible but not touching to avoid capacitor overload. What is “Refractory” VT/VF?

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Don't Forget the Bubbles

SEPTEMBER 27, 2023

This series of DFTB articles aims to increase awareness of the Choosing Wisely ® recommendations. Each article will take a deep dive into each recommendation’s supporting evidence and practical implications. But if you have clinical suspicion, why not just order the more specific test? What do the guidelines say?

Emergency Department 84

Emergency Department Pediatrics Point-of-Care Testing Hospitals 84

Mind The Bleep

FEBRUARY 9, 2024

Intensive care units provide the highest-level care for patients within the hospital. At most hospitals, the CCOT service is run by nurses and other advanced healthcare professionals who are very experienced in assessing and looking after unwell patients. Who to refer to ITU?

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

Don't Forget the Bubbles

JUNE 26, 2023

In this case-based article, we’ll talk about single ventricle defects and their management (both medical and surgical), then look at the two main shunt options during Stage 1 reconstruction. More blood flow to the lungs means less blood flow to the body, and vice versa. They are very rare, occurring in just 5/100,000 newborns.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Pediatric Education

NOVEMBER 5, 2023

The parents were concerned about his head shape as they thought that his forehead seemed more pointed. His posterior fontanelle was closed but his anterior fontanelle was open, was 1-2 cm in size and was in a normal position without pulsations. When do the fontanelles usually close? Figure 135 – Craniosynostosis Types.

Radiology 52

Radiology Radiology Pediatrics Wellness 52

EMDocs

JUNE 9, 2023

How do we manage the agitated child in the pre-hospital environment? After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children.

EMS 75

EMS Documentation/Coding Pediatrics Emergency Department 75

Dr. Smith's ECG Blog

JANUARY 9, 2024

Looking more closely at the tracing however, it becomes apparent that atrial activity is not consistent with atrial flutter. The ECG in sinus rhythm will also be more easy to assess with regards to ischemia The VT was not appreciated and patient was admitted with telemetry and IV amiodarone. Do you agree with this strategy?

EKG/ECG 86

EKG/ECG Stroke Hospitals Documentation/Coding 86

Pediatric Education

JULY 23, 2023

Patient Presentation A 4-day-old male came to clinic for his routine followup appointment after discharge from the hospital after birth. The left atrium now has a relatively higher pressure than the right atria, and therefore pressure on the flap valve closes the foramen ovale. ASDs occur in about 1.6/1,000 It can also lead to emboli.

Stroke 40

Stroke Pediatrics Outcomes Hospitals 40

Mind The Bleep

NOVEMBER 27, 2023

Introduction: This exploration of peri-orbital cellulitis and orbital cellulitis is designed to aid in the diagnosis and management of two distinct but closely related ophthalmological conditions that are commonly managed by both ENT and Ophthalmology services. Intravenous antibiotics are essential.

Best Practices 52

Best Practices Outcomes Hospitals 52

ACEP Now

JANUARY 13, 2024

We must know a little about a lot or, more accurately, a lot about a lot. More than just security and metal detectors, where were the mental health resources to support this health care professional? Was anyone close to him checking on him, asking questions? We must be flexible. We must be ready to intervene.

Emergency Department 52

Emergency Department Resuscitation Patient Safety Hospitals 52

EMDocs

JUNE 8, 2023

This collection of posts features recently published must-know articles. Strengths of this article include it being a multicenter, double blinded, randomized controlled trial with intention to treat analysis and no loss to follow-up. More research is needed on this topic, yet the authors of the EXTEND trial discontinued enrollment.

Stroke 76

Stroke Administration Outcomes Documentation/Coding 76

SheMD

OCTOBER 1, 2023

While some of that time was spent getting to know residents and faculty, much it of it was spent wandering through cafeterias, workrooms, and hospitals. Read , our disclosure for more info. you’ll learn a lot more about how residents spend their free time and how often they truly get together.

Hospitals 52

Hospitals Wellness 52

SheMD

APRIL 24, 2023

We will have two more once they grow. You probably diagnose these way more than I do. Yes, I do diagnose them more than she does. A colleague met me at the hospital and performed an ultrasound once more to confirm. My husband left the fire station and rushed to the hospital to be with me. And we did.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

RebelEM

AUGUST 14, 2023

Article: Liu S, Yao C, Xie J, et al. 7 Clinically speaking, they used an increase of the SOFA score by 2 or more points to indicate this. 001) Hospital mortality: Placebo 22.8% 8 It helps translate the impact of treatment into a more understandable and clinically relevant statistic. JAMA Intern Med. 2023;e230780.

Sepsis 90

Sepsis Outcomes Administration Research 90

Don't Forget the Bubbles

JULY 5, 2023

Sickle cell patients have more than 50% of haemoglobin S instead of the normal haemoglobin A (HbAA). See this helpful summary article for more info. Why are sickle cell patients more susceptible to severe infections? Sickle cell disease (SCD) is the most common type of haemoglobinopathy followed by thalassaemia.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

RebelEM

JULY 31, 2023

REBEL Cast Ep121: The Battle of the Blades – VL vs DL Click here for Direct Download of the Podcast Article: Prekker ME, Driver BE, Trent SA, et al. The pragmatic study design closely mirrored real-world clinical experiences. Most facilities were teaching hospitals, limiting generalizability to community hospitals.

Operations 87

Operations Outcomes Emergency Department Airway Management 87

Don't Forget the Bubbles

MAY 3, 2023

With millions of journal articles published yearly, it is impossible to keep up. This time the PEM MSc team from QML , in association with DFTB, are taking over… Article 1: Insulin infusion in paediatric DKA – high or low? More studies are needed to define the optimal insulin infusion dose in paediatric DKA.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

EMDocs

OCTOBER 21, 2023

7 A cause of BAO more commonly seen in young patients is traumatic vertebral artery dissection. More common in the setting of atherosclerotic lesions than emboli, which typically occur with sudden onset of symptoms. 2 BAO has an estimated incidence of 4/100,000 people per year. 8 Reduced consciousness is another key finding in BAO.

EMS 73

EMS Stroke Outcomes Hospitals 73

Pediatric Education

SEPTEMBER 10, 2023

Patient Presentation A term newborn male was transferred to the regional children’s hospital after having respiratory distress that developed after birth. The left dorsal arch forms the ductus arteriosus, which later closes and is termed the ligamentum arteriosum.” The right dorsal arch regresses.

Pediatrics 40

Pediatrics Radiology Radiology Wellness 40

EMDocs

MAY 26, 2023

Patients may be brought to hospital by police under restraint (e.g. Be patient and listen, and then listen more — not to reply, but to validate and to understand, responding only with, “I think I understand. Tell me more”. But what about the patient who is agitated, and is a potential danger to themselves or to the ED staff?

Pediatrics 75

Pediatrics Emergency Department Psychiatric Documentation/Coding 75

Mind The Bleep

JUNE 18, 2023

It is a very common presentation or comorbidity to see in community services and general hospital. This article outlines the main factors related to the presentation, aetiology, and treatment of BPSD. The symptoms of BPSD are listed below. ICD-10 codes: F00-03 are the ICD codes for dementia and its subtypes F02.

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 52

RebelEM

MARCH 23, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal Click here for Direct Download of the Podcast Clinical question : Is a phenobarbital-based or lorazepam-based alcohol detoxification protocol associated with a lower hospital length of stay compared to Ativan for alcohol withdrawal? Paper : Hawa F et al.

Emergency Department 52

Emergency Department Outcomes Hospitals Burns 52

Don't Forget the Bubbles

MAY 15, 2023

Please note: This article will focus mainly on hypoglycaemia beyond the early neonatal period and in the non-diabetic patient. As such, thresholds for intervention remain under debate and vary across different hospitals and countries. Why are infants and young children more predisposed to hypoglycaemia than adults?

Wellness 103

Wellness Seizures Hospitals Dehydration 103

Pediatric Education

AUGUST 20, 2023

He had a history of Alagille syndrome, liver transplantation and liver abscesses; all of which had been successfully treated and he continued to follow closely with the liver transplantation service. per 100,000 hospitalizations in 2014. To view current news articles on this topic check Google News. Mortality rate was 0.8%.

Pediatrics 40

Pediatrics Infectious Diseases Wellness Sepsis 40

EMDocs

OCTOBER 30, 2023

1 The shortage in supply posed difficulties for hospitals that significantly depend on GE Healthcare as their supplier, which encompassed approximately 50% of hospitals in the United States (US). The primary aim of this article is to examine the clinical insights derived from scarcity and its consequences. 11 Table 1.

Radiology 72

Radiology Radiology Emergency Department Hospitals 72

The Skeptics' Guide to EM

FEBRUARY 20, 2021

There is an SGEM bottom line and a link to the original SGEM episode to provide more results and critical appraisal. There is also a link to the original article for people to read the primary literature for themselves. Key results are provided with a number of the study limitations (dog leash) identified. steroids).

Fractures 52

Fractures Outcomes Hospitals 52

EMDocs

APRIL 22, 2024

1-3 VTE is responsible for hospitalizing over 250,000 Americans every year, and there are an estimated 100,000 deaths annually associated with these conditions. 6,7 Once a DVT embolizes into the pulmonary arterial circulation, symptoms develop when more than 20% of their pulmonary vasculature is occluded.

Ultrasounds 80

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Shock 80

Sensible Medicine

MAY 19, 2023

I listened closely to everything my peers and attendings said on rounds and eavesdropped on any conversation that seemed like it might be useful. I also constantly questioned pharmacists, translators, physical therapists, nurses, and the hospital chaplains. During that month, I had quoted from every single article I knew.

Wellness 53

Wellness Hospitals 53

RebelEM

OCTOBER 31, 2022

Article: Lamontagne F et al. Median enrollment time was close to 12 hours after ICU admission Groups also had similar urine output and fluid balance during the first 7 days in the ICU Overall compliance was excellent 96% of patients received at least 90% of their doses. N Engl J Med 2022. PMID: 35704292. This is a huge difference.

Sepsis 52

Sepsis Outcomes Research Shock 52

Dr. Smith's ECG Blog

MAY 19, 2022

Several more ECGs were obtained during his admission. More cases involving BTWI: A 60-something male presents with crushing chest pain A 50-something Australian with sudden severe epigastric and chest pain presented looking extremely ill. BTWI ( B enign T - W ave I nversion ) Syndromes are often mistaken for more serious pathology.

EKG/ECG 52

EKG/ECG Hospitals 52

ACEP Now

APRIL 5, 2024

“For some reason the male of the species becomes psychotic and the female of the species dies in relation to sex” after using cocaine, he said in an interview in the Miami Herald at the time, and speculated that this could be due to genetic traits that were more common in certain populations. References Gehrke D.

Forensics 49

Forensics Psychiatric Burns Hospitals 49

Don't Forget the Bubbles

AUGUST 10, 2023

The proximal part of the hand is more towards the forearm, whereas the distal end is towards the fingers. This is partly because the hands (including fingers) of children & young people have a tendency to fracture without as much compressive force being applied to the bones when compared with adult hands.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

EM Guide Wire

NOVEMBER 2, 2020

3.08; P = 0.0008) and hospital admission (RR, 0.55; 95% CI, 0.31-0.95; Overall, the use of magnesium sulfate did not improve hospital admission rates. However, the greatest clinical response was seen in children with more severe attacks (SaO 2<92%) at presentation and those with preceding symptoms lasting less than 6 h.

Pediatrics 52

Pediatrics Anaphylaxis Hospitals Administration 52

FEMinEM

JANUARY 26, 2021

And as he and his wife were physicians, I didn’t need to convince them of the hell that the pandemic had caused; they too had worked when patients with COVID-19 were quickly filling our hospital beds to capacity, when we were told to limit our mask use because our hospital faced shortages of personal protective equipment.

Research 52

Research CDC Hospitals PPE 52

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. More importantly, though, we mirror the national averages regarding sepsis. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

JANUARY 29, 2024

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. It is important to monitor the blood pressure closely and adjust the treatment accordingly, keeping in mind the principles of maintaining adequate cerebral perfusion and preventing further bleeding.

Stroke 72

Stroke Outcomes EMS Seizures 72