EMCrit

SEPTEMBER 28, 2023

background Today the Van de Bergh group in Belgium released a RCT investigating tight versus liberal glycemic control in the ICU. Before diving into this study, let's take a walk down memory lane.

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Emergency Live

MARCH 19, 2024

perceived temperatures in Rio de Janeiro reached the record figure of 62.3 On the day of the autumn equinox for the Southern Hemisphere, record temperatures continue to be recorded, especially in Brazil Sunday morning, around 10 a.m., degrees, a figure not seen since 2014.

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St. Emlyn

DECEMBER 26, 2023

St.Emlyn's - Emergency Medicine #FOAMed Air France Flight 447 takes off at 1930hrs on the final day of May in 2009, from Rio de Janeiro en route to Paris, carrying 228 passengers. In charge is … AI & Medicine: Saviour or Snake Oil? Read More » The post AI & Medicine: Saviour or Snake Oil?

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Dr. Smith's ECG Blog

FEBRUARY 10, 2023

These are preceded by ST depression and are de Winter's T-waves, though somewhat atypical. Among these patterns are de Winter T waves — which is the reason Dr. Smith selected the ECG in today's case. de Winter and colleagues ( Drs. Figure-1: The de Winter T Wave Pattern , as first described by Robbert J. What is it?

EKG/ECG 52

EKG/ECG 52

EM Ottawa

OCTOBER 30, 2023

5 Loke DE, et al. Methodology: 1.5/5 5 Usefulness: 1.5/5 2022 Mar;24(2):206-213. Question and Methods: Trying to quantify gender disparities in CT turnaround time and ED LOS and determine if intervention in the form of protocolized point-of -care pregnancy testing would eliminate the disparity.

Radiology 111

Radiology Radiology 111

Emergency Live

MARCH 12, 2024

De Palma: “£1500 per week from the UK, up to €2900 per month from the Netherlands! Health, Nursing Up Report. European countries are upping the ante with their own economic proposals and are targeting Italian nurses, the most specialized figures in the Old Continent.”

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Dr. Smith's ECG Blog

NOVEMBER 3, 2023

LBBB with de Winter hyperacute T waves in leads V2-V5. Then, the patients third ECG showed a very rare combination of de Winter T waves happening during LBBB. link] Some references on de Winter morphology: 1. de Winter RJ, Verouden NJ, Wellens HJJ, Wilde AA. Time = 3 hours: the next troponin returns at 60 ng/L.

EKG/ECG 78

EKG/ECG Shock Documentation/Coding Academics 78

Pediatric EM Morsels

JUNE 9, 2023

Carneiro de Moura, 2018 ] Seen in 57% of cohort. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! Carneiro de Moura M, Chen S, Kamath BM, Ng VL, Ling SC. Keep patient comfortable. Obtain large-bore access.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

EMDocs

DECEMBER 11, 2023

Source: [link] This case is consistent with the De Winter Sign. De Winter Sign [4,6] First described in 2008 this pattern be seen in proximal left anterior descending artery occlusion and should be evaluated by emergent angiography. Her vital signs are stable. Her ECG is shown below. J Emerg Med. 2021 Mar;60(3):273-284. Ann Emerg Med.

EKG/ECG 108

EKG/ECG Emergency Department Academics Operations 108

Emergency Live

OCTOBER 24, 2023

Success for FormAnpas at Dallara Academy Headquarters: The “Rebirth” Edition After Pandemic On Saturday, October 21, Anpas Emilia-Romagna, the association that brings together 109 regional public assistance agencies, held its annual FormAnpas event at the extraordinary Dallara Automobili headquarters in Varano de’ Melegari, Parma.

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RebelEM

JULY 5, 2023

Sepsis) De Winters T waves are the earliest sign of an anterior wall MI but will only be present in ~ 2% of LAD infarcts Patients with Wellens Syndrome on ECG should have a cardiac cath within 24 hours, not necessarily within the first 60 minutes of ED arrival.

EKG/ECG 113

EKG/ECG Sepsis EMS 113

Don't Forget the Bubbles

JANUARY 8, 2024

These suggested medications are based on the NSW Health guidelines for managing patients with acute severe behavioural disturbance in the emergency department Verbal De-escalation of the Agitated Teen A crucial aspect in managing agitated adolescents is mastering verbal de-escalation.

Research 105

Research Emergency Department Psychiatric Outcomes 105

Don't Forget the Bubbles

NOVEMBER 22, 2023

Jornal de pediatria. Vanlander AV, Okun JG, de Jaeger A, Smet J, De Latter E, De Paepe B, et al. Treasure Island (FL): StatPearls Publishing. Available at: [link] (Accessed: 14 September 2023). Filho EM, Riechelmann MB. Propofol use in newborns and children: is it safe? A systematic review. 2020;96(3):289-309.

Pediatrics 126

Pediatrics Research EKG/ECG Operations 126

EMDocs

FEBRUARY 9, 2024

Although commonly referred to as torsades de pointes (TdP), not all PVT is TdP. ECG Pointers: Torsades de Pointes is diagnosed by the combination of polymorphic ventricular tachycardia in addition to a prolonged QT-interval. Pharmacological treatment of acquired QT prolongation and torsades de pointes. Torsade de pointes.

EKG/ECG 70

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 70

The Skeptics' Guide to EM

MARCH 9, 2024

An old friend, Dr. Matt De Stefano invited me to […] The post SGEM Xtra: A Philosophy of Emergency Medicine first appeared on The Skeptics Guide to Emergency Medicine. An old friend, Dr. Matt De Stefano invited me to give a lecture to the PGY-3 Emergency Medicine Residents.

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EMS 75

Don't Forget the Bubbles

JULY 24, 2023

Discitis en niños menores de 3 años. Serie de casos y revisión de la literatura. Revista Española de Cirugía Ortopédica y Traumatología. Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis. American Journal of Neuroradiology. 2017 Oct;38. Miranda I, Salom M, Burguet S.

Radiology 98

Radiology Radiology Infectious Diseases Pediatrics 98

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Portends Torsades de Pointes” The patient was given additional magnesium and started on an infusion of magnesium and a goal of high normal electrolyte repletion. Prolonged ST segment and T-wave alternans with torsade de pointes secondary to hypocalcemia due to hypoparathyroidism: A case report. Liu J, Hou H, Xu H, Chen Y, Su X.

EKG/ECG 108

EKG/ECG Documentation/Coding Psychiatric EMS 108

Ken Grauer, MD

DECEMBER 1, 2023

ECG Blog #266 — Reviews distinction between P osterior M I vs de W inter T waves ( with anterior terminal T wave positivity reflecting " R eperfusion" T - w aves). ECG Blog #271 — Reviews determination of the ST segment baseline ( with discussion of the entity o f the entity of d iffuse S ubendocardial I schemia).

EKG/ECG 359

EKG/ECG EMS Wellness 359

Mind The Bleep

AUGUST 14, 2023

In the webinar below, Dr Henry de Boer ( radiology registrar) provides a structured approach to CT abdomen & pelvis interpretation, with an overview of common cases & pitfalls. Our Webinar

Radiology 52

Radiology Radiology 52

Mind The Bleep

AUGUST 14, 2023

In the webinars below, Dr June Lau & Dr Henry de Boer ( radiology registrars) provides a structured approach to interpreting shoulder, elbow, forearm, wrist & hand x-rays, with an overview of common cases & pitfalls. Our Webinar

X-Ray Interpretation 52

X-Ray Interpretation Radiology Radiology 52

University of Maryland Department of Emergency Med

JULY 20, 2023

This was a cross sectional review of 698 patients ages 1 year to 18 years who presented to a tertiary care center with fever of at least 38 de. Click to view the rest

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Dr. Smith's ECG Blog

OCTOBER 18, 2023

Polymorphic VT in the setting of long QTc is called Torsades de Pointes, and this again can be acquired or based on inherited long QT syndromes. That said — I focus my comment on the development of Torsades de Pointes. Torsades de Pointes — is defined as PMVT that occurs in association with a long QTc on baseline ECG.

EKG/ECG 93

EKG/ECG Hospitals Academics Outcomes 93

Dr. Smith's ECG Blog

MAY 31, 2023

This is classic de Winter pattern, and here it involves both anterior and inferior walls, so this is probably OMI of the mid LAD that also supplies the inferior wall (a "wraparound," or "Type III," LAD because it wraps around to the inferior wall). It is one of the few OMI patterns that is really well described: de Winter’s T-waves.

EKG/ECG 74

EKG/ECG Outcomes Academics Wellness 74

ACEP Now

NOVEMBER 13, 2023

The difficulty with this approach is that these officers often lack the skills and context needed to de-escalate complex behavioral crises. In one ED in the San Francisco area, a law enforcement officer staffed there said they would appreciate additional support for de-escalating patients. Community Ment Health J. 2021;(7):1278-1287.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

ECG Guru

SEPTEMBER 10, 2023

The QT interval of the sinus beats does not appear prolonged, thus ruling out Torsades de Pointes tachycardia. This EKG shows a sinus rhythm with ventricular bigeminy and retrograde conduction leading to retrograde depolarization of the sinus node, resulting in a longer pause (sinus node reset).

EKG/ECG 52

EKG/ECG 52

Ken Grauer, MD

DECEMBER 15, 2023

ECG Blog #183 — Reviews the concept of de W inter T - W aves ( with reproduction of the illustrative Figure from the original deWinter NEM manuscript ). ECG Blog #194 — Reviews how to tell IF the “culprit” ( ie, acutely occluded ) artery has reperfused using clinical and ECG data.

EKG/ECG 316

EKG/ECG EMS Hospitals 316

NIOSH Science Blog

APRIL 15, 2020

Cuando ocurren brotes de enfermedades infecciosas, dependemos de los profesionales de atención médica para que cuiden a los afectados, lo cual los pone en mayor riesgo de exposición al patógeno causante de la enfermedad. Para ayudar a los centros de atención médica que tengan escasez de respiradores N95 debido

Infectious Diseases 52

Infectious Diseases 52

Board Bombs

JANUARY 15, 2023

You will absolutely have to sedate patients as an ED physician, and know how to de-escalate situations. You will absolutely have to sedate patients as an ED physician, and know how to de-escalate situations. Will the REAL Slim Shady, please stand up, please stand up? Let’s talk acute agitation in the ED. Episode 160. Episode 160.

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Taming the SRU

MAY 13, 2024

AUTHORED BY Julius de castro, MD Dr. de Castro is a PGY-3 in Emergency Medicine at the University of Cincinnati EDITING BY DR. marlena wosiski-kuhn AND THE ANNALS OF B POD EDITORS References 1. Kanona H, Al Samaraee A, Nice C, Bhattacharya V.

Ultrasounds 87

Ultrasounds Emergency Department Wellness Operations 87

AENJ: Current Issue

SEPTEMBER 30, 2023

Clinicians must seek out medical etiologies of agitation and always attempt verbal de-escalation before initiating chemical or physical restraints. Rapid clinical evaluation and behavioral management are keys to preventing detrimental maternal and fetal complications.

Psychiatric 55

Psychiatric Emergency Department Outcomes Wellness 55

Dr. Smith's ECG Blog

OCTOBER 6, 2023

Smith : now there are precordial hyperacute T-waves with depressed ST takeoff (de Winter's). de Winter's T-waves have a depressed ST segment and an upright hyperacute T-wave. Figure-1: The de Winter T Wave Pattern , as first described by Robbert J. de Winter et al in N Engl J Med 359:2071-2073, 2008.

EKG/ECG 63

EKG/ECG Academics Shock Outcomes 63

Dr. Smith's ECG Blog

MARCH 19, 2024

There are hyperacute T-waves in inferior leads, with depressed ST takeoff (inferior de Winters -- yes, de Winter's can manifest in any territory and, yes, it can manifest in the presence of LBBB.) There is concordant ST depression in V3. It only takes one such lead to fulfill the 2nd criterion of the Smith Modified Sgarbossa criteria.

EKG/ECG 80

EKG/ECG Hospitals Documentation/Coding Outcomes 80

EMDocs

SEPTEMBER 19, 2023

Learning points: Patients with LBBB and Sgarbossa/Smith-modified Sgarbossa criteria, posterior STEMI, hyperacute T waves, De Winter T waves should go to the cath lab per the 2022 ACC consensus statement.

Seizures 71

Seizures Documentation/Coding EKG/ECG Emergency Department 71

Emergency Medicine Cases

MARCH 28, 2023

The post EM Quick Hits 47 HFNC, Dissection Drugs, ADJUST-UNLIKELY for PE, Antibiotic Course Duration, Skin Glue Hacks, ESP Block, Learner Oversight appeared first on Emergency Medicine Cases.

EMS 52

EMS 52

Dr. Wes

JUNE 20, 2022

Recently, there have been a rash of initiatives by unaccountable non-profit physician credentialing organizations (Federation of State Medical Boards, the American Boards of Internal Medicine, Family Medicine and Pediatrics), and the American Medical Association to come to the public's rescue by de-credentialing U.S.

Pediatrics 52

Pediatrics 52

Emergency Medicine Journal

JANUARY 22, 2024

This is an Institutional Review Board-exempt retrospective review of de-identified ED data available for the state of Maryland through the Healthcare Cost and Utilization Project (HCUP) database from 2016 to 2018. Many overdose deaths are associated with patient co-use of opioids and other substances, such as benzodiazepines.

Outcomes 40

Outcomes Emergency Department Poisoning Documentation/Coding 40

Mount Sinai EM

MARCH 20, 2023

, amniotic fluid volume, fetal cardiac activity, and femur length (> 4cm may survive ex-utero) Vaginal exam: look for bleeding, amniotic fluid, cervical dilation or effacement Immunization: Anti-D immune globulin for rhesus D negative patients Kleihauer-Betke: quantifies maternal-fetal hemorrhage to de Tetanus vaccine is safe in pregnancy Antenatal (..)

Documentation/Coding 130

Documentation/Coding Resuscitation 130