Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59

Dr. Smith's ECG Blog

OCTOBER 28, 2022

Case: The call was an elderly gentleman who was at home when he experienced a sudden onset of vague chest discomfort along with nausea, and left arm aching. Unfortunately, many or most physicians, including EM and cardiology, do not know this and too many also are too arrogant to learn from a paramedic. Great job!!

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Dr. Smith's ECG Blog

MAY 23, 2023

EMS arrived and recorded this ECG: What do you think? 65 year old with syncope and a 'normal' ECG: discharge home? Loss of r wave between leads V1-to-V2, with development of an abnormal Q wave in lead V2 on this initial ECG suggests infarction occurred at some point over those previous 24 hours when the patient was still at home.

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Dr. Smith's ECG Blog

JULY 16, 2022

He was prescribed omeprazole and sent home from clinic. This illustration comes from Charles Bruen's great blog, Resus Review Coronary Artery Diagramming – Resus Review Charles is another illustrious graduate of the Hennepin EM Residency; actually, the EM/IM combined residency.

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Dr. Smith's ECG Blog

MARCH 6, 2023

The patient had this ECG recorded at 7 minutes after registration at triage as a walk-in (not by EMS): What do you think? page 1932 • “The application of STEMI ECG criteria on a standard 12-lead ECG alone will miss a significant minority of patients who have acute coronary occlusion. (21) Here is the case in total. hours duration.

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EKG/ECG Emergency Department Ultrasounds EMS 52

The Skeptics' Guide to EM

APRIL 20, 2019

Talk Trauma is a two-day conference for nurses, allied health and EMS professionals involved in providing care for the adult and paediatric trauma patient. Case: A 52-year-old man presents to the emergency department via EMS after a motor vehicle collision while driving home from the city. You suspect he has been drinking.

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Dr. Smith's ECG Blog

MARCH 15, 2023

Ibutilide increased the QTc significantly (432+/-37 before vs. 482+/-49 afterward) Although the point is not discussed in the paper, I would not send such a patient home unless the QT is no longer prolonged. = For more on SSS — See My Comment at the bottom of the page in the July 5, 2018 post in Dr. Smith’s ECG Blog.

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EKG/ECG Dehydration Stroke Wellness 52

ALiEM

MAY 13, 2024

Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Lam SHF, Sivitz A, Alade K, Doniger SJ, Tessaro MO, Rabiner JE, Arroyo A, Castillo EM, Thompson CA, Yang M, Mistry RD. Ann Emerg Med. 2020 Jul;76(1):67-77. doi: 10.1016/j.annemergmed.2020.01.004. 2020.01.004.

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Ultrasounds Pediatrics Emergency Department Wellness 64

Dr. Smith's ECG Blog

NOVEMBER 11, 2022

Written by Pendell Meyers Family of an elderly woman with many comorbidities called EMS when she suddenly experienced shortness of breath, nausea, vomiting, and near syncope. A 12 lead ECG was obtained by EMS and is shown below: What do you think? Take-Home POINT: Not all rhythm recording systems are the same.

EKG/ECG 52

EKG/ECG Shock EMS Documentation/Coding 52

Dr. Smith's ECG Blog

JANUARY 21, 2023

Case submitted and written by Dr. Mazen El-Baba and Dr. Evelyn Dell, with edits from Jesse McLaren EMS brought a John Doe, in his 30s, who was found in an urban forest near a homeless encampment on a cool fall day. EMS reported an initial GCS of 8 with pupils equal and reactive. Take home : Not all STEs are STEMIs or OMIs.

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Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Dr. Smith's ECG Blog

JANUARY 3, 2022

Clearly — posterior leads are standard procedure in many EMS systems, and they are routinely ordered by many emergency providers. The September 21 , 2020 post in Dr. Smith's ECG Blog — My Comment ( at the bottom of the page ) emphasizes utility of the Mirror Test for diagnosis of acute Posterior MI.

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Dr. Smith's ECG Blog

OCTOBER 10, 2022

Written by Pendell Meyers and Peter Brooks MD A man in his 30s with no known past medical history was reported to suddenly experience chest pain and shortness of breath at home in front of his family. In addition to all of the above, there are T wave inversions in III and aVF, as well as T wave inversions in V2-V4.

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Dr. Smith's ECG Blog

JUNE 2, 2023

That said — after careful study ( in the comfort of my home study ) — I came to the conclusion that my calipers would simply not walk out any consistent atrial activity ( I fully acknowledge how much more challenging it is to try and identify AV dissociation at the bedside of a crashing patient! Figure 3: Key features of idiopathic VT.

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EB Medicine

JUNE 6, 2019

Jeff: Table 1 is also worth reviewing while you’re on page 3 as it lists a few of the common dangerous mimics that often lead to misdiagnosis on initial presentation. Most EM training programs certainly emphasize the importance of the the pelvic exam for women with lower abdominal pain, but some recent papers have questioned its role.

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Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). Annals of Emergency Medicine March 2015 ; Volume 65, Issue 3, Pages 268–276.e6 Quinn et al. women, and 4.7% hospitalized.

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Emergency Department EKG/ECG Outcomes Seizures 52