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Proning for ARDS

Northwestern EM Blog

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. 2002 for ED setting) When possible, explain the indications and process of the maneuver to the patient and/or family. Adjust all tubing and reassess connections.

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Post #2 Back-to-Sleep Series

Sensible Medicine

For example, Bergman reports a 2002 study in which ventilated premature babies were placed to sleep on either their tummies or backs, and the following states were measured: quiet sleep, active sleep (which is less restorative than quiet sleep), crying time, number of stress responses (startle, tremor, and twitch), and oxygen saturation.

CDC 114
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Inferior Hyperacute T-waves

Dr. Smith's ECG Blog

Methods : We searched the catheterization laboratory database for all cases coded as acute Inferior STEMI from January 2002 through March 2008. All cases were reviewed and the presenting ECG, as well as the first ECG that was used for diagnosis of acute STEMI, were analyzed.

EKG/ECG 52
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Cardiac Rhythms/ECG Module

Don't Forget the Bubbles

A cardiac family history should of course be sought, but think a little outside the box as well. On arrival at hospital the child was well with normal observations. It is also worth considering: Cardiac channel mutations in SIDS: a population-based molecular autopsy study, Ackermann et al, Circulation 2002. Family history.

EKG/ECG 98
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Why we need continuous 12-lead ST segment monitoring in Wellens' syndrome

Dr. Smith's ECG Blog

The above principles are all well illustrated with this figure from my book, The ECG in Acute MI (2002). It is well documented with continuous 12-lead monitoring that acute re-occlusion is frequently asymptomatic. Here is the most recent documentation that T-wave inversion does indicate reperfusion: [link] 6.

EKG/ECG 52
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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

The patient did well and was ultimately discharged home. Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. As for our patient, on discharge, her EKG had completed returned to her baseline morphology and she has been doing well in follow-up.

EKG/ECG 92
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MI in Children

Pediatric Emergency Playbook

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.