Sensible Medicine

AUGUST 7, 2024

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 113

CDC Documentation/Coding Research Pediatrics 113

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

FEBRUARY 12, 2024

Research from our very own SIUH department of radiology recommended that contrast-enhanced CT scans can safely exclude obstructive urolithiasis just as well as noncontrast CTs. 2002; 225(2):441-449. When you are using CT imaging, a CT with IV contrast is preferred. 2011; 18(7):699-707. Gottlieb RH, La TC, Erturk EN, et al.

Radiology 77

Radiology Radiology Emergency Department Ultrasounds 77

The Skeptics' Guide to EM

JULY 3, 2021

Background: Hypothermia has been a mainstay of post-arrest care after the publication of two trials in 2002 that both suggested a benefit. Hypothermia resulted in a large improvement in neurologic outcomes, defined as well enough to be sent home or to a rehab facility. The results of this Australian trial seemed too good to be true.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Outcomes Wellness 52

PEMBlog

AUGUST 14, 2024

Dosing and When to Use It For anxiolysis and minimal sedation, a dose of 1-2 mcg/kg intranasally works well. 2002 Aug;95(2):461-6, table of contents. The duration of its effects can vary depending on the dose, but you can expect it to last up to 30 minutes, which is usually enough time for shorter, non-painful procedures. Anesth Analg.

Pediatrics 59

Pediatrics Wellness 59

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. Overnight, she had to wake him to feed.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

EMDocs

JUNE 8, 2024

Post septal (retrobulbar) is higher risk to vision and requires CT imaging to diagnose as well as thorough exam to check for proptosis, afferent pupillary defect, increased intraocular pressure [7]. Bethesda (MD): National Cancer Institute (US); 2002-. Orbital hemorrhage: preseptal is less dangerous and more obvious on exam.

EMS 98

EMS Allergic Reactions Poisoning Emergency Department 98

Greater Sydney Area HEMS

APRIL 26, 2023

Both the stuff of legend and go by multiple names including harness hang syndrome and orthostatic intolerance, as well as bigfoot and the abominable snowman, respectively. UK Health and Safety Executive, London; 2002. What do suspension trauma (ST) and the Yeti have in common? I thought you’d never ask. That’s it? I haven’t finished.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

Don't Forget the Bubbles

AUGUST 2, 2023

As well as nonpharmacological treatments included physiotherapy and psychological therapy, 79% were also prescribed medication, most commonly gabapentin. 2002 Jul;141(1):135-40. More recently, Mesaroli et al. References Bayle-Iniguez X., Audouin-Pajot C., Sales de Gauzy J., Complex regional pain syndrome type I in children.

Psychiatric 98

Psychiatric Pediatrics Outcomes Fractures 98

Dr. Smith's ECG Blog

AUGUST 26, 2009

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

EKG/ECG Documentation/Coding Research Academics 52

EMDocs

JANUARY 29, 2024

However, other sources suggest that the optimal blood pressure target is not well established and may vary depending on the individual patient’s characteristics and the type of hemorrhagic transformation [7]. 2002 May;33(5):1315-20. This includes intraparenchymal hemorrhage and subarachnoid hemorrhage (SAH). Stroke 2019; 50:e344.

Stroke 99

Stroke Outcomes EMS Seizures 99

PulmCCM

JANUARY 22, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Pediatric Emergency Playbook

JUNE 1, 2017

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.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Dr. Smith's ECG Blog

JULY 22, 2023

The patient did well and was ultimately discharged home. As for our patient, on discharge, her EKG had completed returned to her baseline morphology and she has been doing well in follow-up. Is there fever again? There were no dysrhythmias on cardiac monitor during observation. See more cases of Brugada due to fever here.

EKG/ECG 92

EKG/ECG Hyperthermia / Hypothermia Documentation/Coding Wellness 92

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

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. New ST elevation diagnostic of STEMI [equation value = 25.3

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Wellness 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

There is a certain subset of patients in septic shock whose adrenal axis functions well enough to support them in a state of health but are unable to support them in a state of unwell. Background: Corticoid steroids have had a tumultuous history when it comes to their use for the treatment of septic shock.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Advanced Emergency Nursing from AENJ

MAY 27, 2015

If mere criminality was the only matter, there’s some cash, personal electronics, appliances, and business machines; if not merely criminal, and well-studied beforehand, there are to be had radioactive materials, drugs, toxins, chemicals, and many who would pay a ransom for the loved ones within. 10/30/2002). CFR.org editorial staff.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

Advanced Emergency Nursing from AENJ

NOVEMBER 7, 2015

" Well, then, what to do? When we say to a colleague, "Say, you did a great job in talking that patient down!" " … we are saying that "You did a nice job in establishing rapport and communicating ideas, possibilities, and understandings." Find a continuing education course in hypnotherapy. Erickson, M.D. (an

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 40

ACEP Now

MAY 10, 2024

A retrospective study of 34 patients including both children and adults aged 2–78 years, evaluated the duration of EAC FB and its relationship to successful removal as well as complications. 2002; 23(4):473-5. During this time, outpatient ENT appointments were difficult to obtain. Singapore Med J. 2005; 46(4):172-8. Otol Neurotol.

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

PHEM Cast

APRIL 18, 2016

All things Pre Hospital Ketamine – Minh Le Cong Key point: patients remember if you manage their pain well. Hauwald, 2002 A co-operative patient does not require immobilization unless their conscious level deteriorates. Many of the lectures were recorded today and will be available to view soon on the Trauma Care website.

Fractures 40

Fractures Operations Administration Shock 40

Don't Forget the Bubbles

FEBRUARY 26, 2024

Increasing PEEP is thought to cause bronchodilation by providing direct mechanical stimulus as well as secondary stimulation through pulmonary stretch receptors coupled with activation of the non-cholinergic parasympathetic pathway. 2002 Apr 1;3(2):181-4. This, in turn, inhibits the bronchoconstriction cholinergic pathway.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. 2002 Jun;94(6):426-9. Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. PloS one 13.8

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Don't Forget the Bubbles

JULY 26, 2023

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

EKG/ECG Hospitals Shock Documentation/Coding 98

Dr. Smith's ECG Blog

JANUARY 30, 2019

I remember Allie well from her days in the Research volunteer program at Hennepin. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. A repeat EKG was performed at that time and showed this: The STE had almost completed resolved and the STE depression is improved as well. F (rectal).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 52

Sensible Medicine

MARCH 8, 2024

He has been doing well but has noticed worsening exercise tolerance. In 2002, I gave the courses case control study lecture having had no sleep, four hours after my first child was born. [1] PF is a 72-year-old man with heart failure with preserved ejection fraction. Twenty-five years is a very long time to do anything.

Academics 49

Academics Administration Research Wellness 49

ACEP Now

MARCH 14, 2024

These can be delayed, up to weeks later, so it’s important to educate patients on the importance of follow-up with burn care well-versed with electrical injuries or neurology if they have or develop these symptoms. 30(11):p S424-S430, November 2002. Electrical Safety Foundation International. Koumbourlis, Anastassios C.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

PulmCCM

JANUARY 24, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

2002; 3:3-13. Do a total body check. Heart disease or Hypovolemia - is there a history of congenital heart disease? Part 15: Neonatal Resuscitation: 2010 American Heart Association Guidelines. Circulation. 2010;122:S909-S919. Okada PJ, Hicks B. Neonatal Surgical Emergencies. Clin Ped Emerg Med.

Seizures 40

Seizures Sepsis Pediatrics Shock 40

Pediatric Emergency Playbook

JANUARY 1, 2016

Consider surgical causes of forceful vomiting, especially if the child does not look anything other than well. 2002; 141(6):793-7. They are not allowed to vomit (forceful, unpleasant contraction of abdominal muscles). J Emerg Med. 2012; 43(1): e49–e51. Marcin JP, Glaser N, Barnett P et al. Parashette KR, Croffie J.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Dr. Smith's ECG Blog

AUGUST 3, 2017

Furthermore although there is no literature on morphology of ST-elevation in posterior leads, it is interesting to note that the morphologies of these elevations are in and of themselves concerning as well. So treating these as STEMI is well within the bounds of guideline recommendations (6). References: 1.

EKG/ECG 52

EKG/ECG Outcomes Wellness 52

Advanced Emergency Nursing from AENJ

APRIL 8, 2014

The idea of placing one's mouth on the mouth of an apparently dead victim, particularly where the mouth may be covered with foam, mucus or blood, as often the case in asphyxia victims, as well as the fear of possible transmittal of disease is revolting to the average person and is difficult to overcome." Bauer, Robert O. Tercier, J.

Resuscitation 40

Resuscitation Ambulance Services Research Military 40

Dr. Smith's ECG Blog

JULY 3, 2020

She had multiple rib fractures as well as serious hemorrhage and underwent massive transfusion. The mechanism for these ECG changes of hyperkalemia is interesting ( Webster et al: Emerg Med J 19:74-77, 2002 ). Her initial troponin I, part of a critical care order set, returned at 0.55

Blood Transfusions 52

Blood Transfusions EKG/ECG Shock Fractures 52

Advanced Emergency Nursing from AENJ

JULY 9, 2015

Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric. Before} 19 May 01. Trucs et ficelles du métier: Intubation extra-hospitalière : Intubation inverse, technique dite de «l’intubation au piolet Urgence-Pratique.com {Defunct} Archived at < [link] > Google Translation. Smally, A.

Airway Management 40

Airway Management Pediatrics Resuscitation Emergency Nursing 40

Dr. Smith's ECG Blog

DECEMBER 18, 2022

The patient recovered well. Circulation 2002; 105(4): 539-42. This is seen just millimeters beyond the tip of the catheter. Compare to the anatomy after stenting: The lower of the 2 now easily seen branches is the circumflex, now with excellent flow. His peak troponin was over 5000 ng/L.

EKG/ECG 40

EKG/ECG Wellness 40

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 2002 Jan 2;287(1):92-101. They are used clinically to detect pathological inflammation or measure response to treatment [1-2]. Polymyalgia rheumatica in patients with a normal erythrocyte sedimentation rate. Arthritis Rheum. doi: 10.1002/art.1780390220.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. Neonatal pain pathways are particularly plastic; prompt assessment of and increased alertness to neonatal pain may help to mitigate long-lived pain sensitivity and hyperalgesia ( Taddio 2002 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Dr. Smith's ECG Blog

APRIL 8, 2015

True Syncope: If, on the other hand, the patient is well, had no other serious symptoms , has a normal sinus rhythm, and normal physical exam , then you need to be certain the syncope was not due to a dangerous brady- or tachydysrhythmia that could recur. Vasovagal syncope is generally benign. ED diagnosis of vasovagal syncope (-1) 8.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52