Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged. 2003, May).

EKG/ECG 116

EKG/ECG Wellness Fractures Emergency Department 116

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. 2003 Oct 28;61(8):1047-51. 2003 Nov;42(5):619-26.

Stroke 91

Stroke Outcomes EMS Seizures 91

Taming the SRU

APRIL 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) EM@3AM: Hernia.” 6, June 2005, pp.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

The Skeptics' Guide to EM

OCTOBER 31, 2018

He is a deputy editor for EM: RAP and, associate editor for REBEL EM. […] The post SGEM#235: Edoxaban for Cancer Associated VTE – Would the NEJM Lie to You? He is a deputy editor for EM: RAP and, associate editor for REBEL EM. Joseph’s Regional Medical Center in Patterson, NJ. Reference: Raskob GE et al.

EMS 52

EMS Outcomes Wellness 52

RebelEM

JANUARY 23, 2023

Noninferiority trials, covered here on REBEL EM , are helpful when the experimental treatment offers a distinct advantage over the standard treatment. Studies funded by pharmaceutical companies are four times more likely to have favorable results than studies from other sources (Lexchin 2003). J Allergy Clin Immunol. PMID: 14767453.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

RebelEM

MARCH 13, 2023

Does the inclusion of patients pronounced dead on scene and the presence of a physician-based EMS organization affect the pooled mortality rate and survival with favorable neurologic outcomes for prehospital TCA? Subcategory data on EMS system type is still extremely variable, given the range of included EMS systems and regions.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

EM Curious

JULY 24, 2015

EMS appears with a patient who just wiped out big time on the ice. Identify the triangle shaped femoral nerve, lateral to the femoral artery, as well as the iliopsoas muscle and the fascia illiaca running over its surface. Our inaugural post today: femoral nerve blocks. He's gripping his thigh with his hands, and he is screaming.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

EMDocs

AUGUST 22, 2024

Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter. July-August 2003. 15 Ensuring bilingual providers are tested and credentialed.

Documentation/Coding 100

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 100

RebelEM

DECEMBER 28, 2022

However, the optimal treatment duration for UTI in men is not well studied, and current practice guidelines are based on historical dogma. Another trial suggests that two weeks of treatment performed similarly to 4 weeks (Ulleryd, 2003). There is a paradigm shift towards shorter courses of antibiotics for many conditions.

Outcomes 52

Outcomes Documentation/Coding Hospitals EMS 52

RebelEM

JANUARY 19, 2023

The study was well-powered, with target participants reaching 236 total patients. In 2003 a systematic review and meta-analysis found studies funded by a company are four times more likely to have favorable results than studies from other sources (Lexchin 2003). Investigators asked a patient-oriented research question.

Outcomes 52

Outcomes Hospitals Research EMS 52

Dr. Smith's ECG Blog

MARCH 15, 2023

But when you see this, you should suspect that the AV node is not well. Emergency providers only see the “tip of the iceberg” of this huge number of AFib episodes — which consists of patients who call EMS or present to the ED with new-onset palpitations, heart failure exacerbation, acute stroke ( or other symptom related to their AFib ).

EKG/ECG 52

EKG/ECG Dehydration Stroke Shock 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer. Police officers have poor hit probability, ricochets may occur, suppressive fire may be used (“keep ‘em pinned down”), or even ‘spray and pray.” Do not compromise your care.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Advanced Emergency Nursing from AENJ

JULY 9, 2015

Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric. YouTube.com [Time=33’11” Presentation] EMS World. Your self-assigned goal is be prepared by forethought and practice to deal with any awkward circumstance. Your team is prepared, and camaraderie is shared. Before} 19 May 01. McClusky, S., Koetter, K.

Airway Management 40

Airway Management Pediatrics Resuscitation Emergency Nursing 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension. N Engl J Med 2003; 348:1756-1763, 5/1/2013.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

EMDocs

JULY 15, 2023

We’ll keep it short, while you keep that EM brain sharp. The patient reported feeling better, pain and other symptoms were well controlled 24 hours after starting antibiotics and pain medication. The infection began to subside 72 hours after starting therapy. During her admission, an MRI was ordered and was negative for osteomyelitis.

EMS 84

EMS Infectious Diseases Shock Ultrasounds 84

ACEP Now

AUGUST 1, 2023

Factoring such, an order to transfer the patient immediately by ground or air EMS is the only actual support per se these non-physicians receive. A rural ED staffed by a well-trained EP is an essential resource in small communities that may be otherwise lacking in readily available healthcare resources.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Peripheral obtained from IV line; central obtained from central venous line.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

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. Academic Emergency Medicine, 2003 Volume 10, Number 5 539-540.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

FEBRUARY 28, 2025

leaving the nail in place and just trephinating for drainage) ( Seaberg 1991 , Roser 1999 , Batrick 2003, Dean 2012 ). You would be well supported by the data if you chose to skip nail replacement. 2003 Jan;20(1):65. appeared first on REBEL EM - Emergency Medicine Blog. Treatment of uncomplicated subungual haematoma.

Outcomes 52

Outcomes Pediatrics Emergency Department EMS 52

RebelEM

FEBRUARY 7, 2024

Sheridan (2003). Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 117.0 – Infections of Pregnancy appeared first on REBEL EM - Emergency Medicine Blog. References: Abbrescia, K. “Complications of second and third trimester pregnancies.” ” Emerg Med Clin North Am 21 (3): 695-710, vii. Mulik (2007).

Sepsis 91

Sepsis Shock Hospitals Ultrasounds 91

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Expiratory airway obstruction may well have been frequently misdiagnosed as it can produce breath-stacking and ball-valve obstruction that impedes any airflow with mask ventilation if neither a nasal nor an oral airway is used and the lips have closed under the mask. Lubricate well. Should EMS Use Nasotracheal Intubation?

Airway Management 40

Airway Management Resuscitation EMS CPR 40

Taming the SRU

JULY 24, 2024

Use pacesetting to get quick results from a highly motivated and competent team Use coaching to help an employee improve performance and develop long-term strengths Social EM Grand Rounds: Interpersonal and community violence WITH drs. What is an IUP? Can an airway assessment score predict difficulty at intubation in the ED?

Domestic Violence 52

Domestic Violence Leadership Ultrasounds Academics 52