Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged. 2003, May). RV: Cavity size normal. 1900: RBBB and LAFB are almost fully resolved. 2300: QRS now within normal limits. No other significant injuries were found. Cramer, M.

EKG/ECG 116

EKG/ECG Wellness Fractures Emergency Department 116

ACEP Now

SEPTEMBER 5, 2024

Creation of an accurate database of emergency physicians living and working within a state, as well as a network of each states’ EM groups and ED medical directors would help chapter leaders disseminate relevant information, strengthen advocacy efforts, and plan regional solutions summits to focus on unique challenges.

Leadership 98

Leadership PPE EMS Wellness 98

ACEP Now

JULY 11, 2024

The United States Preventive Services Task Force (USPSTF) recommends screening for problem drinking in the primary setting, but we know that patients who present to the ED are twice as likely to engage in dangerous drinking, so arguably the ED is an important venue for screening as well. Anton RF, O’Malley SS, Ciraulo DA, et al.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

ACEP Now

NOVEMBER 8, 2024

11 As with LMAs, Combitubes are at risk of balloon rupture as well, and attention is needed to avoid damaging the inflating sections of the device both while in storage and during placement. I-Gel The i-gel was designed in the UK in 2003 and features a gel-style cuff that surrounds the larynx.

Airway Management 40

Airway Management EMS Hospitals Administration 40

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) 1) In a study performed by Chen et al.

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

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

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]. 2003 Oct 28;61(8):1047-51. 2003 Nov;42(5):619-26. doi: 10.1212/01.wnl.0000092498.75010.57. 0000092498.75010.57.

Stroke 91

Stroke Outcomes EMS Seizures 91

Don't Forget the Bubbles

AUGUST 9, 2023

There is no pain or discharge, no lymphadenopathy, and she is otherwise well. 2003) Frequency of subclinical hypothyroidism among healthy children and those with neurological conditions in the state of Mérida, Venezuela. Her parents first noticed it when she was two years old, and since then, it has gradually been increasing in size.

Ultrasounds 98

Ultrasounds Pediatrics Wellness 98

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

Pediatric Emergency Playbook

AUGUST 1, 2017

Pediatr Surg Int 2003; 19:439. Pediatr Surg Int 2003; 19:247. 2003; 12(4):241-253. 2003; 21:909-935. Khan AR, Vujanic GM, Huddart S. The constipated child: how likely is Hirschsprung's disease? Singh SJ, Croaker GD, Manglick P, et al. Hirschsprung's disease: the Australian Paediatric Surveillance Unit's experience.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

JULY 13, 2024

2003 Aug;82(8):730-5. Am J Obstet Gynecol. 1985 Dec 1;153(7):737-9. doi: 10.1016/0002-9378(85)90335-7. PMID: 4073137. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. Incidence, treatment and outcome of peripartum sepsis. Acta Obstet Gynecol Scand. doi: 10.1034/j.1600-0412.2003.00265.x. 1600-0412.2003.00265.x. PMID: 12848644. Moldenhauer, Julie S.

OB/GYN 81

OB/GYN EMS Sepsis Fluid Resuscitation 81

The Skeptics' Guide to EM

OCTOBER 31, 2018

Standard therapy at this time for both symptomatic and asymptomatic VTE is with LMWH based on results from the CLOT trial ( Lee 2003 ). Treatment in this group entails a number of challenges including a higher rate of thrombosis recurrence and a higher risk of bleeding. The NOACs also add ease of use for the patient.

EMS 52

EMS Outcomes Wellness 52

EM Curious

JULY 24, 2015

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. Get your tip as close as possible to the nerve, and under the fascia illiaca, then inject (well, after aspirating first, of course). Emergency Medicine Australasia,21(2), 124–130.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 2003 Jun;111(12):1805-12. 2003 Jul;112(2):299. 2003 Jun;111(12):1805-12. 2003 Jul;112(2):299. They are used clinically to detect pathological inflammation or measure response to treatment [1-2]. J Clin Invest.

Infectious Diseases 89

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

PHEM Cast

JULY 14, 2016

2003 Dec 25;349(26):2510–8. Crane T, Cooke MW, Wellings R, Wayte S, Higgins J. References Stiell IG, Clement CM, McKnight RD, Brison R, Schull MJ, Rowe BH, et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med. Oteir AO, Smith K, Stoelwinder JU, Middleton J, Jennings PA.

Fractures 52

Fractures Hospitals Shock Research 52

RebelEM

JANUARY 23, 2023

Studies funded by pharmaceutical companies are four times more likely to have favorable results than studies from other sources (Lexchin 2003). 2006) “Management of acute allergic reactions and anaphylaxis in the Emergency Department between 1993-2003,” Journal of Allergy and Clinical Immunology , 117(2). J Allergy Clin Immunol.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Pediatric Education

AUGUST 20, 2023

Patient Presentation An 8-year-old male came to clinic for his well-child care after moving to the area. Patients needed prolonged treatment and followup (up to 88 days) but did well without recurrences. He was also being followed by nephrology for some mild hypertension that did not need current treatment.

Pediatrics 40

Pediatrics Infectious Diseases Wellness Sepsis 40

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

JANUARY 17, 2023

My Comment by K EN G RAUER, MD ( 1/17 /2023 ): = As per Dr. Smith — pulse - tap artifact used to be a "new" phenomenon to us ( as well as to virtually all medical providers ). Did YOU Notice the change in both the baseline — as well as in the size of the ST-T wave alternating every-other-beat in the long lead II rhythm strip?

EKG/ECG 52

EKG/ECG Wellness 52

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. 2003 Revision. 2003 Revision. After the death is reported, the Coroner will attempt to identify the decedent. Searchable statute from commercial site. Accessed 07/25/2016.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Don't Forget the Bubbles

FEBRUARY 28, 2024

The researchers concluded that oral brivudine offers an effective, well-tolerated therapy in immunocompromised children and could be used as an outpatient treatment. 2003; 59(1): 49–56. By week 2, 78% of patients had complete healing, with the remaining 12% better by week 3. Do you believe the results? Antiviral Research.

Pediatrics 59

Pediatrics Infectious Diseases Outcomes Research 59

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

I suspect we are seeing a combined ECG effect ( as well as a tall, slender R' in lead V1 from myocardial contusion-induced incomplete RBBB). BOTTOM LINE: As per Dr. Smith's discussion above — the markedly elevated serum troponin — as well as additional imaging studies confirmed RV Myocardial Contusion.

EKG/ECG 52

EKG/ECG Fractures Hyperthermia / Hypothermia Wellness 52

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

PHEM Cast

SEPTEMBER 6, 2017

H Spontaneously breathing carbon dioxide waveforms where phase III is not well delineated. G Esophageal intubation resulting in the gastric washout of residual carbon dioxide and subsequent carbon dioxide will be zero. I Dual capnogram in one lung transplantation patient.

CPR 52

CPR Resuscitation Operations Shock 52

Dr. Smith's ECG Blog

MARCH 15, 2023

But when you see this, you should suspect that the AV node is not well. Ballatore et al — Medicina (Kaunas) 55(8): 497, 2019 — and — Page et al — Circulation 107:1141-1145, 2003 ). I do not know why she did not have a rapid rate. An estimated 10-to-40% of all patients with AFib do not have symptoms associated with this arrhythmia.

EKG/ECG 52

EKG/ECG Dehydration Stroke Shock 52

RebelEM

MARCH 13, 2023

PMID: 22770439 Stiell IG, Nesbitt LP, Pickett W, Munkley D, Spaite DW, Banek J, Field B, Luinstra-Toohey L, Maloney J, Dreyer J, Lyver M, Campeau T, Wells GA; OPALS Study Group. 2003 Feb;237(2):153-60. 2012 Jul 6;16(4):R117. The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. 2019 Dec 4;367:l6373.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 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. 4, April 2003 The Eddie Eagle GunSafe® Program National Rifle Association Gun Control Controversy GunFacts.Info website 119 pp pdf Lott, John R. Do not compromise your care.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Taming the SRU

APRIL 10, 2023

5] There are reports of OAHL occurring after oral, intranasal, intravenous, and transdermal administration, as well as one case of intra-arterial administration. 2003 May 27;168(11):1421-3. Opioid-Associated Hearing Loss Epidemiology Opioid-associated hearing loss (OAHL) was first reported in 1979 associated with hydrocodone abuse. [1]

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration Emergency Department 52

Advanced Emergency Nursing from AENJ

JULY 9, 2015

Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric. 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. Intensivmedizin und Notfallmedizin, 30, 426-7. McClusky, S., Koetter, K. NREMT (2008).

Airway Management 40

Airway Management Pediatrics Resuscitation Emergency Nursing 40

Advanced Emergency Nursing from AENJ

MAY 27, 2014

Henderson , it would seem, was an enthusiast, well-convinced of his opinions, with missionary zeal, who would firmly argue his positions and tirelessly campaign them. 2003; 47 (2) : 146-147 **Shows devices and problematic history of CO2 and equipment. In 1920, he put forward his paper on CO2. Bhargava, C. Wrigley, M., & Nandi, P.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

As for other invasive therapies , intra-aortic balloon counterpulsation (12, 13) appears to work well in non-randomized studies, and this would also make sense: the balloon in the aorta inflates in diastole, increasing diastolic pressure and thus coronary flow. N Engl J Med 2003; 348:1756-1763, 5/1/2013. Circulation 1970;41:623-627 9.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

ACEP Now

AUGUST 1, 2023

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. Quillen College of Medicine (2003) Response The workforce study shook the foundation of emergency medicine (EM).

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

EMDocs

JULY 15, 2023

The patient reported feeling better, pain and other symptoms were well controlled 24 hours after starting antibiotics and pain medication. Erysipelas is characteristically nonpurulent , and lymphangitis and regional lymphadenopathy may be present, but these often occur in cellulitis as well. M., & Bédane, C. link] Brindle, R.,

EMS 84

EMS Infectious Diseases Shock Ultrasounds 84

Pediatric Emergency Playbook

JANUARY 1, 2017

Children have long suffered from an under-treatment of their pain, due both to our incomplete acknowledgement of their pain and our fear of treatment ( Howard 2003 ). Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Dr. No

MARCH 6, 2022

A doctor whose investigation starts in one year may well still be under investigation over a year later, and so is still part of the at risk population, but will only be counted once, in the year the in which the investigation started. And finally, there is the duration of the investigation.

Wellness 52

Wellness Research 52