Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain.

EKG/ECG 107

EKG/ECG EMS Emergency Department Wellness 107

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. Poor blood pressure management can worsen the outcome of hemorrhagic stroke by increasing the risk of hematoma expansion, cerebral edema, and ischemia [8-14]. PMID: 11988609.

Stroke 99

Stroke Outcomes EMS Seizures 99

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. Based on 2005 data, the prevalence of 1 month MDD was 5% with a lifetime prevalence of major depression of 13%.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

ACEP Now

MAY 10, 2024

Cantor is professor of emergency medicine and pediatrics, director of the pediatric emergency department, and medical director of the Central New York Regional Poison Control Center at Upstate Medical University in Syracuse, New York. External auditory canal foreign body extraction outcomes. 2005; 46(4):172-8.

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

The Skeptics' Guide to EM

MARCH 6, 2021

Background: Epistaxis is a common Emergency Department (ED) complaint with over 450,000 visits per year and a lifetime incidence of 60% ( Gifford 2008 , Pallin 2005 ). You administer phenylephrine topically, reapply pressure and, consider the use of tranexamic acid (TXA).

EMS 52

EMS Emergency Department Outcomes 52

The Skeptics' Guide to EM

JULY 9, 2022

Great emergency care takes a team from the prehospital setting, emergency department, inpatient and outpatient all working together. Another reanalysis was done by Kwiatkowski et al 2005 that also confirmed that the baseline imbalance in the NINDS trial did not account for the better outcome of tPA-treated patients.

Stroke 52

Stroke Emergency Department EMS Outcomes 52

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. Discrimination between an IUP and an interstitial pregnancy is critical as interstitial pregnancies can have devastating outcomes.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. In 7 studies with 4164 patients, PCT with a cut-off > 0.1 ng/mL (strongly recommended against antibiotics), 0.1-0.25

Infectious Diseases 89

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

RebelEM

JANUARY 23, 2023

Health care professional involved in patient management and outcome assessment was completely blinded. Multicenter study of emergency department visits for insect sting allergies. 2005 Sep;116(3):643-9. Multicenter study of emergency department visits for food allergies. J Allergy Clin Immunol. Ledford, D.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

The Skeptics' Guide to EM

NOVEMBER 2, 2019

Case: A 26-year-old right-handed male presents to the emergency department on Friday night with a swollen right hand after punching a wall.The x-ray confirms an uncomplicated boxer’s fracture. Poolman et al ( Cochrane 2005 ) did a SRMA and pooled together five studies with a total of only 252 patients.

Fractures 40

Fractures EMS Emergency Department Outcomes 40

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. J Pediatr 2005; 146:787.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. More on this below as we work through a few cases…. Neurosurg Focus.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

PEMBlog

AUGUST 20, 2024

Pediatric Emergency Care , 40(8), 618-622. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. And of course, there needs to be more data on outcomes in pediatrics. Future prospective studies should focus on outcomes across a broad array of pediatric patients.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

EMDocs

FEBRUARY 12, 2024

There is well-documented evidence that low systolic blood pressure, a low Glasgow Coma Score (GCS), and a high Injury Severity Score (ISS) are known predictors of poor outcomes, and in combination with serum lactate provide adequate prognostic value. Int J Emerg Med. Eur J Emerg Med. 2005 Nov;140(11):1122-5. Emerg Med J.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

EMDocs

NOVEMBER 16, 2024

13 Management: Dislocation As with all dislocation, early reduction improves outcomes. 9,23 Disposition: Dislocation : If successfully reduced in the emergency department may discharge with strict mobility restrictions and Orthopedic follow up. Epidemiology of total hip arthroplasty: demographics, comorbidities and outcomes.

EMS 98

EMS Dislocations Fractures Operations 98

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. These premonitory symptoms were negative predictors of adverse outcomes in EGSYS. 2) Boston syncope rule: J Emerg Med. The ROSE (Risk Stratification of syncope in the emergency department) Study.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

MAY 15, 2024

Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. Application of the MASCC and CISNE Risk-Stratification Scores to Identify Low-Risk Febrile Neutropenic Patients in the Emergency Department.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

EMDocs

DECEMBER 16, 2023

An 18-month-old boy presents to the emergency department with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. 2005 Oct 5;9(5):R498-501. doi: 10.1186/cc3771. link] Chava, R.,

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

The Skeptics' Guide to EM

FEBRUARY 29, 2020

Randomised control trial of adult therapeutic colouring for the management of significant anxiety in the Emergency Department. AEM February 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Reference: Rajendran et al.

Emergency Department 40

Emergency Department Academics Psychiatric Outcomes 40

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. 2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

EMDocs

NOVEMBER 4, 2024

A comprehensive, patient-centered approach to pain management ensures effective treatment across these diverse pain syndromes, ultimately improving patient outcomes. Am J Emerg Med. The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Don't Forget the Bubbles

MARCH 3, 2025

This systematic review examined 15 observational studies from around the world, exploring the relationship between increasing air pollution levels and the rate of hospitalisations and emergency department visits for respiratory illnesses in children. Short-term exposure to PM2.5 2024 Jan 14. Whats it about?

Hospitals 88

Hospitals Emergency Department Research Forensics 88

EMDocs

JANUARY 20, 2025

13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. Volume status Assessing volume status, especially in critically ill patients, can be challenging. Inwald et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75