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. The LCx and OM vessels are not as well visualized. Annals of Emergency Medicine , 31 (1), 3–11. link] Fesmire, F. Bardoner, J.

EKG/ECG 107

EKG/ECG EMS Emergency Department Wellness 107

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Chen et al.,

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013. West J Emerg Med.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

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

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

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department. It’s stressful for the ED clinical staff as well. This has a downstream effect.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

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. Jones is assistant professor of pediatric emergency medicine at the University of Kentucky in Lexington. 2005; 46(4):172-8. Otol Neurotol.

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 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. ng/mL, 0.25-0.5

Infectious Diseases 89

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

ACEP Now

AUGUST 15, 2023

A 16-year-old female presents to the emergency department (ED) after being sexually assaulted by two males at a party at her friend’s house. She is asking for an exam, as well as medications to avoid pregnancy and diseases. She denies any complaints or injuries. She refuses to allow her parents or the police to be notified.

Sexual Assault 52

Sexual Assault Forensics EMS Risk Management 52

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. 2005 Jun;23(6):1217-23. A non-contrast head computed tomography (CT) demonstrates a diffuse hyperdensity consistent with subarachnoid hemorrhage (SAH). doi: 10.1161/01.str.0000014509.11540.66.

Stroke 99

Stroke Outcomes EMS Seizures 99

PEMBlog

AUGUST 20, 2024

Pediatric Emergency Care , 40(8), 618-622. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. eCPR is typically performed in specialized centers with highly trained personnel in well coordinated teams. for this emerging therapy. Circulation.

CPR 52

CPR Resuscitation Pediatrics Hospitals 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. He appears well and is triaged to an ESI 4. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

RebelEM

JANUARY 23, 2023

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. Patients were randomized in a 1:1 ratio. The effectiveness of IV cetirizine was determined to be statistically non-inferior. PMID: 16159637.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S. Postpartum Emergencies. Emergency department evaluation and management of peripartum cardiomyopathy. The Journal of emergency medicine, 36(2), 141-147. Not in the textbook, but it worked.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Their mission is to share knowledge with paramedics, nurses, medical student and also young doctors as they take their first steps in the field of emergency medicine. Each month they post new content and focus two main topics, the medical therapy of the month as well as tricks for dealing with complex emergencies.

Hospitals 40

Hospitals Emergency Department Ultrasounds EMS 40

The Skeptics' Guide to EM

NOVEMBER 2, 2019

Annals of EM 2019 Guest Skeptic: Martha Roberts is a critical and emergency care, triple certified nurse practitioner, currently living and working in western Massachusetts. She is the host of EM BOOTCAMP in Las Vegas, as well as a usual speaker and faculty member for The Center for Continuing Medical Education ( CCME ).

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

RebelEM

DECEMBER 10, 2023

Background: The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. As always, we should consider new data as it emerges. Acad Emerg Med.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

Advanced Emergency Nursing from AENJ

NOVEMBER 7, 2015

In my opinion, hypnosis is a little-understood but potentially valuable technique for the emergency department. Why isn't hypnosis used more in emergency departments? " Well, then, what to do? Hypnosis in the treatment of acute pain in the emergency department setting. 2005, April).

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 40

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

Act V, scene I [Text from Folger Shakespeare Library] [Audio recording of Dramatic Reading; Chapter Vox] [Video recording of Act V, scene1] Most deaths that are brought to, or occur in, an emergency department will require, at least, discussion with the local Coroner or Medical Examiner. " January 2005; Last updated May 16, 2005.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

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

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. 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

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Downeast Emergency Medicine

MARCH 24, 2021

OVERVIEW Diarrhea is a common complaint for our pediatric patients in the emergency department. Just like other patients in the emergency department, the child should be recognized as “sick” or “not sick.” Overall, pediatric patients with diarrhea for the most part have a good prognosis and do well with oral hydration.

Pediatrics 52

Pediatrics Dehydration Emergency Department Wellness 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2016

in Pediatric Emergency Care evaluated the safety and efficacy of their institution’s standardized pediatric migraine practice guideline in the emergency department, which used ths cocktail, based on the best evidence available. A comparison of acute treatment regimens for migraine in the emergency department.

Pediatrics 52

Pediatrics Seizures Emergency Department Wellness 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

It was extremely well-liked by field personnel, but virtually unknown in hospitals. However, they could be used easily and well with the assist of head-straps which were never sold as part of the complete “kit” but only as an uncataloged “spare part.” The Journal of emergency medicine, 40(6), 661-667. Filbrun, T., Weingart, S.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

Advanced Emergency Nursing from AENJ

MAY 27, 2015

An ambulance pulls up, in haste, to the Receiving door of the Emergency Department with a last squeal of the siren. Thereafter, “siege warfare” conditions prevail, and no one does very well with that, as in Mumbai, Waco , etc. Department of Health and Human Services. Department of Labor.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

Mind The Bleep

JANUARY 28, 2025

per 1000 emergency department attendances in the UK (1). British journal of hospital medicine (London, England : 2005), 83(12), 17. Epidemiology Pretibial lacerations may occur following minor trauma to the shin area, particularly in elderly individuals with fragile skin. The prevalence of these injuries is estimated at 5.2

Documentation/Coding 52

Documentation/Coding Head Injuries Fractures Emergency Department 52

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. 10 This is addressed in a prior emDOCs article: [link] Figure 1: Vision, aphasia, neglect emergent large vessel occlusion screening tool. vs. 38.1%) with a good functional outcome.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

EMDocs

NOVEMBER 4, 2024

She denies any trauma, swelling, or redness in the joints, as well as fever or weight loss. The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine. J Emerg Med. Acad Emerg Med. J Emerg Med. Ann Emerg Med.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. If soap and water are unavailable, the CDC recommends an alcohol-based hand rub with at least 60% alcohol.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

EMDocs

JANUARY 6, 2025

She receives IV calcium gluconate and bicarbonate as well as oral potassium binders for hyperkalemia. Malnutrition Refugees arriving or living in Uganda face a significant malnutrition burden, with a Global Acute Malnutrition (GAM) rate of 9.1%, just below the World Health Organization’s emergency threshold. Ann Emerg Med.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75