The Trauma Pro

DECEMBER 26, 2023

Screening looks at patient factors such as age, obesity, and previous VTE, as well as injury risk factors like spine and pelvic fractures and decreased mobility. J Thrombosis Thrombolysis 23:25-30, 2006. Chest 127(5):1631-1636, 2005. A randomized study.

Fractures 124

Fractures Documentation/Coding Hospitals Research 124

Dr. Smith's ECG Blog

OCTOBER 23, 2023

2006 Jan 17;47(2):269-81. Epub 2006 Jan 4. This 1910 description by Lewis serves well to this day to remind us of the 2 principal clinical situations in which electrical alternans is most often encountered: i ) Supraventricular reentry tachycardias; and , ii ) Pericaradial tamponade. Pacing Clin Electrophysiol. doi: 10.1111/j.1540-8159.2007.00849.x.

EKG/ECG 131

EKG/ECG Documentation/Coding Psychiatric EMS 131

Taming the SRU

DECEMBER 11, 2023

8] While there is no standardized screening tool for SRB, there are well established trends that emergency medical providers may use to identify patients at risk.[9] In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs.Rockville (MD)2006. Emergency Department Visits Related to Suicidal Ideation, 2006-2013.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

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

ALiEM

NOVEMBER 6, 2023

WPW Syndrome consists of characteristic EKG findings as well as symptomatic arrhythmias. 2006 Oct;11(4):340-53. WPW is a pre-excitation syndrome characterized by an accessory pathway caused by a congenital failure of cells to resorb near the AV valves. European heart journal. 1999 Dec 1;20(24):1826-32. Wolff L, Parkinson J, White PD.

EKG/ECG 78

EKG/ECG Academics Outcomes Wellness 78

EMDocs

FEBRUARY 7, 2024

Unionization of healthcare providers can create opportunities to improve staff’s financial and general well-being, but may also facilitate future strikes. Trainees and attending providers should be informed about both the opportunities that come with unionization, as well as the challenges that come with managing strikes.

Hospitals 98

Hospitals Research Patient Safety Wellness 98

ALiEM

SEPTEMBER 25, 2024

His exam revealed a well-appearing male in no acute distress. 2006 Oct;49(10):1546-51. He denies chest pain, cough, shortness of breath, fevers, nausea, vomiting, diarrhea, constipation, rectal bleeding, dysuria, and increased urinary frequency. Intussusception of the bowel in adults: a review. World J Gastroenterol. 2009;15(4):407.

Emergency Department 56

Emergency Department Wellness Radiology Radiology 56

Northwestern EM Blog

APRIL 15, 2024

2006): 576-579. 1,2 As you have outlined, understanding both the chronicity of the tracheostomy as well as the indication for the procedure are key history when managing a displaced tube. Rajendram, R., Repositioning a displaced tracheostomy tube with an Aintree intubation catheter mounted on a fibre-optic bronchoscope."

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

The Injectable Orange

JUNE 20, 2017

While well evaluated, you see the residents go back to the shop floor and struggle to apply any of the lessons that the group agreed had been take homes from the previous sim session. How do they do it so well?” Well done”……. Check back. Confirmation. Completion. he thought. This demands more research.” Deep breath. “OK

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

Don't Forget the Bubbles

NOVEMBER 8, 2023

Tilly is normally fit and well, with no significant past medical history. The Shera Score Children with a low Shera score (less than 3) who are otherwise systemically well may be suitable for discharge home with safety netting advice , whereas patients with high scores (8 or more) warrant immediate surgical referral. Doria, A.S.,

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

PHEM Cast

MARCH 17, 2016

2006: 30(1); 63-67. video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. Von Goedecke A, Wenzel V, Hormann C, Voelckel WG, Wagner-Berger HG, Zecha-Stallinger A, Luger TJ, Keller C. Journal of Emergency Medicine.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

Taming the SRU

JULY 24, 2023

Risk factors associated with increased risk of acute perforated cholecystitis include age greater than 65 years old, as well as diabetes mellitus, atherosclerosis, or organ failure (1, 2). The most well-accepted classification of acute perforated cholecystitis is the Niemeier classification which is outlined as below (3,6).

Ultrasounds 79

Ultrasounds Sepsis Radiology Radiology 79

Don't Forget the Bubbles

AUGUST 9, 2023

There is no pain or discharge, no lymphadenopathy, and she is otherwise well. 2006) Subclinical thyroid disorders and cognitive performance among adolescents in the United States.BMC Pediatr. Her parents first noticed it when she was two years old, and since then, it has gradually been increasing in size. Clin Endocrinol.

Ultrasounds 98

Ultrasounds Pediatrics Wellness 98

Dr. Smith's ECG Blog

DECEMBER 13, 2024

Nevertheless, this recommendation is still based on the papers published before 2006." KEY Point: As soon as we recognize that ECG #1 is an irregularly irregular WCT without P waves that consistently manifests a ventricular response well over 220/minute we have made the diagnosis of very rapid AFib in a patient with WPW.

EKG/ECG 103

EKG/ECG Ambulance Services Emergency Department EMS 103

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Brief aside: "Early repolarization" is a frequently proclaimed and poorly understood electrocardiographic phenomenon which mostly serves to reassure clinicians that not all ST elevations are ischemic (something readers of this blog know well). linking the finding with long term risk of idiopathic ventricular fibrillation. Grines, C.

EKG/ECG 131

EKG/ECG Documentation/Coding Wellness Emergency Department 131

Advanced Medical Reviews

SEPTEMBER 15, 2017

Especially since millennial satisfaction with the healthcare system is lower – only 32 percent report being treated well , according to an Accenture survey – than it is for preceding generations. Access to personalized recommendations, as well as public reviews, is a defining feature of the current media landscape.

Operations 56

Operations Research Wellness Hospitals 56

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

This definition includes clinically apparent seizures as well as those seen only on EEG.) Or… is it something else as well? 2006; 368: 222–29. 2006; 5:246-256. Definition of status epilepticus:Continuous seizure activity of 5 minutes or greater – OR – Recurrent activity without recovery between intervals. Lancet Neurol.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Don't Forget the Bubbles

OCTOBER 7, 2024

The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. Mechanisms of Injury Industrial electrical injuries are typically high-voltage injuries, resulting in deep tissue damage, burns, and significant systemic effects. Narayanan, K., and Marijon, E., Electrical injury.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Critical Care Now

MARCH 3, 2022

I am quick to praise the ones that say they never smoked, as well as the ones who say they have quit. I encourage the ones who say that they are trying, as well as the ones who say that they are thinking of quitting. 2006, May 2 ). COPD continues to be a problem for many adults. European Respiratory Society. Etminan, M.,

COPD 52

COPD Research Hospitals Wellness 52

Downeast Emergency Medicine

JULY 17, 2021

2006 Aug; 48(2): 173-81.[ The primary endpoint was pain reduction at 30 minutes with secondary outcomes looking at 15, 45, and 60 minute scores as well as need for rescue analgesia and adverse effects. American Journal of Emergency Medicine. 2020 Feb; 38 (2): 165-172.[ Pubmed ] 3. Ann Emerg Med. Pubmed ] Additional reading 4.

Emergency Department 52

Emergency Department Wellness Administration EMS 52

Pediatric Emergency Playbook

FEBRUARY 1, 2017

Symptoms – either typical dysuria, urgency, frequency in a verbal child, or non-descript abdominal pain or vomiting in a well appearing child. In a low risk child, with obviously very vigilant parents, who is well appearing, you may choose not to test now, and ensure close follow up. 2006 Jan;13(1):76-81. No obvious source?

Dehydration 52

Dehydration Wellness Ultrasounds Pediatrics 52

PEMBlog

OCTOBER 19, 2023

Tyrosinemia The patient’s CT scan revealed liver replaced and distorted by innumerable, variably-enhancing nodules, as well as nephromegaly. 2006 Jul 24 [Updated 2017 May 25]. Tyrosinemia Click here to reveal the correct answer E. He was ultimately admitted to the general pediatric service for further management. Rashad MM, Nassar C.

Urgent Care 52

Urgent Care Pediatrics Poisoning Wellness 52

Pediatric Education

OCTOBER 22, 2023

Patient Presentation A 2-week-old female came to clinic for her 2 week well child appointment. Her parents felt that she was doing well with feeding every 2-3 hours with many urine and stool diapers per day. Her mild jaundice had disappeared. They were concerned about some hard masses on her right cheek. A review can be found here 2.

Radiology 52

Radiology Radiology Fractures Pediatrics 52

Pediatric Education

MAY 5, 2024

Overall he was growing and developing well. When he was well, he denied any bad taste in mouth, heartburn symptoms, chest pain, abdominal pain and no diarrhea or irregular stools. .” The pathogenesis appears to be multifactorial and not well understood.

Pediatrics 40

Pediatrics Wellness 40

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. Eur Heart J 2001;22:1997–2006. The evolution is to deeper and more symmetric waves (Wellens pattern B).

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Wellness 52

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. This has been studied in children as well, and an elevated lactate in children – typically above 4 – was a predictor of prolonged ICU course and mortality in septic patients. 2006; 107(1)21-31.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Sensible Medicine

SEPTEMBER 29, 2023

The promise is that well-constructed and validated prediction models will lead to diseases being diagnosed earlier and treatment for the right patients, in the right place, at the right time. In some cases, models that appear to perform well may pose risks to patients if used to make clinical decisions. 2006 Apr;332(7550):1127-9.

Research 60

Research Hospitals Academics Emergency Department 60

Pediatric Emergency Playbook

JANUARY 1, 2016

Consider surgical causes of forceful vomiting, especially if the child does not look anything other than well. 2006; 26(5):1485-500. 2006 Apr;7(2):75-80. They are not allowed to vomit (forceful, unpleasant contraction of abdominal muscles). Radiographics. Glaser NS, Wootton-Gorges SL, Buonocore MH et al. Pediatr Diabetes.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

ACEP Now

SEPTEMBER 13, 2023

We wanted to reach emergency physicians, nurses and others working in trauma as well as those at Health and Human Services and the Centers for Disease Control. as well as working closely on behalf of the association on projects with the White House and the Departments of Veterans Affairs, Defense, and Health and Human Services.

EMS 45

EMS Research Academics Military 45

EMDocs

APRIL 22, 2024

If RV pressure is extreme, it can exceed LV pressure causing paradoxical septal wall motion toward the LV as well. When RV pressures elevate, RA pressures increase as well given forward blood flow is obstructed. 4, 2006, pp. In the setting of acute PE, complex hemodynamic changes affect right ventricular function. Chest , vol.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Craniosynostosis Craniosynostosis is rare. It is due to the premature closure of the sutures rather than positional changes to an otherwise normal skull. The Radiology Assistant: Craniosynostosis Accessed 10.01.2024 Mawji, A., Vollman, A. Hatfield, J., McNeil, D.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

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

Pediatric Emergency Playbook

AUGUST 1, 2017

2006; 26:1485-1500. 2006; 22:1021-1024. Pediatr Rev. 1988; 9(7):219-226. Malrotation with Midgut Volvulus Applegate KE. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Radiographics. Kapfer SA, Rappold JF. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Pediatric Emergency Playbook

MAY 1, 2017

Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric Emergency Playbook

DECEMBER 1, 2016

If the otherwise healthy child one month and older is: Euvolemic Not hypoxic Well appearing He can likely go home. The short answer is that the American Academy of Pediatrics, the UK’s National Institute for Health and Care Excellence, as well as the Canadian Pediatric Society currently recommend against them. 2006 Oct;118(4):1774-93.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

PulmCCM

OCTOBER 9, 2023

After two studies published in NEJM 2001 and 2006 showed intensive glucose control (to 80-110 g/dL) improved outcomes in adult medical and surgical patients, and then in kids (all at a single center in Leuven, Belgium), tight glucose control quickly became standard care in the U.S. and many other countries.

Shock 52

Shock Outcomes Hospitals Wellness 52

AED Leader

AUGUST 15, 2023

2006) linked inflammation with diets that are high in sugar, refined starches, and saturated trans-fatty acids, and low in omega-3 fatty acids, natural antioxidants, and fiber from fruits, vegetables, and whole grains. A review published by Giugliano et al. Opt for products with no added sugar when buying packaged goods.

Stroke 52

Stroke Outcomes Wellness 52