Dr. Smith's ECG Blog

FEBRUARY 18, 2024

This could be easily overlooked since there is complete heart block, but recognizing the atrial arrhythmia may mean prescribing anticoagulation to prevent stroke. In this case, it is atrial fibrillation.

EKG/ECG 90

EKG/ECG Stroke 90

Pediatric EM Morsels

JULY 21, 2023

[Simpson 1991] No one system universally accepted like adult standard GCS [Simpson 1991, Jain 2022] “There is an evident need for valid standards of paediatric head injury severity, to permit comparisons of different methods of treatment.” PubMed: 29631516] van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. 2008 Apr;39(4):1347-8. 107.498345.

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Head Injuries Pediatrics Outcomes Shock 246

ACEP Now

OCTOBER 29, 2024

Passively, I watch another clinician’s cursory examination of a critically ill patient to determine how they deem a patient “toxic-appearing” or their bedside neurological assessment to activate a code stroke. Actively, I ask them on their patients that we both had the opportunity to see: What abscesses would they prefer to pack?

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

ACEP Now

SEPTEMBER 13, 2023

This funding expanded the committee’s work to include three reports: Hospital Based Emergency Care – at the Breaking Point ; Emergency Medical Services – at the Crossroads ; and Emergency Care for Children – Growing Pains ,” all released in 2007. Prescott, MD, another member of the committee. “We

EMS 45

EMS Research Academics Military 45

Critical Care Now

MAY 12, 2022

The Pre-brief When we think of lysing things in the emergency department (ED), we think of alteplase busting up a blood clot in either ischemic stroke or in patients experiencing a massive pulmonary embolism. 2007; 75: 1523 – 28. Interests include trauma, toxicology, and infectious diseases. Cerumen Impaction. Am Fam Physician.

Infectious Diseases 52

Infectious Diseases Stroke Administration Emergency Department 52

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. This guideline revision is particularly timely as EMS systems have shown their abilities to dramatically improve survival and neurologic outcome after cardiac arrest, STEMI, acute stroke, and other time-sensitive conditions.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

ACEP Now

APRIL 2, 2024

8,9 There is one case of a 17-year-old who died from acute cerebellar stroke after participating in the “One Chip Challenge” (eating a capsaicin infused food chip as a game) that prompted Hershey Co. Boca Raton (FL): CRC Press/Taylor & Francis; 2007. Capsaicin pepper exposures send about 300-350 people to the hospital annually.

Burns 40

Burns Poisoning Seizures Stroke 40

Pediatric Emergency Playbook

JANUARY 1, 2017

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. Surgical pain is not “erased” by opioids ( Thomas 2003 , Poonai 2014 ); treating pain improves specificity to certain surgical emergencies with retained diagnostic accuracy ( Manterola 2007 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

DECEMBER 16, 2023

Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. Patients with heat stroke have hot, dry skin and altered mental status (e.g., C, and heat stroke occurs at a core temperature > 40°C. C, and heat stroke occurs at a core temperature > 40°C. Temps greater than 41.5C Bendall, J.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

Sensible Medicine

APRIL 29, 2024

Say blueberries and rates of stroke. Then they applied the specification curve analysis to one specific database—the NHANES (National Health and Nutrition Examination Survey) from 2007 to 2014. This time in nutritional epidemiology. Take a moment and think about the methods section of a standard association study.

Stroke 138

Stroke Documentation/Coding Shock Research 138

Pediatric Emergency Playbook

JUNE 1, 2017

The previously well child now decompensated: undiagnosed thrombophilia Asymptomatic patent foramen ovale (PFO) is the cause of some cases of cryptogenic vascular disease, such as stroke and MI. 2007; 2:2-11. 2007; 5(3):172-176. However, the presence of PFO alone does not connote higher risk. Congenit Heart Dis. Aliku TO et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

ACEP Now

DECEMBER 11, 2023

These included oral and nasal spray formulations of these two decongestants, but a third, phenylpropanolamine, was excluded due to safety concerns relating to hemorrhagic strokes. These changes are of note because data regarding limited efficacy were presented to the FDA in 2007 and 2015.

Administration 64

Administration Outcomes Research Stroke 64

Pediatric Emergency Playbook

JUNE 1, 2016

Conversely, is the heart rate too slow – even if the stroke volume is sufficient, if there is severe bradycardia, then cardiac output -- which is in liters/min – is decreased. 2007; 35:64-8. Could this be a supraventricular tachycardia that does not allow for enough diastolic filling, leading to poor cardiac output? mg/kg up to 0.5

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Don't Forget the Bubbles

FEBRUARY 7, 2024

“Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. The cremasteric reflex The cremasteric reflex is a superficial reflex in males, triggered by lightly stroking the inner part of the thigh. The cremaster muscle contracts, elevating the testicle on that side. Soyer, T.U.T.K.U.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Don't Forget the Bubbles

AUGUST 21, 2023

Stimulation of baroreceptors results in a catecholamine-mediated increase in heart rate , stroke volume, contractility, and systemic vascular resistance (SVR). The LV dysfunction is often asymptomatic in the early stages of the disease. A range of adaptive processes occurs to compensate for falling cardiac output. 24; 15-25 Fenton M.,

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

EB Medicine

DECEMBER 1, 2018

In 2007-2008, an oseltamivir-resistant H1N1 strain emerged globally. J: Also, for our NP and PA listeners, we have a special offer this month: You can get a full year of access to Emergency Medicine Practice for just $199--including lots of pharmacology, stroke, and trauma CME--and so much more! Again, that’s www.ebmedicine.net/APP.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

EB Medicine

MAY 3, 2019

Nachi: Just as telestroke has changed stroke care forever, as technology advances, telepsychiatry may provide a solution to easily expand access to outpatient services and consultation in a cost effective manner - offering quick psychiatric care to those that never had access. Jeff: The last cutting-edge topic to discuss is telepsychiatry.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

Dr. Smith's ECG Blog

APRIL 8, 2015

2007 Oct; 33(3): 233–239. to 1.45) for fatal or nonfatal stroke. Of the 67 patients who underwent targeted tests, suspected diagnoses were confirmed in 49 (73%) patients: aortic stenosis (n = 8, 1%), pulmonary embolism (n = 8, 1%), seizures/stroke (n = 30, 5%), and other diseases (n = 3). g/dL —Hypotension (obviously!)

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52