Dr. Smith's ECG Blog

MAY 2, 2019

Written by Pendell Meyers I received this prehospital ECG (we receive prehospital ECGs by telemetry from EMS in a large area around our hospital) and was told that there was a patient in her 50s with chest pain who was headed to an outside hospital (which happens to be a catheterization center). Here is the ECG: What do you think?

Hospitals 52

Hospitals EKG/ECG Wellness EMS 52

Northwestern EM Blog

MARCH 27, 2025

Mount Sinai Hospital Department of Anesthesia Perioperative Interactive Education. John Bailitz, MD Vice Chair for Academics, Department of Emergency Medicine Professor of Emergency Medicine, Feinberg School of Medicine Northwestern Memorial Hospital How To Cite This Post: [Peer-Reviewed, Web Publication] Premer-Barragan, C.,

Ultrasounds 52

Ultrasounds Dehydration Academics Hospitals 52

PulmCCM

MAY 12, 2024

Source: Wikipedia Thanks to advances in critical care in recent decades, many more patients today survive out-of-hospital cardiac arrest to hospital discharge. Unfortunately, neurologic outcomes have remained poor over that time, with most survivors of out-of-hospital cardiac arrest remaining severely disabled.

Hospitals 59

Hospitals Outcomes 59

RebelEM

JANUARY 9, 2024

Additionally, multiple studies demonstrate increased harm with IV antibiotics such as increased rate of diarrhea ( Haran 2014 ), complications from IV placement ( Li 2015 ), and increased length of stay or cost ( Lorgelly 2010 ). The use of oral temafloxacin compared with a parenteral cephalosporin in hospitalized patients with pneumonia.

Infectious Diseases 99

Infectious Diseases Pediatrics EMS Administration 99

Pediatric EM Morsels

AUGUST 18, 2023

Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications. From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%. J Pediatric Infect Dis Soc.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

RebelEM

MAY 27, 2024

mg/kg) or starting at 12 mg might be more effective for certain populations (Deck 2023, Cabalag 2010). These rates are significantly lower than those in other research (Holdgate 2006). Evidence suggests that a weight-based dosing approach (0.1

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Outcomes Research Operations Hospitals 137

Greater Sydney Area HEMS

JULY 27, 2023

Weds 30th August 2023, 1630-2010 In person at Bankstown Aerodrome or online – REGISTRATION ESSENTIAL The NSW Institute of Trauma and Injury Management proudly presents the Pre-Hospital Trauma Evening in collaboration with the NSW Ambulance Service. Register now for the ITIM Prehospital Trauma Evening, hosted by Sydney HEMS.

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Ambulance Services Hospitals 52

ACEP Now

DECEMBER 6, 2024

Physicians are outspent by Big Pharma, hospitals, and health insurers, but wonder why they are always first on the chopping block fiscally or in legislation. million, raised in 2010. He said the reality of American politics is that money buys access, access leads to influence, and influence results in laws leading to change.

Hospitals 98

Hospitals Research 98

PHEM Cast

JANUARY 4, 2017

Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Top 10 (+1) tips to get started with in situ simulation in emergency and critical care departments. Bredmose PP, Habig K, Davies G, Grier G, Lockey D. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

EB Medicine

OCTOBER 1, 2017

In fact, in 2010, two studies estimated that COPD exacted a direct and indirect cost of somewhere between $36 and $50 billion dollars in the US. million ED visits for COPD - related problems, with nearly 1/5th requiring hospitalization. million ED visits for COPD-related problems, with nearly 1/5th requiring hospitalization.

COPD 40

COPD Hospitals 40

Don't Forget the Bubbles

SEPTEMBER 13, 2023

2006;67(9):1542-1550 Royal Children’s Hospital Melbourne. 2010-3318 Veerapandiyan A, Aravindhan A, Takahashi JH, Segal D, Pecor K, Ming X. Afebrile Seizures. Accessed online at [link] Sawires R, Buttery J, Fahey M. Published 2022 Jan 13. doi:10.3389/fped.2021.801321 Neurodiagnostic evaluation of the child with a simple febrile seizure.

Seizures 131

Seizures Pediatrics Emergency Department Radiology 131

ACEP Now

JUNE 14, 2024

Transferring patients from one ED to another hospital is an established part of emergency medicine practice. Patients who need inpatient services do not match the index hospitals’ capabilities, or the patient requests such a transfer, or the hospital has no available inpatient space. Click to enlarge.

Emergency Department 52

Emergency Department Operations Hospitals Leadership 52

ACEP Now

SEPTEMBER 5, 2024

With elimination of CME funding in many of our hospitals and groups, it is crucial to continue to add value and communicate that value to residents before graduation. While some issues are handled locally, many issues cannot be solved in our emergency department or hospital.

Leadership 98

Leadership PPE EMS Wellness 98

Pediatric Emergency Playbook

OCTOBER 1, 2017

2010; 30:76–81. Predictors of In-Hospital Mortality in Children After Long-Term Ventricular Assist Device Insertion. 2010; 6: 46-53. Journal of Chemical Neuroanatomy; 2011; 42: 288–296. Intrathecal Pumps Borowski A, Littleton AG, Borkhuu B et al. Complications of Intrathecal Baclofen Pump Therapy in Pediatric Patients.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

PHEM Cast

APRIL 10, 2016

Severe Sepsis in Pre-Hospital Emergency Care. 2010 Apr;38(4):1045–53. Prehospital Sepsis Project (PSP): knowledge and attitudes of United States advanced out-of-hospital care providers. Prehospital Sepsis Project (PSP): knowledge and attitudes of United States advanced out-of-hospital care providers. 2009;13(5):R167.

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Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Dr. Smith's ECG Blog

APRIL 24, 2015

We found that 38% of out of hospital ventricular fibrillation was due to STEMI. Correlation of STEMI in Resuscitated Non-traumatic out-of-hospital Cardiopulmonary Arrest patients with Initial Rhythm and Cardiac Catheterization Findings (Abstract 580). Academic Emergency Medicine 17(s1):S194; May 2010 Reference : Scott NL.

Resuscitation 52

Resuscitation EKG/ECG Academics Hospitals 52

Don't Forget the Bubbles

JUNE 26, 2023

Staged reconstructions are a topic in itself (click here for a nice summary by Children’s Hospital of Philadelphia), but here we focus on Stage 1. The seminal trial addressing this in the Norwood population was The Single Ventricle Reconstruction Trial, published in 2010. Stage 1 is performed in the first days of life. Int J Cardiol.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Emergency Medicine Journal

NOVEMBER 28, 2023

Overprescribing and inappropriate antibiotic selection for children with pharyngitis in the United States, 1997-2010. Cochrane Database Syst Rev. 2021; 12 (12):CD000023. Dooling KL, Shapiro DJ, Van Beneden C, Hersh AL, Hicks LA. JAMA Pediatr. 2014; 168 (11):1073-4. Llor C, Bjerrum L. Ther Adv Drug Saf. 2014; 5 (6):229-41.

Emergency Department 40

Emergency Department Hospitals Pediatrics Research 40

Broome Docs

APRIL 6, 2023

2010 Oct 5;182(14):1527-32. Epub 2010 Aug 23. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. doi: 10.1503/cmaj.091974. JAMA Intern Med. doi: 10.1001/jama.2022.21805.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

OCTOBER 30, 2024

female patients; those with atypical symptoms that were not abrupt or did not include chest, back, or any pain; patients with an absence of pulse deficit or hypotension; or those who initially presented to a nontertiary care hospital. Debrief codes and odd encounters for yourself, your team, and your hospital system.

Hospitals 52

Hospitals Emergency Department EKG/ECG Documentation/Coding 52

Urgent Care Ultrasounds

APRIL 1, 2018

The apical 4 chamber view is unfortunately under gained in the near field) On admission to hospital Cr = 298 eGFR = 25, and a subsequent renal biopsy confirmed glomerulonephritis. 2010; 31(6):703-11. However, the point of care ultrasound images also reveal a dilated cardiomyopathy with severely reduced LV systolic function.

Urgent Care 52

Urgent Care Ultrasounds Hospitals 52

RebelEM

MARCH 9, 2023

Pompili 2010) However, >65% of patients who endorse suicidal ideation when intoxicated no longer endorse suicidal ideation once sober. Suicide attempts in which alcohol is involved: a special group in general hospital emergency rooms. 2010 Apr;7(4):1392-431. Epub 2010 Mar 29. Acta Psychiatr Scand.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2010; 26:769-781. 2010; 149(3):386-391. Management of the child after enema-reduced intussusception: hospital or home? 2010; 45:1182-1186. 2010; 28(11):544-548. Acute Intestinal Obstruction in children: Experience in a Tertiary Care Hospital. 2010 Oct;40(4):613-20. . J Emerg Med. 2012; 43(1):49-51.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

The Skeptics' Guide to EM

MARCH 20, 2021

Background: Historically most patients with PEs have been admitted to the hospital in the USA. A study from 2010 showed that half of PE patient from one centre in Ontario were safely being treated as outpatients ( Kovacs ). The patient has normal vital signs and no comorbidities.

Academics 52

Academics Hospitals Wellness 52

Don't Forget the Bubbles

MAY 29, 2023

A qualitative study of 2,815 pre-hospital clinicians reported that nearly half of the respondents had experienced incivility from professional teams at least once a week. Psychological Bulletin [Internet] 2010: 136 :5:894–914. Speaking up for patient safety by hospital-based health care professionals: a literature review.

Leadership 98

Leadership Patient Safety Academics Research 98

ACEP Now

NOVEMBER 7, 2023

Out-of-hospital cardiac arrest unfortunately occurs relatively commonly and emergency physicians must be equipped to diagnose and treat this rapidly. The primary outcome was survival to hospital discharge. Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

PulmCCM

SEPTEMBER 23, 2024

Daily duration of long-term oxygen therapy and risk of hospitalization in oxygen-dependent COPD patients. JAMA 2010 Retraction Watch The Truth about China’s Cash-for-Publication Policy, MIT Technology Review , July 2017 “Why Fake Research Is Rampant in China,” The Economist, February 2024 The End of Publish or Perish?

COPD 52

COPD Research Academics Hospitals 52

PulmCCM

JANUARY 22, 2024

Although those studies only included out of hospital cardiac arrests due to ventricular fibrillation, induced hypothermia was rapidly and widely adopted and applied to most cardiac arrest patients, regardless of initial rhythm or location of arrest. °C despite acetaminophen, etc).

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Taming the SRU

FEBRUARY 12, 2024

She initially agreed to be transported to the hospital by ambulance, but jumped from the moving vehicle and was subsequently struck and pinned under the fuselage for 10-15 minutes. Hospital Course Based on the primary survey, no acute airway interventions were undertaken. BMC Pharmacol Toxicol. May 2; 19(1): 19. Schulman, S et al.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

SheMD

MAY 11, 2023

Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians. 2010; 85(8): 1276- 1281. Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. JAMA Intern Med. 2017; 177(2): 206- 213. Wayne NL, Vermillion M, Uijtdehaage S.

Leadership 52

Leadership Documentation/Coding CPR Teamwork 52

The Skeptics' Guide to EM

JUNE 22, 2019

NEJM 2019 Guest Skeptic: Dr. David Glaser, emergency physician from a community teaching hospital in Denver and faculty member for the annual Emergency Medicine and Acute Care course series. In the United States especially, these patients are often admitted to the hospital with rate control and cardiology decides on cardioversion.

Academics 40

Academics Emergency Department Hospitals EKG/ECG 40

PulmCCM

FEBRUARY 19, 2024

Let Families Activate Rapid Response Teams, Says SCCM The Society of Critical Care Medicine (SCCM) issued a new guideline on how hospitals and care teams should respond to emergencies outside the ICU or ED (i.e., SCCM now suggests this should be a standard practice at most hospitals. on the medical and surgical wards). Read it here.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

RebelEM

JANUARY 23, 2023

Despite being highly effective in treating acute allergic reactions, first-generation H1 antihistamines cross the blood-brain barrier and bind to H1 receptors, which can lead to undesirable side effects, including drowsiness, sedation, fatigue, and decreased cognition (Church MK 2010). 2010 Apr;65(4):459-66. Epub 2010 Feb 8.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Taming the SRU

JANUARY 29, 2024

Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. She had improvement of the swelling in her left arm with return of sensation and function during her five-day hospital course. Epub 2010 Feb 6. J Thromb Haemost. 2010;8(4):684. J Int Med Res.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

RebelEM

JANUARY 19, 2023

However, management continues to be debated and may lead to unnecessary hospitalization. PMID: 32622394 Clinical Question: Can ambulatory management of patients with primary spontaneous pneumothorax reduce the length of hospitalization? Control: Standard treatment as per the 2010 BTS Pleural Guidelines. 2020;396(10243):39-49.

Outcomes 52

Outcomes Hospitals Research EMS 52

The Skeptics' Guide to EM

JULY 2, 2022

You have been reading about the overuse of objective cardiac testing (OCT) and wonder if this patient really needs admission to the hospital. Backus and colleagues published their multi-centre validation of the HEART score in 2010. In prior decades nearly all patients presenting to EDs with chest pain were admitted to hospital.

EKG/ECG 40

EKG/ECG Academics Emergency Department Hospitals 40

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). 2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., PLOS ONE 13(12): e0208622.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97