Dr. Smith's ECG Blog

JULY 21, 2024

In both tracings — an exceedingly fast PMVT is documented. Of interest — the ectopic beats triggering PMVT/VFib in such studies were often mapped to endocardial sites displaying Purkinje potentials within the myocardial scar — suggesting potential responsivity to a 1A agent ( Nogami — Pacing Clin Electrophysiol 34(8): 1034-1049, 2011 ).

EKG/ECG 131

EKG/ECG Shock Hospitals Sepsis 131

ACEP Now

NOVEMBER 13, 2023

For the safety of staff as well as patients, interventions that interrupt escalations before they blossom into violence deserve further study. FIGURE 1: Number of nonfatal workplace violence injuries and illnesses with days away from work, 2011-18. Click to enlarge.) Dr. Santamaria is a current second year medical student at A.T

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

Dr. Smith's ECG Blog

AUGUST 26, 2009

Research presented at 2011 SAEM in Boston. Methods : We searched the catheterization laboratory database for all cases coded as acute Inferior STEMI from January 2002 through March 2008. All cases were reviewed and the presenting ECG, as well as the first ECG that was used for diagnosis of acute STEMI, were analyzed.

EKG/ECG 52

EKG/ECG Documentation/Coding Research Academics 52

Taming the SRU

NOVEMBER 14, 2023

A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6 B) on right: hand drawn images of layers of ear demonstrating auricular hematoma The epidemiology and incidence of ED presentation for auricular hematomas has not been well-studied because it is a relatively uncommon condition.

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. Based upon California Health and Safety Code 102850 and Government Code 27491. Based upon California Health and Safety Code 102850 and Government Code 27491.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Don't Forget the Bubbles

FEBRUARY 26, 2024

Increasing PEEP is thought to cause bronchodilation by providing direct mechanical stimulus as well as secondary stimulation through pulmonary stretch receptors coupled with activation of the non-cholinergic parasympathetic pathway. 2011 Oct;46(10):949-55. uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2019.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

Don't Forget the Bubbles

MAY 6, 2024

of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. The data was collected from a cohort from 2011- 2015 (nearly ten years ago). Of the 74.9% showed clinical improvement without antibiotics.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

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

ACEP Now

AUGUST 1, 2023

A rural ED staffed by a well-trained EP is an essential resource in small communities that may be otherwise lacking in readily available healthcare resources. emergency department deserves access to an emergency physician no matter their zip code. Three take home points for what I believe. Every patient in a U.S.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

RebelEM

MARCH 27, 2023

There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. Unfortunately, its not clear whether the documentation came from RTs or ED providers. 2011 Feb 15; Epub 2010 Aug 27. PMID: 19325480 Gajic O, et al. Am J Respir Crit Care Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is critically important to document the physical findings in a plain-seeing, plain-speaking, non-judgmental manner that will not color or taint future investigations. Accurate time entries are important to document. If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. 2 The astute paramedic recognized this possibility and announced a CODE STEMI. Heart 2011; 97 : 838-843 [link] 14. Look at the aortic outflow tract. What do you see? J Am Coll Cardiol.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Advanced Emergency Nursing from AENJ

MAY 27, 2014

This is a cased kit of a Sparklet Resuscitator (J size), with pressure chamber, regulator, tubing, reservoir bag, flow stopcock, and funnel mask, with associated documents. Henderson , it would seem, was an enthusiast, well-convinced of his opinions, with missionary zeal, who would firmly argue his positions and tirelessly campaign them.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Mind The Bleep

FEBRUARY 7, 2024

Should also document presence of shunt, size and direction. Your histogram allows you to visualise how well your patient is oxygenating over a longer time period rather just a snapshot, and this gives you the opportunity to optimise oxygenation by altering ventilator settings if required. 2/3 systemic is normal.

Wellness 52

Wellness Seizures Documentation/Coding Operations 52

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. The history of necrotising enterocolitis The earliest documented cases resembling Necrotising enterocolitis (NEC) date back to the late 19th and early 20th centuries.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Dr. Smith's ECG Blog

APRIL 15, 2019

Here was his initial ED ECG: There is sinus tachycardia at a rate of about 140 There is profound ST Elevation across all precordial leads, as well as I and aVL. In this abstract from 2011, we found that 4%(4 of 99) type 2 MI and 38% of type 1 MI had ST Elevation. He presented very tachycardic with a very high fever.

EKG/ECG 40

EKG/ECG Sepsis Documentation/Coding Shock 40

EB Medicine

AUGUST 1, 2018

In fact, cannabis use has been documented for medical use dating as far back as 600 BC in West and Central Asia. Jeff: And the etiology of CHS is not well understood. Nachi: There is a well-studied theory here and it relates to the TRPV1 receptor that we talked about earlier.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 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

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

Don't Forget the Bubbles

JUNE 5, 2023

These are the preferable contraceptive choice, so this point appears to have been well communicated in the video. Babies born between March-May 2020 were compared with a historic baseline” cohort of babies (1 629 babies ) born between 2008-2011. This study also demonstrated the usefulness of social media as a research platform.

Outcomes 124

Outcomes Research Wellness Documentation/Coding 124

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.” Accessed July 28, 2014 **Quoting original documents of fascinating history.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

EB Medicine

JANUARY 2, 2019

For a completed abortion, you would expect a closed OS with no IUP on ultrasound with a previously documented IUP. Per a 2010 and 2011 Cochrane review, there is not evidence to recommend one antibiotic over another, so let your local antibiograms guide your treatment. Patients may or may not note the passage of products of conception.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

Pediatric EM Morsels

OCTOBER 6, 2023

(Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective.

Pediatrics 164

Pediatrics CDC Seizures Documentation/Coding 164

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Expiratory airway obstruction may well have been frequently misdiagnosed as it can produce breath-stacking and ball-valve obstruction that impedes any airflow with mask ventilation if neither a nasal nor an oral airway is used and the lips have closed under the mask. Lubricate well. June 6, 2011. Gerkin] Priceless. Rogue Medic.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Mind The Bleep

SEPTEMBER 17, 2024

Document clearly: The location of all wounds Medical photography or drawn labelled diagrams can aid in explaining the exact location. Always consider an ATLS approach to the assessment. Feel for any swelling/collection/abscess. Move: Assess the range of motion of the surrounding joints to help determine the involvement of adjacent structures.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52