Dr. Smith's ECG Blog

MAY 20, 2024

Annals of Emergency Medicine 2011; Suppl 58(4): S211. So the patient was admitted to the hospital with no plan for an angiogram. The Queen of Hearts now sees no OMI with low confidence: The patient did not receive an angiogram on day two of his hospitalization because the cath lab was too busy. Murakami MM. Smith: What???!!!

EKG/ECG 124

EKG/ECG Hospitals Wellness Emergency Department 124

Don't Forget the Bubbles

SEPTEMBER 30, 2024

examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent. A 2011-2012 Australian study by Blake et al. Nearly 1 in 5 returned within seven days, and around 8% required hospital admission.

Emergency Department 89

Emergency Department Research Pediatrics Hospitals 89

ALiEM

JANUARY 22, 2024

The patient during his hospital stay developed ARDS and was on mechanical ventilation for 20 days. 2011 Oct 18;183(15):E1152. Epub 2011 Sep 12. Fever was documented to be 102°F and was not associated with any chills or rigors. He was then extubated and discharged after 27 days. Curr Infect Dis Rep. 2009 Jan;11(1):66-72.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. 2011; 106 : 732–737. [iv] Those who are shocked, shut down with limited or no other options for peripheral access require central access. The Lancet. iv] Breschan C, Graf G, Jost R et al.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. Epub 2011 Dec 2. Endophthalmitis following open-globe injuries. Eye (Lond).

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

The Skeptics' Guide to EM

JANUARY 20, 2024

Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences. JAMA Pediatr. JAMA Pediatr.

Pediatrics 75

Pediatrics Anaphylaxis Emergency Department Outcomes 75

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. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.

Administration 81

Administration Fractures Anaphylaxis Head Injuries 81

PulmCCM

JANUARY 23, 2025

Of course, they also have limitations you won’t likely learn from the marketers and hospital administrators eager to implement the latest advancements. Septicyte was cleared by FDA in 2021 for use in hospitalized patients with suspected sepsis. organ dysfunction plus suspected infection with or without evidence).

Sepsis 45

Sepsis Wellness Emergency Department Research 45

ALiEM

OCTOBER 30, 2024

Clinical impact: Rather than arguing with the patient about the likelihood of this phenomenon occurring and whether this is a true allergy, the patient is informed that they do not need to immediately start treatment to receive care in the hospital. 2011 Dec;6:1-4. Annals of Clinical and Laboratory Science. 2023 Jan 1;53(1):140-2.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

The Skeptics' Guide to EM

APRIL 28, 2018

He has been generally unwell for around one week, with a worsening cough, shortness of breath […] The post SGEM#216: Pump It Up – Corticosteroids for Patients with Pneumonia Admitted to Hospital first appeared on The Skeptics Guide to Emergency Medicine. This is an update from their previous review on the topic published in 2011.

Hospitals 40

Hospitals Emergency Department Outcomes Shock 40

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. Speaking up for patient safety by hospital-based health care professionals: a literature review. Internet] 2011:41(1):41-47. Available at: [link] Palanski ME.

Leadership 98

Leadership Patient Safety Academics Research 98

PHEM Cast

APRIL 16, 2018

Critical Care; 2011. Effect of adrenaline on survival in out of hospital cardiac arrest: randomised double-blind placebo controlled trial. 2011; 82: 1138-43. Epidemiology and aetiology of TCA in England… Resuscitation; 110 (2017): 90-94. Russell RJ et al. Phil Trans R Soc. Doi: 1098/rstb.2010.0232 2010.0232 Wise et al.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

EMDocs

AUGUST 22, 2024

3,4 Notably, institutions receiving federal funding (such as hospitals receiving Medicare reimbursement) must abide by Title VI of the 1964 Civil Rights Act, which entitles persons with NELP to language assistance. Improving patient safety systems for patients with limited English proficiency: a guide for hospitals. February 2011.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

Don't Forget the Bubbles

OCTOBER 18, 2024

Clinical practice guidelines Midline Catheters, Dr Liz Prentice, Anaesthetic Department, The Royal Children’s Hospital, Melbourne, September 2011 The post Midline Catheters in Paediatrics – The Long and Short of it. JAMA Pediatr. 2023 Nov 1;177(11):1132-1140. doi: 10.1001/jamapediatrics.2023.3526. PMID: 37695594; PMCID: PMC10495929.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

Pediatric Emergency Playbook

OCTOBER 1, 2017

2011; 7:491-500. Journal of Chemical Neuroanatomy; 2011; 42: 288–296. Predictors of In-Hospital Mortality in Children After Long-Term Ventricular Assist Device Insertion. 2011; 58(11):1183–90 Fraser CD, Jaquiss RDB, Rosenthal DN et al. References Vagus Nerve Stimulators (VNS) Elliott RE, Rodgers SD, Bassani L et al.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Mind The Bleep

FEBRUARY 27, 2024

This is hospital dependent and you should be told about which fluid to prescribe at your induction (or I’m sure the nurses will tell you!) 3] The type of IV fluid you use will vary depending on which hospital you are working in and what is available. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. How much fluid?

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Ken Grauer, MD

JULY 22, 2023

The C ASE C ontinues : En route to the hospital — another tracing was done 2 minutes after ECG #1. C ASE C onclusion : On their way to the hospital, the EMS crew requested cath lab activation — because they recognized the above "dynamic" ST-T wave changes. What is an " N -Wave" ?

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

ALiEM

AUGUST 28, 2023

2011 Dec;145(6):935-9. Epub 2011 Jul 13. Author information Rachel Sealby, DO Resident Physician Department of Emergency Medicine HCA Florida Orange Park Hospital | The post SAEM Clinical Images Series: There’s a Stone Under My Tongue appeared first on ALiEM. References Huoh KC, Eisele DW. Otolaryngol Head Neck Surg.

Dehydration 52

Dehydration Emergency Department Academics Hospitals 52

EB Medicine

OCTOBER 1, 2017

With respect to the ED – in 2011, there were more than 1.7 million ED visits for COPD - related problems, with nearly 1/5th requiring hospitalization. It was peer review ed by Dr. Gabriel Wardi of the University of California San Diego and Dr. Geralda Xavier of Kings County Hospital in New York City.

COPD 40

COPD Hospitals 40

PHEM Cast

FEBRUARY 7, 2022

2011; 364: 189-190. Frostbite: a practical approach to hospital management. The value of technetium 99 scintigraphy in the prognosis of amputation in severe frostbite injuries of the extremities: A retrospective study of 92 severe frostbite injuries. The Journal of Hand Surgery. 2000; 25(5): 969-978. Cauchy et al. Cauchy et al.

Hospitals 52

Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. The classic paper on ACLS drugs is called OPALS (Ontario Pre-hospital Advanced Life Support) study and was done by Dr. Ian Stiell and team.

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. Background: The AHA has five steps in the Chain-of-Survival for out-of-hospital cardiac arrest (OHCA). published in Resuscitation 2011. Reference: Perkins et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

JANUARY 9, 2021

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Sepsis Hospitals 52

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children. However, there has been continued debate on what ‘normal’ is in relation to HR and RR. What is the problem?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Ken Grauer, MD

MARCH 23, 2023

The 12-lead ECG and long lead II rhythm strip shown in Figure-1 — was obtained from a previously healthy, elderly woman who collapsed in the hospital parking lot. A series of cardiac arrhythmias were seen during the course of her resuscitation — including the interesting arrhythmia shown in the long lead II of Figure-1.

EKG/ECG 195

EKG/ECG Resuscitation Hospitals 195

Taming the SRU

SEPTEMBER 25, 2023

Case You are working solo coverage in a community hospital during a busy evening shift in the ED. 2011 Jan-Feb;50(1):62-7. It is key to identify this fracture when patients present to the Emergency Department with ankle injuries to ensure definitive management and prevention of complications down the line. J Foot Ankle Surg.

Fractures 102

Fractures Operations Emergency Department EMS 102

PHEM Cast

APRIL 21, 2021

2011 Dec;82(12):1519-24. Epub 2011 Jul 2. The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. Breckwoldt J, Klemstein S, Brunne B, Schnitzer L, Mochmann HC, Arntz HR. Resuscitation. doi: 10.1016/j.resuscitation.2011.06.028. 2011.06.028.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

ACEP Now

AUGUST 1, 2023

Our Indiana ACEP colleagues have helped us all as emergency physicians in championing the passage of state legislation mandating a physician leading a hospital’s emergency department to be physically present in that hospital.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Pediatric Emergency Playbook

AUGUST 1, 2017

2011; 364(3):255-264. 2011; 29:1136-1140.:205-211. Management of the child after enema-reduced intussusception: hospital or home? 2011; 523-527. 2011; 24: 552-561. 2011; 146(6):660-665. Acute Intestinal Obstruction in children: Experience in a Tertiary Care Hospital. Necrotizing Enterocolitis.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Dr. Smith's ECG Blog

JULY 14, 2023

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

Resuscitation 98

Resuscitation EKG/ECG CPR Outcomes 98

EMDocs

JANUARY 29, 2024

Blood Pressure Variability Predicts Poor In-Hospital Outcome in Spontaneous Intracerebral Hemorrhage. 2011 Sep;15(2):211-40. American Heart Association/American Stroke Association. 2022 Jul;53(7):e282-e361. doi: 10.1161/STR.0000000000000407. 0000000000000407. Epub 2022 May 17. PMID: 35579034. Divani AA, et al. 2019 Aug;50(8):2023-2029.

Stroke 98

Stroke Outcomes EMS Seizures 98

Pediatric Emergency Playbook

MARCH 1, 2017

An update on out-of-hospital airway management practices in the United States. 2011 Oct;41(4):369-73. 2011 Dec;66 Suppl 2:45-56. Carlson JN, Mayrose J, Wang HE. How much force is required to dislodge an alternate airway? Prehosp Emerg Care. 2010 Jan-Mar;14(1):31-5. Diggs LA, Yusuf JE, De Leo G. Resuscitation. Ehrlich PF et al.

Airway Management 52

Airway Management Pediatrics Resuscitation Hospitals 52

EMDocs

OCTOBER 21, 2023

In hospital mortality estimated at 30-40%. 17 65-78% of survivors have significant disability one month after hospital discharge. 2011, 10:1002-1014. 20 Prognosis: Despite advances in imaging and treatment options, BAO is associated with high morbidity and mortality. Mortality in absence of reperfusion reach as high as 83-96%.

EMS 97

EMS Stroke Outcomes Hospitals 97

Don't Forget the Bubbles

JUNE 17, 2024

Creating a culture of safety and respect through professional accountability: case study of the Ethos program across eight Australian hospitals. 2011 Apr 1;78(2):202-9. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J. Australian Health Review. 2022 May 12;46(3):319-24. Edmondson, Amy C.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

ACEP Now

NOVEMBER 13, 2023

FIGURE 1: Number of nonfatal workplace violence injuries and illnesses with days away from work, 2011-18. A study done at the University of Kansas found that approximately 10 percent of the ED volume at a local county hospital was attributed to some type of behavioral emergency and that approximately one in eight ED visits in the U.S

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

RebelEM

SEPTEMBER 11, 2023

2011 Mar;18(3):227-35. References: Ross M, Brown M, McLaughlin K, Atkinson P, Thompson J, Powelson S, Clark S, Lang E. Emergency physician-performed ultrasound to diagnose cholelithiasis: a systematic review. Acad Emerg Med. PMID: 21401784. Hilsden R, Mitrou N, Hawel J, Leeper R, Thompson D, Myslik F.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68