Ken Grauer, MD

JULY 29, 2023

This young woman did well for a year — but unfortunately suffered another cardiac arrest, from which she could not be resuscitated. Insight into this question is provided by 2 Hoffmayer et al manuscripts ( JACC 58(8):831-838, 2011 — and — Front Physiol 3:23, 2012 ). MRI confirmed ARVC. About A RVC/ A RVD.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

Pediatric EM Morsels

APRIL 28, 2023

Has undergone many modifications as well to include up to 5 types. The Athlete is at risk of both Osgood Schlatter’s disease as well as Tibial Tubercle Avulsion Fracture. J Child Orthop 5, 465–470 (2011). J Child Orthop 5, 465–470 (2011). Anterior knee pain is not always Osgood Schlatter’s. JBJS reviews 8.4

Fractures 130

Fractures Pediatrics Operations Wellness 130

Pediatric EM Morsels

JULY 21, 2023

2011 Apr;48(4):331-2. Orso 2020] One pediatric study in this systematic review, and the intubated patients had worse outcome than non-intubated Early airway protection = lower rates of complications (in TRAUMA), but this is not always true with medical patients. PMID: 33303004; PMCID: PMC7726605. Raman S, Sreenivas V, Puliyel JM, Kumar N.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

ACEP Now

MARCH 11, 2025

2-4 A study in Annals of Emergency Medicine of almost 300,000 patients hospitalized with acute PE between 2011-2020 found that the use of UFH increased from 41.9 The pervasive maxim quick on, quick off for UFH doesnt hold up as well as touted. percent to 56.3 percent despite guideline recommendations. 6 The question is: Why?

Hospitals 52

Hospitals Administration Outcomes Stroke 52

Northwestern EM Blog

FEBRUARY 4, 2025

Treating Kratom toxicity varies based upon the clinical presentation as well as severity of symptoms. Over 1100 cases of Kratom only exposure were reported to the National Poison Control Center from 2011-2017. Just over half of these cases required medical intervention.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

Ken Grauer, MD

SEPTEMBER 6, 2024

Alternatively — when a portion of the reentry circuit is made up of an AP ( A ccessory P athway ) — the retrograde P wave will typically manifest a moderately long RP' interval ( that occurs well after the QRS — usually within the latter part of the ST segment ). What is happening in today's case is different.

EKG/ECG 248

EKG/ECG Administration Operations Wellness 248

EMDocs

DECEMBER 6, 2024

5 Severe metabolic acidosis persists Multi-system organ failure The endpoints of deferoxamine are less well defined but it can be weaned off as the patient is clinically improving, the anion gap resolves, and down-trending serum iron concentration. Can titrate up to maximum of 40 mg/kg/hr, although hypotension may limit dose of deferoxamine.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

Ken Grauer, MD

MAY 12, 2023

ECG Blog #240 — Reviews the definition of what an "SVT" is — as well as illustrating the different types of reentry SVT rhythms ( with assessment of the RP' interval ). González-Torrecilla et al: Ann Noninvasive Electrocardiol 16(1):85-95, 2011 — Reviews distinction between AVNRT vs AVRT and other regular SVT rhythms in patients without WPW.

EKG/ECG 195

EKG/ECG Wellness 195

Sensible Medicine

AUGUST 19, 2024

NEJM published STITCH in 2011. I would have never guessed that medical therapy could perform so well against surgery in patients with such advanced heart disease. The teaching points extend beyond cardiology. Sensible Medicine is a reader-supported publication. To me, STITCH shows the value of medical evidence and RCTs.

Outcomes 110

Outcomes Ultrasounds Wellness 110

Dr. Smith's ECG Blog

MAY 20, 2024

Annals of Emergency Medicine 2011; Suppl 58(4): S211. It does appear more likely that his chest pain was GI in nature (possibly esophageal spasm and/or GERD) given his large meal preceding onset of chest pain, as well as CT findings consistent with large amount of ingested material in stomach.” Smith: What???!!!

EKG/ECG 126

EKG/ECG Hospitals Wellness Emergency Department 126

ALiEM

JANUARY 22, 2024

The patient also complained of shortness of breath for one week associated with a dry cough, as well as an altered sensorium for one day. 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.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. Its use in the prehospital environment is not well known or studied and may be an interesting area for future research. [i] 2011; 106 : 732–737. [iv] i] Leibowitz A, Oren-Grinberg A, Matyal R. The Lancet.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

ALiEM

OCTOBER 21, 2024

F; RR 22; O2 Sat 100% RA General : Alert, interactive, well-appearing HEENT : Left ear with moderate redness, swelling, warmth, and tenderness of the auricle sparing the lobule. 2011 Jan;13(1):21-4. The patient was on amoxicillin for strep throat, which was diagnosed a week before the onset of his symptoms and was improving.

Academics 67

Academics Wellness 67

Sensible Medicine

OCTOBER 10, 2024

The exact number is the subject of debate and not well studied. One article from 2011 approximates 86 cancers and 11 deaths per 100,000 women due to breast cancer screening. Thus, over decades of screening, radiation exposure may not be trivial, particularly in women with extremely dense breasts.

Hospitals 129

Hospitals Wellness 129

Ken Grauer, MD

JULY 22, 2023

Not only is this slight ST elevation missing from leads V2,V3 in ECG #1 — but the ST segment in these leads ( as well as in neighboring leads V1; and V4,V5 ) is distinctly flat! In 2011 — Niu et al described the presence of an "N-Wave" — or delayed activation wave of the left ventricular basal region. What is an " N -Wave" ?

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

EMDocs

FEBRUARY 7, 2024

Multiple well-designed, multicenter, multinational studies suggest GLP-1 agonists are associated with improved glucose control in diabetes type 2 and approximately a 15% reduction in weight over 1-2 years (around 2/3s of patients regain weight if treatment is stopped). 2011 Aug 02;108(3 Suppl):33B-41B. 2011;(203):53-74.

Allergic Reactions 98

Allergic Reactions Anaphylaxis Dehydration Wellness 98

PulmCCM

OCTOBER 14, 2024

How well does it work? Some of its initial results were presented at a 2011 conference but were never published in a journal. In this way albumin produces most of the vascular system’s oncotic pressure—the force tending to retain fluid in blood vessels without its leaking into the extravascular space.

Resuscitation 52

Resuscitation Shock Wellness 52

Don't Forget the Bubbles

JANUARY 24, 2024

The first human trials for children with SRSE were conducted in 2014 where 2 patients responded well to the treatment and there have been encouraging results in open label adult trials more recently. 2017 May 25;376(21):2011-2020. There are small scale case series of its use in FIRES with some success. N Engl J Med. PMID: 28538134.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

RebelEM

SEPTEMBER 23, 2024

However, it is well-established that even a single dose of etomidate can cause adrenal suppression ( Albert 2011 ). The drug has a number of reported advantages including rapid onset and a favorable hemodynamic profile (etomidate itself does not cause vasodilation or cardiac depression).

EMS 77

EMS Resuscitation Outcomes Wellness 77

American Medical Compliance

NOVEMBER 3, 2022

noted, “While the worst days of COVID-19 pandemic are hopefully behind us, there is an urgent need to attend to physicians who put everything into our nation’s response to COVID-19, too often at the expense of their own well-being.” Jack Resneck Jr. doctors was 62.8%. These numbers have increased from 38.2% in 2020, 43.9%

Telemedicine 52

Telemedicine Wellness 52

Don't Forget the Bubbles

JANUARY 29, 2024

He has a diagnosis of epilepsy and was on multiple anti-seizure medications as well as a ketogenic diet. 2017;376(21):2011‐20 Duda, J and Reinert, JP. Super-refractory status epilepticus is associated with high morbidity and mortality and poses significant management challenges. A 4-year-old boy is admitted to your PICU.

Seizures 122

Seizures Pediatrics Research Wellness 122

EMDocs

JANUARY 3, 2024

10 This procedure has well-described rare complications including infection, blood loss, allergic reaction, arrhythmia, pneumothorax if approaching via the internal jugular vein, embolization of the device, and pulmonary artery perforation or dissection. 2011 Feb 19;377(9766):658-66. 8 The device itself is 2 x 2.5 The Lancet.

Allergic Reactions 114

Allergic Reactions Hospitals EMS Emergency Department 114

The Skeptics' Guide to EM

JULY 17, 2021

His chest X-ray (CXR) confirms your findings, but he is well enough to be treated as an outpatient. This is because most pneumonias in this age-group are caused by viral pathogens ( Bradley et al 2011 ). Bradley et al 2011 ). There is also high-quality evidence that pre-school children do not routinely need antibiotics.

Pediatrics 52

Pediatrics Emergency Department Wellness 52

Emergency Medicine Ireland

OCTOBER 14, 2024

Similarly loculations can be very easily seen with ultrasound, better than CT it seems but again don’t necessarily correlate that well with empyema. Well, adding extra or bigger drains is all very reasonable and it would seem wise to involve a thoracic surgeon at some point. 365, 518–526 (2011). LDH>1000 Sugar <2.2

Wellness 52

Wellness Ultrasounds 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. However, that guidance needs to take into account the influence of emotion, environment, body temperature, as well as the underlying disease process, on vital signs, especially in younger infants.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

ALiEM

SEPTEMBER 13, 2024

On arrival to our emergency department, the patient expressed continued eye pain with bloody discharge as well as blurry vision from his right eye. Epub 2011 Dec 2. At the outside hospital, he was given analgesia, antiemetics, and a tetanus booster, and transferred to our hospital for ophthalmologic evaluation. Eye (Lond).

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

EMDocs

JANUARY 29, 2024

However, other sources suggest that the optimal blood pressure target is not well established and may vary depending on the individual patient’s characteristics and the type of hemorrhagic transformation [7]. 2011 Sep;15(2):211-40. This includes intraparenchymal hemorrhage and subarachnoid hemorrhage (SAH). N Engl J Med.

Stroke 101

Stroke Outcomes EMS Seizures 101

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. Emergency Medicine News 33(12):p 8,9, December 2011. | The patient states they were cutting an avocado when the knife pierced through and punctured his hand.

EMS 96

EMS Fractures Operations Ultrasounds 96

RebelEM

FEBRUARY 12, 2024

Research from our very own SIUH department of radiology recommended that contrast-enhanced CT scans can safely exclude obstructive urolithiasis just as well as noncontrast CTs. 2011; 18(7):699-707. When you are using CT imaging, a CT with IV contrast is preferred. Gottlieb RH, La TC, Erturk EN, et al. 2002; 225(2):441-449.

Radiology 77

Radiology Radiology Emergency Department Ultrasounds 77

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

I have discussed burnout and wellness a number […] The post SGEM Xtra: The Water is Wide first appeared on The Skeptics Guide to Emergency Medicine. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Shanafelt et al.

Emergency Department 52

Emergency Department Wellness 52

Mind The Bleep

FEBRUARY 27, 2024

1] It is worth mentioning this formula was designed for well, euvolaemic children, which does not represent the popluation of children who require IV fluids. The curve on this graph can be split into 3 linear sections corresponding to the following weight categories: 0-10kg, 10-20kg, and 20-70kg. [1]

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Rural Doctors Net

DECEMBER 7, 2013

He is way to humble to mention that he got the Antarctica Medal in 2011 for this work. By all reports the expeditioners are doing well , a credit to the expertise of the AAD. He is also a useful doctor – trained as both rural & remote doctor, plus GP-surgeon and GP-anaesthetist.

Wellness 52

Wellness 52

PHEM Cast

FEBRUARY 25, 2021

In the UK sea water is very unlikely to be icy or cold enough – however, small areas of water may well be, particularly in the winter months. Tipton & Golden (2011). References Szpilman D, Bierens JJ, Handley AJ, Orlowski JP (2012) Drowning. New Engl J Med. 366: 2102–10.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

ALiEM

OCTOBER 30, 2024

The Wounds Common among patients who use xylazine, the necrotic and exudative wounds are still not fully understood [5-8], but are likely due in part to direct cytotoxic effects of the drug and its impurities, as well as possible nutritional deficiencies common in those with dependence. 2011 Dec;6:1-4. 2023 Jan 1;53(1):140-2.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

Dr. Smith's ECG Blog

JULY 21, 2024

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 ). The patient was already intubated and sedated.

EKG/ECG 131

EKG/ECG Shock Hospitals Sepsis 131

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