Dr. Smith's ECG Blog

OCTOBER 20, 2013

Because the patient had asystole, was resuscitated without difficulty, and had no neurologic function, suspected a cerebral hemorrhage was suspected as the etiology of the arrest, specifically subarachnoid hemorrhage. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Emergency Department 52

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. Published 2013 Aug 15. Which one do you select? 2013;9(1):30.

Basic Life Support 108

Basic Life Support CPR Fractures Emergency Department 108

Northwestern EM Blog

APRIL 15, 2024

While most of the immediate complications of tracheostomy will occur in the ICU, these patients still frequent our emergency department with and without tracheostomy related emergencies. As with any high stress situation in resuscitation, it helps to fall back onto our ABCs, airway being of principle importance here.

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Resuscitative Thoracotomy in Children In a 40-year review of ED thoracotomy, Moore et al. REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. 2013 Sep;184(1):352-7. J Pediatr Surg.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

PHEM Cast

JANUARY 4, 2017

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. 2013; 22: 468-477. Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. BMJ Quality & Safety.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

PHEM Cast

APRIL 10, 2016

It is worth noting, that with “Sepsis 3” many of these terms will become out-of-date – but validation work is required… The Rivers’ paper can be accessed here: [link] It was a single centre study which compared standard care with protocolised resuscitation packaged together as early goal-directed therapy (EGDT).

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. This does not deviate from general resuscitation principles for acute hemorrhage. Cohen, AT et al.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. 2013 Apr 1;131(4):e1150–7. Acad Emerg Med. Emerg Med J.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

EMDocs

SEPTEMBER 25, 2023

Incidence and factors associated with cardiac arrest complicating emergency airway management. Resuscitation 2013; 84(11): 1500 – 4. actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department. Int J Emerg Med. J Emerg Med.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Audrey’s academic interests include trauma and resuscitation. Outside of medicine, Audrey likes […] The post SGEM#301: You Can’t Stop GI Bleeds with TXA first appeared on The Skeptics Guide to Emergency Medicine. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Stroke 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. I’m Jeff Nusbaum and I’m back with Nachi Gupta for the 30 th episode of EMplify and the first Post-Ponte Vedra Episode of 2019.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 90

CPR Burns Airway Management Wellness 90

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Feng, MD Management of Cord Prolapse & Shoulder Dystocia [ppt] Eliza Rivera-Mitu, RN, MSN Cord Prolapse - Perinatal Services British Columbia [pdf] Umbilical cord prolapse A plan for an ob emergency By Sharon T. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S. Nickson, C.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

ACEP Now

OCTOBER 30, 2023

These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios. ESEM hosted the second Global Network Collaborative Conference on Emergency Medicine in 2013 and organized its first large scientific conference in Dubai in December 2014.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. 2013 Jul;44(7):1846-51. Epub 2013 May 23. ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. doi: 10.1161/STROKEAHA.113.001212.

Stroke 99

Stroke Outcomes EMS Seizures 99

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. 2013; 95(6): 474-477.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EB Medicine

AUGUST 6, 2019

Jeff: For all agents, regardless of the DOAC, the initial resuscitation follows the standard principles of hemorrhage control and trauma resuscitation. It may be given as a part of of a balanced massive transfusion resuscitation, but otherwise, at this time, there doesn’t seem to be a clear role. should all be used as needed.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

PHEM Cast

APRIL 21, 2021

Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Pediatric Emergency Playbook

APRIL 1, 2016

used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history. Cardiology in the Young; 2013. 2013; 88(10): 1127–1140. 2013; 29:715-719. for the Pediatric Emergency Care Applied Research Network.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. External Validity: It is unclear if this data applies to patient you see in your emergency department. Goal-directed resuscitation for patients with early septic shock. link] Published June 30, 2013. EBM Commentary 1.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is not possible during acute resuscitation or at any time before a complete investigation, or even trial, to know who is innocent, guilty, or what occurred during the altercation. Ballistic injuries in the emergency department. Emergency medicine practice, 13(12), 1-30. Khoshdel, A. Modaghegh, M. Gustafson, C.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. and I sent him the above ST vector explanation.

EKG/ECG 52

EKG/ECG Shock Emergency Department Wellness 52

Pediatric Emergency Playbook

JUNE 1, 2016

Pulmonary embolism in the pediatric emergency department. 2013 Oct;132(4):663-7. 2013; 41:580-637. 2013; 17:R246. Pediatrics. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. Jaff MR et al.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Northwestern EM Blog

SEPTEMBER 12, 2022

These patients are expected to decompensate within the hour but did not need immediate resuscitation [2]. Expert Commentary This is a great review of MCI management in the Emergency Department by Drs. Am J Emerg Med. Epub 2013 Mar 6. These patients are likely to need the vast majority of resources and staff.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

This finding does not alter the need to pursue emergent reperfusion, although it might suggest a poorer prognosis.”[3] New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Knotts RJ, Wilson JM, Kim E, Huang HD, Birnbaum Y.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EMDocs

FEBRUARY 12, 2024

Trauma surgeons have traditionally relied on ABGs to assess acid-base status for overall prognostication of trauma injury severity and to screen for occult injury or malperfusion, as this might alter management and aggressive resuscitation. Int J Emerg Med. Eur J Emerg Med. 2023 Mar 10;16(1):18. doi: 10.1186/s12245-023-00486-0.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

Pediatric Emergency Playbook

APRIL 1, 2017

34 “The mother, or other trusted adult, places her mouth over the child’s open mouth, forming a firm seal as if about to perform mouth-to-mouth resuscitation. Am J Emerg Med. Emergency department management of foreign bodies of the external ear canal in children. Pediatrics. 2013;132(2):275-281. doi:10.1542/peds.2013-0260.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope. 2013 Sep;26(9):965-1012.e15.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

Taming the SRU

MARCH 11, 2024

Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). He works in both the emergency department as well as the sports medicine clinic.

Dislocations 108

Dislocations Emergency Department Fractures Operations 108

RebelEM

MAY 15, 2024

Pathogens ( Gudiol 2013 ) : The pathogens responsible for neutropenic fever have changed over time. Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. Ann Emerg Med. Support Care Cancer.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Don't Forget the Bubbles

DECEMBER 5, 2023

A 2013 study found that half of young Australians are dissatisfied with school-based sex education. Data was collected at 2 emergency departments in America and included assessment by both clinicians and patients for a total of 31 patients. Wounds are a common presentation to both adult and paediatric emergency departments.

Resuscitation 111

Resuscitation Outcomes CPR Emergency Department 111

Pediatric Emergency Playbook

JANUARY 1, 2017

The FPS-R uses more neutral and realistic faces and, unlike the Wong Baker scale, does not use smiling or crying faces to anchor the extremes of pain ( Tsze 2013 ). Ibuprofen may be more effective than acetaminophen (paracetamol) for odontogenic pain ( Bailey 2013 ). Author’s advice: take codeine off your formulary.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JUNE 27, 2024

Critical Care Medicine 41(12):p A191, December 2013. 2013 Jan-Mar;16(1):91-5. Epub 2013 Aug 7. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 0.4

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

EMDocs

JUNE 7, 2023

Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Parenteral organophosphorus poisoning in a rural emergency department: a case report. 2013; 6:524. Published 2013 Dec 9. Clin Toxicol (Phila) 51: 838, 2013. BMC Res Notes.

Poisoning 98

Poisoning Airway Management Seizures PPE 98

EM Literature of Note

OCTOBER 14, 2024

“Lactated Ringer vs Normal Saline Solution During Sickle Cell Vaso-Occlusive Episodes” A “target trial emulation” providing observational evidence supporting the superiority of lactated ringers solution over normal saline for the resuscitation of patients being admitted with sickle cell crises.

Stroke 89

Stroke Emergency Department Resuscitation Best Practices 89

RebelEM

DECEMBER 23, 2024

saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). PMID: 39250114 Clinical Question: In adult patients admitted for a vaso-occlusive episode, does early fluid resuscitation with Lactated Ringer solution compared to 0.9%

Fluid Resuscitation 129

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 129