Dr. Smith's ECG Blog

AUGUST 4, 2024

Context: a man in his 40s presented to the emergency department with 1 day of sudden onset chest pain. A DDENDUM ( 8/3/2024 ) : In the following 5 Figures — I post written summary from my ECG-2014-ePub on the ECG diagnosis of A cute P ericarditis. I sent this to our group without information and Dr. Smith responded: "Not OMI.

EKG/ECG 117

EKG/ECG Wellness Operations Emergency Department 117

EMDocs

DECEMBER 2, 2023

2014 May;7(2):103-4. He has no known medical history and has never been to the doctor. The left eye is deviated inferiorly and laterally during frontward gaze. Rosh Review Website Link FOAM Reading [link] [link] [link] References: Diyora B, Kukreja S, Nayak N, Kamble H, Sharma A. Oman J Ophthalmol. doi: 10.4103/0974-620X.137177. Kelliny, M.,

EMS 93

EMS Operations Pediatrics Emergency Department 93

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. Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

MARCH 25, 2024

2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. Decreasing length of stay with emergency ultrasound examination of the gallbladder. Acad Emerg Med. Ma and Mateer’s Emergency Ultrasound, 3e. New York, NY: The McGraw-Hill Companies; 2014. 1999;6:1020-1023.

Ultrasounds 98

Ultrasounds Radiology Radiology Operations 98

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Prerost 2014) In a patient with chronic alcohol use, hallucinations should prompt consideration of acute intoxication, alcoholic hallucinosis, or delirium tremens (DT). Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). 2014 Jun 26;23(12):653-9. Exposure to incivility hinders clinical performance in a simulated operative crisis. 2015 May;30:656-74.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

The Skeptics' Guide to EM

NOVEMBER 20, 2021

You wonder if any emergency department (ED)-based interventions would help her and people like her be safe. In 2014 the SGEM looked at a systematic review by Dr. There are three other GEAR 1.0 Background: We looked at geriatric falls on an SGEM Xtra in 2015. Reference: Hammouda et al.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. Evaluation of fever in the emergency department. ng/mL (strongly recommended against antibiotics), 0.1-0.25

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Northwestern EM Blog

MAY 16, 2022

1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2 Follow up CT should depend on the patient and ultrasound operator. In this study, 40.7%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Don't Forget the Bubbles

SEPTEMBER 23, 2023

Facilitator-in-chief’ is my role when leading the ED Musos virtual choir and orchestra, and this also applies to my job in the hospital as Director of the Emergency Department. I love emergency medicine because, as Dan Sandberg once said, it is ‘ the most interesting 15 minutes of every other speciality ’.

Leadership 136

Leadership Teamwork Hospitals Emergency Department 136

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

Ballistic injuries in the emergency department. Emergency medicine practice, 13(12), 1-30. Spinal Cord (2014) 52, 504–510; doi:10.1038/sc.2014.56; New CPRC Report: Errors in Bloomberg’s latest report on Mass Shootings October 2, 2014 Crime Prevention Research Center Lott, John R., Gustafson, C. de Barros Filho, T.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. 63M with an Erythematous Abdomen Limitations of POCUS As with all ultrasound applications, soft tissue POCUS is operator dependent. Pediatr Emerg Care.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Don't Forget the Bubbles

MAY 3, 2023

This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergency department (ED). Because of the retrospective nature of the study, the decision to use the bougie was operator-dependent. Rees et al.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

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. Pediatric emergency department thoracotomy: a large case series and systematic review. 2014 Apr;133(4):e1104-16. Pediatrics.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

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

Pediatric Emergency Playbook

APRIL 1, 2017

Neodymium magnet toys (“buckyballs”) were recalled in 2014 (but are still out there!) Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. Am J Emerg Med. Not all magnets are created equal. Am Fam Physician.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Don't Forget the Bubbles

NOVEMBER 1, 2023

This month, Bubble Wrap has teamed up with Sheffield Children’s Hospital Emergency Department to have a look at what’s new in paediatric literature. Lactate as a screening tool for critical illness in a pediatric emergency department. Pediatric Emergency Care. 2023 Oct 1;39(10):735-8. What’s it about?

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

EMDocs

OCTOBER 17, 2023

CT is the most useful examination for patients with suspected complications of colonic diverticulitis because of its reproducibility, superior diagnostic accuracy (98%)m accuracy for alternative diagnoses with a similar presentation, risk-stratification of patients for operative versus nonoperative treatment, and inpatient versus outpatient triage.

Radiology 94

Radiology Radiology Operations Best Practices 94

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. It can also able to be applied in multiple scenarios, not just the operating theatre, and it more accurately depicts real-world practice. Intubation of the Critically Unwell Child in the Emergency Department.

Airway Management 98

Airway Management Pediatrics Teamwork Emergency Department 98

EMDocs

DECEMBER 18, 2023

When analyzing the receiver operating characteristic (ROC) curve of the pooled data, optimal diagnostic accuracy of MDW for sepsis prediction was seen (pooled sensitivity of 0.838 and specificity of 0.704 for Sepsis-3 criteria). Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department. Intensive Care Med.

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

Pediatric Emergency Playbook

JANUARY 1, 2017

Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. CRIES ( Table 1 ) was validated for post-operative patients; to adapt its use for the ED, the most conservative approach is to substitute “preoperative baseline” with normal range for age.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Advanced Emergency Nursing from AENJ

MAY 27, 2015

An ambulance pulls up, in haste, to the Receiving door of the Emergency Department with a last squeal of the siren. Los Angeles Times, March 5, 2014. 5 June 2014) Terrorist attacks on hospitals 1982-2013 (June). Department of Homeland Security. Emergency Preparedness. Emergency Preparedness.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

It wrongly frightened some medical personnel as it was operated by a 50 psi wall source or from a step-down regulator from a tank (some thought the patient received wall 50 psi or 1500 psig from the tank directly to the lung. Accessed July 28, 2014 **Quoting original documents of fascinating history. Grainge, C. Weingart, S.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. American College of Emergency Physicians (ACEP) gave a level C recommendation that either LP or CTA could be used to rule out SAH after a negative NCCT. vs. 38.1%) with a good functional outcome.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

EMDocs

NOVEMBER 4, 2024

The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine. J Emerg Med. Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial. Acad Emerg Med.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Taming the SRU

MAY 22, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g., Most frequent reasons for emergency department visits, 2018. 2014 May;4(3):432-5. RICE), and symptomatic management (e.g.,

Fractures 77

Fractures Dislocations Operations Radiology 77

Taming the SRU

MAY 23, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge Counsel on expected course of injury, supportive care (e.g., Foot injuries in the emergency department. 2014 May;4(3):432-5. 2014 May;4(3):432-5. RICE), and symptomatic management (e.g.,

Fractures 57

Fractures Dislocations Operations EMS 57

RebelEM

DECEMBER 18, 2024

The “syringe” technique: a hands-free approach for the reduction of acute nontraumatictemporomandibulardislocations in the emergency department. J Emerg Med. 2014; 47(6):676-81. Rosens Emergency Medicine: Concepts and Clinical Practice, 7 ed. Philadelphia: Elsevier Saunders, 2014. Riviello RJ.

Dislocations 52

Dislocations Fractures Operations EMS 52

EMDocs

JANUARY 16, 2025

Emerg Med J. 2014 Oct;31(e1):e19-24. but PPV ranges from 25.1-39.5% years Internal validation cohort: 43,400 patients with mean age 3.7 years External validation cohort: 45,855 patients with mean age 2.6 0.38 (95% CI 0.20-0.39) 0.39) AUROC of 0.71-0.92 0.92 (95% CI 0.70-0.92) and PPV of 5.3-7.1% and PPV of 22.2% but PPV ranges from 25.1-39.5%

Sepsis 95

Sepsis Pediatrics Shock Hospitals 95

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

Acute hyperkalemia in the emergency department: a summary from a Kidney Disease: Improving Global Outcomes conference. Eur J Emerg Med 2020. The vicious cycle of "BRASH" Syndrome is operative. Early Repolarizaton vs. Hyperkalemia Recognize subtle findings of hyperK and, if present, treat with Calcium immediately!

EKG/ECG 118

EKG/ECG Shock Operations Emergency Department 118

Don't Forget the Bubbles

JULY 5, 2023

Afro-Caribbean patients should be screened for sickle cell before anaesthesia for possible pre-operative transfusion. A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. 2014; 349–356. What could be the differential diagnosis? Macharia AW et al.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Dr. Smith's ECG Blog

DECEMBER 16, 2024

male who hasn't doctored in several years presented to the emergency department by ambulance for chief complaint of chest pain. The accuracy of bedside Echo is clearly a function of operator skill and experience and at times it may be difficult to exclude the possibility of WMA ( W all M otion A bnormality ) from bedside Echo alone.

Ultrasounds 105

Ultrasounds EKG/ECG Operations Emergency Department 105

Taming the SRU

MARCH 3, 2025

Because of this, emergency department (ED) physicians need to maintain a high index of suspicion for inhalation injury in the case of any exposure to smoke or fire, especially in closed or small space exposures. It is also critical to be prepared for a surgical approach in the event of a cant intubate, cant ventilate scenario (9).

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Look for scars indicating previous central lines, peritoneal dialysis catheters or operations.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. This article aims to help guide you through managing these patients and what factors you might want to consider. Regular medications. Lewis, K., & Pay, J. Wound Irrigation. In StatPearls. StatPearls Publishing. Rowley, Stephen & Clare, Simon.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52