Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." 2016, April 13). He was intubated for altered mental status.

EKG/ECG 109

EKG/ECG Wellness Fractures Hospitals 109

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Barr 2016 , Trevejo-Nunez 2015) Patients are at high risk of bleeding from the GI tract due to clotting factor impairment or devastating hemorrhage from esophageal varices in the setting of portal hypertension.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Taming the SRU

NOVEMBER 27, 2023

These patients may be discharged with close outpatient follow-up, and should be instructed to return to the Emergency Department if they develop worsening and/or spreading pain and swelling, as this may be indicative of an infectious process. Tintinalli’s emergency medicine: A comprehensive study guide (Ninth edition.).

Soft Tissue Injuries 92

Soft Tissue Injuries Emergency Department EMS Fractures 92

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. The patient is agitated on a backboard with C-collar in place. Ther Adv Drug Saf. Nov 26; 10.

Administration 78

Administration Fractures Anaphylaxis Head Injuries 78

EM Guide Wire

MAY 19, 2019

Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e New York, NY: McGraw-Hill; 2016. 2016; 37(4): 146-158. Delayed Identification of Pediatric Abuse-Related Fractures. Journal of Emergency Nursing. 2016; 42(2): 128-138. link] Accessed May 15, 2019. Christian CW. PEDIATRICS. PEDIATRICS.

Pediatrics 40

Pediatrics Soft Tissue Injuries Fractures Emergency Nursing 40

Taming the SRU

JANUARY 29, 2024

She was concerned that this was not improving and decided to come to the emergency department (ED). Notable Diagnostics CBC : unremarkable, BMP : unremarkable X-ray imaging of the left hand, wrist, and forearm: chronic degenerative changes without acute fracture or bony abnormality. 2016 Feb;50(2):98-101. Ann Plast Surg.

Emergency Department 91

Emergency Department Fractures Hospitals Operations 91

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e. McGraw Hill; 2016. His ECG was unremarkable.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Taming the SRU

OCTOBER 1, 2023

This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. Institutional resources and specialty services may further dictate the management of PTX.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

Act V, scene I [Text from Folger Shakespeare Library] [Audio recording of Dramatic Reading; Chapter Vox] [Video recording of Act V, scene1] Most deaths that are brought to, or occur in, an emergency department will require, at least, discussion with the local Coroner or Medical Examiner. Accessed 07/30/2016. Accessed 07/30/2016.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Taming the SRU

JANUARY 1, 2024

Contraindications to placing an IO include a prior attempt at the same site, known orthopedic fracture or local hardware, overlying skin infection, and structural bone disease such as osteogenesis imperfecta (6). Ann Emerg Med. Intraosseous vascular access in adults using the EZ-IO in an emergency department. J Emerg Med.

Emergency Department 90

Emergency Department Ultrasounds Administration Burns 90

The Skeptics' Guide to EM

JULY 2, 2017

Case: A 22-year-old patient presents to the emergency department with sudden onset shortness of breath. She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago. Kirsty is also the creator of a knowledge translation project called #PaperinaPic.

Fractures 40

Fractures Outcomes Emergency Department Ultrasounds 40

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Emerg Med J. Paediatr Int Child Health. 2024 Jan 11:1-7.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently. 2 Vertical shear fractures are also unstable.

Fractures 54

Fractures Resuscitation Operations EMS 54

Pediatric Emergency Playbook

JANUARY 1, 2017

NON-PHARMACOLOGIC TREATMENT The first line of treatment in all pain management is non-pharmacopeia ( Horeczko 2016 ). Some are simple comfort measures such as splinting (fracture or sprain), applying cold (acute soft tissue injury) or heat (non-traumatic, non-specific pain), or other targeted non-pharmacology. Acad Emerg Med.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance. 2016 Aug;25(1):29-39.

Seizures 85

Seizures Stroke Outcomes EMS 85

The Skeptics' Guide to EM

NOVEMBER 2, 2019

Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? Annals of EM 2019 Guest Skeptic: Martha Roberts is a critical and emergency care, triple certified nurse practitioner, currently living and working in western Massachusetts. A Randomized Controlled Trial.

Fractures 40

Fractures EMS Outcomes Emergency Department 40

Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. None of the physicians in the study believe that the rate of violence has decreased at all.

EKG/ECG 91

EKG/ECG Shock Fractures Emergency Department 91

Don't Forget the Bubbles

JULY 17, 2023

Original clinical studies Distribution and pattern of hand fractures in children and adolescents. 2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Don't Forget the Bubbles

JULY 22, 2024

The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. 2016 Aug;51(8):868–76. Annals of Emergency Medicine. 2016 May;67(5):593-601.e3. Pediatr Pulmonol.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

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. 2016 Dec;115(6):317-21. Evaluation of fever in the emergency department. ng/mL, 0.25-0.5

Infectious Diseases 86

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 86

RebelEM

MAY 22, 2023

However, its use remained limited in emergency medicine due to exorbitant costs and stringent prescribing restrictions. A turning point occurred in 2016 when a generic formulation of IV acetaminophen became available, significantly reducing costs and potentially facilitating broader utilization in routine practice.

Administration 91

Administration Emergency Department Dislocations Hospitals 91

EB Medicine

JUNE 6, 2019

Jeff: Abdominal pain is the one of most frequent complaint in US emergency departments, representing 8% of all adult ED visits, with admission rates for all patients with abdominal pain ranging between 18-42% and reaching as high as 60% for the elderly. Emerg Med Clin North Am. Talk to you next month! Abdom Imaging. Review) 83.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

MAY 29, 2023

Louis); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 54-year-old female with a past medical history of rheumatoid arthritis presents to the emergency department (ED) with generalized fatigue. 2016 Dec;115(6):317-21. Identifying serious causes of back pain: cancer, infection, fracture.

Infectious Diseases 53

Infectious Diseases Emergency Department EMS Hospitals 53

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. in 2016, is a more succinct evaluation for LVO that has been shown to be as sensitive and more specific than the NIHSS. 1 One study found that CTA head and neck was ordered for 2.5%

Stroke 87

Stroke Radiology Radiology Emergency Department 87