Pediatric EM Morsels

JULY 21, 2023

2016 Aug;23(8):878-84. Epub 2016 Aug 1. Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Acad Emerg Med. doi: 10.1111/acem.13014. PMID: 27197686. Holmes, James F et al. 2005): 814–819.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. Geneva: World Health Organization; 2016. A previously healthy 23-year-old male with no medical or surgical history presents to the ED with generalized malaise and no energy, progressively getting worse over the last six weeks. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5

EMS 96

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 96

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 ). The October 31, 2016 post in Dr. Smith's ECG Blog.

EKG/ECG 248

EKG/ECG Administration Operations Wellness 248

Mind The Bleep

FEBRUARY 2, 2025

Here we assume you know the basics , and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Further reading For more information on potential biases, read Thinking Fast and Slow by Daniel Kahneman For more information on clinical decision making, see: Trimble M & Hamilton P (2016).

Dehydration 97

Dehydration Documentation/Coding Wellness 97

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. Epsilon waves are best seen in leads V1 , V2 — and a bit less well seen in V3,V4. MRI confirmed ARVC. About A RVC/ A RVD. ARVD is a genetic disorder of the myocardium.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

Pediatric EM Morsels

JULY 5, 2024

We collected data directly from the bedside clinician which enabled us to gather pertinent patient symptoms and physical examination findings that may not be well documented in the medical record, but more accurately identify the child’s injuries.” 2016; Published June 20, 2016. J Spinal Disord Tech. 2015;28(7). PMID: 26165728.

Pediatrics 164

Pediatrics Head Injuries Dislocations Research 164

Pediatric EM Morsels

APRIL 7, 2023

Observation, interaction with patient, as well as parent information is key to bring the whole picture together! Epub 2016 Oct 17. 2016 Dec 2;2016(1):625-631. J Stroke Cerebrovasc Dis. 2017 Jan;26(1):108-115. doi: 10.1016/j.jstrokecerebrovasdis.2016.08.038. 2016.08.038. PMID: 27765556. J Chronic Dis. 1985;38(6):495-505.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

EMDocs

DECEMBER 23, 2024

The most recent and well-known trial is the PROCAMIO trial (1). Well, the trial was a multicenter prospective open label trial. Well, lets look at some other trials. Epub 2016 Oct 15. Ok, so now that we know what each drug is used for and what the side effects are, which one is the right choice? J Emerg Med. 2016.09.010.

EKG/ECG 75

EKG/ECG Shock Wellness EMS 75

Mind The Bleep

AUGUST 12, 2024

As you transition from medical school to your first year as an FY1 doctor, it’s important to recognise the challenges you’ll face and prioritize your well-being. It’s vital to monitor your well-being and recognise when you might be experiencing burnout. Prioritise it, and you’ll be well-equipped to handle the challenges ahead.

Wellness 96

Wellness 96

Northwestern EM Blog

MARCH 1, 2025

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

EMDocs

NOVEMBER 19, 2024

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. 2016 Dec;54(10):899-923. 1,2,6 Neurologic effects: Sedation is a primary concern with overdose. Clin Toxicol (Phila).

Poisoning 111

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

The Trauma Pro

OCTOBER 4, 2024

years from 2013 to 2016. And unfortunately, I’m not able to guess the numbers well enough to do the power calculation for this study. Be sure to follow with your performance improvement program to make sure that they actually do work as well as you think! Did they have the statistical power to show such a difference?

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Sensible Medicine

NOVEMBER 28, 2023

Being perfectly honest, not all the articles have aged well. One of these was an article that Vinay Prasad and I wrote back in 2016: Wearables, Smartphones and Novel Anticoagulants: We Will Treat More Atrial Fibrillation, but Will Patients Be Better Off? I am actually embarrassed by a few of them and many are forgettable.

Stroke 96

Stroke Academics Outcomes Administration 96

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency […] The post SGEM Xtra: Right, You’re Bloody Well Right, You’ve got the Bloody Right to Care first appeared on The Skeptics Guide to Emergency Medicine. Reference: Dorsett et al.

Wellness 52

Wellness Emergency Department EMS 52

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. McGraw Hill; 2016. 10 Maximum daily dose of 6-8g total of defuroxamine. & Rangan, C.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

Sensible Medicine

MARCH 28, 2024

In 2016, Jonathan Reiner said this about Carrie Fisher’s mother, who died very shortly after her daughter. Just 3 examples: #1 #2 #3 Here is the problem: Adjuvant chemotherapy is a well described medical term, but preventive chemotherapy is a colloquialism.

Hospitals 110

Hospitals Outcomes Wellness 110

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged. 2016, April 13). RV: Cavity size normal. 1900: RBBB and LAFB are almost fully resolved. 2300: QRS now within normal limits. No other significant injuries were found. Zangouri, V.,

EKG/ECG 115

EKG/ECG Wellness Fractures Emergency Department 115

EMDocs

JANUARY 23, 2024

Published February 15, 2016. Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. J Emerg Med. 2020 Aug;59(2):216-223. doi: 10.1016/j.jemermed.2020.05.001. 2020.05.001. BRASH syndrome: Bradycardia, Renal failure, Av blocker, Shock, and Hyperkalemia.

Shock 115

Shock Dehydration Sepsis EKG/ECG 115

Sensible Medicine

NOVEMBER 14, 2023

He also co-led the team whose work led the CDC to issue a major clarification of its 2016 opioid prescribing guideline and is currently a principal investigator of the only national study to examine individual suicides that occur after the reduction of prescribed opioids. . Criticism of these programs is both well-deserved and unfair.

Research 132

Research Psychiatric CDC Best Practices 132

EMDocs

JULY 9, 2024

2016 Nov 7;170(11):e162521. Epub 2016 Nov 7. Addressing social determinants of health at well child care visits: a cluster RCT. 2016 Mar;16(2):168-74. Effects of Social Needs Screening and In-Person Service Navigation on Child Health: A Randomized Clinical Trial. JAMA Pediatr. doi: 10.1001/jamapediatrics.2016.2521.

Pediatrics 75

Pediatrics Emergency Department Research Burns 75

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. 2016 Oct;41:62-5. Epub 2016 Jul 21. 2016 Dec 22;375(25):2457-2467. doi: 10.1016/j.seizure.2016.07.006. 2016.07.006.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

Dr. Smith's ECG Blog

OCTOBER 12, 2024

The providers documented concern for ST elevation in the precordial and lateral leads as well as a concern for hyperkalemic T waves in the setting of succinylcholine administration. 2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. Potassium resulted as 4.9, initial troponin I 0.05 Lee DH, Walsh B, Smith SW. Am J Emerg Med.

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. She had a precipitous delivery while the ambulance was pulling in. Triage vital signs (VS) include BP 88/45, HR 121, T 97.1, RR 28, SpO2 89% on 6L NC.

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

ACEP Now

SEPTEMBER 11, 2023

While summitting Carstensz in Indonesia in October 2015, he and his wife led a Wild Med Kilimanjaro Expedition and summited Kili in March 2016. Elbrus, the highest peak in Europe, through contacts on his Indonesia expedition and summited in August of 2016. On that same trip, they put together a trip to Russia climbing Mt.

Wellness 126

Wellness 126

The Injectable Orange

JUNE 20, 2017

While well evaluated, you see the residents go back to the shop floor and struggle to apply any of the lessons that the group agreed had been take homes from the previous sim session. How do they do it so well?” 2016 Mar;18(2):136-42. Well done”……. Debrief2Learn Sept 2016. Eppich (2016). Auerbach, A.

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

Dr. Smith's ECG Blog

APRIL 30, 2024

I fully acknowledge some speculation — given that we lack precise timing of these serial tracings, as well as not knowing the corresponding serum K+ level at the time each tracing was recorded. I focus my comments on: i ) The initial rhythm; and , ii ) Reasons for the dramatic changes in ST-T wave appearance between ECG #1 and ECG #2.

EKG/ECG 108

EKG/ECG EMS CPR Resuscitation 108

Taming the SRU

JANUARY 1, 2024

For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Additional Resources Please see a previous Taming the SRU post for extra tips and trouble-shooting tricks, as well as a video demonstration for IO access. 2016 Dec 14;20(1):102.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

Sensible Medicine

JUNE 21, 2024

“Well,” my friend advised, “if you’re feeling nervous right now, that is because the thing you are about to do might upset people, and that takes courage.” It was the night before a health ethics conference at a university. ” It felt like I was hearing this for the very first time. .”

Academics 85

Academics Research Burns Outcomes 85

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. 2016 Nov;23(11):1298-1306. Epub 2016 Nov 1. 2016 Feb;169:122-7.e1.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Don't Forget the Bubbles

OCTOBER 2, 2023

P aediatric R esearch A cross the M idlands ( PRAM ) is a trainee-led research collaborative across the West Midlands, networking since 2016. This American single-centre retrospective review of 145 previously-well children referred to endocrinology to evaluate hypoglycaemia (<3.9 BMJ Paediatrics Open 2023;7:e001842.

Outcomes 138

Outcomes Research Wellness Emergency Department 138

EMDocs

AUGUST 22, 2023

Published 2016 Jan 29. In cardiac arrest, EtCO 2 is dependent on compressions AND the underlying cause. Other organ system involvement & hypotension/low perfusion affect EtCO 2. PMID: 24381677 Bou Chebl R, Madden B, Belsky J, Harmouche E, Yessayan L. BMC Emerg Med. PMID: 26821648 Hemnes AR, Newman AL, Rosenbaum B, et al. Eur Respir J.

Emergency Department 95

Emergency Department Blood Transfusions Resuscitation Sepsis 95

Don't Forget the Bubbles

JANUARY 22, 2024

The campaign started in the United States in 2012, in Canada two years later, and in the United Kingdom in 2016. Choosing Wisely UK was launched in 2016 by the Academy of Medical Royal Colleges to identify tests, treatments, and procedures of questionable value. 2016 ;50(13):826-8. Br J Sports Med. Regan W, Hothi D, Jones K.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

Total Medical ComplianceHIPAA

NOVEMBER 7, 2022

Website owners are required to tell visitors what kind of cookies they use, as well as how they use and disclose the visitor’s information collected by their website. Cookies are like flags that allow a website to recognize and remember your device if you return to that site in the future.

Documentation/Coding 72

Documentation/Coding Wellness 72

Don't Forget the Bubbles

AUGUST 2, 2023

carried out a retrospective chart review of children with CRPS presenting to a paediatric Chronic Pain Clinic in Canada over a 5-year period (2012 to 2016). As well as nonpharmacological treatments included physiotherapy and psychological therapy, 79% were also prescribed medication, most commonly gabapentin. Published 2016 Apr 29.

Psychiatric 98

Psychiatric Pediatrics Outcomes Fractures 98

ALiEM

SEPTEMBER 9, 2024

Past surgical history was significant for laparoscopic ventral hernia repair with mesh and lysis of adhesions (three years ago), as well as prior appendectomy, cholecystectomy, c-section, and right nephrectomy. C); BP 110/56; HR 64; RR 16; SpO2 100% General : No acute distress, well appearing. 2016 Dec 28;7(Suppl 44):S1150-S1153.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

PHEM Cast

MARCH 17, 2016

2016: 28(1); 67-72. 2016; 193(3): 273-280. 2016 [cite Date Accessed]. video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. The Journal of Emergency Medicine. 2010; Grant S, Khan F, Keijzers G, Shirran M, Marneros L. Oxygenation.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

Taming the SRU

JUNE 24, 2024

Conduction Abnormalities AV blocks, which can also be seen in patients with MI, may require pacing as well, due to ischemia affecting the electrical pathways of the heart. Bektas, Firat, and Secgin Soyuncu. The efficacy of transcutaneous cardiac pacing in ED.” The American Journal of Emergency Medicine , vol. Circulation , vol.

Advances Cardiac Life Support (ACLS) 90

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 90