Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. 2017 Sep-Oct;50(5):561-569. Epub 2017 Apr 19. Blood glucose was not low at 162 mg/dL.

EKG/ECG 94

EKG/ECG Documentation/Coding Emergency Department COPD 94

RebelEM

NOVEMBER 6, 2024

2017 Jul;9(3):195-204. Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644703 Robinson PM, Griffiths E, Watts AC. Simple elbow dislocation. Shoulder Elbow. J Am Acad Orthop Surg.

Dislocations 109

Dislocations Fractures Soft Tissue Injuries Outcomes 109

The Skeptics' Guide to EM

OCTOBER 28, 2017

[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. Pediatrics 2017 Guest Skeptic: Dr. Anthony Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. Anthony is also the creator of SketchyEBM.

Pediatrics 52

Pediatrics Documentation/Coding Emergency Department Hospitals 52

ALiEM

JANUARY 10, 2025

A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. Other documented pharmacological causes of anisocoria include nebulized ipratropium bromide and scopolamine (14-19). Am J Emerg Med. Published 2017 Apr 12. 2019;37(6):1217.e3-1217.e4.

Pediatrics 64

Pediatrics Documentation/Coding Academics Administration 64

EB Medicine

DECEMBER 1, 2018

Nachi: And just last year we saw the 2017-2018 influenza epidemic with record-breaking ED visits. Antigen drift refers to small point mutations to the viral genes that code for H and N. When cells are infected by 2 or more strains, a new strain can emerge after genetic reassortment. Jeff: The reason for this is multifactorial.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. Erratum in: West J Emerg Med. 2019 Jul;20(4):688-689. Acad Pediatr.

Psychiatric 66

Psychiatric Pediatrics Emergency Department Administration 66

PEMBlog

MAY 11, 2023

These were used by two independent reviewers to determine Neonatal Facial Coding System with pain scores. Acad Emerg Med, 2017 This was a single-center (one academic Pediatric Emergency Department) randomized double-blind trial of J-Tip versus EMLA – topical anesthetic (TA) cream for pain relief in 66 infant LPs.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Outcomes 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. In 2017, these were performed 60%, 18%, and 3% of the time. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Skeptics' Guide to EM

DECEMBER 2, 2017

[display_podcast] Date: November 24th, 2017 Reference: Andersen et al. JAMA 2017 Guest Skeptic: Dr. Bob Edmonds is an Emergency Physician in the US Air Force. He is currently deployed, practicing emergency medicine in an undisclosed location. display_podcast] Date: November 24th, 2017 Reference: Andersen et al.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. Jeff: a 2017 ACEP clinical policy also recommends against routine lab testing in those with acute psychiatric complaints.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Osna 2017) Alcohol can contribute to pancreatitis, CKD, epilepsy, and countless other conditions. Sanvisens 2017) Consideration of WE when conducting a physical exam can be lifesaving.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons. Promoting hot debriefing in an emergency department. Tannenbaum, S.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

EB Medicine

AUGUST 6, 2019

Nachi: Next we have Betrixaban, the latest Factor Xa inhibitor to be approved, back in 2017. Because it’s utility is limited to venous thromboembolism prophylaxis in mostly medically ill inpatients, it’s unlikely to be encountered by emergency physicians very frequently. This can help with destination selection when relevant.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

Don't Forget the Bubbles

MARCH 19, 2024

Despite being deemed medically fit for discharge in August 2017, Jack lived in limbo between two hospitals for two and a half years due to delays in disability services and social services arranging a specialist placement for him. Key messages Consider social determinants of health and document these in a child’s clinical notes.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. AAGBI Safer Prehospital Anaesthesia 2017, available here. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2 20(12);681-686.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

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. Electrical injuries in the emergency department: an evidence-based review. Emerg Med Pract. Am J Cardiol.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Don't Forget the Bubbles

JULY 5, 2023

A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. However, there are documented adverse events such as haemorrhagic cerebrovascular accidents or recurrence of VOC after drug withdrawal, which represent a drawback in its regular use. Anemia ; 2015.DOI:10.1155/2015/791498.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Don't Forget the Bubbles

DECEMBER 16, 2024

Clear history taking In the Emergency Department, healthcare professionals should prioritise thorough history-taking when assessing potential suspected cases. JOINT committee on vaccination and immunisation code of practice June. European Centre for Disease Prevention and Control. Measles facts [Internet]. Epidemiol Infect.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

Dr. Smith's ECG Blog

DECEMBER 27, 2018

This ECG comes from Pierre Taboulet ( [link] /)( [link] ) an ECG whiz who codes a lot of ECGs for Cardiologs' Artificial Intelligence Deep Neural Network algorithm ( [link] ). A Deep Neural Network learning algorithm outperforms a conventional algorithm for emergency department electrocardiogram interpretation. Peguero JG et al.

EKG/ECG 40

EKG/ECG Documentation/Coding Emergency Department Wellness 40

Don't Forget the Bubbles

JULY 3, 2023

This time we have our first group of colleagues from Birmingham Children’s Hospital Emergency Department. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol.

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105

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. 2017 Nov;35(4):525-537.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

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. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). Int J Emerg Med. The role of venous blood gas in the emergency department: a systematic review and meta-analysis.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

RebelEM

MAY 15, 2024

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. Epub 2017 Nov 22. Ann Emerg Med. 2017 Jun;69(6):755-764. Coding for Mucositis. Support Care Cancer. 2018 May;26(5):1465-1470.

Infectious Diseases 93

Infectious Diseases Administration Sepsis Anaphylaxis 93

EMDocs

NOVEMBER 16, 2024

Posterior – Shortened, adducted, internally rotated 5,6 Anterior – Shortened, abducted, externally rotated 5,6 As with all dislocations, perform and document distal neurovascular exam before and after management. 8 Perform and document distal neurovascular exam. 2017 May 26;114(20):347-353. Arthroplasty 5 , 2 (2023).

EMS 76

EMS Dislocations Fractures Operations 76

Don't Forget the Bubbles

JANUARY 22, 2024

Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. You receive a referral for a 7-year-old Josh, who presented to the emergency department (ED) with a 5-day history of fever, cough, and borderline oxygen saturation.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

Dr. Smith's ECG Blog

JANUARY 17, 2024

This case was one of the 4% of true positive Code STEMI with an initial ECG labeled ‘normal’ by computer interpretation,[2] and there are dozens more such cases detailed here. Here you will sign up for the Queen of Hearts on the Telegram app: [link] Or, you can get the PM Cardio app with Queen of Hearts function through this QR code.

EKG/ECG 96

EKG/ECG Documentation/Coding Wellness Emergency Department 96

Downeast Emergency Medicine

OCTOBER 21, 2021

Background Suicide is disturbingly prevalent among patients we care for in the Emergency Department. October 2017; 92 (10): 1486-1493.[ December 2017, Volume 177, Number 12.[ The New England Journal of Medicine March 23, 2017, 376; 12.[ All other applications were coded as “not consistent.” Mayo Clin Proc.

Documentation/Coding 52

Documentation/Coding Emergency Department Shock Research 52

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. MD; Ghajar, Jamshid MD, PhD.

Seizures 86

Seizures Stroke Outcomes EMS 86

Dr. Smith's ECG Blog

APRIL 8, 2015

Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful. Academic Emergency Medicine., The ROSE (Risk Stratification of syncope in the emergency department) Study. Thiruganasambandamoorthy, V., Sivilotti, M., Mukarram, M., Baumann, B.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

NOVEMBER 11, 2024

What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. 2017 Sep;279(1):70-89. Nat Biomed Eng. 2019 Jul;3(7):520-531. PMID: 31086325 Pickard JM, Zeng MY, Caruso R, Núñez G. Immunol Rev.

Sepsis 84

Sepsis Outcomes Administration Shock 84

EMDocs

JANUARY 6, 2025

4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. HIV Prevention and Treatment: The Evolving Role of the Emergency Department. Ann Emerg Med. Use of Medical Interpreters in the Emergency Department.;

Infectious Diseases 57

Infectious Diseases CDC PPE Rapid Diagnostic Testing 57