Dr. Smith's ECG Blog

OCTOBER 23, 2023

Macroscopic T-Wave Alternans: A Red Flag for Code Blue. 2017 Oct 1;177(10):1520-1522. J Am Coll Cardiol. 2006 Jan 17;47(2):269-81. doi: 10.1016/j.jacc.2005.08.066. 2005.08.066. Epub 2006 Jan 4. PMID: 16412847. Moore PK, Raffel KE, Whitman IR. JAMA Intern Med. doi: 10.1001/jamainternmed.2017.3191. 2017.3191.

EKG/ECG 120

EKG/ECG Documentation/Coding Psychiatric EMS 120

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. AAGBI Safer Prehospital Anaesthesia 2017, available here. Resuscitation. Crit Care 21, 31 (2017). Resuscitation. Tracheal intubation. Anaesthesia & Intensive Care Medicine. 20(12);681-686. 2011 Dec;82(12):1519-24. 2011.06.028.

Airway Management 52

Airway Management Resuscitation EMS Hospitals 52

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. 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.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

Advanced Emergency Nursing from AENJ

NOVEMBER 27, 2017

The International Liaison Committee on Resuscitation (ILCOR) has for some years been meeting and agreeing upon resuscitation practices every five years; in addition to which there is the necessary slack time before and after each meeting to produce and disseminate the newly appropriate course materials.

CPR 40

CPR Basic Life Support Resuscitation Pediatrics 40

ACEP Now

MARCH 14, 2024

Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. Documentation with coronary arteriography within 12 1/2 hours of the onset of symptoms in two cases (three episodes). Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

The Injectable Orange

JUNE 20, 2017

This is met with resistance, “we’re too busy theirs not enough staff or time”, “the staff have done mock codes before, they really disrupt things and they hated them”. Hicks (2017). Mental practice: a simple tool to enhance team-based trauma resuscitation. Stimulus by Prof. link] Petrosoniak, A., Auerbach, A. Wong and C.

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

Downeast Emergency Medicine

APRIL 26, 2021

Trauma patients between the ages of 18-90 years had to have either had one documented episode of hypotension (defined as a systolic BP <90 mmHg) or tachycardia (>100 beats/minute) to be included in the study. Military application of tranexamic acid in trauma emergency resuscitation (MATTERs)study. Arch Surg 2012; 147:113-119.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Don't Forget the Bubbles

JUNE 10, 2024

The history of necrotising enterocolitis The earliest documented cases resembling Necrotising enterocolitis (NEC) date back to the late 19th and early 20th centuries. Let’s delve into the significant challenges posed by small bellies: big battles – the not-so-simple case of necrotising enterocolitis. ANZNN Annual Report.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 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). In contrast, ABG and pH alone are not reliable in determining the clinical futility of resuscitation after major trauma. (14,

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation. 2017 Nov;35(4):525-537. Beck’s triad only happens all 3 together in approximately 1/3rd of patients. Smith comment : First, IV fluids are indicated to improve preload. J Am Soc Echocardiogr. 2013.06.023.

EKG/ECG 52

EKG/ECG Ultrasounds Documentation/Coding COPD 52

EB Medicine

AUGUST 6, 2019

Nachi: Next we have Betrixaban, the latest Factor Xa inhibitor to be approved, back in 2017. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%. should all be used as needed.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

RebelEM

MAY 15, 2024

Epub 2017 Nov 22. 2017 Jun;69(6):755-764. Coding for Mucositis. Give appropriate fluids, vasopressors, and antibiotics. Default to using whichever score your oncologist is more comfortable with. Support Care Cancer. 2018 May;26(5):1465-1470. doi: 10.1007/s00520-017-3985-0. Clarke, R. Warnick, J., Stretton, K., Littlewood, T.

Infectious Diseases 105

Infectious Diseases Administration Sepsis Anaphylaxis 105

Pediatric Emergency Playbook

JUNE 1, 2017

Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. The best documented cormorbidity is sickle cell disease, although other pro-thrombotic conditions also put the child at risk. 2017; 15:47-50. Interactive Cardiovascaulr and Thoracic Surgery. 2009; 8:67-69. Güvenç O et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

JULY 8, 2019

Nachi: Taken all together, the rising rates of obesity and the rising success and availability of bariatric procedures has led to an increased number of bariatric procedures, with 228,000 performed in the US in 2017. In 2017, these were performed 60%, 18%, and 3% of the time.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Unstable patients do not belong in a radiology suite - they belong in the ED resus bay to be resuscitated first. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EB Medicine

OCTOBER 1, 2018

And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Patient’s need adequate fluid resuscitation. Just a reminder that a history of CHF doesn’t preclude proper fluid resuscitation.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

Don't Forget the Bubbles

JULY 3, 2023

This data relies heavily on the coding, which we know is not standardized across healthcare sites- and, therefore may not be truly reflective. All paediatric trauma patients aged eight or under screened for CSI at the trauma centre between July 2017 and December 2020 were included. Why does it matter?

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105

EB Medicine

JANUARY 2, 2019

Nachi: This month’s issue was authored by Dr. Ryan Pedigo, you may remember him from the June 2017 episode on dental emergencies, though he is perhaps better known as the director of undergraduate medical education at Harbor-UCLA Medical center. This result was for the most part re-confirmed in a 2017 cochrane review.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40