EMDocs

JANUARY 4, 2024

3 Always get an EKG to assess for cardiotoxicity, including widened QRS and prolonged QTc, although this may not be evident right away. 3 Cardiotoxicity 3 All patients need an EKG and cardiac monitoring. Case Follow-up: The patient required a dose of lorazepam in the emergency department. Eds (2017).

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

Dr. Smith's ECG Blog

JANUARY 13, 2024

The next morning, the following ECG was obtained. Repeat ECG from the emergency department is shown. The ECG read also says "Please have pacer interrogated to check atrial sensing." The following day, he had clear ECG evidence of pacemaker malfunction that went unrecognized. What do you think?

EKG/ECG 110

EKG/ECG Hospitals Fractures Emergency Department 110

EMDocs

SEPTEMBER 25, 2023

actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department. Okubo M, Gibo K, Hagiwara Y, Nakayama Y, Hasegawa K; Japanese Emergency Medicine Network Investigators. Int J Emerg Med. 2017 Dec;10(1):1. Epub 2017 Jan 25. J Emerg Med.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Post-resuscitation ECGs demonstrating ST segment elevation are significant in delineating which patients might benefit most from advanced reperfusion techniques. Circulation. 2018;137(12). Kimblad H, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Dr. Smith's ECG Blog

FEBRUARY 10, 2022

The ECG was labeled ‘normal’ by the computer (Marqette 12SL), later confirmed by the cardiologist. Smith : this proves my impression that the inferior T-waves on the first ECG are hyperacute. Six hours later a repeat ECG was done, with a repeat troponin downtrending at 1,000 ng/L. What do you think?

EKG/ECG 40

EKG/ECG Emergency Department Outcomes 40

EMDocs

MAY 11, 2024

Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med. Erratum in: Ann Emerg Med. 2017 Nov;70(5):758. 2015 Sep;66(3):322-333.e31. doi: 10.1016/j.annemergmed.2015.06.031. 2015.06.031. PMID: 26304253.

Stroke 110

Stroke EMS EKG/ECG Radiology 110

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. A normal ekg of course does not rule out a cardiac cause of their presentation.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

FEBRUARY 5, 2019

He had a triage ECG at time 0 (ECG-1): Computer read, with Physician overread: Sinus rhythm. If you see this, you must very closely question the patient about any chest symptoms, and even if no relevant symptoms, to be certain to look for old ECG, and to do serial ECGs and troponins. A 3rd ECG was recorded at 3.5

EKG/ECG 52

EKG/ECG Emergency Department Wellness Shock 52

ACEP Now

AUGUST 11, 2024

A 41-year-old woman arrived in a Hawaii emergency department with her husband early in the morning. An EKG was performed on arrival, showing no abnormalities. California Department of Public Health Division of Communicable Disease. Published December 2017. State of California Health and Human Services Agency.

Poisoning 52

Poisoning Infectious Diseases EKG/ECG Emergency Department 52

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 Fractures Documentation/Coding 52

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. EKG RV strain.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Dr. Smith's ECG Blog

OCTOBER 3, 2018

The medics recorded the following initial ECG at time 0: The computer read (see below) gives no further comment beyond ventricular pacemaker. He refused to listen to the medic and was convinced that the ECG was due to hyperkalemia and that acute MI cannot be diagnosed in the presence of paced rhythm. What do you think?

EKG/ECG 52

EKG/ECG Emergency Department Research Outcomes 52

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. 1,4-5 Thus, an electrocardiogram (ECG) and cardiac monitoring should be performed for unstable, electrical injury patients.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EM Guide Wire

MARCH 22, 2019

Myasthenia Gravis and Crisis: Evaluation and Management in the Emergency Department. The Journal of Emergency Medicine , 53(5): 843-853. Tintinalli's emergency medicine: A comprehensive study guide (Eighth edition.). & Levine, J.M Neuromuscular topics for Neuroscience ICU RNs. Fleming M.E., link] Tintinalli, J.

Airway Management 40

Airway Management EKG/ECG Emergency Department 40

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.

EKG/ECG 40

EKG/ECG Documentation/Coding Emergency Department Wellness 40

Dr. Smith's ECG Blog

NOVEMBER 3, 2017

Beware of using it to reverse your prior opinion that the ECG represents LAD occlusion. I recommend using it when you are worried that an ECG with apparent normal ST Elevation might be LAD occlusion. J Electrocardiology 50(5):561-569; September/October 2017. WARNING: the formula is not perfect. Sensitivity is not perfect.

EKG/ECG 52

EKG/ECG Outcomes Emergency Department Ultrasounds 52

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

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

Example ECG: The heart rate is 167; the RR interval is 0.36 Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate. See this review of computer interpreted ECGs. If the QT is longer than 40% of the RR, then do a formal measurement and correction.

EKG/ECG 52

EKG/ECG Outcomes Wellness Hospitals 52

ACEP Now

MARCH 11, 2025

A 16-year-old male presents to the emergency department (ED) with his mother with the chief complaint of intermittent abdominal pain and constipation for several weeks. The prevalence and correlates of eating disorders in adult emergency department patients. 16 An elevated amylase suggests repetitive vomiting as well.

Emergency Department 83

Emergency Department Psychiatric Dehydration Pediatrics 83

Northwestern EM Blog

JANUARY 24, 2022

Hypocalcemia can be hinted at through history or by hints such as a prolonged QTc on an ECG. Revised National Estimates of Emergency Department Visits for Sepsis in the United States. 2017; 45(9): 1443-1449. may have greater severity of shock with increased mortality. Intensive Care Medicine. 2010; 36: 2019-2029.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

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. Nachi: And finally let’s touch upon the ekg and ACS. Talk to you next month!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Abnormal ECG – looks for cardiac syncope. Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. If no previous ECG was available, ECG was classified as abnormal if any abnormality was present. orthostatic vitals b.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Dr. Smith's ECG Blog

AUGUST 10, 2023

Emily Austin, with edits from Jesse McLaren A 50 year-old patient presented to the Emergency Department with sudden onset chest pain that began 14-hours ago. ECG interpretation: sinus rhythm, normal conduction (PR, QRS, and QTc), normal axis, delayed R-wave progression, and normal voltages. What do you think?

EKG/ECG 98

EKG/ECG Emergency Department Wellness 98

Dr. Smith's ECG Blog

JANUARY 17, 2024

Patient 1 (ECG on the left) was a 45 year-old male, and patient 2 (ECG is on the right) was a 70 year-old male. Using T wave amplitude, can you tell which ECG has hyperacute T waves? What other parts of the ECG would you like to see, and how will you use this to refine your interpretation?

EKG/ECG 118

EKG/ECG Documentation/Coding Emergency Department Wellness 118

EMDocs

DECEMBER 16, 2023

A 12-lead EKG shows sinus tachycardia but is otherwise normal. An 18-month-old boy presents to the emergency department with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

EMDocs

NOVEMBER 4, 2024

million patient complaints in 2017, making it the second most common ED complaint. Pain can be associated with a friction rub on cardiac auscultation, a pericardial effusion on a bedside echocardiogram, or diffuse ST elevations on an EKG. J Emerg Med. Acad Emerg Med. J Emerg Med. 05 2018;54(5):731-736. Cephalalgia.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

normal glucose, and mild acute on chronic renal failure (Creatinine from 140 to 170 umol/L), and the following ECG, and they were sent to the ED. Theres no prior ECG to compare - but the bradycardia, prolonged PR and peaked T waves could all be from hyperkalemia. regardless of the ECG (when the repeat level came back).[1]

EKG/ECG 118

EKG/ECG Shock Operations Emergency Department 118

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

He presented to the emergency department for evaluation. Below is his presentation ECG. The above ECG was originally recorded with a paper speed of 50mm/sec. Interpretation: The ECG shows sinus rhythm at 94 beats per minute. This ECG shows a lot of "acuity". How will you manage this patient in each scenario?

EKG/ECG 89

EKG/ECG Shock COPD Wellness 89

Taming the SRU

FEBRUARY 3, 2025

Work-up and Diagnosis in the Emergency Department Initial presentation of TLS typically includes generalized symptoms such as gastrointestinal distress, decreased appetite, muscle cramping, palpitations, hematuria / oliguria, and altered mental status. in females and 2.5-7.0 in males) phosphate > 4.5 mg/dl (adults) and > 6.5

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56