Ken Grauer, MD

SEPTEMBER 22, 2023

For review — Check out My Comment — at the bottom of the page in the following posts on Dr. Smith's ECG Blog: The June 4, 2018 post ( LA-LL reversal ). The July 29, 2018 post ( LA-RA reversal ). The November 4, 2018 post ( Leads V1,V2 misplacement ). The February 11, 2020 post ( LA-RA reversal ).

EKG/ECG 446

EKG/ECG Wellness 446

Pediatric EM Morsels

OCTOBER 6, 2023

Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective.

Pediatrics 161

Pediatrics CDC Seizures Documentation/Coding 161

Ken Grauer, MD

AUGUST 16, 2024

Excellent review of diagnostic testing for acute PE ( Moore et al — Cardiovasc Diagn Ther 8(3):225-243, 2018 ). In Figure-4 — I've included the video recording of this view. For a 10-minute video review on reading Pulmonary CT Scan — WATCH_this_VIDEO by Dr. Jake Gibbons.

EKG/ECG 394

EKG/ECG Wellness Shock 394

Pediatric EM Morsels

JUNE 14, 2024

Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g. 28,1 (2008): 105-20.

Pediatrics 141

Pediatrics EMS Outcomes 141

Ken Grauer, MD

DECEMBER 8, 2023

The July 31, 2018 post in Dr. Smith's ECG Blog ( Please scroll down to the bottom of the page to see My Comment ). The August 22, 2020 post in Dr. Smith's ECG Blog — which illustrates another case of dynamic ST-T wave changes that resulted from a repolarization variant.

EKG/ECG 412

EKG/ECG Hospitals 412

Ken Grauer, MD

APRIL 5, 2024

For additional examples of this phenomenon whereby automatic truncation of an EMS ECG may mistakenly result in LVH serving to mimi c ischemia — Check out My Comment at the bottom of the page of the following posts in Dr. Smith's ECG Blog — the November 29, 2023 post — June 20, 2020 — March 31, 2019 — March 29, 2019 — and t he December 27, 2018 post.

EKG/ECG 238

EKG/ECG EMS Hospitals 238

The Trauma Pro

MARCH 1, 2024

J Trauma 84(2):379-385, 2018. Reference: No intravenous access, no problem: Intraosseous administration of tranexamic acid is as effective as intravenous in a porcine hemorrhage model.

Military 273

Military Resuscitation Administration Hospitals 273

Ken Grauer, MD

JANUARY 13, 2024

That said — distinction between "classic" HCM vs the apical HCM for m may be useful because: i ) ECG findings tend to be different ( Lyon et al — Europace 20:102-112iii, 2018 ) ; — ii ) Echo appearance is different when hypertrophy localizes to the apex; and , iii ) There is a significantly greater incidence of AFib with apical HCM.

EKG/ECG 400

EKG/ECG Hospitals 400

PEMBlog

OCTOBER 31, 2024

2018 Nov 22;379(21):2002-2014. N Engl J Med 2018; 379:2015-2026. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. N Engl J Med. doi: 10.1056/NEJMoa1802598. PMID: 30462938; PMCID: PMC6358014. Freedman et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. Parker et al.

Outcomes 105

Outcomes Pediatrics Emergency Department Research 105

Sensible Medicine

MARCH 4, 2024

In 2018, the NEJM and the Lancet published three trials that randomized tens of thousands of patients without heart disease to either low-dose aspirin or a placebo. In the absence of heart disease, based on the 2018 trials, I had recommended patients stop taking aspirin. The ARRIVE trial excluded patients taking aspirin at baseline).

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Emergency Live

DECEMBER 19, 2023

Research conducted by Tufts University revealed that in 2018, approximately 14.1 […] The post Diabetes and Lifestyles: A Global Correlation appeared first on Emergency Live.

Research 111

Research 111

EMCrit

JUNE 18, 2024

Part I: SUP-ICU (2018) This was a large multicenter RCT […] EMCrit Project by Josh Farkas. I would view this as the triquel following SUP-ICU and PEPTIC. In order to understand REVISE in context, let's briefly review SUP-ICU and PEPTIC trials, before discussing REVISE.

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Emergency Live

FEBRUARY 29, 2024

This device, mandatory on all new models of cars and light vans since March 31, 2018, is designed to automatically send an emergency call to […] The post eCall: The Invisible Guardian of Europe's Roads appeared first on Emergency Live.

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Pediatric EM Morsels

JUNE 9, 2023

Carneiro de Moura, 2018 ] Seen in 57% of cohort. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! 2018 Sep;67(3):371-376. Infections occurred in 30% of those with acute variceal bleeding. doi: 10.1097/MPG.0000000000002039.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

PulmCCM

SEPTEMBER 8, 2024

From the 2018 SCCM clinical practice guidelines for prevention and management of pain, agitation/sedation, and delirium: Question: Does the level of arousal influence delirium assessments with a validated screening tool? Ungraded Statement : Level of arousal may influence delirium assessments with a validated screening tool. Read more

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MEDEST118

MAY 14, 2024

2018 Sep;5(3):208-209. AJR Am J Roentgenol. 2014 Feb;202(2):418-25. doi: 10.2214/AJR.13.10711. PMID: 24450686. Reid C, Fogg T, Healy G. Deformation of a humeral intraosseous catheter due to positioning for thoracostomy. Clin Exp Emerg Med. doi: 10.15441/ceem.17.243. Epub […]

Pediatrics 81

Pediatrics 81

Pediatric EM Morsels

JUNE 21, 2024

Palmieri 2002, Choi 2018, Raymond 2018] A systematic review with moderate quality evidence found no difference in the rate of wound healing or epithelialization with silver sulfadiazine compared to silver impregnated foam dressing. Irie 2018] Moral of the Morsel Burns are Bad! Get the Goop!

Burns 169

Burns Pediatrics Hospitals Wellness 169

The Trauma Pro

OCTOBER 18, 2024

Journal of Trauma Nursing, 25 (3), 192-195, 2018. If the score is less than 6 further scrutiny is needed to determine if a consult from or transfer to trauma should be recommended. References: Nonsurgical Admissions With Traumatic Injury: Medical Patients Are Trauma Patients Too. Am Surg, 88(7), 1537-1540, 2022.

Documentation/Coding 147

Documentation/Coding Emergency Department Hospitals 147

Pediatric EM Morsels

SEPTEMBER 22, 2023

2018 Oct;14(2):47-54. Epub 2018 Oct 31. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: [link] Ko HY. Revisit Spinal Shock: Pattern of Reflex Evolution during Spinal Shock. Korean J Neurotrauma. doi: 10.13004/kjnt.2018.14.2.47. 2018.14.2.47. PMID: 30402418; PMCID: PMC6218357.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

Dr. Smith's ECG Blog

JUNE 5, 2024

Uncontrolled coronary spasm may be associated with serious arrhythmias , including cardiac arrest ( Looi et al — Postgrad Med, 2012 ; Tan et al — Eur Heart J Case Rep, 2018 ; Chevalier et al — JACC, 1998 ; Rodriguez-Manero — EP Europace, 2018 ). As a result — an ICD may need to be considered in selected cases.

EKG/ECG 109

EKG/ECG Outcomes 109

Pediatric EM Morsels

AUGUST 4, 2023

Ganss, 2018) There are additional associations with scoliosis, burn injuries, and spinal cord injuries. (Oka, Ganss, 2018) At least one case of abdominal compartment syndrome noted in the literature. (Oka, 2023) Female to male predominance with a ratio of 3:2.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Emergency Live

JUNE 22, 2023

Significant collaboration between ADAC Luftrettung and Volocopter for the development of electric vertical take-off and landing aircraft (eVTOL) for rescue services A step forward in air rescue and emergency medicine The collaboration is the result of a partnership that began in 2018, when ADAC Luftrettung, a German air rescue organisation, and Volocopter, (..)

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Pediatric EM Morsels

APRIL 5, 2024

Globally, ticks are the second most common vector to transmit illnesses after mosquitos (Parola 2018). 2018 Mar; 3(1): 8. Travel Medicine and Infectious Disease, 2018, 26, pp.1-2. There are species of ticks found on every continent and carrying a variety of vectors capable of infecting humans. John H, Jian J, RIchards AL.

CDC 161

CDC Infectious Diseases Pediatrics Wellness 161

Emergency Medicine Journal

OCTOBER 23, 2024

This standard was updated in 2018 4 to recommend that all EDs treating children should have a PEM consultant. Audit data published in 2022 demonstrated that 41%.

Emergency Department 52

Emergency Department EMS 52

RebelEM

NOVEMBER 6, 2024

2018 Jun;54(6):849-854. Epub 2018 Apr 19. 2018 Apr 4;100(7):e46. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521261 Gottlieb M, Schiebout J. Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. doi: 10.1016/j.jemermed.2018.02.011. 2018.02.011. J Am Acad Orthop Surg.

Dislocations 59

Dislocations Fractures Soft Tissue Injuries Outcomes 59

Pediatric EM Morsels

AUGUST 18, 2023

Wirth 2018) One study including 4.4 Meesters 2018) Resistance is growing (likely from inappropriate / overuse)! (Noel 2007) In a very robust, recent multicenter, randomized, double-blind controlled study Moxifloxacin was compared to a comparator drug (IV ertapenem followed by PO Augmentin) for complex intraabdominal infections.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Emergency Medicine Journal

OCTOBER 26, 2023

Methods We investigated four 18-month periods between 2005 and 2018. Over all study periods, survival at hospital discharge increased from 12% in 2005 to 25% in 2018 (p<0.001), and return of spontaneous circulation at hospital admission increased from 43% to 58% (p=0.004).

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

Emergency Medicine Journal

SEPTEMBER 25, 2024

1 The EMLeaders programme was launched in 2018 as a collaboration between the Royal College of Emergency Medicine (RCEM), Health Education England and National Health Service (NHS) England as a structured approach to leadership development of emergency physicians in training.

Leadership 52

Leadership Emergency Department Outcomes Wellness 52

PulmCCM

NOVEMBER 18, 2024

The company won FDA clearance in 2018 to market its FlowTriever™ thrombectomy device for PEs based on prospective observational data showing mechanical thrombectomy to be reasonably safe and effective at improving right ventricular function acutely after clot removal (as measured by the RV/LV ratio).

Shock 52

Shock Wellness 52

The Trauma Pro

OCTOBER 25, 2024

Here are the factoids: The original data were derived from a 17-center study conducted from 2018-2020; this study only included 1,387 patients who had pelvic fractures (as well as other injuries). The primary outcome was the development of VTE during the hospitalization.

Fractures 147

Fractures Head Injuries Operations Ultrasounds 147

Pediatric EM Morsels

JULY 7, 2023

Cunningham, 2018 ] Account for less than 1% of all knee injuries. Epub 2018 Apr 19. The PTF joint is inherently stable with good ligamentous support, especially when the knee is in extension. Cunningham NJ, Farebrother N, Miles J. Review article: Isolated proximal tibiofibular joint dislocation. Emerg Med Australas. PMID: 29671944.

Dislocations 141

Dislocations Fractures Pediatrics EMS 141

SCGH ED

MAY 6, 2024

Upper Limb: All Quick Reference: Clavicle / Upper Arm / Forearm: Elbow: Wrist: Hand: Lower Limb: Base of 5th Metatarsal Fracture – Patient Information Handout 01/2018 Date implemented – 04/2024Review date – nil plannedAuthor […] The post Basic Fracture Management Guidelines 04/2024 appeared first on Charlie's ED.

Fractures 52

Fractures 52

Ken Grauer, MD

APRIL 18, 2023

For review — Check Out My Comment — at the bottom of the page in the following posts on Dr. Smith's ECG Blog: The June 4, 2018 post ( LA-LL reversal ). The July 29, 2018 post ( LA-RA reversal ). The November 4, 2018 post ( Leads V1,V2 misplacement ). The February 11, 2020 post ( LA-RA reversal ).

EKG/ECG 195

EKG/ECG Wellness 195

Pediatric EM Morsels

JULY 21, 2023

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! 2018 Jun;128(6):1612-1620. 2018): 192–200. Fun fact for animal lovers!- Brennan PM, Murray GD, Teasdale GM. Simplifying the use of prognostic information in traumatic brain injury. J Neurosurg.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Ken Grauer, MD

DECEMBER 15, 2023

The July 31, 2018 post in Dr. Smith's ECG Blog ( Please scroll down to the bottom of the page to see My Comment ). The August 22, 2020 post in Dr. Smith's ECG Blog — which illustrates another case of dynamic ST-T wave changes that resulted from a repolarization variant.

EKG/ECG 381

EKG/ECG EMS Hospitals 381

American Medical Compliance

JUNE 12, 2024

History and Background of CCPA The California Consumer Privacy Act (CCPA) was enacted in 2018 and marked a significant milestone in the realm of data privacy and legislation in the United States. In June 2018, the California Legislature passed Assembly Bill 375, which Governor Jerry Brown signed into law, giving birth to the CCPA.

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Pediatric EM Morsels

JUNE 7, 2024

2018 Jun 19;6:170. References Licari A, Brambilla I, Marseglia A, De Filippo M, Paganelli V, Marseglia GL. Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population. Front Pediatr. doi: 10.3389/fped.2018.00170. 2018.00170. PMID: 29971223; PMCID: PMC6018103. Clin Med Res. 2004 Aug;2(3):155-63. 2.3.155.

Pediatrics 268

Pediatrics Emergency Department Wellness EMS 268