Dr. Smith's ECG Blog

OCTOBER 20, 2024

sepsis, anemia, hypoxemia, severe hypotension etc., The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. The patient was given aspirin and heparin. While preparing for transport the patient became ashen and confused with cool and clammy skin and a very weak pulse.

EKG/ECG 127

EKG/ECG Shock Emergency Department Ambulance Services 127

Don't Forget the Bubbles

JUNE 30, 2023

Importantly, there were no differences between the groups regarding complications, including acute respiratory distress syndrome, multiple organ failure, venous thromboembolism, sepsis, and transfusion-related complications. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. 2018, Kuttab, Lykins et al. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Interdisciplinary Neurosurgery, 13, 66-70.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. In total, they pulled references from 1966 until 2018. Jeff: Let’s move on to evaluation in the emergency department.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

The Skeptics' Guide to EM

FEBRUARY 10, 2018

[display_podcast] Date: February 6th, 2018 Reference: Foster SJ et al. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. display_podcast] Date: February 6th, 2018 Reference: Foster SJ et al.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

The Skeptics' Guide to EM

FEBRUARY 24, 2018

[display_podcast] Date: February 14th, 2018 Reference: Venkatesh S et al. NEJM January 2018. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. NEJM January 2018. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

The Skeptics' Guide to EM

FEBRUARY 2, 2019

The Lancet 2018. Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. DISCLAIMER: THE […] The post SGEM#243: Enough is Enough (O2 Saturation of 94-96%) first appeared on The Skeptics Guide to Emergency Medicine. The Lancet 2018. The Lancet 2018. Reference: Chu DK et al.

Poisoning 52

Poisoning Administration Hospitals Outcomes 52

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Don't Forget the Bubbles

JULY 5, 2023

Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. Sickle cell patients also qualify to receive the annual influenza vaccine, since influenza virus infection predisposes to bacterial pneumonia and sepsis caused by S. Pneumococcal sepsis B.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. Complications of acute gallbladder perforation include localized peritonitis, hepatic, subhepatic, or pelvic abscess formation, pneumonia, pancreatitis, acute renal failure, and sepsis (7). World J Emerg Surg 13, 9 (2018).

Ultrasounds 77

Ultrasounds Sepsis Radiology Radiology 77

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Enrollment period was from February 2016 to August 2018. West J Emerg Med. Am J Emerg Med.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

Taming the SRU

JULY 21, 2023

Eye Pathology Now let’s dive back into some common eye disease processes you may see on a typical day in the emergency department. In infants, this can represent a medical emergency as it can quickly lead to orbital cellulitis and sepsis. HOW DOES TREATMENT BETWEEN INFANTS (< 1 year old) AND ADULTS DIFFER?

Emergency Department 86

Emergency Department EMS Burns Wellness 86

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). 2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., A., & Koehler, P. Cabellos, C.,

Infectious Diseases 96

Infectious Diseases Seizures Ultrasounds Sepsis 96

Northwestern EM Blog

JANUARY 24, 2022

Acidosis Acidosis in shock states can present from multiple different sources, including sepsis, hypoxemia, ingestions, hyperlactatemia from hypoperfusion, amongst others. 2018; 44(5): 652-655. Hypothyroidism and Adrenal Insufficiency in Sepsis and Hemorrhagic Shock. 2018; 22(1):215. Intensive Care Medicine. 3) Farkas J.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

EMDocs

MAY 11, 2024

Cavernous sinus syndrome (B) usually presents with cranial nerve deficits, diplopia, periorbital cellulitis, and facial swelling that may progress to meningitis or sepsis. Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med.

Stroke 90

Stroke EMS EKG/ECG Radiology 90

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Klein 2018) Despite the high risk of pathology and decompensation, many patients with presumed alcohol intoxication can be evaluated and discharged without any labs or imaging. Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Don't Forget the Bubbles

JULY 22, 2024

The 2018 PREVIEW trial reported a significant reduction in length of stay (LOS) in children given prednisolone in Australia (24-71 months, mean 41 months) compared to placebo. There is an increased risk of pneumonia and sepsis in the 31-90 days after prescription and an increased risk of fractures, GI bleeds and sub-optimal growth.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

The Skeptics' Guide to EM

APRIL 20, 2019

The article was called “A lexicon for gender bias in academia and medicine: Mansplaining is the tip of the iceberg” It was published in the December 2018 edition of the BMJ. Case: A 52-year-old man presents to the emergency department via EMS after a motor vehicle collision while driving home from the city.

Emergency Nursing 40

Emergency Nursing Sepsis EMS Fractures 40

EMDocs

JUNE 27, 2024

2018 Aug;46(3):144-151. Epub 2018 Oct 17. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 Am J Hematol.

Pediatrics 76

Pediatrics Dehydration EMS Hospitals 76

EMDocs

JULY 26, 2023

Mother states that the rash started as flat spots but then became raised bumps. The virus then disseminates to lymphoid organs, and viral amplification within lymphoid organs results in a secondary viremia, which heralds the onset of symptoms. 3 Incubation period is about 12 days (range 7-19 days). 3-4 There are no asymptomatic carriers.

CDC 69

CDC Research Pediatrics Wellness 69

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. Always consider management as per ATLS protocol and SEPSIS 6 if relevant. English hospital episode data analysis (1998–2018) reveal that the rise in dog bite hospital admissions is driven by adult cases. Eplasty, 13, e27. Fleming, K.M.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Don't Forget the Bubbles

FEBRUARY 5, 2024

The study surveyed 2855 Canadian adolescents in 2018 and found that those who skipped breakfast were 2.55 Role of diagnostic tests for sepsis in children: a review. Procedural sedation programme minimising adverse events: a 3-year experience from a tertiary paediatric emergency department. Anagnostou A, et al.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Can J of Cardiol 2018, 34: 132-145 Here are some other cases: LVH, LBBB, RBBB, and RVH may manifest ST depression without any ischemia! Am J Med 2019, 132(5):622-630.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 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. was sensitive for 28-day mortality in sepsis. In one study, a SI > 0.7

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Dr. Smith's ECG Blog

MAY 19, 2020

She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). pulmonary embolism, sepsis, etc.), An elderly woman had sudden ventricular fibrillation. ECMO Flow was achieved after approximately 1 hour of high quality CPR. myocarditis).

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. This is true in life-threatening conditions such as sepsis. Hibberd, O.;

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

Don't Forget the Bubbles

NOVEMBER 1, 2023

This month, Bubble Wrap has teamed up with Sheffield Children’s Hospital Emergency Department to have a look at what’s new in paediatric literature. Lactate as a screening tool for critical illness in a pediatric emergency department. Pediatric Emergency Care. 2023 Oct 1;39(10):735-8. What’s it about?

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

Taming the SRU

SEPTEMBER 16, 2024

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. While they are a lifesaving staple of medicine, they also come with risks that emergency providers must be aware of. 2, July 2022, pp. 169–173, [link] Aubron, C., Transfusion Clinique et Biologique , vol. Accessed 8 Sept.

Blood Transfusions 88

Blood Transfusions Anaphylaxis Emergency Department Sepsis 88

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. 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. 2018 May;26(5):1465-1470. Ann Emerg Med.

Infectious Diseases 104

Infectious Diseases Administration Sepsis Anaphylaxis 104

EMDocs

OCTOBER 17, 2023

A 2018 risk score incorporates the presence of abdominal guarding, WBC, and CRP. Those with abdominal guarding, WBC over 20,000, and CRP over 25 mg/dL demonstrated a risk of complicated diverticulitis of over 85% (Bolkenstein 2018). A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department.

Radiology 68

Radiology Radiology Operations Best Practices 68

The Skeptics' Guide to EM

JUNE 15, 2018

[display_podcast] Date: June 12th, 2018 Reference: DeMeester S et al. Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. display_podcast] Date: June 12th, 2018 Reference: DeMeester S et al.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

RebelEM

NOVEMBER 11, 2024

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. address in the article discussed below. JAMA Intern Med.

Sepsis 84

Sepsis Outcomes Administration Shock 84