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ECG Video Blog #407 (292): Why the Patient Died?

Ken Grauer, MD

Instead, he left the hospital — only to be found dead at home 36 hours later. The July 31, 2018 post in Dr. Smith's ECG Blog ( Please scroll down to the bottom of the page to see My Comment ). ECG #2 was recorded 1 hour after ECG #1. Initial troponin was negative. Cardiac cath was advised — but the patient refused.

EKG/ECG 408
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Pre-Hospital Antibiotics in Sepsis?

RebelEM

PMID: 35387313 Clinical Question: Do prehospital antibiotics impact 28 day mortality, length of stay in the hospital and ICU length of stay for patients triggering sepsis compared to usual care (No prehospital antibiotics)? to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26 to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 130
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Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Pediatric EM Morsels

2018;Volume 00(00):DOI:10.1097/BPO.0000000000001169. Hospital versus home management of children with buckle fractures of the distal radius. old) with pure buckle fracture of the distal radius, ulna or both were: treated with a removable wrist brace, parents given specific activity restrictions and directions on removal of splint.

Fractures 290
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Giving TXA Via An Intraosseous Line?

The Trauma Pro

The US military has adopted its routine use at forward combat hospitals. J Trauma 84(2):379-385, 2018. This drug is cheap and has antifibrinolytic properties that may be beneficial if given for life-threatening bleeding within 3 hours of initial injury. But what if you don’t have IV access?

Military 279
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Lung Abscess in Children

Pediatric EM Morsels

Lung abscess is a rare subset of these (< 1% of admitted cases of pneumonia ( Wojsyk-Banaszak, 2018 ) Lung abscess = collection of fluid within a thick-walled localized area of necrotic lung parenchyma. Lung abscess: 14 years of experience in a tertiary paediatric hospital. 2018 May;24(5):376-382. 2018 May;24(5):376-382.

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ECG Blog #412 — Is Cardiac Cath Indicated?

Ken Grauer, MD

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 397
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ECG Video Blog #408 (392) — 20 Minutes Later.

Ken Grauer, MD

About 20 minutes later ( on the way to the hospital ) — the patient's CP resolved, and ECG #1 was recorded. The July 31, 2018 post in Dr. Smith's ECG Blog ( Please scroll down to the bottom of the page to see My Comment ).

EKG/ECG 378