Dr. Smith's ECG Blog

MARCH 15, 2023

We designed a step-up protocol in which shocks at 50, 100, 200, 300, and 360 J were used for transthoracic cardioversion. IF the Patient is Younger and Athletic: The mechanism of AFib in younger, athletic individuals is often heavily influenced by increased vagal tone ( Rao and Shipon — ACC, 2019 — and — Calvo et al — Br J Sports Med, 2012 ).

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

EMDocs

DECEMBER 16, 2023

Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. Patients with heat stroke have hot, dry skin and altered mental status (e.g., C, and heat stroke occurs at a core temperature > 40°C. C, and heat stroke occurs at a core temperature > 40°C. Temps greater than 41.5C Heatstroke.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Date: September 11th, 2019 Reference: Putzu et al. Date: September 11th, 2019 Reference: Putzu et al. Case: A 45-year-old female in the emergency department is being admitted to the intensive care unit (ICU) for septic shock secondary to urinary tract infection (UTI). Critical Care Medicine. Critical Care Medicine.

Sepsis 52

Sepsis Shock Outcomes Stroke 52

Taming the SRU

AUGUST 30, 2023

The 2019 Journal of Arthroplasty practice guidelines to screen for periprosthetic joint infections recommend using ESR at 30mm/hr and CRP at 10mg/L, citing pooled sensitivities and specificities ranging from 75%-86% and 70-72.3%, respectively, for ESR and 88% and 73-74%, respectively, for CRP [32]. 2019 Feb;34(2S):S187-S195.

Infectious Diseases 86

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 86

RebelEM

JUNE 8, 2023

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. Epub 2019 Jul 3. Nontraumatic hypotension and shock in the emergency department and the prehospital setting, prevalence, etiology, and mortality: a systematic review.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 First up is the link between cannabis use and stroke or TIA. times higher risk of stroke or TIA. An RCT is underway in Canada on the use of ondansetron versus haloperidol with an estimated completion of July 2019.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Dr. Smith's ECG Blog

JANUARY 9, 2024

Slow VT below the detection rate of the ICD lead to worsening heart failure and low stroke volume. Lowering the back up rate (LRL) of the ICD/pacer allowed for an intrinsic rhythm with physiologic AV conduction and normal AV synchrony with resultant increase in stroke volume and cardiac outpt.

EKG/ECG 102

EKG/ECG Stroke Hospitals Documentation/Coding 102

RebelEM

JUNE 26, 2023

J Trauma Acute Care Surg 2019. Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 NOT STATISTICALLY SIGNIFICANT Also no difference in individual components given Thromboembolic Events: 4F-PCC: 35% Placebo: 24% Absolute Diff: 11%; 95% CI 1 to 21% Relative Risk 1.48; 95% CI 1.04 to 2.10; P = 0.03

Administration 144

Administration Outcomes Resuscitation Radiology 144

RebelEM

FEBRUARY 8, 2024

Background: Patients with shock frequently present with hypotension. Many of these patients are started on vasopressor and inopressor medications to assist in efforts to normalize blood pressure to help improve organ perfusion. In shocky patients, arterial lines are often used to monitor hemodynamic parameters and inform treatment decisions.

Resuscitation 116

Resuscitation Outcomes EMS Sepsis 116

ACEP Now

NOVEMBER 7, 2023

Double sequential external defibrillation (DSED) is a technique in which rapid sequential shocks are placed from two defibrillators, with defibrillation pads in two planes, such as anterior-lateral and anterior-posterior. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

Don't Forget the Bubbles

JULY 5, 2023

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. Stroke Authors’ Recommendation: CTA head/neck should be acquired in patients with stroke symptoms presenting within 24 hours of symptom onset.

Stroke 87

Stroke Radiology Radiology Emergency Department 87

Dr. Smith's ECG Blog

JANUARY 5, 2020

IJC Heart and Vasculature 25(2019). speci fi city of the General Electric (GE) algorithm for AF, but they excluded cases with ventricular paced rhythm (VPR), in which the underlying atrial rhythm was frequently AF;we did not exclude VPR, as accurate identi fi cation of AF in VPR is important for determination of stroke risk [ 22 ].

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 52

Taming the SRU

APRIL 26, 2023

First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Misdiagnosis of exertional heat stroke and improper medical treatment. N Engl J Med 2019. Cooling Methods in Heat Stroke. Am Fam Physician 2019; 99:482. Resuscitation 2020. Druyan A, Janovich R, Heled Y.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52