Mount Sinai EM

OCTOBER 10, 2024

He pointed to a retrospective cohort study (Riehm et al, 2019) showing that adolescents who self-reported more than three hours a day on social media experienced double the rate of anxiety and depression symptoms. To make it directly related to our wellness, I’ll focus on studies of adults. Vivek Murthy, the U.S. Lambert et al.,

Wellness 100

Wellness Research Outcomes 100

Pediatric EM Morsels

APRIL 5, 2024

Silva-Ramos 2021) Majority of cases arise from travel to South Africa. (Frean 2019) The classic triad described is fever, eschar and rash. Ricardi 2019) Tick-Borne Encephalitis has a biphasic pattern of symptoms. Ricardi 2019) Initial symptoms are nonspecific and include fever, malaise, headache, nausea, vomting and myalgias.

CDC 161

CDC Infectious Diseases Pediatrics Wellness 161

Pediatric EM Morsels

JULY 7, 2023

Horan, 2006 ] Anatomy of the PTF Joint [ Cunningham, 2019 ] The PTF joint is a synovial joint between the lateral condyle of the tibia and the head of the fibula. Seen in sports that involved aggressive twisting of the knee (ex, snowboarding, soccer, horse-riding) as well as direct trauma. 2019 Apr;31(2):156-162. MANAGE PAIN!

Dislocations 141

Dislocations Fractures Pediatrics EMS 141

NIOSH Science Blog

MAY 14, 2020

This year has seen nurses all over the world step up and battle coronavirus disease 2019 (COVID-19) fearlessly, often while navigating evolving guidance and operating under difficult conditions with strained resources. The World Health Organization proclaimed 2020 the Year of the Nurse and Midwife.

Wellness 52

Wellness Operations 52

ALiEM

OCTOBER 11, 2024

On the day of presentation, she developed a painful, intermittently bleeding “blood blister” to the left lower cheek that had increased in size, as well as new red spots on her arms and legs. Initial diagnostics include a CBC which will show isolated thrombocytopenia, as well as hemolysis labs to exclude alternative etiologies.

Academics 60

Academics Wellness 60

The Trauma Pro

OCTOBER 4, 2024

And unfortunately, I’m not able to guess the numbers well enough to do the power calculation for this study. Be sure to follow with your performance improvement program to make sure that they actually do work as well as you think! J Ped Surg 54:335-339, 2019. Did they have the statistical power to show such a difference?

Pediatrics 147

Pediatrics Outcomes Operations Emergency Department 147

Pediatric EM Morsels

JUNE 21, 2024

Chaganti 2019] Other studies have not shown a difference in infection rates between silver-containing creams and antimicrobial ointments. Antibacterial ointments , like bacitracin, tend to be well tolerated and promote faster wound healing than silver sulfadiazine and other creams in partial thickness wounds. Get the Goop!

Burns 169

Burns Pediatrics Hospitals Wellness 169

EM Literature of Note

SEPTEMBER 11, 2023

Well, PRISMS demonstrated unfavorable results. The population included for analysis is the Austrian Stroke Unit Registry from 2018 until 2019, an original cohort of 53,899 patients. The remaining ~4,000 were analyzed both in their unadjusted cohorts, as well as propensity scored cohorts comprised of roughly 20% of the original.

Stroke 113

Stroke Outcomes Wellness 113

EMergucate

NOVEMBER 5, 2019

He is clinically well and his haemodynamics are all within normal limits. Following ECG was obtained from a 24 years of age man complaining of a week history of intermittent chest pain. Describe t…

EKG/ECG 52

EKG/ECG Wellness 52

EMergucate

APRIL 8, 2020

He’s in a mild discomfort but looks well from the end of the bed and hi… Following is an ECG of a 25 years old man with a four day history of left sided chest pain and its 0400 hours in the morning.

EKG/ECG 52

EKG/ECG Wellness 52

EMergucate

AUGUST 13, 2019

She looked well from the end of the bed and at clinical exami… 61 years of age lady presented with an acute shortness of breath whilst walking her dog. She denied any chest pain nor any pre-syncope.

EKG/ECG 52

EKG/ECG Wellness EMS 52

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

Pediatric EM Morsels

SEPTEMBER 22, 2023

” Children compensate for blood and volume loss very well… until they don’t. McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. Physical exam findings of occult shock in children can be subtle. Fortunately, there are screening tools for occult shock.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency […] The post SGEM Xtra: Right, You’re Bloody Well Right, You’ve got the Bloody Right to Care first appeared on The Skeptics Guide to Emergency Medicine. Reference: Dorsett et al. Reference: Dorsett et al.

Wellness 52

Wellness Emergency Department EMS 52

Emergency Medicine Ireland

OCTOBER 14, 2024

Similarly loculations can be very easily seen with ultrasound, better than CT it seems but again don’t necessarily correlate that well with empyema. Well, adding extra or bigger drains is all very reasonable and it would seem wise to involve a thoracic surgeon at some point. 2019, (2019). LDH>1000 Sugar <2.2

Wellness 52

Wellness Ultrasounds 52

Dr. Smith's ECG Blog

JUNE 14, 2024

But artifact is "alive and well" — and learning to recognize it will amaze many of your colleagues ( and may serve to avoid an unnecessary defibrillation or two ). KEY Point: As per Dr. Frick: i ) Artifact is "alive and well" in 2024. The September 22, 2019 post — intermittent ST-T wave artifact.

EKG/ECG 73

EKG/ECG Wellness Hospitals 73

Pediatric EM Morsels

JULY 26, 2024

These females should have imaging with either MRI or CT as well as abdominal or transvaginal ultrasound to assess for ovarian teratoma. Epub 2019 Dec 19. The prevalence ranges from 12.5%-61% 61% in females of reproductive age, with approximately 45% of females older than 18 years old with teratoma. 2020 Feb;75:55-62. 2019.12.016.

Seizures 265

Seizures Psychiatric Outcomes Pediatrics 265

Pediatric EM Morsels

MARCH 17, 2023

Judge 2019) Best when given within 4 hours of the bite, but still effective within 24 hours Always give an entire vial of antivenom, never a partial vial. Published November 13, 2019. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S. It’s expensive, so if you’re giving some of a vial, give it all.

CDC 130

CDC Poisoning Pediatrics Shock 130

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

EMDocs

AUGUST 22, 2024

Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter. April 2019. January 2019. January 2019. 45:446-458. Taira B, et al.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

American Medical Compliance

JANUARY 16, 2024

Rates and Statistics of Workplace Violence According to the Bureau of Labor Statistics, 20,870 workers in the private industry experienced trauma from nonfatal workplace violence in 2019. 68% of these individuals identified as female as well. Also, these incidents required days away from work.

Wellness 52

Wellness 52

Don't Forget the Bubbles

DECEMBER 11, 2023

Naturally, it can seem obvious to us now that abuse and trauma in childhood can affect your health and well-being quite significantly, but what was surprising at the time was not just that these events had an impact but how much of an impact these adverse childhood events had. Could there be an element of causation as well as correlation?

Wellness 104

Wellness Research Outcomes Shock 104

SheMD

JULY 30, 2023

According to ,, AAMC , there were 53,371 medical school applicants in the 2019-2020 application cycle, and only 21,869 matriculated. Remember, letter writers can talk about your intellectual strengths as well as your personal attributes and character. Ask your potential letter of recommendation writers well in advance.

Academics 104

Academics Leadership Research Wellness 104

Pediatric EM Morsels

APRIL 7, 2023

Observation, interaction with patient, as well as parent information is key to bring the whole picture together!

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

Dr. Smith's ECG Blog

OCTOBER 3, 2024

Smith : "Gestalt, but if I must explain: well formed J-waves and high voltage R waves." It has some inferior ST elevation with some reciprocal ST depression and inverted T in aVL. This usually indicates inferior OMI. My answer: "Fake: pretty certain, but not 100% certain." Sam : "why do you say fake?"

EKG/ECG 105

EKG/ECG Wellness 105

Pediatric EM Morsels

AUGUST 18, 2023

Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications. (Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

The Trauma Pro

SEPTEMBER 14, 2023

” This guideline was implemented in 2018-2019, and patients presenting before implementation were compared to those arriving after. The Medical College of Wisconsin trauma group performed a retrospective review of 391 patient charts to test a new 300cc rule defining when a hemothorax is “too big.”

Resuscitation 162

Resuscitation Hospitals Wellness 162

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. Respiratory and cardiovascular exams are normal. BMP : Na 136, K 4.3,

Ultrasounds 97

Ultrasounds Emergency Department Wellness Operations 97

Don't Forget the Bubbles

OCTOBER 14, 2024

The government recognizes they cannot return to their country of origin owing to a well-founded fear of being persecuted for the reasons provided for in the United Nations Refugee Convention or European Convention on Human Rights (such as persecution due to race, sexuality, political opinions, or religion). Harbingers’ Magazine. The BMJ.

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

33 Charts

NOVEMBER 5, 2021

Our patients are seen as collections of proteins, genes and markers (I was privileged to talk about this at DotMD 2019). It owns the space where technology, art, digital culture, creativity, wellness and human narrative collide for a broader view of the care experience. All of this neutralizes the texture of the human journey.

Wellness 91

Wellness 91

Dr. Smith's ECG Blog

DECEMBER 19, 2023

The patient did well afterward without any recurrence of symptoms. From My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog: A subject well worth periodic review — is the concept of Terminal QRS Distortion ( T-QRS-D ). Figure-4: I've labeled the first 2 ECGs shown in the November 14, 2019 post ( See text ).

EKG/ECG 113

EKG/ECG EMS Wellness Operations 113

EMDocs

OCTOBER 8, 2024

Tachycardia may be present both from many medications or drugs, as well as withdrawal. Let’s use the example of the well appearing patient, without significant comorbidities. Disposition of sinus tachycardia depends on many factors, however the well-appearing asymptomatic patient does not require admission for tachycardia alone.

Shock 95

Shock Emergency Department Pediatrics EKG/ECG 95

SheMD

AUGUST 3, 2023

AMCAS- $170 for processing fee + one med school designation, $40 for additional designations (AAMC, 2019) AACOMAS- $195 initial application fee + one med school designation, $45 for additional designations (AACOMAS, 2019) TMDSAS- $185 flat rate (TMDSAS, 2019) Secondaries- varies by school. Best of luck applying to med school!

Wellness 98

Wellness 98

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

He did well and was discharged. Osborn waves have been reported with hypercalcemia, brain injury, subarachnoid hemorrhage, Brugada syndrome, cardiac arrest from VFib — and — severe, acute ischemia resulting in acute MI ( See My Comment in the November 22, 2019 post on Dr. Smith’s Blog ). C), with Cardiac Echo -- A Pathognomonic ECG.

Hyperthermia / Hypothermia 127

Hyperthermia / Hypothermia EKG/ECG Wellness 127

PHARM

SEPTEMBER 21, 2023

We studied the quality of prehospital care in severe TBI patients by analyzing adherence to recommended target ranges for ventilation and blood pressure, prehospital time expenditure, and their effect on mortality, as well as quality of prehospital ventilation assessed by arterial partial pressure of CO2 (PaCO2) at hospital admission.

Hospitals 40

Hospitals Resuscitation Wellness Outcomes 40

Dr. Smith's ECG Blog

AUGUST 2, 2024

The LCx and OM branches are not as well seen. We've highlighted a considerable number of acute RV MI cases in Dr. Smith's ECG Blog ( See the October 7, 2019 and May 10, 2024 posts , to name just two ). This is the right anterior oblique cranial view Here is a representative still. There is non-obstructive disease here.

EKG/ECG 103

EKG/ECG Fluid Resuscitation Academics Resuscitation 103

ALiEM

APRIL 12, 2023

The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. Hemmings, Talmage D.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103