Dr. Smith's ECG Blog

AUGUST 2, 2024

The LCx and OM branches are not as well seen. Yet recognition of acute RV MI is extremely important clinically — because emergency treatment will often require different priorities (ie, avoidance of nitroglycerine; fluid resuscitation for hypotension ). This shot is typically best for viewing the LAD and its diagonal branches.

EKG/ECG 119

EKG/ECG Fluid Resuscitation Academics Resuscitation 119

EMDocs

NOVEMBER 1, 2023

ECG – May show tachycardia or rate related ST depressions Laboratory evaluation: CBC w/ differential – may reveal leukocytosis with left shift CMP, Lipase – can reveal alternative intra-abdominal diagnoses as well as show findings of end-organ hypoperfusion (elevated serum creatinine, transaminitis, etc.) McGraw-Hill Education; 2020.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. 2020:395(10241):1927-1936. Sleep well, endoscopist: January 2021 Annals of Emergency Medicine journal club. Patients should be assessed for evidence of hypovolemia or active exsanguination. Dionne JC, Oczkowski SJW, Hunt BJ, et al. Crit Care Med. 2022;50(3):e313-e319.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

Mind The Bleep

FEBRUARY 9, 2024

She is moderately frail with a few well-managed comorbidities, and states that she would not want to live if she was not able to do her gardening or hold her grandchildren. University of Aberdeen (2020) Making decisions about who to admit to Intensive Care, University of Aberdeen. References and further reading Smith G, Nielsen M.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

Taming the SRU

MAY 5, 2023

Despite the complexity and heterogeneity of patients with sepsis, there have been few interventions which have been demonstrated to decrease mortality: early antimicrobial and fluid administration (Levy, Evans et al. There were similar baseline characteristics and the groups were well-matched. Adam (2020). 2021, Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed. As with soldiers in war, we know that as soon as we stop doing, we will start feeling.”

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. Welcome to your first day with the neonates! Upon arriving for your initial shift, you set down your bag, and shortly after, you’re asked to evaluate Baby A.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EMDocs

JANUARY 20, 2024

The most common findings on ECG are ST elevation , most often in the anterior precordial leads, as well as sinus tachycardia and QT interval prolongation. Additional fluids will not improve her condition and may worsen it. 2020 Apr;7(2):400-406. 2020 Jan 3;12(1):e6556. ESC Heart Fail. J Med Life. 2020;13(1):3-7.

EMS 101

EMS Fluid Resuscitation Shock EKG/ECG 101

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2020 Feb 12;10(1):2470. C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

RebelEM

DECEMBER 23, 2024

VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ). saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). Lactated Ringer (LR) and 0.9% JAMA Intern Med.

Fluid Resuscitation 129

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 129

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 17, 2025

Venous Congestion in Adult Critical Care In adults, venous congestion is a well-recognized contributor to organ dysfunction in many conditions, including septic shock and heart failure. In the adult population, for example, most cases of volume-overloaded congestion respond well to diuretics, as these are often related to left heart failure.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Taming the SRU

MARCH 3, 2025

million fires in 2020, with some studies quoting over 500,000 emergency room visits annually for burn and inhalation injuries (4). Because of this high number of visits, it is important for ED physicians to have a broad knowledge base for treating chemical inhalation injuries as well as fire and smoke related injuries.

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52