Ken Grauer, MD

AUGUST 22, 2024

Given that this patient is symptomatic ( as well as hemodynamically unstable ) — it no longer matters whether this rhythm is of supraventricular etiology or VT because regardless — immediate cardioversion is clearly indicated. Instead — immediate cardioversion is indicated!

EKG/ECG 257

EKG/ECG Wellness 257

The Trauma Pro

APRIL 2, 2024

A Brief Report in the British Medical Journal Open shows us what may very well be the next stage in treating these injuries. It may very well eliminate the need for a diverting colostomy. BMJ Open 5(1) epub 5/12/2020. Ditto for the distal rectal washout. But remember, this is only a case report.

Wellness 147

Wellness 147

Ken Grauer, MD

AUGUST 29, 2024

The patient was offered EP ( E lectro P hysiologic ) study — but she refused, since she "was feeling well". Working through a case of a regular WCT Rhythm in this 80-something woman — See My Comment in the May 5, 2020 post on Dr. Smith’s ECG Blog. Troponin — was negative for acute infarction.

EKG/ECG 392

EKG/ECG Hospitals Wellness 392

The Trauma Pro

OCTOBER 25, 2024

Authors from several well-known trauma centers collaborated to re-analyze data from the CLOTT study. Here are the factoids: The original data were derived from a 17-center study conducted from 2018-2020; this study only included 1,387 patients who had pelvic fractures (as well as other injuries).

Fractures 147

Fractures Head Injuries Operations Ultrasounds 147

Ken Grauer, MD

MARCH 27, 2024

Working through a case of a regular WCT Rhythm in this 80-something woman — See My Comment in the May 5, 2020 post on Dr. Smith’s ECG Blog. Another case of a regular WCT Rhythm in a 60-something woman — See My Comment at the bottom of the page in the April 15, 2020 post on Dr. Smith’s ECG Blog.

EKG/ECG 469

EKG/ECG Wellness 469

Pediatric EM Morsels

APRIL 5, 2024

This is true of hard ticks , which carry the majority of bacteria and viruses which can infect humans (Rochlin 2020) This is not true when the infectious agent is carried by a soft tick. Rochlin 2020) Shares many of the same symptoms as African tick-bite fever. In the US, outbreaks have been linked to rental cabins near national parks.

CDC 161

CDC Infectious Diseases Pediatrics Wellness 161

Ken Grauer, MD

OCTOBER 10, 2024

This is not to say that sinus tachycardia will never go faster than 170/minute — but rather to suggest that when the rate of the regular SVT rhythm you are assessing is well over this rate range — then the rhythm is less likely to be sinus tachycardia. NOTE : This ~140-160/min. range is for untreated AFlutter.

EKG/ECG 425

EKG/ECG Sepsis Wellness 425

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Date: February 11th, 2020 Reference: Yeh et al. Case: A 32-year-old woman with no previous medical history calls you while a passenger on a […] The post SGEM#284: Might as Well Jump, but We would Recommend a Parachute first appeared on The Skeptics Guide to Emergency Medicine. Date: February 11th, 2020 Reference: Yeh et al.

Wellness 52

Wellness Outcomes Emergency Department Research 52

Pediatric EM Morsels

AUGUST 11, 2023

Having authored 575 ( well, now 576 ) of them, I am often quite convinced that there are no new topics to discuss. 2020 Oct 24;12(10):e11141. This is the 601st Ped EM Morsel ! Then July happens and we get 14 more amazing interns who help educate me and remind me that there is always more to learn. Can Fam Physician. doi: 10.46747/cfp.6809661.

Burns 130

Burns Pediatrics EMS Outcomes 130

NIOSH Science Blog

MAY 14, 2020

The World Health Organization proclaimed 2020 the Year of the Nurse and Midwife. None of us could have anticipated how prescient that would be.

Wellness 52

Wellness Operations 52

Pediatric EM Morsels

APRIL 7, 2023

Observation, interaction with patient, as well as parent information is key to bring the whole picture together! American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults. 2020 Apr 28;4(8):1554-1588. doi: 10.1182/bloodadvances.2019001142.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

PEMBlog

SEPTEMBER 26, 2024

Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com. Check out all of this year’s cases as well as the previous online cases at EmergiQuiz.com ! Traditionally these cases are presented live at the AAP National Conference and Exhibition.

Wellness 52

Wellness 52

Ken Grauer, MD

AUGUST 8, 2024

But, given my heightened clinical suspicion — there is no denying ST segment straightening in leads I and aVL , as well as in the inferior leads. ECG Blog #193 — Reviews the basics for predicting the " culprit " artery ( as well as reviewing why the term "STEMI" — should be replaced by "OMI" = O cclusion-based MI ).

EKG/ECG 412

EKG/ECG Resuscitation Wellness 412

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Date: January 27th, 2020 Guest Skeptics: Dr. Richelle Cooper is a Professor of Emergency Medicine at the UCLA Department of Emergency Medicine. Date: January 27th, 2020 Guest Skeptics: Dr. Richelle Cooper is a Professor of Emergency Medicine at the UCLA Department of Emergency Medicine. Reference: Dorsett et al.

Wellness 52

Wellness Emergency Department EMS 52

EMergucate

AUGUST 5, 2020

The patient is well known to the department, with frequent presentations with chest pain. A 50 year old female presents to ED complaining of chest pain. Recent MPS shows mild reversible inferior ch…

EKG/ECG 52

EKG/ECG Wellness 52

EMergucate

AUGUST 4, 2020

The patient is well known to the department, with frequent presentations with chest pain. A 50 year old female presents to ED complaining of chest pain. Recent MPS shows mild reversible inferior ch…

EKG/ECG 52

EKG/ECG Wellness 52

Ken Grauer, MD

JUNE 14, 2024

The above said, when for whatever reason sinus P waves are not well seen in lead II — the 2nd -best lead when looking to determine if sinus rhythm is present, is lead V1. ECG Blog #193 — Reviews the basics for predicting the "culprit" artery ( as well as reviewing why the term "STEMI" should be replaced by "OMI" = O cclusion-based MI ).

EKG/ECG 407

EKG/ECG Wellness Hospitals 407

PEMBlog

SEPTEMBER 24, 2024

Since 2020 the AAP Section on Emergency Medicine has also been sponsoring the publication of online cases on EmergiQuiz.com. Check out all of this year’s cases as well as the previous online cases at EmergiQuiz.com ! Traditionally these cases are presented live at the AAP National Conference and Exhibition.

Wellness 59

Wellness 59

EMergucate

APRIL 28, 2020

He looks well from the end of the bed and his haemodynamics a… Following is an ECG of a 62 years of age Vietnamese man who has presented with an 8 hour history of intermittent left sided chest pain.

EKG/ECG 52

EKG/ECG Wellness EMS 52

EMergucate

APRIL 7, 2020

He’s in a mild discomfort but looks well from the end of the bed … 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 EMS 52

EMergucate

AUGUST 18, 2020

This 36 year old normally well woman presented with an episode of chest pain radiating to her arm. Her ECG … Continue reading →

EKG/ECG 52

EKG/ECG Wellness 52

EMergucate

NOVEMBER 17, 2020

The ECG below is from a 46 year old lady who has presented to ED at 7pm after experiencing palpitations since 2am that day, but otherwise feels well.

EKG/ECG 52

EKG/ECG Wellness 52

EMergucate

AUGUST 18, 2020

This 36 year old normally well woman presented with an episode of chest pain radiating to her arm. Her ECG … Continue reading →

EKG/ECG 52

EKG/ECG Wellness 52

Ken Grauer, MD

JUNE 7, 2024

Improvement of symptoms that correlates with improvement in ECG findings does not mean "all is well". ECG Blog #193 — Reviews the basics for predicting the " culprit " artery ( as well as reviewing why the term "STEMI" — should be replaced by "OMI" = O cclusion-based MI ). Figure-2: I've labeled the initial ECG in today's case.

EKG/ECG 445

EKG/ECG Wellness 445

Sensible Medicine

OCTOBER 15, 2024

Forced masking sends a false signal to the public that health care facilities are “dangerous” This idea did tremendous harm in the first covid wave in 2020 when many patients with serious symptoms avoided hospitals. Being forced to comply with irrational requirements is a well-understood cause of moral injury and burnout.

Hospitals 129

Hospitals Wellness 129

ALiEM

FEBRUARY 9, 2024

Let’s apply the ESC 2020 0/1 hour pathway [2], with some modifications based on the 2022 ACC guidelines [1]: Figure 1. Pulses are well felt in all four limbs. She would be low risk by gestalt or structured scoring systems (Wells or revised Geneva), and a negative D-dimer would essentially rule out pulmonary embolism here.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

EMergucate

NOVEMBER 17, 2020

The ECG below is from a 46 year old lady who has presented to ED at 7pm after experiencing palpitations since 2am that day, but otherwise feels well.

EKG/ECG 40

EKG/ECG Wellness 40

Pediatric EM Morsels

NOVEMBER 3, 2023

falciparum accounts for >70% of cases of imported malaria , primarily seen in those returning from travel in Sub-Saharan Africa (Mischlinger 2020) Other species include P. 2020 Mar 11;33(2):e00104-19. vivax , P. malariae , and the less common P. knowlesi and P. simium (Forgie 2022) P. vivax and P. vivax , P. knowlesi and P.

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

Dr. Smith's ECG Blog

DECEMBER 13, 2023

And she learned it well: She is not highly confident, but she does diagnose OMI. Figure-1: I've labeled the initial ECG in today's case — as well as enlarging the QRST complex in lead V2. So we taught the Queen on cases with very low voltage that were OMI. OR — Maybe there is LA-LL Lead Reversal ???

EKG/ECG 113

EKG/ECG COPD Wellness Outcomes 113

Dr. Smith's ECG Blog

OCTOBER 20, 2024

This series of ECGs ( ECG #1 , #2 and #4 ) illustrate well that subtotal occlusion of the left main is usually associated with severe subendocardial ischemia (profound and diffuse ST depression), whereas an ECG recorded during total occlusion of the LMCA (ECG #2) will show widespread ST elevations. There is now some flow in the LMCA!

EKG/ECG 125

EKG/ECG Shock Emergency Department Ambulance Services 125

SheMD

JULY 30, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. According to ,, AAMC , there were 53,371 medical school applicants in the 2019-2020 application cycle, and only 21,869 matriculated. Ask your potential letter of recommendation writers well in advance.

Academics 104

Academics Leadership Research Wellness 104

Ken Grauer, MD

APRIL 18, 2023

This blog post reviews the basics for predicting the " C ulprit" A rtery ( as well as reviewing why the term "STEMI" — should replaced by " OMI" = O cclusion-based MI ). The February 11, 2020 post ( LA-RA reversal ). The March 18, 2020 post ( LA-RA reversal ). The August 28, 2020 post ( LA-LL reversal ).

EKG/ECG 195

EKG/ECG Wellness 195

EM Literature of Note

SEPTEMBER 13, 2024

Most regions used a strategy in which nirsevimab was provided to new births during RSV season, as well as other young infants born prior to the onset of the season. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

Emergency Department 85

Emergency Department Pediatrics Administration Wellness 85

Sensible Medicine

JANUARY 11, 2024

She and the audience reflected on the dark days of 2020. I remember a hike in the mountains of northern New Mexico, summer 2020, on which everyone pulled on a mask when passing each other on the trail. If I reside too far to one side of my well-adjusted, poetry reading acquaintances, I imagine the masked live too far on the other side.

Wellness 105

Wellness 105

Ken Grauer, MD

MAY 16, 2024

ECG Blog #193 — Reviews the basics for predicting the " culprit " artery ( as well as reviewing why the term "STEMI" — should be replaced by "OMI" = O cclusion-based MI ). R elated E CG B log P osts to Today’s Case : ECG Blog #205 — Reviews my S ystematic A pproach to 12-lead ECG Interpretation.

EKG/ECG 405

EKG/ECG Wellness 405

ALiEM

MARCH 15, 2024

It can be caused by ocular surgery and neoplastic disease, as well. 2020, March 18). The most common cause is blunt trauma to the eye. Spontaneous hyphemas can also occur and are often associated with sickle cell disease. Patients should elevate the head of the bed to 45 degrees since layering of the blood is gravity-dependent.

Academics 64

Academics Administration Wellness 64

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? 2020 Nov;163(5):915-922. Epub 2020 Jun 2. 2020, August 18). Article: Kim DJ et al. Acad Emerg Med.

Ultrasounds 130

Ultrasounds Radiology Radiology Operations 130