Ken Grauer, MD

SEPTEMBER 22, 2023

The November 27, 2021 post ( LA-RA reversal ). The March 18, 2020 post ( LA-RA reversal ). The July 28, 2020 post ( RA-LL reversal ). The August 28, 2020 post ( LA-LL reversal ). The November 19, 2020 post ( LA-LL reversal ). The April 17, 2022 post ( Leads V1,V2 misplacement ). The May 5, 2022 post ( LA-RA reversal ).

EKG/ECG 442

EKG/ECG Wellness 442

Science Based Medicine

SEPTEMBER 12, 2023

Doctors who repeatedly predicted herd immunity in 2020 and 2021, mocking and berating those who disagreed, now treat herd immunity as a taboo phrase. The post When Did “Herd Immunity” Become a Taboo Phrase? first appeared on Science-Based Medicine.

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144

Science Based Medicine

AUGUST 25, 2024

Vinay Prasad started treating vaccine side effects as a fate worse than death in February 2021, before these was a COVID vaccine for children. The post Dr. Vinay Prasad Opposed The Pediatric COVID Vaccine Before There Was A Pediatric COVID Vaccine first appeared on Science-Based Medicine.

Pediatrics 132

Pediatrics 132

Science Based Medicine

OCTOBER 1, 2023

Overselling the vaccine in 2021 was not being pro-vaccine. It was pro-stop-worrying-about-the pandemic, from the doctors who assured us herd immunity was imminent. The post Overhyping Vaccines Wasn’t Pro-Vaccine. It Was Pro-Stop-Worrying-About-COVID. first appeared on Science-Based Medicine.

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Pediatric EM Morsels

MARCH 17, 2023

In the US, the venomous snakes include rattlesnakes , copperheads, cottonmouths/water moccasins , and coral snakes [ CDC, 2021 ] Rattlesnakes live all across the United State s Copperheads inhabit the eastern U.S. If you are managing a snake bite from a snake that does not typically reside in the U.S.,

CDC 130

CDC Poisoning Pediatrics Shock 130

Science Based Medicine

OCTOBER 23, 2023

Tech bro turned antivax influencer Steve Kirsch is claiming that Michigan State University economist Mark Skidmore has been "exonerated" after having had a paper retracted claiming 278K deaths from COVID-19 vaccines in 2021 alone.

134

134

Emergency Medicine Journal

NOVEMBER 21, 2024

million ED visits from 2016 to 2021. of self-injury-related ED visits in 2020 and 2021, respectively (pandemic years), compared with an average of 8.4% Results Our analysis covered 419.4 Individuals experiencing homelessness constituted 1.8% (7.4 million) of ED visits. Overall, 1.8% of ED visits (7.7 in the previous years.

Emergency Department 52

Emergency Department Outcomes Hospitals 52

Pediatric EM Morsels

AUGUST 9, 2024

2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. 2021 Feb 5;14(2):e240532.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

Pediatric EM Morsels

JUNE 16, 2023

2021) Morel-Lavallee lesion , Orthobullets. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Soft Tissue Injuries 152

Soft Tissue Injuries Dehydration Fractures Operations 152

Mount Sinai EM

OCTOBER 10, 2024

2021) of 16 prospective studies with 619 total patients found a sensitivity of 90% and specificity of 85% for elevated ICP, as compared to invasive ICP monitoring. Image Credit: POCUS Toronto Contraindications to Evaluation : Globe rupture The Evidence: A meta-analysis (Ohle et al., A meta-analysis (Aletreby et al.,

Urgent Care 232

Urgent Care Ultrasounds 232

Pediatric EM Morsels

NOVEMBER 3, 2023

Travel Medicine and Infectious Disease 44 (2021) 102196. falciparum parasitemia , and no other defined cause of AMS (WHO 2023). PMID: 36209409 Comelli A, Guarner ME, Tomasoni LR, Zamboni AF, Pavo BM, Zanotti P, Caligaris S, Matteeli A, Soriano-Arandes A, Castelli F.

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

Emergency Medicine Cases

SEPTEMBER 26, 2023

The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framework.

Anaphylaxis 121

Anaphylaxis Resuscitation EMS 121

RebelEM

JULY 1, 2024

Balkan Med J 2021. Balkan Med J 2021. Cureus 2021. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20

COPD 127

COPD Emergency Department Outcomes EMS 127

RebelEM

FEBRUARY 19, 2024

The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med 2021. CHEST 2024. PMID: 37611862 Evans L et al.

Administration 132

Administration Sepsis EMS Shock 132

Pediatric EM Morsels

JULY 26, 2024

2021 Oct 9;22(20):10911. search=anti+nmda+receptor+encephalitis&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H2973236366. Wu CY, Wu JD, Chen CC. The Association of Ovarian Teratoma and Anti-N-Methyl-D-Aspartate Receptor Encephalitis: An Updated Integrative Review. Int J Mol Sci.

Psychiatric 269

Psychiatric Seizures Outcomes Pediatrics 269

The Trauma Pro

JANUARY 8, 2024

However, it is at odds with a paper published in 2021 from George Washington University. 2021 Nov;49:393-398. They advise that the chest ultrasound should be used alone with caution. Bottom line: This is an interesting and relatively large study. false negative rate. T hese are very disparate numbers. EAST 2024, Podium paper 21.

Ultrasounds 113

Ultrasounds Fractures 113

Science Based Medicine

NOVEMBER 3, 2023

Part 1 is available here. “There is No COVID Heart” On May 14, 2021, three “medical conservatives,” Drs. ” Though the virus had existed for barely over year, they were very […] The post Part 2: Is an Abnormal Lab Value After Vaccination More Concerning Than Death From COVID?

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110

Emergency Live

OCTOBER 19, 2023

In the case of Corey O’Connell, a young Australian who went missing in 2021, it was drone technology that provided the decisive breakthrough in […] The post Drones and Photogrammetry: help in the Search for Missing Persons appeared first on Emergency Live.

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Sensible Medicine

OCTOBER 18, 2023

2021 May 1;320(5):H2101-H2111. Epub 2021 Mar 26. Weissler Snir A, Connelly KA, Goodman JM, Dorian D, Dorian P. Exercise in hypertrophic cardiomyopathy: restrict or rethink. Am J Physiol Heart Circ Physiol. doi: 10.1152/ajpheart.00850.2020. 00850.2020. PMID: 33769918.

102

102

Pediatric EM Morsels

MAY 12, 2023

2021 Sep;78(3):321-330.e1. Epub 2021 Jun 17. PECARN is highly sensitive for identifying those with clinically important TBI. of these had a CT performed 1 (0.2%) had a clinically important TBI (ciTBI) 10 (5.1%) had any TBI on CT 9 (4.6%) had skull fractures Remember to always watch out for NAT ! Ann Emerg Med. 2021.04.015.

Head Injuries 130

Head Injuries Fractures Pediatrics EMS 130

EMDocs

DECEMBER 19, 2023

McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed August 25, 2022. link] Zafren K, Thurman R, Jones ID. Marine Dermatitis.

Poisoning 100

Poisoning Seizures Anaphylaxis Burns 100

Emergency Medicine Journal

NOVEMBER 21, 2024

The survey was repeated in 2021 after the first wave of the COVID-19 pandemic. The 2021 questionnaire was completed by 79 AED workers and 50 PED workers. Results The 2019 questionnaire was completed by 125 AED workers and 65 PED workers.

Emergency Department 93

Emergency Department Teamwork Patient Safety Hospitals 93

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. 2021 May 12:34894211015590. Published on October 25, 2021. Accessed on December 3, 2021. Two investigators independently assessed and screened all studies for eligibility. AJR Am J Roentgenol. 2015 May;204(5):1064-8. PMID: 25905942. Ann Otol Rhinol Laryngol.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

Don't Forget the Bubbles

NOVEMBER 29, 2023

2021 May;77(5):532-544. Epub 2021 Jan 21. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This article is based on: Mayberry, H., Burgart, A.M. and Kanaris, C., Intubated, awake, and paralysed: a never event. Intensive Care Research , 1 (3-4), pp.60-64. W hat is the problem?

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Science Based Medicine

JULY 4, 2023

817,000 thousand Americans had already died of COVID by December 23, 2021, and 244,000 more would die the next year. Millions more survived, but were injured. The post When Doctors Have Different Standards of Evidence for the Virus and the Vaccine first appeared on Science-Based Medicine.

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101

ALiEM

APRIL 10, 2023

Updated 2021 Jun 30]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2021 SAEM Annual Meeting | Copyrighted by SAEM 2021 – all rights reserved. References Diaz-Frias J, Badri T. doi: 10.1111/j.1087-0024.2004.00827.x.

Pediatrics 98

Pediatrics EKG/ECG Academics Wellness 98

Dr. Smith's ECG Blog

MAY 27, 2024

Curr Cardiol Red 2021 3. J Am Heart Assoc 2021 6. IJC Heart and Vasc 2021 8. Systematic review and meta-analysis of diagnostic test accuracy of ST-segment elevation for acute coronary occlusion. Int J Cardiol 2024 2. Nikus et al. Conduction disorders in the setting of acute STEMI. Kontos et al. Phibbs and Nelson. Meyers et al.

EKG/ECG 126

EKG/ECG Documentation/Coding Emergency Department 126

RebelEM

SEPTEMBER 27, 2023

Mohan 2021 ) Recall that the subsequently alkalemia will shift potassium intracellular. 2021 Sep;61(3):259-264. Epub 2021 Jun 17. As a result, it is essential to replete potassium simultaneously. References Boehnert MT, Lovejoy FH Jr. PMID: 4022081. Mohan S, Backus T, Furlano E, Howland MA, Smith SW, Su MK. J Emerg Med.

Poisoning 97

Poisoning Seizures Administration EKG/ECG 97

ALiEM

FEBRUARY 9, 2024

This is endorsed in the 2022 ACC pathway [1] and the 2021 AHA chest pain guidelines [7]. 2021 May 14;42(19):1908] [published correction appears in Eur Heart J. 2021 May 14;42(19):1925] [published correction appears in Eur Heart J. 2021 May 13;:]. 2021 Jun 22;143(25):e1118]. 2021 Nov 30;144(22):e455].

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

EM Literature of Note

AUGUST 25, 2024

It’s NHAMCS – so it is representative data being transformed into rough weighted estimates – between 2010-2021, but we see its use increasing from 3.5% Well, yes to all of the above, in the appropriate clinical context – But, most prominently, as featured in this brief report, for asthma – particularly childhood asthma.

Administration 94

Administration Emergency Department Wellness Pediatrics 94

Stop and Think

NOVEMBER 19, 2023

His cardiac arrest occurred months after the vaccine was released in 2021. In fact, the authors reported a decline in sudden cardiac death during the years 2021-2022. The cardiac arrest of the famous Danish football star Christian Eriksen added a mental glue to these connections.

Documentation/Coding 130

Documentation/Coding Wellness Resuscitation 130

RebelEM

MAY 25, 2023

Anesth Analg 2021. NEJM 1994. [2] 250 cc) up to 1L) VASOPRESSORS Current dogma is that vasopressors are not helpful in trauma patients as they can worsen ischemia (no reason to squeeze the pipes if the tank is empty). Richards JE et al. of injured limbs Tourniquet patients were less likely to arrive in shock compared to no torniquets (13.0%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

ALiEM

AUGUST 7, 2023

Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2021 SAEM Annual Meeting | Copyrighted by SAEM 2021 – all rights reserved. Patients with a previous history of sternoclavicular dislocation are at higher risk of developing thoracic outlet syndrome.

Dislocations 98

Dislocations Fractures Academics Emergency Department 98

PulmCCM

AUGUST 7, 2023

In early 2021, as hospitals overflowed, deaths mounted, and the economy languished, these felt like vital national goals. We didn’t know all this in 2021. Reducing the severity of illness after infection is what the vaccines are so amazingly, miraculously good at, not prevention of transmission. university campuses.

CDC 98

CDC Hospitals Administration Research 98

Emergency Medicine Journal

APRIL 22, 2024

Methods This was a multicentre prospective observational study of adult ED patients presenting to five Australian hospitals between November 2020 and September 2021. Participants included those with symptoms of suspected AMI (without ST-segment elevation MI on presentation ECG).

Emergency Department 98

Emergency Department Outcomes EKG/ECG Hospitals 98

ALiEM

NOVEMBER 17, 2023

link] Published 2021. link] Published 2021. Laufer M, Emans S. Overview of vulvovaginal conditions in the prepubertal child. Uptodate.com. Accessed January 5, 2022. Evaluation of vulvovaginal bleeding in children and adolescents. Uptodate.com. Accessed January 5, 2022.

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

PulmCCM

OCTOBER 7, 2024

Observational Trials of Midodrine in the ICU At least six observational studies on midodrine in the ICU were published between 2016 and 2021. What’s the evidence for this practice, in terms of efficacy, outcomes, and safety? All but one were retrospective.

Shock 98

Shock Outcomes 98