Ken Grauer, MD

MAY 20, 2023

In the October 15, 2022 post of Dr. Smith's ECG Blog — Drs. Smith and Meyers in their October 15, 2022 post on Precordial Swirl. Figure-3: Selected sets of V1,V2 leads from the examples of Precordial Swirl provided in the October 15, 2022 post in Dr. Smith's ECG Blog. What is P recordial S wirl ?

EKG/ECG 363

EKG/ECG Wellness 363

Pediatric EM Morsels

MARCH 1, 2024

Wojsyk-Banaszak, 2018 ) Mainstay of initial therapeutic management is: ( Wojsyk-Banaszak, 2018 ; Fernando, 2022 ) Prolonged course of IV antibiotics Chest physiotherapy Patients managed with medical strategies (compared to surgical) had lower complication rates and shorter hospitalizations. 2022 Jul;92(7-8):1850-1855. Epub 2022 Jun 9.

Ultrasounds 169

Ultrasounds Pediatrics Operations Hospitals 169

Pediatric EM Morsels

JUNE 30, 2023

PMID: 28050458 Salerno M, Sessa F, Cocimano G, Roccuzzo S, Esposito M, Pomara C. Congenital Cystic Adenomatoid Malformation (CCAM) Type II: A Rare Case of Sudden Infant Death. Dec: 9 (12): 1830. link] PMID: 36553274 The post Congenital Pulmonary Airway Malformation (CPAM) appeared first on Pediatric EM Morsels.

Ultrasounds 281

Ultrasounds Pediatrics Operations EMS 281

Ken Grauer, MD

MAY 31, 2024

The October 21, 2022 post — for " artifactual VT". The April 6, 2023 post — excessive baseline artifact misdiagnosed as AFib ( instead of sinus rhythm with AV Wenckebach — as in Figure-4 in this post ). The March 17, 2023 post — for PTA. The January 17, 2023 post — for PTA. The November 10, 2020 post — for PTA.

Shock 414

Shock EKG/ECG Seizures 414

The Trauma Pro

JULY 23, 2024

Legal Medicine, Volume 54, 101996, 2022. Only they can appreciate the nuances and reconstructive needs of this injury. Reference: Mechanism of transverse fracture of the skull base caused by blunt force to the mandible.

Fractures 264

Fractures 264

Pediatric EM Morsels

JUNE 2, 2023

Allergy Asthma Clin Immunol 18, 54 (2022). Food protein-induced enterocolitis syndrome in a tertiary pediatric center: safety of guideline-conforming food challenges. link] The post Food Protein Induced Enterocolitis Syndrome (FPIES) appeared first on Pediatric EM Morsels.

Dehydration 189

Dehydration Shock Pediatrics Emergency Department 189

Pediatric EM Morsels

APRIL 5, 2024

CDC 2022) Testing for many of these illnessess can take time during the acute phase as many are ELISA or PCR tests. CDC 2022) Divided into Soft tick relapsing fever and Hard tick relapsing fever , depending on what type of ticks carry the Borrelia sp (CDC 2022) There is also a louse which carries a Borrelia sp.

CDC 161

CDC Infectious Diseases Pediatrics Wellness 161

Pediatric EM Morsels

SEPTEMBER 22, 2023

Updated 2022 Feb 10]. Updated 2022 Mar 3]. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. In: Strange and Schafermeyer’s: Pediatric Emergency Medicine. 5 th Edition. McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. Neurogenic Shock. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

The Trauma Pro

OCTOBER 22, 2024

Scand J Trauma open access 30: article 7, 2022. The information will assist our prehospital colleagues in making the best decisions possible when faced with patients trapped in their cars. Reference: Assessing spinal movement during four extrication methods: a biomechanical study using healthy volunteers.

EMS 264

EMS 264

First 10 EM

JANUARY 15, 2024

I did a pretty thorough review of all COVID antiviral therapies in 2022, both on First10EM and on the EMCases Journal Jam, but that was 2 years ago. We are once again buried in a wave of viral respiratory illnesses, and much of the burden of illness is still COVID.

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138

Pediatric EM Morsels

AUGUST 2, 2024

Balanitis and Balanoposthitis – Basics Terminology [Assim 2022, Dynamedex 2024, Perkins 2024] Balanitis – Inflammation of the glans penis Posthitis – Inflammation of the foreskin (prepuce) Balanoposthitis – Inflammation of both (ouch!)

Pediatrics 152

Pediatrics Allergic Reactions EMS Infectious Diseases 152

Pediatric EM Morsels

MARCH 29, 2024

Pediatr Rev (2022) 43 (7): 371–383. Incidence of inborn errors of metabolism in British Columbia, 1969–1996. Pediatrics. 2000; 105:e 10. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A. Schrier Vergano. link] The post Rebaked: Inborn Errors of Metabolism presenting in the ED appeared first on Pediatric EM Morsels.

Dehydration 294

Dehydration Pediatrics Sepsis EMS 294

Pediatric EM Morsels

AUGUST 9, 2024

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. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. 2022 Dec 27;14(12):e33009. PMID: 37604180.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

Pediatric EM Morsels

MARCH 17, 2023

Ahmed 2008, Meyers 2022) Of course, treat any other systemic symptoms (like respiratory failure, hypotension) as you typically would. If you are managing a snake bite from a snake that does not typically reside in the U.S., please utilize other resources and local Toxicology experts for help with management protocols.

CDC 130

CDC Poisoning Pediatrics Shock 130

EMCrit

SEPTEMBER 24, 2022

Where are we on Fluids on 2022? EMCrit Project by Scott Weingart, MD FCCM.

128

128

Pediatric EM Morsels

NOVEMBER 17, 2023

2022 May 11;10:864766. 2022 Apr;29(4):406-414. Epub 2022 Jan 12. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Incidence of Post-extubation Stridor in Infants With Cuffed vs. Uncuffed Endotracheal Tube: A Retrospective Cohort Analysis. Front Pediatr. doi: 10.3389/fped.2022.864766. 2022.864766.

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

Ken Grauer, MD

APRIL 18, 2023

The April 17, 2022 post ( Leads V1,V2 misplacement ). The May 24, 2022 post ( LA-LL reversal ). The May 26, 2022 post ( LA-LL reversal ). The August 17, 2022 post ( LA-RA reversal ). = The November 19, 2020 post ( LA-LL reversal ). The November 27, 2021 post ( LA-RA reversal ).

EKG/ECG 195

EKG/ECG Wellness 195

Pediatric EM Morsels

AUGUST 11, 2023

2022 Sep;68(9):661-663. Coli Proteus species Non-Abscess infection: Staphylococcus aures = the most common Pseudomonas aeruginosa and others still may be seen Perichondritis of the Ear: Presentation Redness , Pain , and Swelling of the pinna Typically spares the lobule ! References: Kim MM, Goldman RD. Can Fam Physician. doi: 10.46747/cfp.6809661.

Burns 130

Burns Pediatrics EMS Outcomes 130

The Trauma Pro

JANUARY 5, 2024

The only prior study I could find was published in 2022 by a group at the University of Nevada at Las Vegas. 2022 Nov;279:62-71. Bottom line: Well, this was a new one for me. They irrigated 82 of 198 patients undergoing chest tube placement. They noted a decrease in hospital, ICU, and ventilator days. EAST 2024, Podium paper #17.

Hospitals 133

Hospitals Wellness Outcomes 133

Pediatric EM Morsels

JULY 28, 2023

ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. 2022; 23( 7): 835- 856. Nicole Glaser, Maria Fritsch, Leena Priyambada, Arleta Rewers, Valentino Cherubini, Sylvia Estrada, Joseph I. Wolfsdorf, Ethel Codner Glaser, N, Fritsch, M, Priyambada, L, et al. Pediatr Diabetes.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

Emergency Live

APRIL 11, 2024

The findings from Fondazione Gimbe highlight a concerning increase in healthcare expenses for Italian households in 2022, raising serious socio-health questions. Throughout 2022, Italian families had to bear a considerable burden for healthcare expenses.

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The Trauma Pro

MARCH 25, 2024

The best-known example, ChatGPT, burst onto the scene in November 2022 and caught most of us off guard. Generative artificial intelligence (AI) is the newest shiny toy. The earliest versions were interesting and showed great promise for a variety of applications.

Research 258

Research Radiology Radiology Academics 258

Don't Forget the Bubbles

MAY 31, 2023

2023 May 17:archdischild-2022-325280. doi: 10.1136/archdischild-2022-325280. in the Lancet Diabetes and Endocrinology 2022 , stated that an ‘ additional pronounced increase during the COVID-19 pandemic were general phenomena observed in most registries from different countries and continents.’ 2022 Nov 1;10(11):786-94.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

Broome Docs

JUNE 20, 2023

2022 Aug;48(8):1009-1023. Epub 2022 May 13. Epub 2022 Oct 19. Epub 2022 Oct 19. Epub 2022 Dec 22. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia. Intensive Care Med. doi: 10.1007/s00134-022-06684-3. Ann Emerg Med. 2023 Jan;81(1):96-98. 2022.07.008.

Emergency Department 132

Emergency Department Sepsis Best Practices 132

RebelEM

SEPTEMBER 21, 2023

Up to 80% of patients will have at least one troponin sent ( Gabrielli 2022 ). The available literature shows that SVT is not associated with ACO, Type I MI or serious outcomes either in the short term or after prolonged follow up ( Gabrielli 2022 ). Additionally, they found that up to 30% of the troponins sent are positive.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

Pediatric EM Morsels

JUNE 16, 2023

2022) Morel-lavallee lesions – diagnosis and practical management of these troublesome injuries! 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. Arch Gen Med. and Taylor, B.

Soft Tissue Injuries 152

Soft Tissue Injuries Dehydration Fractures Operations 152

Pediatric EM Morsels

AUGUST 23, 2024

Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898. PMID: 37316210. The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels.

Seizures 270

Seizures Pediatrics Academics Emergency Department 270

Pediatric EM Morsels

JULY 7, 2023

May have: Pain with knee extension Visual deformity Crepitance Locking or popping In Children, should consider it when: [ Sacchetti, 2022 ] Patient refuses to bear weight, Has Painless Range of Motion of the Knee, and Tenderness over the Fibular Head. 2022 Apr;54:328.e3-328.e4. References: Sacchetti A, Verbaro J. Am J Emerg Med.

Dislocations 141

Dislocations Fractures Pediatrics EMS 141

Ken Grauer, MD

FEBRUARY 3, 2024

An all-too-common misconception is that the absence of obstructive coronary disease on cardiac catheterization rules out acute coronary occlusion as the cause of the patient's acute event.

EKG/ECG 411

EKG/ECG Resuscitation Hospitals Wellness 411

RebelEM

MAY 25, 2023

J Trauma Acute Surg 2022 [15] Multicenter prospective observational trial ≈1400 adult patients with extremity trauma injuries requiring a trauma center Patients either received prehospital tourniquets or no tourniquets Tourniquets controlled bleeding in 87.7% Lancet Haematol 2022. Cureus 2022. J Trauma Acute Care Surg 2022.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Mount Sinai EM

DECEMBER 27, 2022

Case study, Radiopaedia.org (Accessed on 26 Dec 2022) [link] Gaillard F, Lustosa L, Murphy A, et al. Reference article, Radiopaedia.org (Accessed on 26 Dec 2022) [link] [link] Rose NGW, Green TJ. Print Publication year: 2022 Sports Medicine for the Emergency Physician A Practical Handbook , pp. Lisfranc injury.

Dislocations 130

Dislocations Fractures Operations Radiology 130

Broome Docs

DECEMBER 9, 2023

2022 Nov;63(5):645-650. Epub 2022 Oct 12. 2022 Oct 25;7(1):e000886. doi: 10.1136/tsaco-2022-000886. PMID: 32303736 Briggs B, Kalra S, Panacek E. Risk of Radiation Exposure to Emergency Department Personnel From Portable Radiographs. J Emerg Med. doi: 10.1016/j.jemermed.2022.08.002. 2022.08.002. Emerg Med Australas.

Infectious Diseases 120

Infectious Diseases Emergency Department Stroke Pediatrics 120

Emergency Live

OCTOBER 9, 2023

New record for REAS 2023: 29,000 attendees from 33 countries in Europe and around the world REAS 2023 marked a new milestone with an attendance of 29,000 visitors, an increase of 16% compared to the previous edition in 2022.

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116

Mount Sinai EM

JANUARY 11, 2023

Updated 2022 Apr 28]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Ankle (lateral view). Reference article, Radiopaedia.org (Accessed on 04 Jan 2023) [link] Patel P, Russell TG. Ankle Radiographic Evaluation. In: StatPearls [Internet]. Available from: [link] Raby Nigel, Berman L, Morley S, de Lacey G. Ankle & Hindfoot.

Radiology 130

Radiology Radiology Fractures Dislocations 130

Emergency Live

MAY 23, 2024

Sexually transmitted diseases are spreading more widely worldwide A Global Spread The World Health Organization (WHO) states that new cases of syphilis in people aged 15 to 49 increased by almost 1 million in 2022, reaching 8 million. There were 230,000 deaths related to syphilis.

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Pediatric EM Morsels

JULY 26, 2024

2022 Jul 6;9(5):e200013. Resources: Yeshokumar A, Gordon-Lipkin E, Arenivas A, Rosenfeld M, Patterson K, Blum R, Banwell B, Venkatesan A, Lancaster E, Panzer J, Probasco J. Younger Age at Onset Is Associated With Worse Long-term Behavioral Outcomes in Anti-NMDA Receptor Encephalitis. Neurol Neuroimmunol Neuroinflamm. doi: 10.1212/NXI.0000000000200013.

Psychiatric 269

Psychiatric Seizures Outcomes Pediatrics 269

EM Ottawa

OCTOBER 30, 2023

2022 Mar;24(2):206-213. Methodology: 1.5/5 5 Usefulness: 1.5/5 5 Loke DE, et al. Question and Methods: Trying to quantify gender disparities in CT turnaround time and ED LOS and determine if intervention in the form of protocolized point-of -care pregnancy testing would eliminate the disparity.

Radiology 110

Radiology Radiology 110