Pediatric EM Morsels

NOVEMBER 3, 2023

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). falciparum parasitemia , and no other defined cause of AMS (WHO 2023). falciparum parasitemia , and no other defined cause of AMS (WHO 2023).

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

Pediatric EM Morsels

AUGUST 23, 2024

Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. Progression through Return to Learn and Return to Sport:[ Patricios, 2023 ] Is individualized and based on the person’s symptoms Typically takes a minimum of 1 week. 2023 Aug;104(8):1343-1355. 2023.03.036.

Seizures 270

Seizures Pediatrics Academics Emergency Department 270

Pediatric EM Morsels

JANUARY 19, 2024

CDC 2023] In 2021, there were over 2800 cases of congenital syphilis, tripled from 2017. CDC 2023] Pseudoparalysis of Parrot – Presentation and Exam Infant presents with lack of movement of one or both upper extremities, and will cry with palpation. April 11, 2023. Updated 2023 Aug 8]. Accessed January 16, 2024.

Infectious Diseases 269

Infectious Diseases CDC Pediatrics Fractures 269

Pediatric EM Morsels

MARCH 15, 2024

Nicotera, 2024; Bacus, 2023 ] The laughing often described as being unmotivated or disproportionate to the emotional context. Bacus, 2023 ] Cases as young as 4 months have been described. 2023 Jun 6;23:100609. 2023 Nov 8. Pathologic uncontrollable laughing without mirth (lacking joy). Can even become status gelasticus.

Seizures 258

Seizures Pediatrics Psychiatric Emergency Department 258

Greater Sydney Area HEMS

NOVEMBER 4, 2023

Airway Registry learning points reflect the challenges described and wisdom shared by Sydney HEMS personnel and guests at the Clinical Governance Airway Registry presentations. Cases are discussed non-contemporaneously, anonymised and amalgamated over a period of time to draw together unifying take-home messages.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

The Bottom Line

FEBRUARY 7, 2024

What’s new in the Critical Care literature – monthly updates

117

117

Pediatric EM Morsels

SEPTEMBER 22, 2023

Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. In: Strange and Schafermeyer’s: Pediatric Emergency Medicine. 5 th Edition. McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. Neurogenic Shock. Updated 2022 Feb 10]. In: StatPearls [Internet]. Korean J Neurotrauma.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

Pediatric EM Morsels

SEPTEMBER 8, 2023

Accessed September 06, 2023. Shah A, Sobolewski B, Mittiga MR. Summer Penile Syndrome. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. McGraw Hill; 2021. link] Smith GA, Sharma V, Knapp JF, Shields BJ. The summer penile syndrome: seasonal acute hypersensitivity reaction caused by chigger bites on the penis.

Poisoning 275

Poisoning Pediatrics EMS 275

Ken Grauer, MD

SEPTEMBER 22, 2023

The May 13, 2023 post ( LA-RA reversal ). The May 30, 2023 post ( LA-RA reversal ). The May 5, 2022 post ( LA-RA reversal ). The May 24, 2022 post ( LA-LL reversal ). The May 26, 2022 post ( LA-LL reversal ). The August 17, 2022 post ( LA-RA reversal ).

EKG/ECG 446

EKG/ECG Wellness 446

Ken Grauer, MD

DECEMBER 29, 2023

A DDENDUM ( 12/30/2023 ) : The Audio Pearl below reviews the concept of "shark fin" ST elevation. — — E CG M edia P EARL # 73 ( 5:40 minutes Audio ) — Reviews the concept of " S hark F in" S T e levation and d epression as a sign of extensive acute infarction.

EKG/ECG 438

EKG/ECG Resuscitation Hospitals Wellness 438

Ken Grauer, MD

AUGUST 26, 2023

These tall T waves are associated with flattening ( straightening ) of the ST segment in the inferior leads — with slight S T elevation in leads V2-thru-V6 ( albeit not enough to qualify as a "STEMI" — Akbar et al, StatPearls, 2023 ). This point is discussed in detail in the March 24, 2023 post of Dr. Smith’s ECG Blog ).

EKG/ECG 363

EKG/ECG EMS Hospitals 363

Ken Grauer, MD

SEPTEMBER 21, 2024

This is because clinicians ( including too many cardiologists ) have trouble accepting the fact that a young patient can have an acute MI ( See case discussion in the January 9, 2023 post in Dr. Smith's ECG Blog — with links at the bottom of this post to a series of more cases illustrating this phenomenon ).

EKG/ECG 302

EKG/ECG Resuscitation Outcomes Hospitals 302

Pediatric EM Morsels

OCTOBER 27, 2023

Available at: [link] (Accessed: 26 October 2023). Available at: [link] (Accessed: 27 October 2023). References: Emergency Medical Services for Children- Enhancing Pediatric Safety (no date) Study Packet for the Correct Use of the BroselowTM Pediatric Emergency Tape. and Seaver, M. Rosenberg, M.S.

Pediatrics 269

Pediatrics Resuscitation Documentation/Coding Wellness 269

Pediatric EM Morsels

JUNE 9, 2023

Banc-Husu, 2023 ] Cholestastis Inflammatory conditions Genetic and Metabolic diseases Pediatric cirrhotic liver disease has many complications. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! 2023 Feb;43(1):100-116. Portal Hypertension in children is a heterogenous disease ]. Semin Liver Dis.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

RebelEM

NOVEMBER 6, 2024

2023 Aug 4. 2023 Nov 5. Multiple Concomitant Injuries in One Upper Extremity: A Case Report. Am J Case Rep. 2016 Jan 6;17:6-11. doi: 10.12659/ajcr.894984. PMID: 26732673 Akhondi H, Varacallo M. Anterior Interosseous Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. J Am Acad Orthop Surg.

Dislocations 118

Dislocations Fractures Soft Tissue Injuries Outcomes 118

Pediatric EM Morsels

AUGUST 9, 2024

Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally. Congenital syphilis differs from syphilis contracted by an “adult” in that: [ Hussain, 2023 ] T. Hussain, 2023 ] Excellent prognosis if treated early. doi: 10.1136/bcr-2023-257694. Epub 2023 Aug 18. From asymptomatic to stillbirth.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

Ken Grauer, MD

JANUARY 13, 2024

A bout H CM ( Different Forms of this Entity ): I've excerpted what appears below from My Comment in the December 26, 2023 post in Dr. Smith's ECG Blog. HCM is an "umbrella term" applied to the presence of LVH in the absence of "abnormal cardiac loading conditions" ( Hughes et al — JAHA 9:e015294, 2020 ).

EKG/ECG 400

EKG/ECG Hospitals 400

Ken Grauer, MD

AUGUST 16, 2024

References on Echo for PE Diagnosis: Oh and Park - Korean J Intern Med 38(4):456-470, 2023 — and — Hritani et al - Cleveland Clin J Med 85(11):826-828, 2018 — and — IF you want an excellent 5-minute video review on recognition of the McConnell Sign on Echo — WATCH_this_VIDEO by Dr.

EKG/ECG 394

EKG/ECG Wellness Shock 394

Ken Grauer, MD

JULY 29, 2023

And, in 2023 — virtually any young adult with an episode of VT should have follow-up evaluation including cardiac MRI to rule out mimics of severe underlying cardiac pathology, such as ARVD or sarcoidosis with cardiac involvement. A DDENDUM ( 7/29/2023 ) : I summarize KEY features regarding Idiopathic VT in Figure-4.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

Pediatric EM Morsels

JULY 19, 2024

2023 Aug;171:111644. Epub 2023 Jul 6. Shin TJ, Hasnain F, Shay EO, Ye MJ, Matt BH, Elghouche AN. Treatment of post-tonsillectomy hemorrhage with nebulized tranexamic acid: A retrospective study. Int J Pediatr Otorhinolaryngol. doi: 10.1016/j.ijporl.2023.111644. 2023.111644. PMID: 37423163.

Airway Management 286

Airway Management Pediatrics Wellness Administration 286

Pediatric EM Morsels

JULY 26, 2024

2023 Jul 17. UpToDate , June 2023, www.uptodate.com/contents/autoimmune-including-paraneoplastic-encephalitis-clinical-features-and-diagnosis?search=anti+nmda+receptor+encephalitis&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H2973236366. Neurol Neuroimmunol Neuroinflamm. doi: 10.1212/NXI.0000000000200013.

Psychiatric 269

Psychiatric Seizures Outcomes Pediatrics 269

Science Based Medicine

MARCH 29, 2024

A new analysis of 2023 MIS-C cases reveals that the COVID-19 vaccine significantly reduces the risk of this dreaded complication. The post COVID-19 Vaccination Significantly Reduces Risk of Severe Inflammatory Syndrome in Kids first appeared on Science-Based Medicine.

141

141

Ken Grauer, MD

DECEMBER 15, 2023

For review on when despite acute OMI — the initial hs-troponin may come back normal — See the March 24, 2023 post in Dr. Smith’s ECG Blog. The importance of the new OMI ( vs the old STEMI ) Paradigm — See My Comment in the July 31, 2020 post in Dr. Smith's ECG Blog. This case is remarkable for the dynamic ST-T wave changes that are seen.

EKG/ECG 381

EKG/ECG EMS Hospitals 381

RebelEM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Resus 2023. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Available at: HERE Branch KHR et al.

CPR 145

CPR EMS Documentation/Coding Outcomes 145

The Trauma Pro

DECEMBER 22, 2023

1485, Dec 2023. And I’m very interested in comments from both old and young trauma professionals on this topic. Reference: The Use of Radio-opaque Markers is Medical Dogma, doi:10.1111/acem.1485,

Operations 264

Operations Outcomes 264

Broome Docs

NOVEMBER 17, 2023

This is another lecture by the always amazing Dr Justin Morgenstern from the series of talks he delivered on his tour of Perth in September 2023. This is another lecture by the always amazing Dr Justin Morgenstern from the series of talks he delivered on his tour of Perth in September 2023. What is the […]

Resuscitation 138

Resuscitation 138

St. Emlyn

JULY 14, 2024

In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.

Resuscitation 129

Resuscitation Research 129

Broome Docs

MARCH 28, 2024

doi: 10.1136/emermed-2023-213285. 2023 Sep 21:ciad571. 2023 Sep 19:S0196-0644(23)00671-6. 2023 Dec;193:109991. 2023 Aug 21:S0012-3692(23)05350-3. 2024 Jan 29:jme-2023-109651. doi: 10.1136/jme-2023-109651. Emerg Med J. 2024 Jan 22;41(2):96-102. Is our PPE evidence-based? Clin Infect Dis. Ann Emerg Med.

PPE 107

PPE Ultrasounds Resuscitation Administration 107

Ken Grauer, MD

APRIL 5, 2024

For additional examples of this phenomenon whereby automatic truncation of an EMS ECG may mistakenly result in LVH serving to mimi c ischemia — Check out My Comment at the bottom of the page of the following posts in Dr. Smith's ECG Blog — the November 29, 2023 post — June 20, 2020 — March 31, 2019 — March 29, 2019 — and t he December 27, 2018 post.

EKG/ECG 238

EKG/ECG EMS Hospitals 238

The Trauma Pro

SEPTEMBER 1, 2023

J Trauma 94(3):385-391, 2023. Reference: Are we waiting for the sky to fall? Predictors of withdrawal of life-sustaining support in older trauma patients: A retrospective analysis.

Hospitals 198

Hospitals Wellness 198

Dr. Smith's ECG Blog

SEPTEMBER 15, 2023

K en G rauer gives a thorough explanation here: A 60 year old with chest pain == MY Comment , by K EN G RAUER, MD ( 9/15 /2023 ): == The 1st time that I saw APTA ( A rterial P ulse T ap A rtifact ) — I did not know what it was. Awareness of the mathematical relationships discussed in this Jan.

EKG/ECG 136

EKG/ECG Wellness 136

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. New England Journal of Medicine June 2023 Reference: Snelling et al. He is also a fully-fledged ultrasonographer.

Fractures 122

Fractures Ultrasounds Pediatrics Outcomes 122

The Skeptics' Guide to EM

DECEMBER 16, 2023

AEM Dec 2023 Date: December 14, 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. AEM Dec 2023 Date: December 14, 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary.

Emergency Department 116

Emergency Department Research Outcomes 116

Ken Grauer, MD

OCTOBER 29, 2023

= NOTE: These are my "slides" for November 2, 2023 — for my M edALL p resentation. The talk will be recorded and posted on-line. Based on ECG Blog #351 ( www.tinyurl.com/KG-Blog-351 ) LINK to this Page — www. tinyurl.com/KG-MedAll-351 — = = ECG Blog #205 = The Systematic Approach I favor.

EKG/ECG 195

EKG/ECG 195

Ken Grauer, MD

JUNE 14, 2024

Prompt cath is therefore advised if the post-ROSC shows an acute STEMI. The decision of whether to cath patients with a less definitive post-ROSC ECG is less clear.

EKG/ECG 407

EKG/ECG Wellness Hospitals 407

Pediatric EM Morsels

JUNE 16, 2023

Available at: [link] (Accessed: 12 June 2023). Available at: [link] (Accessed: 12 June 2023). Arch Gen Med. 1863;1:20-38, 172-200, 300-332 Sharareh, B. and Taylor, B. 2021) Morel-Lavallee lesion , Orthobullets. 2022) Morel-lavallee lesions – diagnosis and practical management of these troublesome injuries!

Soft Tissue Injuries 152

Soft Tissue Injuries Dehydration Fractures Operations 152

Life in the Fast Lane

JUNE 6, 2024

Sunayana Samantaray and Mike Cadogan The MATE ACT Mandate The Medication Access and Training Expansion (MATE) Act went into effect late 2023. Here is a review of the Top 8 CME Courses to Meet Your Substance Use Disorder Training Requirements

Administration 105

Administration 105