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

EMDocs

JANUARY 8, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline Updates for 2023 were just published. We recommend hospitals develop protocols for postarrest temperature control. 2023 Dec 18. C during postarrest temperature control. COR 1, LOE B-NR. Circulation.

Seizures 98

Seizures Shock CPR Hyperthermia / Hypothermia 98

The Trauma Pro

JUNE 30, 2023

The biggest question is, why does your hospital want you to use it? Typically, hospital administrators pressure trauma programs to adopt an eTFS at some point after implementing the hospital-wide use of an electronic health record (EHR). When I started this series nearly 15 years ago, many hospitals still used paper charting.

Hospitals 100

Hospitals Administration Resuscitation Best Practices 100

Pediatric EM Morsels

JULY 19, 2024

If bleeding has completely stopped, most of these children still come into the hospital for observation so access will likely be necessary and helpful should patient have rebleed event. Even those that are no longer bleeding on arrival, will often require observation in the hospital. 2023 Aug;171:111644. Epub 2023 Jul 6.

Airway Management 290

Airway Management Pediatrics Wellness Operations 290

ACEP Now

NOVEMBER 7, 2023

He practices clinically at Grady Memorial Hospital in Atlanta. The post November 2023 News from the College appeared first on ACEP Now.

Leadership 98

Leadership Administration Research Risk Management 98

EMDocs

SEPTEMBER 27, 2023

This would be similar to how all other Medicare providers (long-term care facilities, hospital payments, etc.) The post Policy Playbook: Fall 2023 Updates appeared first on emDOCs.net - Emergency Medicine Education. are already reimbursed (5). References American Medical Association. ” from [link] Seidenwurm, D. Burleson (2014).

Emergency Department 86

Emergency Department Research Outcomes Hospitals 86

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. 2023 Apr 17. 2023 Apr 25;329(16):1386-1398. 2023 Apr 29. 2023 Apr 24. 2023 Apr 12. 2023 Apr 28. 2023 Apr 25.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Ken Grauer, MD

DECEMBER 15, 2023

About 20 minutes later ( on the way to the hospital ) — the patient's CP resolved, and ECG #1 was recorded. 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. This case is remarkable for the dynamic ST-T wave changes that are seen.

EKG/ECG 376

EKG/ECG EMS Hospitals 376

EMDocs

JANUARY 11, 2025

May 18, 2023) Stercoral Colitis: A Diagnostic Challenge and Therapeutic Approach in an Elderly Patient With Chronic Constipation. 2023 Oct;48(10):3050-3062. Epub 2023 Jun 27. Stercoral colitis in the emergency department: a review of the literature. International journal of emergency medicine, 17(1), 3. Stercoral Colitis.

EMS 97

EMS Sepsis Shock Fluid Resuscitation 97

Emergency Medicine Journal

JANUARY 21, 2025

Methods This was a single-centre, triple-blind, randomised controlled trial conducted in the ED in Thailand between March 2022 and April 2023. The primary endpoints were length of ED stay, hospital admission and ED revisit. The HDICS group had a significantly shorter ED length of stay (adjusted mean difference –133.6

Hospitals 52

Hospitals Outcomes 52

The Skeptics' Guide to EM

JANUARY 6, 2024

July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC.

Emergency Department 137

Emergency Department Pediatrics Anaphylaxis Leadership 137

PulmCCM

DECEMBER 11, 2023

Vitamin C did not improve outcomes among patients hospitalized with Covid-19. LOVIT-COVID and REMAP-CAP ) Twice-daily oral zinc reduced mortality, ICU admission rate, and hospital length of stay in patients with Covid-19 in Tunisia in 2022. It’s the first treatment to appear to do so.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

The Skeptics' Guide to EM

NOVEMBER 25, 2023

Date: November 22, 2023 Reference: Stopyra et al. AEM November 2023. Date: November 22, 2023 Reference: Stopyra et al. AEM November 2023. Many hospitals do not provide PCI, prolonging transportation times, which disproportionately affects rural patients. AEM November 2023. Reference: Stopyra et al.

EMS 139

EMS EKG/ECG Research Hospitals 139

Taming the SRU

DECEMBER 17, 2024

compared the effects of these two among the acute gastroenteritis children and reported that the use of ORT was associated with shorter hospital stay and increased patient satisfaction. demonstrated that use of ORT was characterized by shorter stays at the hospital. Updated 2023 Oct 22]. AtherlyJohn et al. Fluid Management.

Dehydration 85

Dehydration Fluid Resuscitation Resuscitation Administration 85

ACEP Now

JANUARY 11, 2024

The wave of increasing hospital closures and service line cutbacks continues to sweep the United States. hospitals that are closing clinical departments or ending or reducing services. 2 Of these 56 additional hospitals, many are not rural; thus, this specter is expanding. 56 hospitals closing departments or ending services.

Hospitals 52

Hospitals Administration Documentation/Coding Research 52

ALiEM

OCTOBER 14, 2023

Author information Chris Belcher, MD Editor, ALiEM AIR Series Assistant Professor and Assistant Program Director Department of Emergency Medicine University of Kentucky College of Medicine | Twitter | The post ALiEM AIR Series | Respiratory 2023 Module appeared first on ALiEM. Please go to the above link.

EMS 67

EMS Academics Emergency Department Hospitals 67

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. They would be the least difficult and disruptive, the least strain on the hospital staff,” Dr. Wharff explained.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

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 395

EKG/ECG Hospitals 395

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Two really important patient groups were excluded – those who were admitted to hospital and families who were not fluent in English. Martin, S.R., Heyming, T.W., Fortier, M.A. and Kain, Z.N.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. AEM October 2023. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: October 20, 2023 Reference: Cai et al. AEM October 2023. AEM October 2023. Reference: Cai et al.

Emergency Department 135

Emergency Department Radiology Radiology Hospitals 135

ACEP Now

AUGUST 1, 2023

Our Indiana ACEP colleagues have helped us all as emergency physicians in championing the passage of state legislation mandating a physician leading a hospital’s emergency department to be physically present in that hospital.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The hospital is the Paediatric Major Trauma Centre for the South-West. 2023 Nov; doi:10.1016/j.annemergmed.2023.10.008 in higher-resource settings and 28.5%

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Ken Grauer, MD

JUNE 14, 2024

Retrospective questioning of the driver who brought this patient to the hospital revealed that he was having chest pain as the reason for presenting to the ED. 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 399

EKG/ECG Wellness Hospitals 399

PulmCCM

APRIL 14, 2025

Dr. Rivers and his center, Henry Ford Hospital, had financial relationships with Edwards Lifesciences, makers of the invasive catheter used in Rivers’s trial to measure continuous central venous oxygenation saturation. To avoid financial penalties, hospitals have had to report their compliance with the bundle elements of I.V.

Sepsis 59

Sepsis Infectious Diseases Administration Shock 59

ALiEM

OCTOBER 30, 2024

Clinical impact: Rather than arguing with the patient about the likelihood of this phenomenon occurring and whether this is a true allergy, the patient is informed that they do not need to immediately start treatment to receive care in the hospital. 2023 Jan 1;53(1):140-2. 2022; 06/26/2023. 2023 Jun 1;36:89-91.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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 233

EKG/ECG EMS Hospitals 233

EMDocs

DECEMBER 1, 2024

Treatment significantly shortens the duration of illness, and early initiation of therapy can prevent severe complications and reduce the length of hospitalization. 2023 Oct 26;15(6):700-716. 2023 Oct 26;15(6):700-716. However, some experts recommend doxycycline even in pregnant patients. pregnant patients). Blanton LS.

EMS 104

EMS Infectious Diseases Shock Airway Management 104

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital.

CDC 108

CDC Hospitals EMS Emergency Department 108

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 139

Fractures Ultrasounds Pediatrics Outcomes 139

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Date: August 30, 2023 Reference: Griffey et al. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. Date: August 30, 2023 Reference: Griffey et al. It accounted for roughly 8.9

Diabetic Emergencies 110

Diabetic Emergencies Operations Hospitals Research 110

Sensible Medicine

NOVEMBER 10, 2023

There were no data suitable to support initial emergency use authorization— and there is certainly no data to support administering the shot to a child born in 2023. Finally, 3 doses were approved based on Ab titers, but randomized trials have never shown improvements in severe disease or hospitalization.

CDC 145

CDC Pediatrics Poisoning Hospitals 145

Ken Grauer, MD

FEBRUARY 3, 2024

The November 15, 2023 post in Dr. Smith’s ECG Blog ( See My Comment at the bottom of the page regarding MINOCA ). The November 14, 2019 post in Dr. Smith’s ECG Blog ( Please scroll down to the BOTTOM of the page for My Comment and illustration of the phenomenon of T-QRS-D = T erminal QRS D istortion ).

EKG/ECG 406

EKG/ECG Resuscitation Hospitals Wellness 406

Emergency Medicine Journal

MARCH 25, 2025

Background Appropriate dispatch of critical care teams to out-of-hospital cardiac arrest (OHCA) has been identified as a research priority emergency care in the UK. The study aimed to understand the criteria informing the decision to dispatch a critical care physician-paramedic prehospital team to OHCA in one UK region.

Ambulance Services 52

Ambulance Services Research Hospitals 52

PEMBlog

MARCH 4, 2025

Garcia T, Florin TA, Leonard J, Shah SS, Ruddy RM, Wallihan R, Desai AP, Alter S, El-Assal O, Marzec S, Keaton M, Yun KW, Leber AL, Mejias A, Cohen DM, Ramilo O, Ambroggio L; Childrens Hospitals Initiative for Research in Pneumonia (CHIRP). After a lull during the COVID 19 pandemic, cases reemerged in 2023 and continued to climb into 2024.

Pediatrics 94

Pediatrics Military CDC Seizures 94

Emergency Medicine Journal

JANUARY 21, 2025

Methods After preliminary evaluation of an M-LFD (SureScreen) with laboratory-grown virus and PCR-negative clinical samples, it was evaluated in a real-world setting at the ED of St Thomas’ Hospital (London, UK) from 1 December 2022 to 21 April 2023.

Emergency Department 52

Emergency Department Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 11, 2024

EMJ Nov 2023. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED. EMJ Nov 2023. The annual incidence rate of AD ranges between 2.9

Emergency Department 132

Emergency Department Resuscitation Hospitals EKG/ECG 132

PEMBlog

JANUARY 21, 2025

Diagnostic Costs : RSV rapid tests: $100-$400 (higher end when included in multiplex testing) Risk Stratification : Infants <6 months, especially those with prematurity, chronic lung disease, or congenital heart disease, have a heightened risk of hospitalization. Updated 2023 Jan 23]. Updated 2023 Jun 20].

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Pediatrics Dehydration Outcomes 52