Dr. Smith's ECG Blog

JUNE 13, 2024

EMS arrived to a pulseless patient in V fib. After being transferred to an academic center, she was taken to the cath lab: Proximal RCA occlusion (causing inferior and RV OMI) Unfortunately, she continued to decline despite aggressive measures. The 911 call center and EMS service were also dismissed. The family sued.

EKG/ECG 93

EKG/ECG Documentation/Coding EMS Burns 93

Taming the SRU

FEBRUARY 24, 2024

ENRICH Trial - the leadership journey - EMS grand rounds - r4 capstone - r1 clinical knowledge - pediatric lecture ENRICH Trial WITH visiting professor Dr. david wright ICH makes up only 10-15% of all strokes yet has a higher mortality than ischemic strokes and SAH Current 2022 AHA/ASA guidelines for spontaneous ICH (prior to ENRICH Trial) minimally-invasive (..)

Leadership 94

Leadership EMS Pediatrics Stroke 94

ACEP Now

NOVEMBER 16, 2023

emergency medicine (EM) residency training length has been a decades-long dilemma: four versus three years. First, is three years enough time to become an EM physician? But critical questions remain unanswered when it comes to specialization, career trajectory, and actual competence as an EM physician. percent versus 90.8

Academics 52

Academics EMS Telemedicine Research 52

Emergency Medicine Cases

APRIL 9, 2019

Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric UTI can lead to over-testing, over-treating and even worse outcomes.

Pediatrics 52

Pediatrics Academics EMS Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Alongside his EM residency, he is doing a PhD in epidemiology. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Stroke 52

EMDocs

OCTOBER 30, 2023

Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. 2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. Authors: Saran S. 11 Table 1.

Radiology 92

Radiology Radiology Emergency Department Hospitals 92

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C.,

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CDC Radiology Radiology Head Injuries 111

The Skeptics' Guide to EM

MAY 30, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Case: A 44-year-old male presents to your level 1 trauma center by EMS after a motor vehicle collision. The evidence for TXA providing a patient-oriented outcome (POO) has been mixed. TXA vs. 19.8%

Head Injuries 52

Head Injuries Academics EMS Stroke 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the […] The post SGEM#189: Bring Me To Life in OHCA first appeared on The Skeptics Guide to Emergency Medicine. Academic Emergency Medicine. September 2017. September 2017.

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. He heads curriculum and conference for the academic year and is passionate about resident […] The post SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations?

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose. PMID: 36108346 Clinical Question: What is the efficacy and safety of peripherally administered push dose pressors for the treatment of acute hypotension?

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Administration Emergency Department Outcomes Documentation/Coding 98

The Skeptics' Guide to EM

JANUARY 20, 2018

She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, […] The post SGEM#203: Let Me Clear My Sore Throat with a Corticosteroid first appeared on The Skeptics Guide to Emergency Medicine. display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al.

Academics 52

Academics Emergency Department EMS Administration 52

The Skeptics' Guide to EM

JULY 17, 2018

He is also the CME editor for Academic Emergency Medicine Case: You’re […] The post SGEM#225: NEXUS II – Validation of the Pediatric Head CT Decision Instrument first appeared on The Skeptics Guide to Emergency Medicine. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

RebelEM

NOVEMBER 6, 2023

PMID: 36039127 Post Peer Reviewed By : Salim Rezaie, MD (Twitter: @Srrezaie ) The post Hydroxycobalamin vs Methylene Blue for Vasoplegic Shock from Cardiopulmonary Bypass appeared first on REBEL EM - Emergency Medicine Blog.

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Shock Administration Academics Hospitals 71

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). There was also no increase in survivors with good neurological outcomes with ACLS. We reviewed the Cournoyer et al cohort study as part of the #SGEMHOP series with Academic Emergency Medicine ( AEM ).

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

Cook County EM Blog

APRIL 27, 2022

2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits. Cook County EM Residency | PGY3 @GarrettPrince8 Carlos Mikell, M.D. Am J Emerg Med. 2020;38(7):1310-1314. doi:10.1016/j.ajem.2019.09.007

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Administration EKG/ECG Emergency Department EMS 52

The Skeptics' Guide to EM

APRIL 8, 2023

2023 Apr Guest Skeptics: Dr. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK with a special interest in smaller, rural and remote healthcare. The main outcome was the adjusted odds ratio for in-hospital mortality and hazard ratio for 30-day mortality with some pre-specified subgroups.

Stroke 56

Stroke Emergency Department COPD Academics 56

The Skeptics' Guide to EM

APRIL 21, 2018

He is also the CME editor for Academic Emergency Medicine (AEM). He is also the CME editor for Academic Emergency Medicine (AEM). Our good friend over at REBEL EM , Salim Rezaie put together a nice table showing the score that we will include in the show notes. Blood pressure is elevated, and his pain was sudden in onset.

Emergency Department 52

Emergency Department Academics EKG/ECG Research 52

The Skeptics' Guide to EM

JANUARY 27, 2018

He is also the CME editor for Academic Emergency. He is also the CME editor for Academic Emergency. Outcome: * Primary Outcomes: Reduction in peripheral IV catheters placed post-intervention and usage * Secondary Outcome: PIVC insertion cost (staff and consumables) This is an SGEMHOP episode, so we have the lead author on the show. .

Emergency Department 40

Emergency Department Academics Outcomes Research 40

ALiEM

JULY 17, 2023

sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. Many of these findings were similar to a study of the 2022 EM Match results by Murano et al., A staggering 131 (47%) EM residency programs had unfilled PGY-1 positions among in 2023 [7].

EMS 52

EMS Burns Emergency Department Shock 52

Northwestern EM Blog

SEPTEMBER 26, 2022

PTSD is 2 times more prevalent in physicians (14.8%), with EM resident physicians falling in the range from 11.9%-21.5%. In a 12-month review there were 10 process and equipment changes (“hard outcomes”) as a direct result of the STOP5 hot debriefs and 14 additional opportunities for improvement.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

RebelEM

MAY 11, 2023

What They Did: Retrospective cohort study at a single academic medical center between July 1, 2016 to June 30, 2019. Rezaie, MD (Twitter: @srrezaie ) The post Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal appeared first on REBEL EM - Emergency Medicine Blog.

Emergency Department 89

Emergency Department Administration Hospitals Academics 89

PHEM Cast

APRIL 10, 2016

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Academic Emergency Medicine.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Consecutive enrollment avoided sampling bias Limitations: Retrospective observational study at a single academic center limits external validity (ie. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Dr. Smith's ECG Blog

MARCH 14, 2025

He contacted EMS due to acute onset chest pain and feeling unwell and fatigued. Here is evidence for this: Opiates are associated with worse outcomes in Myocardial Infarction. Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the CRUSADE Quality Improvement Initiative. Am Heart J.

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EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). ” Academic Emergency Medicine 20.1 This suggests that differences in FPS rate likely account for the observed differences in adverse events between RSI and FI (14,15).

Emergency Department 84

Emergency Department Soft Tissue Injuries Airway Management Operations 84

RebelEM

FEBRUARY 2, 2023

Small sample size limits the power of the study and increases margin of error A patient-oriented outcome such as mortality was not included Follow-up beyond disposition to evaluate hospitalization recurrences related to atrial fibrillation was not included.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

Queen of Hearts now thinks that this one looks like posterior OMI, since the STD does appear worst in V3-4: None of this seems to have been understood by the EM doctor or the cardiologist who was consulted. Yet this is rarely followed, and patient outcomes like this are the result once in a while. He was diagnosed as NSTEMI.

EKG/ECG 84

EKG/ECG Shock Documentation/Coding Academics 84

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

AUGUST 1, 2023

Factoring such, an order to transfer the patient immediately by ground or air EMS is the only actual support per se these non-physicians receive. Quillen College of Medicine (2003) Response The workforce study shook the foundation of emergency medicine (EM).

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

MAY 3, 2023

Results of this study showed that the use of low-dose insulin infusion led to similar clinical outcomes and fewer adverse events compared to the standard-dose insulin infusion. There were limitations to this study in that only a single academic institution was observed, and retrospective data could create data bias. Why does it matter?

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

ACEP Now

MAY 10, 2024

Primary Outcome: Diagnostic accuracy of identifying Stanford type A and Stanford type B AoDs Secondary Outcomes: Test characteristics of each of the three individual sonographic findings for diagnosing Stanford type A and Stanford type B AoDs. Pape LA, Awais M, Woznicki EM, et al. Prevalence: The prevalence of 3.5 However, 3.5

Ultrasounds 52

Ultrasounds Outcomes Academics Documentation/Coding 52

ACEP Now

AUGUST 25, 2023

Primary Outcome: Discharged home from the ED Secondary Outcomes: There were several secondary outcomes. Another interesting secondary outcome that could confound the results is that children who received IN fentanyl received higher overall total parenteral opioid morphine equivalents. Am J Hematol. Am J Hematol.

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Administration Pediatrics Emergency Department Outcomes 97

RebelEM

DECEMBER 19, 2022

At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here.

EMS 52

EMS CPR Shock Resuscitation 52

ACEP Now

JUNE 7, 2023

Background DHH patients experience disparities in social outcomes as well as health inequities. However, little research has been done to compare ED-focused outcomes for these two groups of patients. 1 This is likely due to audism, which creates privilege for non-DHH people in our society. 1,6 Reference: James TG, et al.

Emergency Department 52

Emergency Department Outcomes Research Academics 52

EMDocs

NOVEMBER 13, 2023

Authors: Mary Hamblen, DO (EM Resident Physician, TX); Justin Hacnik, MD (EM Resident Physician, TX); Katherine Spencer, MD (EM Resident Physician, TX); J.D. demonstrating that functional outcome at 3 months did not differ between the CTA and MRI groups (38.5% vs. 38.1%) with a good functional outcome. Molina, C.

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Stroke Radiology Radiology Emergency Department 103