Dr. Smith's ECG Blog

NOVEMBER 28, 2022

She was discharged after a short hospitalization with oncology and cardiology follow-up. At our hospital, I think all of our docs would want to place a pigtail catheter in the ED, under ultrasound guidance and not wait for cardiology to take the patient to the cath lab. A repeat POCUS showed resolution of her pericardial effusion.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Author continued : STE in aVR is often due to left main coronary artery obstruction (OR 4.72), and is associated with in-hospital cardiovascular mortality (OR 5.58).

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Critical Care Now

MARCH 3, 2022

The Pre-brief Working in a Pulmonary Function Lab plus providing in-patient care within the hospital, I see patients every day that have been diagnosed with chronic obstructive pulmonary disease (COPD). These patients frequently ask if they can be cured of COPD. COPD continues to be a problem for many adults.

COPD 52

COPD Research Hospitals Wellness 52

RebelEM

AUGUST 21, 2023

Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. PMID: 37318140 Clinical Question: Does mild hypercapnia in adults with coma who have been resuscitated following out-of-hospital cardiac arrest provide favorable neurological outcomes in 6 months compared to normocapnia? Paper: Eastwood G, et al. N Engl J Med.

Hospitals 98

Hospitals Resuscitation Outcomes CPR 98

Mind The Bleep

FEBRUARY 2, 2025

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Examples of examination findings you might find helpful to keep in mind (list not exhaustive): GCS 15/15- alert, orientated, looks comfortable, warm and well perfused, in obvious pain, looks pale and clammy etc.

Documentation/Coding 95

Documentation/Coding COPD EKG/ECG Wellness 95

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. May be considered first line in the future however results may be dependent upon provider training and hospital resources [17].

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Sensible Medicine

JUNE 30, 2023

Patients present with troublesome symptoms that they “just want checked out before the weekend” and I’m left either worrying about them all weekend or admitting them to the hospital where I know little will happen for the next two days. She did not require hospitalization. It was not exertional.

Hospitals 98

Hospitals Hospice Resuscitation COPD 98

Emergency Medicine Ireland

MARCH 27, 2023

Oh Chapter 37 is dedicated to NIV in the ICU and is probably worth some time given that this is a common respiratory support both in the ICU and throughout the hospital. Well there are a number of now well established indications where it is entirely appropriate to try and temporise with NIV rather than just putting the tube in.

COPD 52

COPD Wellness Fractures Hospitals 52

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

PulmCCM

JUNE 10, 2024

3 days for anoxic encephalopathy to regain pupillary responses after cardiac arrest, 4-7 days for a DNR/DNI patient to receive NIPPV for COPD exacerbation, etc.) days, with fewer patients receiving mechanical ventilation or invasive procedures, and with no difference in hospital mortality. ICU length of stay fell by a median of 1.3

COPD 45

COPD Outcomes Hospitals EMS 45

EMDocs

APRIL 22, 2024

1-3 VTE is responsible for hospitalizing over 250,000 Americans every year, and there are an estimated 100,000 deaths annually associated with these conditions. If RV pressure is extreme, it can exceed LV pressure causing paradoxical septal wall motion toward the LV as well. 10,11 Vid 1. SubX4 Asystole RV > LV.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Mind The Bleep

NOVEMBER 21, 2023

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Examples of examination findings you might find helpful to keep in mind (list not exhaustive): GCS 15/15- alert, orientated, looks comfortable, warm and well perfused, in obvious pain, looks pale and clammy etc.

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

The Skeptics' Guide to EM

MARCH 25, 2018

Case: An 85-year-old woman with a history of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and type-2 diabetes (DM-2), and her 65-year-old otherwise healthy daughter present to the emergency department after a car accident. However, it is not a homogeneous population.

Outcomes 40

Outcomes Geriatric Emergencies Emergency Department COPD 40

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. At our hospital in southern Manhattan, patients tend to breathe around 16.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Peripheral obtained from IV line; central obtained from central venous line.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

ACEP Now

JUNE 14, 2024

Chronic obstructive pulmonary disease (COPD) is a chronic disease of the lungs caused by inflammatory and structural changes of the small airways and parenchyma of the lungs that result in chronic airflow obstruction and gas trapping. In 2019, the global prevalence of COPD was estimated to be 10.3 8 Bronchodilators Albuterol 2.5-5

COPD 52

COPD Hospitals Emergency Department Outcomes 52

Sensible Medicine

SEPTEMBER 22, 2024

In studies, and in practice, these people tend to be patients with COPD who have resting O 2 sats of < 88%. The primary outcome was a composite of hospitalization or death from any cause within one year. The enrolled patients were not well. The HR for hospitalization or death within 1 year was 0.99; [CI], 0.72

COPD 115

COPD Outcomes Shock Hospitals 115

Taming the SRU

OCTOBER 28, 2024

Most common triggers include respiratory conditions such as asthma, COPD, and pneumonia which can lead to forceful coughing -Other common triggers include forceful exertion, severe coughing or vomiting, asthma exacerbation, intense physical activity, or Valsalva maneuvers (e.g., Unique patient case from UCMC Hospital. PubMed] 13.

COPD 79

COPD Pediatrics Emergency Department Ultrasounds 79

Taming the SRU

JANUARY 22, 2025

2,3] In 2020, the CDC estimates that asthma exacerbations accounted for almost 1,000,000 ED visits and almost 100,000 inpatient hospitalizations. [4] COPD is characterized by episodes of exacerbations, which require prompt recognition and management due to their potential to escalate rapidly and cause significant morbidity and mortality.

COPD 80

COPD CDC Research Emergency Department 80

The Skeptics' Guide to EM

JANUARY 22, 2022

Her vitals signs are all normal and she feels well enough to isolate at home. Early in the pandemic, there was some observational data that concluded that inhaled steroids were associated with an increased mortality from COVID-19 in patients with asthma and COPD ( Schultze Lancet Resp Med 2020 ). It did report positive results.

Urgent Care 40

Urgent Care COPD Outcomes Emergency Department 40

EMDocs

FEBRUARY 8, 2025

Well keep it short, while you keep that EM brain sharp. Four days ago, he presented to the ED for a COPD exacerbation. On chart review, a sputum culture collected during a recent hospital visit grew a species of Aspergillus. COPD, cystic fibrosis), HIV/AIDS, cancer, immunosuppressed (i.e.

Infectious Diseases 72

Infectious Diseases EMS COPD Research 72

PulmCCM

OCTOBER 23, 2023

Among >2500 patients under age 50 in an observational cohort who contracted Covid-19 in the Omicron era, those taking Paxlovid had no fewer deaths, emergency department visits, or hospitalizations (as a composite) than those not treated with the drug , with the exception of those with cardiovascular disease or cancer.

Hospitals 98

Hospitals COPD Emergency Department CDC 98

PulmCCM

SEPTEMBER 28, 2023

There was a strong trend toward reduction in the combined endpoint of hospitalization or death, among patients randomized to inhaled budesonide. Outcomes tested were the time to sustained recovery (three days symptom-free, hazard ratio 1.01), hospitalizations (three in each group), or death by day 28 (there were none).

COPD 95

COPD Stroke Academics Urgent Care 95