ECG Blog #459 — What did the Paramedics See?
Ken Grauer, MD
DECEMBER 6, 2024
The Trauma Pro
DECEMBER 6, 2024
The debate over incidental appendectomy has waxed and waned over the years. And for the most part, it has nearly permanently waned in general surgical cases for now. But every once in a while, I am asked about incidental appendectomy during trauma laparotomy. Is it a good idea? What reasons could there possibly be for doing it? In the old days, we would frequently do an incidental appendectomy because… well, just because we were there.
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Science Based Medicine
DECEMBER 6, 2024
Doctors who gushed over RFK Jr. made their bed, and they'll lie in it. The post Dr. Vinay Prasad Sabotaging RFK Jrs Confirmation Will Increase Vaccine Hesitancy & Doctors Criticizing RFK Jr. Paved the Way for His Ascendancy first appeared on Science-Based Medicine.
Dr. Smith's ECG Blog
DECEMBER 6, 2024
A 50-something man presented with worsening severe exertional chest pain which was just resolving as he had an ECG recorded in triage. Time zero. Are the T-waves in leads I and II hyperacute? Hard to tell. How can we know? By the evolution of the ECG! Watch what happends as the heart recovers from its episode of ischemia. The T-waves deflate, demonstrating that the first one was indeed hyperacute. 2 hours T-waves in lead II are significant smaller In lead I not much difference Troponins returned
EMDocs
DECEMBER 6, 2024
Authors: Haley Dusek, MD (Emergency Medicine Resident, Carolinas Medical Center ); Erik Fisher, MD (Emergency Medicine Attending/Medical Toxicologist, Carolinas Medical Center) // Reviewed by: Anthony Spadaro, MD (@TSpadaro91, Medical Toxicology Fellow, Rutgers New Jersey Medical School, Newark, NJ); James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Alex Koyfman, MD (@EMHighAK); and Brit Long, MD (@long_brit) Case: A 27-
ACEP Now
DECEMBER 6, 2024
By some definitions, you could call former Maryland state legislator Dan Morhaim, MD, FACEP, a retired emergency physician. He thinks of it as re-deployed. Dr. Morhaim spent more than two decades in the Maryland House of Delegates, fighting for legislation to protect health care workers and patients before his final legislative term ended in 2019. His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of
Mind The Bleep
DECEMBER 6, 2024
Introduction The acute scrotum is a constellation of new-onset pain, swelling and/or tenderness of intra-scrotal contents (1). In this article, we will review the limited number of differentials. Please note that a single clinical feature is not the confirmatory to a particular differential but the whole clinical picture will need to be considered when making a diagnosis.
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ACEP Now
DECEMBER 6, 2024
A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. During initial assessment, an ECG was obtained and revealed ST-segment elevation (STE) in the inferior leads with ST depression anteriorly. FIGURE 1. Initial ECG demonstrating inferolateral ST segment elevation and anteroseptal depression, just prior to cardiac arrest.
Pediatric EM Morsels
DECEMBER 6, 2024
Rashes are, as we know, a common complaint in the pediatric ER and one of the most difficult things to diagnose ( in my opinion ). Many of them look the same and distinguishing between what is a benign rash vs something sinister can always be a challenge. As we sort through the potential concerning ailments, it is also good to keep in mind the stereotypic causes of mild pediatric rashes.
ACEP Now
DECEMBER 6, 2024
A 46-year-old female with a prior medical history of asthma presented to the emergency department with shortness of breath and wheezing. After three DuoNeb treatments and 16 mg of dexamethasone, her wheezing improved; however, she continued to report shortness of breath on exertion. Given the persistent symptoms, a cardiac point-of-care ultrasound was obtained.
ALiEM
DECEMBER 6, 2024
A 21-year-old otherwise healthy female presented to the Emergency Department with a fever after recently returning from Ghana. She reported intermittent fever, headache with photophobia, diarrhea, joint pains, and generalized weakness. She also noticed a diffuse, intermittently pruritic rash on her trunk and extremities. While in Ghana, she volunteered at a refugee hospital, ate street food, and was exposed to local animals.
ACEP Now
DECEMBER 6, 2024
As voters across the country braced for uncertainty heading into Election Day 2024, emergency physicians could rest assured that the National Emergency Medicine Political Action Committee (NEMPAC) was looking out for their best interests. Although ACEP members have differing opinions on issues that drove voters to the polls, most agree on the pressing challenges facing emergency medicinepatient boarding, workplace violence, defending emergency medicine against insurer bad practices, and creating
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