Dr. Smith's ECG Blog

NOVEMBER 25, 2024

Introductory Angiography Guide To find the guide later, go to the banner at the top of the blog: This blog is dedicated to improving understanding of ECGs in the context of emergency medicine. A substantial proportion of cases discussed include diagnostic angiography. Attaining expertise in angiography requires dedication and practice. What follows is an introduction to angiography -- a guide meant for people with no prior experience interpreting angiograms.

Documentation/Coding 73

Documentation/Coding EKG/ECG 73

Don't Forget the Bubbles

NOVEMBER 25, 2024

A 7-week-old baby presents to the Emergency Department (ED) with a one-day history of coryza and cough. Parents have recorded a temperature of 38°C at home. In triage, she is noted to be alert and feeding well. Her initial observations show a temperature of 38.2°C, HR 152 bpm, RR 45/min, and oxygen saturation 97% in room air. You perform a viral swab test at ED which comes back positive for SARS-CoV-2.

Point-of-Care Testing 69

Point-of-Care Testing Outcomes Wellness Emergency Department 69

EM Literature of Note

NOVEMBER 25, 2024

Following on the success of Toy Story 2, Inside Out 2, and Avatar 2, we have WOMAN-2, yet another trial featuring emergency medicine’s third-favorite medication: tranexamic acid. However, where those sequels succeeded, WOMAN-2 is more like Miss Congeniality 2 – the one we’re not going to talk about again. But, don’t take it from me – take it from the ChatGPT Agent I created!

Research 64

Research Outcomes Administration Wellness 64

Sensible Medicine

NOVEMBER 25, 2024

When a clinical trial is published, people are relieved. The researchers did the work, analyzed the data, published the report and surely feel a sense of completion. Clinicians are relieved because we have more evidence to use in patient care. The question is how certain we should be about the trial’s result. In April, I covered the work of Dena Zeraatker , from McMaster University, who elegantly showed that there were thousands of ways to analyze data from observational studies.

Research 64

Research Outcomes 64

First 10 EM

NOVEMBER 25, 2024

The First10EM monthly wrap up is a place for me to share updates about the website, about my academic life, and also interesting content, such as books, podcasts, and other FOAMed, that I have encountered in the prior month (or now quarter). Obviously the format means the focus is mostly on content I have found, […] The post The First10EM monthly wrap-up for autumn 2024 appeared first on First10EM.

Academics 61

Academics 61

RebelEM

NOVEMBER 25, 2024

Background: In 2018, the BEAM Trial, a small single-center randomized clinical trial, conducted in the emergency department at Hennepin County Medical Center, demonstrated that bougie use significantly increased the first-attempt intubation success rate compared to the endotracheal tube with stylet (98% vs 87% (absolute difference, 11% [95% CI, 7% to 14%]). 1 Conversely, the 2021 BOUGIE trial—a larger, multicenter randomized clinical trial conducted by the same investigators—found no significant

Outcomes 59

Outcomes Emergency Department Operations Hospitals 59

EMergucate

NOVEMBER 25, 2024

72 year-year-old man with history of type II DM and has a single kidney. Presented with 2 weeks of diarrhoea. He has been in bed for 2 weeks. Unresponsive. Last proper meal was 2 weeks ago.

52

52

PEMBlog

NOVEMBER 25, 2024

The Kocher criteria can help you rule out a septic hip. Transient Synovitis is a much better diagnosis. It used to be called Toxic Synovitis, but that name was too scary so it got changed. Lyrics In a kid with hip pain I’ve got to explain The Kocher criteria And using your brain Cannot bear weight A fever complaint White count 12K ESR 40 today I’ve they’ve got all four The hips septic for sure But if they have none Then show them the door Note: CRP of >2.5 can replace ESR>40, but it was

Infectious Diseases 52

Infectious Diseases 52

EMergucate

NOVEMBER 25, 2024

Question 1: PH = 7.30, that is mild acidaemia. HCO3 = 18, that is low (less than 24), So we have metabolic acidosis.

52

52

PulmCCM

NOVEMBER 25, 2024

More than half a million bloodstream infections occur annually in the U.S. and are estimated to cause nearly 100,000 deaths, with worldwide totals many times higher. Treatment courses for many severe infections have been reduced in length with no apparent detriment, but most trials testing antibiotic durations have excluded patients with bacteremia.

Infectious Diseases 40

Infectious Diseases Research Hospitals Outcomes 40

EMDocs

NOVEMBER 25, 2024

Authors: Kamoga Dickson, MD (EM Resident Physician, Makerere College of Health Sciences, Kampala, Uganda); Jessica Pelletier, DO, MHPE (APD/Assistant Professor of EM/Attending Physician, University of Missouri-Columbia) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 42-year-old male from a rural area in northeastern Uganda presents to the tertiary care emergency department with severe itching, skin changes on his legs, and episodes of blurred vision, describing &

Infectious Diseases 45

Infectious Diseases Emergency Department EMS Administration 45

Science Based Medicine

NOVEMBER 25, 2024

President-Elect Donald Trump has now announced most of picks to lead critical federal health agencies. These picks predictably prioritize grift, quackery, and antivax ideology. The post Antivaxxers, grifters, and quacks: RFK Jr.’s MAHA takes over federal health agencies first appeared on Science-Based Medicine.

CDC 74

CDC 74