Dr. Smith's ECG Blog

JANUARY 21, 2025

I was reading ECGs on the system and saw all of these, from one patient. I read them without clinical context and looked at the clinical context later. A 70-something dialysis patient presented and coronary disease had missed dialysis and then presented with acute onset of shortness of breath. He denied chest pain. There was mild hypoxia prehospital, lowest saturation 90%, On arrival, BP was 140/84, pulse 122, O2sat 100% and the patient had increased work of breathing.

EKG/ECG 63

EKG/ECG Hospitals Wellness 63

Emergency Medicine Journal

JANUARY 21, 2025

A short systematic review was undertaken to assess whether intradermal sterile water injections (ISWI) provide effective pain relief in adult patients presenting to the Emergency Department (ED) with renal colic. MEDLINE, Embase, Cochrane and Google Scholar databases were searched, identifying seven relevant studies. Study information, patient characteristics, key results and methodological weaknesses were tabulated.

Emergency Department 52

Emergency Department Research 52

PEMBlog

JANUARY 21, 2025

The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. Differentiating these pathogens based on clinical presentation is crucial for targeted management, minimizing unnecessary diagnostic tests, and optimizing healthcare resources.

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Pediatrics Dehydration Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

Background Extreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.

Emergency Department 52

Emergency Department Wellness 52

Science Based Medicine

JANUARY 21, 2025

I’m at that age, 67 going in 68, where it is reasonable to yell at the clouds. Which, come to think of it, may be a good title for another collection of my SBM essays. Aging does indeed suck, but it is, usually, better than the alternative. As we, and by we I mean my family and me, age we get the […] The post Old Doctor Yells At Clouds first appeared on Science-Based Medicine.

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Emergency Medicine Journal

JANUARY 21, 2025

Background Growing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences in the utilisation of low-acuity ED visits between culturally and linguistically diverse (CaLD) migrants and English-speaking background (ESB) population.

Emergency Department 52

Emergency Department 52

EMergucate

JANUARY 21, 2025

The following ECG is from a young male who has presented with intermittent palpitations. He has no significant medical history.

EKG/ECG 52

EKG/ECG 52

RebelEM

JANUARY 21, 2025

Background: The current standard care for evaluating pulmonary embolism (PE) advises against D-dimer testing in patients with a high clinical probability. European and American guidelines emphasize a sequential diagnostic approach based on pretest probability assessment using either a formal clinical decision instrument (e.g., Wells’ , Revised Geneva ) or clinical gestalt.

EMS 45

EMS Research Wellness Outcomes 45

Emergency Medicine Journal

JANUARY 21, 2025

Trauma remains a significant cause of mortality and morbidity. Non-compressible torso haemorrhage is one of the key drives of these mortality data. Our contemporary management has focused on damage control resuscitation, with a focus on haemorrhage control, haemostatic resuscitation and permissive hypotension. The evidence for permissive hypotension lacks the robustness as other treatments, such as tranexamic acid.

Resuscitation 52

Resuscitation 52

EM Literature of Note

JANUARY 21, 2025

The last decade or so featured a rather notable increase in palatability for the conservative management of appendicitis. Why undergo surgery for a condition antibiotics can cure? You wouldn’t take out your bladder for a urinary tract infection, would you? This latest randomized trial adds to the evidence surrounding the “antibiotics first” strategy for appendicitis by expanding it to children.

Operations 60

Operations Hospitals 60

Emergency Medicine Journal

JANUARY 21, 2025

Background Rapid identification of individuals with acute respiratory infections is crucial for preventing nosocomial infections. For rapid diagnosis, especially in EDs, lateral flow devices (LFDs) are a convenient, inexpensive option with a rapid turnaround. Several ‘multiplex’ LFDs (M-LFDs) now exist, testing for multiple pathogens from a single swab sample.

Emergency Department 52

Emergency Department Hospitals 52

St. Emlyn

JANUARY 21, 2025

St.Emlyn's - Emergency Medicine #FOAMed Learn more about the Ten Second Triage tool in this interview recorded at Tactical Trauma 24. The post Podcast – Ten Second Triage with Sean Brayford Harris at Tactical Trauma 24 appeared first on St.Emlyn's.

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Emergency Medicine Journal

JANUARY 21, 2025

The need to isolate patients with influenza and COVID-19 in emergency departments (ED) requires quick screening tests for these infections. 1 Given mutations and newer variants of these diseases, vaccines and varying incidence, we assessed the diagnostic accuracy of two rapid screening tests in our ED in Spain during periods of higher and lower prevalence according to the Acute Respiratory Infection Surveillance System data. 2 A retrospective cross-sectional observational study was carried out i

Emergency Department 52

Emergency Department Hospitals 52

Sensible Medicine

JANUARY 21, 2025

Sensible Medicine is spoiled with great submissions. A challenge we face is needing to pass on articles which are interesting, thoughtful, and well-argued but which fall outside our lane – articles that are not even “medicine adjacent” This article, the second we have published by Charles Silver, pushes the edge of the envelope. I think there is enough of the intersection of medicine and society for us to publish this, especially as public health and politics seems to be gettin

Shock 63

Shock Wellness 63

Emergency Medicine Journal

JANUARY 21, 2025

This month’s update is by the Emergency Department of the University Hospital of Heraklion, Crete, Greece. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlighted each paper’s main findings, key limitations and clinical bottom line.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

American Medical Compliance

JANUARY 21, 2025

A study published in BMC Geriatrics found that out of 3,693 nursing staff surveyed (with a response rate of 60.1%), 88.8% reported witnessing at least one incident of resident-to-resident aggression in the past year. Resident-to-resident aggression (RRA) is a growing concern in healthcare facilities, particularly in assisted living and long-term care settings.

Teamwork 59

Teamwork Wellness Best Practices Documentation/Coding 59

Emergency Medicine Journal

JANUARY 21, 2025

Case presentation A 29-year-old man presents to the ED with a foreign body (FB) in his right leg. He was impaled by an organic thorn while doing yard work in his backyard roughly 3 hours prior to presentation. A sample of the type of plant that was inserted into his lower extremity is shown in figure 1. He reports pain with movement of the limb, but no numbness or tingling.

Ultrasounds 52

Ultrasounds Wellness 52

Emergency Medicine Journal

JANUARY 21, 2025

We congratulate Xu et al on developing a machine learning-derived triage tool for major incidents. 1 The use of this technology, together with artificial intelligence, is likely to increase rapidly, and a triage tool that relies on binary questions, rather than quantitative measures or calculations, is intuitively advantageous. However, the proposed tool, while statistically sound, suffers from a lack of face-validity.

Research 52

Research 52

Emergency Medicine Journal

JANUARY 21, 2025

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Research 52

Research 52

Emergency Medicine Journal

JANUARY 21, 2025

We begin this month with the Editor’s Choice, which requires a bit of background. In 2015, the European Association of Science Editors convened a group of experts to develop the Sex and Gender Reporting (SAGER) guidelines with the goal of creating more transparency and detail in reporting sex and gender differences in the research. The guidelines recommend that researchers, and the journals they publish in, explain how the studies took into account potential differences in outcomes by sex

Research 52

Research Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

Background Sex-based disparities in acute coronary syndrome (ACS) presentations exist and women often have worse outcomes after an ACS event. Calling the emergency medical services (EMS) initiates prehospital diagnosis and treatment and reduces in-hospital time to treatment. This study aims to identify factors affecting the intention to call EMS and EMS usage in Australian women and men.

EMS 52

EMS Hospitals Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

Background Female participants are underrepresented in randomised control trials conducted in urgent care settings. Although sex and gender are frequently reported within demographic data, it is less common for primary outcomes to be disaggregated by sex or gender. The aim of this review is to report sex and gender of participants in the primary papers published on research listed on the National Institute of Health and Care Research (NIHR) Trauma and Emergency Care (TEC) portfolio and how these

Urgent Care 52

Urgent Care Research Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

Editorial linked to: Astin-Chamberlain R, Pott J, Cole E, et al. Sex and gender reporting in UK emergency medicine trials from 2010 to 2023: a systematic review. Emergency Medicine Journal Published Online First: 11 September 2024. doi: 10.1136/emermed-2024-214054. The under-representation of women in clinical trials has been well documented but even less appreciated is the lack of attention to potential differences in outcomes according to sex and gender.

Documentation/Coding 52

Documentation/Coding Research Wellness Outcomes 52