Dr. Smith's ECG Blog

AUGUST 18, 2024

Written by Pendell Meyers A man in his 70s presented with history of pacemaker presented with shortness of breath with exertion and presyncope. Here is his triage ECG with minimal symptoms: What do you think? The ECG shows pacemaker failure with inability to capture or sense, with either underlying atrial fibrillation or junctional escape rhythm. The QRS shows LVH and there are diffuse ST-T abnormalities likely in part appropriate for the LVH, though memory T waves are also a consideration.

EKG/ECG 90

EKG/ECG Fractures Burns Wellness 90

University of Maryland CC Project

AUGUST 18, 2024

Dr. Colin Grissom is professor of medicine at Intermountain Healthcare as well as University of Utah. He discusses his experience with implementing best practices, specifically low tidal volume ventilation, across […] Dr. Colin Grissom is professor of medicine at Intermountain Healthcare as well as University of Utah. He discusses his experience with implementing best practices, specifically low tidal volume ventilation, across multiple hospitals and states.

Best Practices 81

Best Practices Wellness Hospitals 81

ECG Guru

AUGUST 18, 2024

We see an ECG with the limb leads and V1/V2. It shows a normal sinus rhythm with 1. degreeAV block and 1 conducted and 1 nonconducted PAC before the pause. There is a short pause in the middle of the ECG, how can this be explained? On closer inspection, a PAC can be seen in the ST segment/at the beginning of the T wave. This cannot be conducted due to the short coupling interval.

EKG/ECG 69

EKG/ECG 69

University of Maryland CC Project

AUGUST 18, 2024

Dr. Lane Smith is a critical care medicine specialist at Atrium Health Carolinas Medical Center located in Charlotte, North Carolina and serving as the Charlotte academic branch of Wake Forest […] Dr. Lane Smith is a critical care medicine specialist at Atrium Health Carolinas Medical Center located in Charlotte, North Carolina and serving as the Charlotte academic branch of Wake Forest School of Medicine.

Shock 75

Shock Academics 75

Science Based Medicine

AUGUST 18, 2024

Dr. Scott Atlas said the Great Barrington Declaration was aligned with the advice he gave to the President of the United States. He also said he never read it. The post Dr. Scott Atlas: “I Never Read the Full Great Barrington Declaration Website and Everything”. first appeared on Science-Based Medicine.

87

87

PulmCCM

AUGUST 18, 2024

Patients who become persistently encephalopathic after the resolution of severe illness (e.g., brain injury due to trauma, ischemic or hemorrhagic stroke) enter a liminal state of existence while those around them decide their fate.

Stroke 59

Stroke 59

Critical Care Now

AUGUST 18, 2024

Reading Time: 2 minutes Article: Dequin P, Meziani F, Quenot J, et al. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023;388(21):1931-1941. PMID: 36942789. ClinicalTrials.gov: NCT025174897 Background: Community-acquired pneumonia (CAP) can lead to significant pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and increased mortality.

Outcomes 52

Outcomes Sepsis Administration EMS 52

Mind The Bleep

AUGUST 18, 2024

Facial trauma commonly presents in Emergency Departments and in primary care. More advanced facial trauma will be redirected to major trauma centres. Due to the proximity to vital structures, it is essential to be able to assess these injuries appropriately and escalate accordingly. History If the patient is stable, it is important to start with a thorough history.

Fractures 52

Fractures Soft Tissue Injuries Burns Emergency Department 52

Pediatric Education

AUGUST 18, 2024

Patient Presentation A 9-month-old male came to clinic because of fussiness and fever for 2 days. The infant had had runny nose and a mild cough for 5 days. Two days previously he started to have fever up to 102.3F and was very fussy. He often would pull on his left ear. His mother took a less medical interventional approach and had been giving him plenty of fluids, warm baths etc. but no antipyretic medication.

Allergic Reactions 40

Allergic Reactions Burns Pediatrics 40

Mind The Bleep

AUGUST 18, 2024

Patients often present to GP practices with oral lesions as they may struggle to get a dental appointment. It is important to know which lesions need to be referred and which lesions are potentially serious and need an urgent 2WW referral. Ulcers Ulcers indicate a break in the oral mucosa. Oral ulcers are very common and most patients will not need to seek medical attention for them.

Burns 52

Burns 52

University of Maryland CC Project

AUGUST 18, 2024

Dr. Christa O’Hana Nobleza is practicing neurointensivisit and an associate professor of neurology at the University of Tennessee Health Science Center in Memphis. Her lecture discusses the importance of mentorship […] Dr. Christa O’Hana Nobleza is practicing neurointensivisit and an associate professor of neurology at the University of Tennessee Health Science Center in Memphis.

40

40

Mind The Bleep

AUGUST 18, 2024

Problems with salivary glands are often seen at GPs and in emergency departments. It is important to be able to differentiate between different causes of facial pain and swelling. Anatomy There are 6 main salivary glands (3 pairs); parotid, submandibular and sublingual. There are hundreds of other minor salivary glands throughout the mouth. The parotid gland duct opens in the inside of the cheek next to the upper molars.

Emergency Department 52

Emergency Department Ultrasounds 52

University of Maryland CC Project

AUGUST 18, 2024

Laurah Turner PhD is an assistant dean for assessment and education at the University of Cincinnati College of Medicine. Her lecture discusses the applications of AI to advance medical education. Laurah Turner PhD is an assistant dean for assessment and education at the University of Cincinnati College of Medicine. Her lecture discusses the applications of AI to advance medical education.

40

40

Mind The Bleep

AUGUST 18, 2024

The temporomandibular joint (TMJ) connects the mandible to the skull. The image below shows the anatomy. The joints are essential for jaw movements. TMJ Disorders TMJ disorders are common and cover musculoskeletal conditions impacting the muscles of mastication and the TMJ. Causes are multifactorial and related to anatomy, trauma, grinding or clenching of the teeth and psychosocial factors (stress, anxiety and depression ).

Dislocations 52

Dislocations Emergency Department 52

University of Maryland CC Project

AUGUST 18, 2024

Dr. Imad Khan is an assistant professor in the Division of NeuroCritical Care at the University of Rochester. His research focuses on monitoring cerebral perfusion and pathophysiology in patients with […] Dr. Imad Khan is an assistant professor in the Division of NeuroCritical Care at the University of Rochester. His research focuses on monitoring cerebral perfusion and pathophysiology in patients with anoxic brain injury in cardiac arrest and cardiogenic shock.

Shock 40

Shock Research 40

University of Maryland CC Project

AUGUST 18, 2024

Dr. Randal O. Dull is a professor of anesthesiology with joint appointments in the departments of pathology, physiology, and surgery at the University of Arizona College of Medicine. With a […] Dr. Randal O. Dull is a professor of anesthesiology with joint appointments in the departments of pathology, physiology, and surgery at the University of Arizona College of Medicine.

Research 40

Research 40

University of Maryland CC Project

AUGUST 18, 2024

Dr. Alain Combes has is a professor of intensive care medicine at Sorbonne Université in Paris. Dr. Combes’ research focuses on the care of critically ill cardiac patients, mechanical circulatory […] Dr. Alain Combes has is a professor of intensive care medicine at Sorbonne Université in Paris. Dr. Combes’ research focuses on the care of critically ill cardiac patients, mechanical circulatory assistance and extracorporeal membrane oxygenation, rescue therapies for severe respiratory failur

Research 40

Research 40