February, 2023

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ECG Blog #366 — Diltiazem didn't work.

Ken Grauer, MD

The ECG and long lead II rhythm strip in Figure-1 — was obtained from a COVID positive patient with persistent tachycardia not responding to Diltiazem. How would YOU interpret this tracing? How to manage the patient? Figure-1: The initial ECG — obtained from a patient with persistent tachycardia. ( To improve visualization — I've digitized the original ECG using PMcardio ).

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Managing Expectations

Mount Sinai EM

Let’s talk about managing expectations. You can do this with almost everyone/everything in your life, your goal being to under sell, over deliver. Some, not all, patients think that when they walk through these hallowed doors, that they’re walking into a place of truth and all-knowing information. They don’t realize the ED is more like a “I’m going to make sure you’re not going to die today or tomorrow, then dispo you as quickly as you came in”-type plac

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NRC Health recognized as Best in KLAS for Patient Experience Improvement

NRC Health

NRC Health, the leading partner in building Human Understanding® through personalized healthcare solutions and data-driven insights, has received the Best in KLAS 2023 Award for Patient Experience Improvement. The post NRC Health recognized as Best in KLAS for Patient Experience Improvement appeared first on NRC Health.

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Signs It’s Time for Your ASC to Upgrade Its Patient ID Solution

PDC Healthcare

Every patient, procedure, and staff member an Ambulatory Surgery Center relies on accurate patient identification. Patient identification wristbands are crucial to ensuring patient safety as they provide a critical link between the patient’s identity, electronic medical record, and treatment. With the high volumes ambulatory surgery centers have to handle, it’s critical to stay updated with […] The post Signs It’s Time for Your ASC to Upgrade Its Patient ID Solution appeared first on

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Violence Against Public Health Workers

NIOSH Science Blog

Many workers who were on the frontlines during the COVID-19 pandemic experienced increased physical and mental stress. One study found that 70% of U.S. workers felt more stressed at work during COVID-19 than at any other point in their professional careers [1]. Public health workers, including epidemiologists, contact tracers, laboratory scientists, community health workers, and data analysts, served on the front lines of the pandemic delivering information, providing services, and conducting re

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EMCrit 344 – Sleep for the Weary II – General Sleep Stuff

EMCrit

All things Sleep--you will add years to your life if you sleep well, so the time investment to listen to this podcast may be well worth it EMCrit Project by Scott Weingart, MD FCCM.

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Why Do So Many Bodybuilders Have Heart Attacks?

AED Leader

The early death of more than a dozen bodybuilders from heart attacks and other heart-related events over the past few years seems surprising given that we’re talking about young men and women who exercise regularly. However, looking a little more closely at the sport reveals several factors that contribute not only to an elevated risk Read More "Why Do So Many Bodybuilders Have Heart Attacks?

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The 2023 Experience Perspective: Perspective on Benchmarks

NRC Health

NRC Health’s 2023 Experience Perspective will be released in February. Get a first look at the topics and key highlights covered in this year’s report. The post The 2023 Experience Perspective: Perspective on Benchmarks appeared first on NRC Health.

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Health System Adopts Thermal Printing, Builds on Reputation for Technological Excellence 

PDC Healthcare

Spartanburg Regional Healthcare Improves Patient Safety by Switching to Thermal Wristband and Label Printing Spartanburg Regional Healthcare System, an integrated healthcare delivery system in South Carolina, is building on its reputation for technological excellence with the recent adoption of thermal print patient identification technology. Spartanburg is one of many health systems across the US that […] The post Health System Adopts Thermal Printing, Builds on Reputation for Technologic

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SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular Fibrillation?

The Skeptics' Guide to EM

Date: February 7, 2023 Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. NEJM 2022 Guest Skeptic: Dr. Sean Moore is an emergency physician working in Kenora Ontario, where he is Chief of Staff at Lake of the Woods District Hospital, Northern Medical Director for the Ornge air medical transport program and associate medical director with CritiCall […] The post SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular F

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EMCrit RACC Lit Review – February 2023

EMCrit

All the lit goodness for Feb 2023 EMCrit Project by Scott Weingart, MD FCCM.

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Imaging Case of the Week 543

EMergucate

The elbow x-ray is from an adult patient with pain, swelling & inability to move their elbow after a fall on outstretched hand. What can be seen?

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Ep 179 Hand Injuries – Finger Tip Injuries, Jersey Finger, PIP Dislocations, Metacarpal Fractures, Thumb Injuries, Tendon Lacerations

Emergency Medicine Cases

ED recognition and management of some commonly missed or mismanaged hand inuries including finger tip avulsions and amputations, nailbed injuries, PIP dislocations, metacarpal fractures, hand tendon lacerations, Stener lesions, Seymour fractures, mallet fingers, jersey fingers, skier's thumb, Bennet fractures and Rolando fractures with masters Dr. Arun Sayal and Dr.

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Indiana Recognizing and Reporting Child Abuse and Neglect Training

American Medical Compliance

The Indiana Recognizing and Reporting Child Abuse and Neglect Training will educate dental healthcare providers (DHCP) on the signs of child abuse and neglect and how mandatory reporters in Illinois report child abuse and neglect cases. The first step in preventing child abuse and neglect is recognizing the signs. Undoubtedly, if you notice a sign of child maltreatment occurring within a family, it is important to take a closer look at the situation.

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Pediatric Collab Preview: Leadership rounding the Driscoll way

NRC Health

The NRC Health 2023 Pediatric Collaborative is truly a can’t-miss experience, with exceptional presentations that will stir innovative ideas for attendees to bring back to their larger PX and marketing teams. The post Pediatric Collab Preview: Leadership rounding the Driscoll way appeared first on NRC Health.

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Inclusion in POCUS Part 2

Ultrasound Gel

This is the second and final part of our episode on diversity, equity, and inclusion within the point-of-care ultrasound community. Guests Almaz Dessie and Javier Rosario lend their insights to the discussion of their articles and practical next steps. [link] This is the second and final part of our episode on diversity, equity, and inclusion within the point-of-care ultrasound community.

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What are these hyperacute T waves, with STE and T-wave inversion in aVL, and STD in inferior leads?

Dr. Smith's ECG Blog

I was reading EKGs on the system and came across this one: What do you think? This is diagnostic of hyperkalemia. HyperK can result in all sorts of pseudoSTEMI or pseudoOMI patterns, including ST elevation, ST depression, and large T-waves. These T-waves are tall but have a narrow base and a corresponding flat ST segment (see lead V4). Also, there are no definite P-waves and this is another result of hyperkalemia.

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Imaging Case of the Week 542 Answer

EMergucate

The chest x-ray shows a cavity near the right cardiophrenic angle.

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ECG Cases 40 – Approach to Spontaneous Coronary Artery Dissection (SCAD)

Emergency Medicine Cases

Dr. Jesse McLaren on when to consider Spontaneous Coronary Artery Dissection (SCAD), which patients are at risk for reocclusion, and the challenges of diagnosing SCAD in patients who have nonischemic ECGs despite silent occlusion, occlusions perfused by collaterals, or from non-occlusive MI on this ECG Cases. The post ECG Cases 40 – Approach to Spontaneous Coronary Artery Dissection (SCAD) appeared first on Emergency Medicine Cases.

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Best #FOAMed Finds Feb 2023 (2)!

Critical Care North Hampton

The last for Feb! All sifted to keep you up to date! Follow us if you aren’t already. Jonny – @wilkinsonjonny Ashley – @ICMteaching Marcus – @ICUltrasonica Jump Menu JAM pick of the papers! Best POCUS Best FOAM History! Podcasts! Best websites! Best Videos Best Meetings! JAM’s Pick of the Papers As ever, we recommend.

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167. Methemoglobinemia: like a box of chocolates

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Cite this podcast as: Briggs, Blake; Husain, Ilitfat. Episode 167. Methemoglobinemia: like a box of chocolates. [link] February 27th, 2023. Accessed [date] Want to experience the greatest in board studying?

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Why Do Athletes Have Such a Low Heart Rate?

AED Leader

Athletes often have a resting heart rate that’s around half that of a non-athlete, but why does this happen and is it good or bad? For budding athletes and current athletes who are thinking about heart health, understanding which symptoms are—and aren’t—a problem can guide potential lifestyle changes and requests for cardiac testing. Why Athletes Read More "Why Do Athletes Have Such a Low Heart Rate?

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Illinois Recognizing and Reporting Child Abuse and Neglect Training

American Medical Compliance

The Illinois Recognizing and Reporting Child Abuse and Neglect Training course is designed to educate dental healthcare providers (DHCP) on the signs of child abuse and neglect and how mandatory reporters in Illinois report child abuse and neglect cases. The United States Federal Government defines child abuse and neglect as when the actions or inactions of a caregiver lead to the risk or impact of harm to a child.

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paper of the week

EMergucate

Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With … Continue reading →

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Over-Sensitive Trops | LP Me Which Way?

JournalFeed

The JournalFeed podcast for the week of Feb 20-24, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Over-Sensitive Trops Spoon Feed High sensitivity cardiac troponins (hs-cTn) can be more complex to interpret than our usual diagnostics and are worth a deep dive to understand.

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SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

The Skeptics' Guide to EM

Reference: Cashen K, Reeder RW, Ahmed T, et al. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center.

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A man in his 40s with epigastric pain and ST Elevation

Dr. Smith's ECG Blog

Case submitted by Magnus Nossen MD, written by Pendell Meyers A previously healthy man in his 40s presented to the ED with epigastric abdominal pain off and on for several days. Vitals were within normal limits. It is unclear whether he had active pain at the time of the first ECG: What do you think? Here is PM Cardio's Queen of Hearts interpretation (AI ECG interpretation trained by Meyers, Smith, and PM Cardio team using thousands of cases and their outcomes): The output number ranges from 0 t

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Pediatric Collab Preview: Patient experience strategy and infrastructure from the ground up

NRC Health

The NRC Health 2023 Pediatric Collaborative is truly a can’t-miss experience, with exceptional presentations that will stir innovative ideas for attendees to bring back to their larger PX and marketing teams. The post Pediatric Collab Preview: Patient experience strategy and infrastructure from the ground up appeared first on NRC Health.

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MRI Level 1 Safety Training

American Medical Compliance

The MRI: Level 1 Safety Training will educate individuals who frequent the MR area on practices and procedures to keep themselves and their patients safe. Individuals who frequent the MR area, such as those who transport patients, those who clean the area, and support assistants who help Level 2 MR Technologists with getting patients on or off the table, should take this course.

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EFFORT

The Bottom Line

In critically ill patients, does a higher dose of protein compared to usual dose protein, improve time-to-discharge-alive from hospital up to 60 days?

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REBEL Core Cast 96.0 – Acute Vision Loss I

RebelEM

Take Home Points: Suspect glaucoma in any patient with an acute change in vision and get an intraocular pressure measurement First line treatment in acute angle closure glaucoma is a topical beta blocker Consider giant cell arteritis in patients with unilateral headache, jaw claudication and change in vision Don’t wait for the biopsy to start steroids in giant cell arteritis as this therapy is vision saving REBEL Core Cast 96.0 – Acute Vision Loss I Click here for Direct Download of the Po

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Imaging Case of the Week 542

EMergucate

Chest x-ray from a 20 year old with cough. What can be seen? Answer will be posted later.

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Fracture identification and Hematoma blocks

Core Ultrasound

In this intro video, we demonstrate the use of ultrasound imaging to identify fractures. Ultrasound-guided fracture identification is a minimally invasive technique that allows for quick and accurate diagnosis of fractures, without the need for radiation or contrast agents. Additionally, it can be used during reductions to assist in identification of adequate alignment without the need for a C-arm!

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NRC Health ranked #1 Best in KLAS for Patient Experience Improvement

NRC Health

This recognition as #1 in the patient experience improvement category, affirms our focus on transforming the healthcare industry with a human-first approach, and highly innovative solutions to pave the way for better outcomes for patients and healthcare organizations alike. The post NRC Health ranked #1 Best in KLAS for Patient Experience Improvement appeared first on NRC Health.

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OSHA Training for Emergency Medical Services (EMS)

American Medical Compliance

OSHA Training for Emergency Medical Services (EMS) will educate emergency medical workers on how to protect themselves and others while adhering to State and Federal OSHA regulations. Congress established the Occupational Safety and Health Administration (OSHA) with the purpose of creating safe and health-conscious work conditions by setting and enforcing standards.

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Modernity and Health

Stop and Think

A recent report on incidental findings from a cardiac monitoring study bolsters my view that modernity is shredding our health. The paper is a re-analysis of one of the most important cardiac trials of the decade—the LOOP trial. First LOOP, then the new study. In LOOP, more than 6000 older patients (age 75) without atrial fibrillation—but with high-stroke-risk features--were randomized to having an implantable loop recorder (ILR) vs standard Danish primary care.

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166. UTI: infections down under

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. You’ve heard of Planet Earth. You’ve heard of UTIs. Well, we were able to hire Sir David Attenborough for this rare episode where we discuss UTI: Infections Down Under. We have the ultimate koala-fications to tell you about presentations, diagnosis, why CT should not be routinely done, and tips/tricks on antibiotics.