Ken Grauer, MD

SEPTEMBER 8, 2023

The ECG in Figure-1 — was obtained from an older man with a history of prior infarction and coronary bypass surgery. How would you interpret this tracing? Clinical implications? Figure-1: The ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Thoughts on the ECG in Figure-1: The rhythm in ECG #1 is sinus at ~65/minute — with an upright P wave in lead II, and a constant and normal PR interval (ie, not more than 0.21 second in duration ).

EKG/ECG 296

EKG/ECG Research 296

Pediatric EM Morsels

SEPTEMBER 8, 2023

Life is full of hazards! Chance encounters with life’s hazards seem to increase in the Summer time (ex, Trampolines , Snakes , Lawn Mowers , Water , and Heat ). It is good that continue to raise awareness of such hazards so we can prevent them ! Certainly, the care of pediatric patients is known for its “ Seasonality. ” Now that the long days of summer ( for us in the Northern Hemisphere ) might be behind us, some of those hazards may also be receding, but injuries and illnesse

Poisoning 275

Poisoning Pediatrics EMS 275

EM Ottawa

SEPTEMBER 7, 2023

According to WHO and CDC: more than nine people die every minute from injuries or violence, and 5.8 million people die every year. It is the leading cause of death in people 1-44 years of age in developed countries (unintentional injuries, homicide, suicide). The most common cardiac rhythm in Traumatic Cardiac Arrest (TCA) is pulseless electrical […] The post Traumatic Cardiac Arrests appeared first on EMOttawa Blog.

CDC 140

CDC Resuscitation 140

RebelEM

SEPTEMBER 7, 2023

BACKGROUND: intracerebral hemorrhage (ICH) makes up 10-15% of all strokes and significantly contributes to overall stroke-related morbidity and mortality ( Hostettler 2019 ). Levetiracetam is frequently used to prevent seizures in patients with conditions such as ICH, traumatic brain injury (TBI), supratentorial neurosurgery, and subarachnoid hemorrhage (SAH).

Seizures 133

Seizures Stroke Outcomes Research 133

EMCrit

SEPTEMBER 3, 2023

In many countries, pulmonary and critical care are commonly bundled together. Consequently, a single person will often be responsible for both inpatient ICU management as well as inpatient pulmonary consultation. Honestly, I have some doubts about whether this is an ideal system. As both pulmonology and critical care medicine become increasingly complex, it's becoming impossible […] EMCrit Project by Josh Farkas.

Hospitals 133

Hospitals Wellness 133

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant. More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior.

EKG/ECG 132

EKG/ECG Resuscitation CPR Emergency Department 132

Don't Forget the Bubbles

SEPTEMBER 4, 2023

This talk, from Joe Brumm, was given at our 2022 DFTB conference. “Bluey” is an iconic Australian children’s animated television series. It follows the adventures of a Blue Heeler puppy named Bluey and her family, including her father, Bandit, her mother, Chilli, and her younger sister, Bingo. [link] There is a profound connection between art and life.

Leadership 126

Leadership 126

First 10 EM

SEPTEMBER 4, 2023

There is an odd paradox in medicine: our sickest patients are in the most need of intervention, but they are also the most likely to have complications from those interventions. (This is why I have always opposed the “kitchen sink” philosophy, in which we throw everything at an apparently dying patient. That philosophy assumes that […] The post PACER: Prophylactic platelets before central lines appeared first on First10EM.

EMS 119

EMS 119

Dr. Smith's ECG Blog

SEPTEMBER 8, 2023

Submitted by anonymous, edited by Jesse McLaren The first person "I" and "me" is this anonymous sender. A 50 year old presented to the emergency department of a remote rural community (where the nearest cath lab is a plane ride away) with one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation.

EKG/ECG 128

EKG/ECG Emergency Department Wellness 128

Medagadget

SEPTEMBER 7, 2023

Researchers at the University of California San Diego have created a bacterial sentinel system that can alert clinicians to the presence of tumors. The technology takes advantage of the specificity of the CRISPR system and the tendency of bacteria to uptake fragments of DNA from their environment. Termed “Cellular Assay for Targeted CRISPR-discriminated Horizontal gene transfer” (CATCH), the system has been created to detect gastrointestinal tumors in its first iteration.

Research 106

Research 106

Science Based Medicine

SEPTEMBER 7, 2023

The fifth installment in the grand debunk the antivaxxer book “Turtles All the Way Down”: Chapter 5. The post The Grand Debunk of the antivaxxer book “Turtles All the Way Down” (part 5/10) first appeared on Science-Based Medicine.

106

106

Emergency Live

SEPTEMBER 8, 2023

Helitech Expo 2023: A Premier Networking Opportunity for Industry Professionals With just three weeks left until the grand opening of Helitech Expo 2023, scheduled for September 26th and 27th at the ExCeL London, the excitement is building! Helitech Expo takes pride in being the industry’s most impactful event, providing a unique platform for professionals to […] The post Helitech Expo 2023: Meet the industry leaders appeared first on Emergency Live.

105

105

Sensible Medicine

SEPTEMBER 4, 2023

Last week I attended the European Society of Cardiology congress in Amsterdam. ESC is one of the largest cardiology meetings. I attend mostly in the role of a physician journalist. Well, not really a journalist, more like an opinion writer and critical appraiser. For me, one study stood out at ESC. This randomized controlled trial had it all—an important question, good trial conduct, surprising results and no spin in the conclusions.

Stroke 99

Stroke Wellness 99

PEMBlog

SEPTEMBER 8, 2023

Did you know that screening laboratory tests in the medical clearance process of pediatric patients who require inpatient psychiatric admission are not recommended unless clinically indicated? This video discusses why we don’t need labs for most children and adolescents who are being admitted to an inpatient mental health facility via an admittedly silly (but representative) conversation.

Psychiatric 98

Psychiatric Pediatrics 98

Life in the Fast Lane

SEPTEMBER 7, 2023

Chris McLenachan and John Mackenzie Pelvic Binders Emergency Procedure: Pelvic Binders. Pelvic binders can be applied to patients following blunt trauma if there is any suspicion of pelvic fracture.

Fractures 98

Fractures 98

Emergency Live

SEPTEMBER 8, 2023

Mega-forest fires: how to protect Spain from this threat Scientists have issued an apocalyptic warning about the future of forest fires in Spain, especially in the Canary Islands, where the possibility of mega-fires that could devastate several islands at once is looming. This growing threat raises the need to profoundly change the territorial model and […] The post The threat of mega-fires in the Canary Islands appeared first on Emergency Live.

105

105

The Bottom Line

SEPTEMBER 6, 2023

In patients with non-ST elevation out-of-hospital cardiac arrest, does expedited delivery of patients to a cardiac arrest centre, compared with delivery to the geographically closest hospital, improve all-cause mortality at 30 days?

Hospitals 98

Hospitals 98

Stop and Think

SEPTEMBER 6, 2023

Before writing a word more, I want to express my thanks for your support. Thank you all x 1000. I recently attended the European Society of Cardiology congress in Amsterdam. I went mostly as a physician journalist/editorial writer. In addition to my duties as a full-time electrophysiologist, I host a weekly podcast called This Week in Cardiology and write regular columns for the online healthcare-news site TheHeart.org | Medscape Cardiology.

EKG/ECG 98

EKG/ECG Wellness 98

Kings County Downstate EM

SEPTEMBER 7, 2023

Author: Jamie Pospishil, MDEditor: Philippe Ayres, MD; Esteban Davila, MDCase:A 68-year-old male with a past medical history of hypertension, insulin-dependent diabetes, and dyslipidemia presents to the ED with chest pain that is intermittent, sharp, “stabbing”, lasting up to one minute at a time, and occurring several times over the past […] The post Stuck in Limbo: The Intermediate HEART Score appeared first on County EM.

EMS 98

EMS 98

Emergency Live

SEPTEMBER 7, 2023

Revolutionary H145 five-bladed helicopters to improve police operations in Lower Saxony and Mecklenburg-Vorpommern The police forces of Lower Saxony and Mecklenburg-Western Pomerania are about to see a revolutionary upgrade of their air operations with the introduction of state-of-the-art H145 five-bladed helicopters. Following a joint European tender launched in August 2022, the Interior Ministries of both […] The post Airbus H145: new helicopters for the German police force appeared firs

Operations 105

Operations 105

Life in the Fast Lane

SEPTEMBER 3, 2023

Pramod Chandru Network Five: Emergency Medicine Conversations Network Five Emergency Medicine Conversations Episode 24 - an interview with Dr Amith Shetty on medical administration, leadership, and more!

Leadership 98

Leadership Administration Patient Safety Research 98

SheMD

SEPTEMBER 7, 2023

QUESTIONS YOU’LL LIKELY BE ASKED ON INTERVIEWS - Part 2 of 4. If you haven’t yet read part 1 , make sure to go back to last week’s blog to learn about interview basics. You’ve confirmed your interview, found the perfect suit (and quiet shoes), and stocked up on mints, but now the jitters are settling in as you try to anticipate what questions you’ll likely be asked.

Leadership 98

Leadership Documentation/Coding Research Wellness 98

Total Medical ComplianceHIPAA

SEPTEMBER 7, 2023

Criminals continuously devise new methods to exploit personal information for financial gain. One such method is vishing, a form of phishing that targets individuals through phone calls. Vishing scams pose a significant threat to the security and privacy of personal health information (PHI), making it crucial for healthcare organizations to understand and mitigate these risks.

95

95

Emergency Live

SEPTEMBER 7, 2023

The long-term effects of fires: environmental, economic and social damage In certain parts of the world it is normal to have fires every year. For example, in Alaska there is the famous ‘Fire Season’ and in Australia there are Bushfires (forest fires), which on certain occasions are controlled flames in their expansion. Dealing with some […] The post The consequences of fires - what happens after the tragedy appeared first on Emergency Live.

105

105

PulmCCM

SEPTEMBER 3, 2023

Pulse oximeters overestimated oxygen saturation in darker-skinned patients with Covid, causing treatment delays. It was a bit of a national and professional embarrassment when after many decades of ubiquitous use of pulse oximetry, calibrated on patients with light skin, someone finally thought to validate it with arterial blood gases in darker-skinned patients in clinical settings — and found pulse oximetry may dangerously overestimate those patients’ arterial oxygen saturation.

CDC 94

CDC Hospitals 94

Medagadget

SEPTEMBER 7, 2023

Researchers at Washington University School of Medicine have developed a COVID-19 breathalyzer test. The technology requires someone to breathe into it just once or twice, and it can then provide an indication if the person is infected with SARS-CoV-2 in as little as one minute. The device could be very useful fo screening large numbers of people prior to access to an indoor event, for instance, or in community clinics to quickly determine if people are infected.

Research 93

Research Hospitals 93

Science Based Medicine

SEPTEMBER 6, 2023

Self-Amplifying RNA vaccines are coming. Here's a primer to get you ready. The post Self-Amplifying RNA Vaccines first appeared on Science-Based Medicine.

96

96

Emergency Live

SEPTEMBER 4, 2023

New H135 helicopter for ADAC Luftrettung introduces groundbreaking features for patient care and safety In a remarkable milestone for both ADAC Luftrettung and Airbus Helicopters, the 1,500th Airbus H135 helicopter was handed over to the non-profit air rescue provider on August 30, 2023, in Donauwörth, Germany. This important event marks over 50 years of partnership […] The post ADAC Luftrettung Celebrates Milestone with 1,500th Airbus H135 Helicopter appeared first on Emergency Live.

105

105

Dr. Smith's ECG Blog

SEPTEMBER 5, 2023

A 60-something awoke with 10/10 crushing chest pain. He walked in to triage. Here is the ECG: Computer interpretation: Normal ECG Interventionalist after doing PCI: SUBTLE STT CHANGES IN LIMB LEADS To me, this first ECG is diagnostic of inferior OMI. I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: YOU TOO CAN HAVE THE PM Cardio AI BOT!!

EKG/ECG 87

EKG/ECG Documentation/Coding Emergency Department 87

Core Medical Group

SEPTEMBER 8, 2023

If you've ever wondered what goes on behind the scenes in the world of healthcare recruitment, you're in for a treat. We talked with Christy, an Allied Healthcare recruiter here at CoreMedical Group to get an insider's perspective on the industry, her journey, and tips on how to achieve successful placements. Christy is someone who not only helps clinicians find their dream jobs but also understands the industry from the inside out.

82

82

Science Based Medicine

SEPTEMBER 8, 2023

As COVID cases and hospitalizations increase yet again, I'd like my contribution to medical research to be more than convincing people to skip vaccine doses. So should you. The post Take a Pledge to Enroll in a Randomized-Controlled Trial first appeared on Science-Based Medicine.

Research 86

Research Hospitals 86

Emergency Live

SEPTEMBER 6, 2023

Off-road driving training for Civil Defence: how to prepare for emergencies Off-road driving is an intricate art, requiring specialised skills and targeted training. This becomes even more important when it comes to special rescue corps such as the Civil Defence. These brave volunteers and law enforcement officers are called upon to perform delicate and crucial […] The post Emergency Driving Training: Crucial Training for Off-Road Rescue appeared first on Emergency Live.

98

98

SheMD

SEPTEMBER 3, 2023

Disclaimer: This post was written before the COVID-19 pandemic. Some of the interview information may not be relevant during the 2020-2021 academic year. This is part 4 of a 4-part series on residency interview strategies from Dr. Stacy Goldbaum. If you’re just joining us, make sure to check ( Part 2 , Part 3 , and Part 4 ) to learn about questions you may be asked on the big day, and questions to ask the residents and program director.

Academics 81

Academics Hospitals Wellness 81

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Date: August 30, 2023 Reference: Griffey et al. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. This is the last show for […] The post SGEM#414: The SQuID Protocol first appeared on The Skeptics Guide to Emergency Medicine.

Operations 78

Operations Diabetic Emergencies Hospitals Research 78

Science Based Medicine

SEPTEMBER 4, 2023

In yet another example of everything hold being new again, antivaxxers have resurrected the claim that deaths due to COVID-19 are being actually due to bacterial pneumonia, just as antivaxxers used to say the same thing about influenza deaths. It is, of course, another case of confusing cause and effect in order to obfuscate. The post The COVID-as-bacterial-pneumonia conspiracy theory rises again first appeared on Science-Based Medicine.

84

84

Emergency Live

SEPTEMBER 6, 2023

Tesla issues safety guidance for owners of vehicles exposed to saltwater In the wake of Hurricane Idalia, Florida electric vehicle owners are facing an unexpected and potentially dangerous threat: saltwater exposure. The recent incident involving a Tesla car catching fire in Dunedin has raised alarm bells among hybrid and electric vehicle (EV) owners in the […] The post Salt water exposure: A new threat for owners of electric vehicles appeared first on Emergency Live.

98

98

EMDocs

SEPTEMBER 6, 2023

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , and Rachel Bridwell, MD ( @rebridwell ), we cover two challenging cases. Episode 85: Tricky Cases Part 1 Case 1: 42-year-old male, GCS 3, HR 190, BP is 90/48 mm Hg, T 105F. Found in garage, hot, question of illicit drug use. IV fluids started, concern for SVT. Cardioverted, followed by sinus tachycardia, remains GCS 3.

Anaphylaxis 71

Anaphylaxis Shock Sepsis Stroke 71