Sat.Apr 16, 2022 - Fri.Apr 22, 2022

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Chest pain, a ‘normal’ ECG, a 'normal trop', and low HEART and EDACS scores: Discharge home? Stress test? Many errors here.

Dr. Smith's ECG Blog

Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chest pain without associated symptoms. ECG was labeled ‘normal’ by the computer (confirmed by the overreading cardiologist) and the high-sensitivity Troponin I was normal at a value of 11 ng/L (Abbott Alinity assay, where normal is S in V2.

EKG/ECG 52
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US-Guided Arthrocentesis

Ultrasound Gel

In this episode, Mike and Jacob dive into an important intersection of musculoskeletal and procedural ultrasound - the ultrasound-guided arthrocentesis. People have been doing arthrocentesis without the help of ultrasound for a while, and most would agree it is feasible. BUT what about those smaller joints - like the wrist, elbow, and ankle? Perhaps that is where the greatest benefit would be in making sure your needle gets to the right place.

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How to Dose Medications During a PIRRT

Critical Care Now

Reading Time: 3 minutes Nishika Patel Critical care pharmacist with a fondness for cats, wine, and all things vintage. Also an insta-nerd who likes to teach ICU tidbits on her IG page @dr.scriptsndrips. The Pre-brief Renal replacement therapy (RRT) in the critical care setting is common. Due to issues with hemodynamic instability, patients are often unable to receive hemodialysis (HD) and instead must be placed on continuous renal replacement therapy (CRRT).

Burns 52
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ECG of the Week 20th April 2022 Answer

EMergucate

The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. He presents to ED complaining of increasing shortness of breath and leg swelling.

EKG/ECG 52
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135. TCA toxicity: Narrow Windows

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. If you could invent a drug that caused the biggest constellation of bad juju. it would already be invented because it's called a TCA. These are scary overdoses. Let's talk about presentation, diagnoses, and management of TCA toxicity.

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Consider The Probe: Spine Sign - It's Got Your Back!

Cook County EM Blog

The Case: A 68-year-old male with a history of CHF, COPD, CAD s/p stenting, HTN, and DM presents to the emergency department with worsening dyspnea and bilateral lower extremity edema for one week with associated orthopnea, and increased home oxygen requirement. VS: T 36.6, HR 95, BP 114/85, RR 28, O2 97% on 3L nasal cannula (home O2 settings) On examination, the patient is tachypneic and diaphoretic.

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Your Patients’ Right of Access

Total Medical ComplianceHIPAA

The HIPAA Privacy Rule grants patients the right to access their health information in a way that is easy and affordable for them. Providers are required to give patients access to their health information. There are some exceptions, of course, so getting the process right can be as confusing as being in a house of mirrors. Patients are entitled to receive all information a provider maintains about them in one or more designated record sets.

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Burnout - From the ER and Beyond, Healthcare Workers at Risk

ER Nurses

The global pandemic, which still continues, has forced many healthcare professionals including nurses to work under the constant and unrelenting pressures of overtime and patient loss. That conicides with a work culture and system that often works to undermine alleviating workload for frontline healthcare professionals.

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Deadly ED Delays | Doppler Pulses

JournalFeed

The JournalFeed podcast for the week of April 4-8, 2022. 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. Deadly Delays Spoon Feed: This large study shows that all-cause 30-day mortality increases with delayed hospital admission from the ED, starting at 5 hours after patient arrival.

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SGEM#365: Stop! It’s Not Always Hammer Time

The Skeptics' Guide to EM

Date: April 16th, 2022 Reference: Blom et al. Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence. BMJ 2021 Guest Skeptic: Dr. Matt Schmitz, Pediatric Orthopedics, Adolescent Sports Medicine and Young Adult Hip Preservation Surgeon at San Antonio Military Medical Center in Texas. Disclaimer: The views and opinions of this blog […] The post SGEM#365: Stop!

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Imaging Case of the Week 502

EMergucate

Following wrist x-rays are from a 38 year old with wrist pain and swelling after a fall on outstretched hand.

EMS 52
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ECG of the Week 20th April 2022

EMergucate

The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. He presents to ED complaining of increasing shortness of breath and leg swelling.

EKG/ECG 40
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Lab case 359

EMergucate

65 year old lady presented with drowsiness and bradycardia, her venous blood gases showed the following: PH = 7.

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Lab case 358 interpretation

EMergucate

Question 1: PH = 7.28, that is mild acidaemia HCO3 = 17 mmol/L. So we have metabolic acidosis.

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