Ken Grauer, MD

MARCH 12, 2023

I start today’s case with the ECG shown in Figure-1 — obtained from a 30-something year old man, who presented with palpitations. How would YOU interpret the ECG in Figure-1 ? Treatment? What is unusual about this arrhythmia? = NOTE: The ECG in Figure-1 has been recorded at the usual 25mm/second speed — but with the Cabrera format ( Please see my Editorial Note near the top of the page in ECG Blog #365 for review of the basics of this recording system ). = Figure-1: The initial ECG in today’s ca

EKG/ECG 195

EKG/ECG Administration Wellness 195

Pediatric EM Morsels

MARCH 17, 2023

There are lots of animals that bite. Since we all inhabit the same beautiful world , and sometimes we humans overtake previous habitats of animals, we inevitably will cross paths with an animal that bites us. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ). Sometimes they bite because that’s how they feed (ie, mosquitoes Eastern Equine Encephalitis ).

CDC 130

CDC Poisoning Pediatrics Shock 130

NIOSH Science Blog

MARCH 15, 2023

Employers can play a vital role in suicide prevention. Historically, suicide, mental health, and well-being have been underrepresented in workplace health and safety efforts, but this is changing. In some European countries, there are workplace standards for workplace psychosocial hazards that put workers at risk for suicide. Additionally, in France, employers have been made accountable for toxic workplaces and management practices that contributed to worker suicides.[1] Some of the latest workp

Best Practices 109

Best Practices Research Wellness 109

EMCrit

MARCH 17, 2023

A new format of ED Critical Care perfectly suited to rural environments EMCrit Project by Scott Weingart, MD FCCM.

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Total Medical ComplianceHIPAA

MARCH 15, 2023

With the pandemic drawing to a close in May , many employers are requiring their workers to return to the physical workplace. Patients that are afraid that their medical situation makes that return too risky at this time are requesting a letter from the doctor preventing that return. If the doctor believes this to be valid, they generate the letter.

Documentation/Coding 59

Documentation/Coding Wellness 59

Dr. Smith's ECG Blog

MARCH 17, 2023

Submitted by anonymous, written by Pendell Meyers A woman in her 50s presented to the Emergency Department with chest pain and shortness of breath that woke her from sleep, with diaphoresis. She had a prior history of "NSTEMI" one month ago, during which she had a coronary angiogram reportedly showing no stenosis in any coronary artery. Her vitals were within normal limits.

EKG/ECG 52

EKG/ECG Emergency Department 52

AED Leader

MARCH 17, 2023

Many people experience heart palpitations after eating certain foods or a heavy meal, and for some, the co-occurrence of an irregular heartbeat and gastrointestinal problems is even more pronounced. But if your heart pounds, races, does flip flops, or appears to miss beats, how do you know if you have a structural heart disease or Read More "Are an Irregular Heartbeat and GI Problems Related?

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Clinical Correlations

MARCH 16, 2023

By Ian Jaffe Peer Reviewed Recent headlines about increasing rates of metastatic prostate cancer have had many patients asking if they should be tested. 1 This article will review the history and role of prostate cancer screening.

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NRC Health

MARCH 16, 2023

NRC Health's 29th annual conference, Human Understanding Beyond | HUB23, is set to take place August 9–11, 2023, in Boston. The post Human Understanding Beyond | HUB23 preview: Compelling presentations planned for Executive Track sessions appeared first on NRC Health.

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Taming the SRU

MARCH 14, 2023

Introduction Hydrocephalus is an accumulation of cerebrospinal fluid (CSF) in the cerebral ventricular system secondary to a mismatch between CSF production and resorption. Excessive production of CSF is rare and occurs with choroid plexus papillomas or other tumors. Impaired drainage or resorption of CSF is a far more common cause of hydrocephalus and can occur due to congenital malformations, tumors, trauma, or infection.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Mind The Bleep

MARCH 15, 2023

Many FY2 doctors spend time in General Practice as part of the Foundation Programme. It is a valuable experience even for those who do not intend to pursue GP as a career. This article offers advice on what to expect during the post and some suggestions on where to look for help when you need it. If you are a GP ST1 or ST2 preparing to start a General Practice placement, much of the following will also apply to you.

Administration 52

Administration Hospitals 52

Dr. Smith's ECG Blog

MARCH 15, 2023

This middle-aged patient has a remote history of cardiac surgery as a young child for a "heart murmur". Her Apple Watch suddenly told her that she is in atrial fibrillation. She did notice something slightly wrong subjectively, but had no palpitations, chest pain, or SOB, or any other symptom. Exam was completely normal except for an irregular heart rate.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

33 Charts

MARCH 15, 2023

In the caverns of our bellies, a tempest brews, A fiery storm, a fierce cascade, acid reflux ensues. With burning rage, it surges forth, a churning tide, A searing pain, a bitter plight, we cannot hide. The tender walls of esophagus, its armor frail, Beneath the onslaught of the beast, it quakes and flails. A burning pyre, a molten flood, our throats besiege, In silent prayer, we seek reprieve, a moment’s peace.

Burns 52

Burns 52

Emergency Medicine Cases

MARCH 14, 2023

In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes?

Poisoning 52

Poisoning Outcomes EMS 52

EM SIM Cases

MARCH 14, 2023

This primer on Rapid Cycle Deliberate Practice was written by academic pediatric emergency medicine specialist and simulation guru Dr. Quang Ngo. He is a staff physian at McMaster Children’s Hospital, scholar with the McMaster Education Research, Innovation and Theory (MERIT) program and Founding Program Director for the Pediatric Emergency Medicine subspecialty residency program.

CPR 52

CPR Resuscitation Pediatrics Academics 52

NRC Health

MARCH 14, 2023

Author, inventor, and entrepreneur Paul Coyne shares his perspective on nursing collaboration and technology innovation in the latest episode of NRC Health’s Patient No Longer podcast. The post When futuristic innovations meet empathy and Human Understanding appeared first on NRC Health.

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Ultrasound Gel

MARCH 13, 2023

Can looking at the diaphragm with ultrasound help us understand a patient's respiratory status? This is one of the first papers to look at this question in an emergency department population. [link] [link] Can looking at the diaphragm with ultrasound help us understand a patient's respiratory status? This is one of the first papers to look at this question in an emergency department population.

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Emergency Department Ultrasounds 52

Life in the Fast Lane

MARCH 13, 2023

Hugo Thomas and Mike Cadogan Suture: Laceration Repair App Ever needed a helping hand with suturing? Suture: Laceration Repair App is a fantastic, simple and effective app created by emergency physician Tom Fadial with videos from Brian Lin of closing the gap.

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Emergency Medicine Ireland

MARCH 13, 2023

Welcome back to the tasty morsels of critical care podcast. Today we’re covering the ambitious topic of CRRT in the ICU. Something that occupies a central part of the daily job, but also occupies Oh Chapter 48, Irwin and Rippe chapter 201 and a few other review papers thrown in for good measure. We’re only going to get so far as the modes today so let’s not get too carried away.

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Dr. Smith's ECG Blog

MARCH 13, 2023

A 40-something woman called 911 in the middle of the night for Chest pain that was intermittent. On arrival, she complained of severe pain. The medics had recorded this ECG and were uncertain whether it was recorded during chest pain: Let's get a better image with use of the PM Cardio app : What do you think? There is deep T-wave inversion in proximal LAD territory (V2-V4, I, aVL) that is all but diagnostic of Wellens'.

EKG/ECG 52

EKG/ECG Administration Hospitals EMS 52

Clinical Correlations

MARCH 13, 2023

By Joshua Novack, MD Peer Reviewed Case: 74 year old male with a history of heart failure with reduced ejection fraction (EF 20%) diagnosed 10 years ago comes in with subacute progressive lower extremity edema, orthopnea,

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Board Bombs

MARCH 12, 2023

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Don’t you hate it when that happens? Cocaine Bear may teach you a few life lessons about this, but we’re going to tell you in this sneak peek Rapid Bomb how to suspect and diagnose these patients.

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RebelEM

MARCH 13, 2023

Background : Traumatic cardiac arrest in the prehospital setting carries an extremely high mortality rate. Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the gold standards of trauma care in and out of the hospital and are effectively the criterion by which we measure outcomes in the trauma literature.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

American Medical Compliance

MARCH 13, 2023

The United States Department of Justice charged 36 defendants for healthcare fraud that amounted to over $1 Billion. The fraudulent actions included telemedicine, cancer and cardiovascular testing, and fraudulent durable medical equipment. The individuals charged ranged in positions from medical company executives to medical professionals. Many of these individuals targeted elderly patients who receive Medicare benefits.

Telemedicine 52

Telemedicine 52

Stop and Think

MARCH 12, 2023

This post remains free to all readers. But thanks to all that have chosen to support my work. I am surprised and grateful. JMM This week I traveled to San Diego to give cardiology rounds at the UCSD. Most ‘cardiology rounds’ come from famous professors who speak about a specific area in cardiology. Mine was different. I was not teaching any one thing.

Hospitals 52

Hospitals Research Outcomes 52

The Skeptics' Guide to EM

MARCH 11, 2023

Date: March 8, 2023 Reference: Smida et al. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital Emergency Care 2023 Guest Skeptic: Dr. Chris Root is a third-year resident physician in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM. […] The post SGEM#396: And iGel Myself, I’m Over You, Cus I’m the King (Tube) of Wishful Thinking f

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

EMergucate

MARCH 11, 2023

The elbow x-ray shows Small irregular densities suggestive of avulsion fractures posterior to the elbow associated with soft tissue swelling.

Fractures 52

Fractures EMS 52

Taming the SRU

MARCH 17, 2023

Ultrasound Guided Nerve Blocks in the ED - CPC w/ Dr. Harward - Pediatric Simulation: Seizure Ultrasound guided nerve blocks in the ed WITH Dr. Arun Nagdev Visit [link] for in depth discussion of each block with accompanying ultrasound and anatomy images Best practices for pain management in the ED Active Non-siloed Should be available 24/7 Multimodal Blocks, ketamine, NSAIDs, APAP Goal is not 100% resolution with blocks, 50% is success with multi-modal treatment Ketamine assisted blocks: 25mg k

Seizures 40

Seizures Fractures Burns Pediatrics 40

Kings County Downstate EM

MARCH 16, 2023

Co-authors: Paul Lavadera and Esteban Davila Peer Editor: Alec Feuerbach Faculty Editor: Mark Silverberg The Case A 65-year-old male with a history of hypertension, hyperlipidemia, diabetes, hypertrophic cardiomyopathy, recent stroke, and atrial fibrillation (AF) (+anticoagulation) presented to the ED for syncope. EMS noted a wide-complex tachycardia.

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Stroke EMS EKG/ECG 40

University of Maryland Department of Emergency Med

MARCH 11, 2023

This study from Sweden looked at 2397 trauma patients and identified 768 with thoracic injury. Those with thoracic injury had a 30-day mortal.

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EMergucate

MARCH 15, 2023

The case: 33 year old primip with shoulder dystocia and subsequent PPH, neonate requiring resuscitation initially by attending pediatrician.

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Resuscitation 40

EMergucate

MARCH 11, 2023

The chest x-ray shows an incidental finding of Azygous lobe.

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EMS 52

University of Maryland Department of Emergency Med

MARCH 16, 2023

Patients with croup often present with a "barky" cough, stridor, and trouble breathing, traditionally worse at night. The mains.

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