Sat.Jan 28, 2023 - Fri.Feb 03, 2023

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ECG Blog #360 — The Patient has Cancer.

Ken Grauer, MD

The ECG in Figure-1 was obtained from an older woman. She presented with shortness of breath. The patient was known to have cancer. QUESTIONS: How would YOU interpret this ECG? Why is every-other-beat changing? Figure-1: ECG obtained from an older woman with shortness of breath. ( To improve visualization — I've digitized the original ECG using PMcardio ).

EKG/ECG 195
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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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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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Intra-articular Lidocaine vs Procedural Sedation and Analgesia for Closed Reduction of Acute Anterior Shoulder Dislocation

RebelEM

Background: Many clinicians have transitioned from procedural sedation and analgesia (PSA) in favor of intra-articular lidocaine (IAL) to manage anterior shoulder dislocation. PSA, also referred to as intravenous sedation in this paper, requires considerable resources, including 1:1 nursing observation, and burdens the emergency department (ED). In addition, many hospitals are still reeling from the COVID-19 pandemic and face crippling staff shortages, and sparing a nurse for PSA will be difficu

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SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)?

The Skeptics' Guide to EM

Date: February 1, 2023 Reference: Wolfrum et al. Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. Circulation. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital.

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163. Hypotensive with PE? Buckle up

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. It’s Fri-YAY. Here is one episode our current premium subscribers are enjoying. We want to give you a taste of what Rapid Bombs is all about. With ITE around the corner for EM residents everywhere, it’s time to show you why everyone is using EM Rapid Bombs to prepare for not just the test, but #EMlife.

EMS 52
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Opioids in Children and Adolescents

EB Medicine

Announcements: The interactive Clinical Pathways have launched and they are available for free! In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the January 2023 Pediatric Emergency Medicine Practice article on the Responsible and Safe Use of Opioids in Children and Adolescents in the Emergency Department DEA-X Waiver Repeal: The Mainstreaming Addiction Act The Medication Access and Training Expansion Act (MATE) FOAMed post Opioids in Children and Adolescents: Introduction

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Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

RebelEM

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Though consensus has been reached for first-line treatment of ventricular rate control 1 with beta blockers (BB) and non-dihydropyridine (non-DHP) calcium channel blockers (CCB), there is still much debate regarding a preferred second-line agent for ventricular rate control.

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Coping with Dental Staffing Shortages

American Medical Compliance

The dental industry, much like the healthcare industry as a whole, is facing severe staffing shortages. There are many reasons this shortage has become so acute, and it is taking a toll on medical staff and patients alike. Dental healthcare providers are facing increased workloads, which can create excessive work stress. Ensuring your dental healthcare employees know how to cope with work stress is important to their mental health and ability to do their jobs effectively.

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Ep 178 Hand Injuries – Pitfalls in Assessment and Management

Emergency Medicine Cases

The hand is anatomically complex. Having an anatomical-based approach to the assessment of patients who present to the Emergency Department is important to preserve quality of life following a hand injury. Hand injuries are the second most common injury leading to days without work. It is no surprise then that open finger injuries land in the top 10 most common diagnoses that end up in court.

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Why Does My Heart Hurt When I Run?

AED Leader

When you’ve just started a running habit—or perhaps you’re a seasoned runner—feeling your heart hurt can be a scary experience. Fortunately, most causes of chest pain while running are benign, but it’s possible that it could be serious or at least something that needs to be looked at by a doctor. Non-Heart-Related Causes of Chest Read More "Why Does My Heart Hurt When I Run?

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Pediatric Collab Preview: How a culture of excellence leads to exceptional patient experiences

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: How a culture of excellence leads to exceptional patient experiences appeared first on NRC Health.

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Gastric POCUS & Sedation

Ultrasound Gel

Delia and Lianne take on the topic of pediatric gastric POCUS. Is it a helpful way to assess the effect of fasting prior to procedural sedation? Is fasting itself a helpful way to empty the stomach?? [link] [link] Delia and Lianne take on the topic of pediatric gastric POCUS. Is it a helpful way to assess the effect of fasting prior to procedural sedation?

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Intro to ECMO by Ken Hoffman (Parts 1 and 2)

Intensive Blog

Author: Dr Ken Hoffman Peer Reviewer: A/Prof Chris Nickson These videos are aimed at ICU staff and trainees who are new to ECMO. Part 1 focusses on nomenclature and components of ECMO (extracorporeal membrane oxygenation). Part 2 focusses on V-V (veno-venous) ECMO. To learn more about ECMO check out the ECMO page on INTENSIVE and the Alfred ICU’s guidelines at ecmo.icu.

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162. AcetamiNoFun Overdose

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. Can you say Tylenope? It might be the most classic tox case ever, and the boards want you to know it! Let's talk when to treat, how to treat, and the key pearls of acetaminophen overdose. Cite this podcast as: Briggs, Blake.

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First10EM Journal Club: January 2023

Broome Docs

We are back with another episode of the BroomeDocs and First10EM podcast. In this episode we try to answer some of the big questions in Emergency Medicine, we also answer a few that you probably would never have thought to ask! Like… How much electricity should we use in refractory VF? Should we suck clots out of legs? Should you put Tegaderm on eyeballs?

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QS-wave in V2: 2 cases, different paradigms lead to different treatment times (STEMI - NSTEMI vs. OMI - NOMI)

Dr. Smith's ECG Blog

Submitted by anonymous, written by Pendell Meyers. Additional case by Smith. Case 1 A middle aged woman presented with acute chest pain and shortness of breath, unclear time since onset, and likely with episodic symptoms off and on throughout the day. Her vitals were within normal limits. ED1 @1512 What do you think? Meyers : Very clear and specific for acute LAD OMI, with hyperacute T waves in the LAD distribution including leads V2-V6, II, III and aVF.

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ECG of the Week 25th January 2023 – Interpretation

EMergucate

ECG of the Week 25th January 2023 – Interpretation When examining ECGs, in addition to taking into account the clinical … Continue reading →

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Bigeminy… Is that a New Zodiac Sign?

Kings County Downstate EM

Author: Jaime Pospishil, Esteban Davila Peer Editor: Alec Feuerbach Faculty Editor: Mark Silverberg A 58-year-old male with a past medical history of diabetes and hypertension presents to the ED for several months of headache and neck pain following a motor vehicle collision. The patient is bradycardic and the triage ECG […] The post Bigeminy… Is that a New Zodiac Sign?

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Api US’s | Cost of EM Life

JournalFeed

The JournalFeed podcast for the week of Jan 23-27, 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. Api US’s Spoon Feed When performed by an experienced EM physician or radiologist, a conclusive appendix ultrasound is both sensitive and specific when evaluating for acute appendicitis and can be used in place of CT.

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Knee aspiration and Injection

Core Ultrasound

Peer reviewed by Ben Smith, MD 1/31/23 Basic Knee Exam MSK Basics Courses

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Imaging Case of the Week 538 Answer

EMergucate

The chest x-ray shows a right paratracheal lucency with bulging thick wall indicating significant esophageal dilatation.

EMS 52
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How to identify blunt cervical vascular injuries

University of Maryland Department of Emergency Med

Missing blunt cervical vascular injuries can lead to delayed catastrophic sequela such as stroke. Usie the epanded Denver criteria to help you id.

Stroke 40
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Don’t live me Breathless

MEDEST118

An original Blog Post by Mario Rugna

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Maryland Critical Care Conference 2022

University of Maryland CC Project

Welcome and Opening Remarks How Do We Prevent ICU Admission?

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Imaging Case of the Week 539

EMergucate

The frontal chest x-ray is from a 45-year-old with right upper quadrant pain and dyspnea. What can be seen?

EMS 52
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Pediatric Otitis Media, just give amox, right?

University of Maryland Department of Emergency Med

Otitis media is a common pediatric complaint seen in the primary care, urgent care, and ED settings. Recommendations for timing of treatment an.

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SGEM Xtra: You Don’t Own Me – Post Roe Emergency Medicine

The Skeptics' Guide to EM

Date: January 22, 2022 Reference: Samuels-Kalow M et al. Post-Roe Emergency Medicine: Policy, clinical, training, and individual implications for emergency clinicians. AEM Dec 2022 Guest Skeptic: Dr. Michelle Lin is an emergency physician and health services researcher whose goal is to transform acute care delivery to best meet the needs of those who experience the […] The post SGEM Xtra: You Don’t Own Me – Post Roe Emergency Medicine first appeared on The Skeptics Guide to Emergency Medicine.

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Head injury, ED Anaesthetics Simulation

EMergucate

Simulation report 2/2/23 Interdisciplinary SIM ED/ Anaesthetics Summery: Head injury requiring intubation post agitation and seizure, ambulance called by police … Continue reading →

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ECG of the Week 1 February 2023

EMergucate

The following ECG was obtained from a 74 year old man with a history of coronary artery bypass grafting and aortic valve replacement who presented to hospital complaining of 4 days of palpitations …

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Norepinephrine + Dobutamine vs Epinephrine

University of Maryland Department of Emergency Med

When managing a hypotensive patient who may have some element of cardiogenic shock, it has long been debated whether it is better to start an.

Shock 40
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C1-Esterase Inhibitor for ACE-Inhibitor Induced Angioedema

University of Maryland Department of Emergency Med

ACE-inhibitor (ACEi) induced angioedema is mediated by bradykinin and there are no proven medications for the treatment of this disease. Th.

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Imaging Case of the Week 536 Answer

EMergucate

The chest x-ray shows an anterior mediastinal mass.

EMS 52
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Lab case 396 interpretation

EMergucate

Question 1: PH = 7.30 that is mild acidaemia. HCO3 = 16 mmol/L (>24) so we have metabolic acidosis.

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Lab case 397

EMergucate

32-year-old man presented to ED with an asthma attack.

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Imaging Case of the Week 537 Answer

EMergucate

The ankle x-rays show a Tillaux fracture. There is a Salter Harris III fracture through the lateral distal tibial epiphysis.